[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2162 Enrolled Bill (ENR)]

        S.2162

                       One Hundred Tenth Congress

                                 of the

                        United States of America


                          AT THE SECOND SESSION

          Begun and held at the City of Washington on Thursday,
            the third day of January, two thousand and eight


                                 An Act


 
  To improve the treatment and services provided by the Department of 
  Veterans Affairs to veterans with post-traumatic stress disorder and 
            substance use disorders, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
    (a) Short Title.--This Act may be cited as the ``Veterans' Mental 
Health and Other Care Improvements Act of 2008''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

         TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

Sec. 101. Tribute to Justin Bailey.
Sec. 102. Findings on substance use disorders and mental health.
Sec. 103. Expansion of substance use disorder treatment services 
          provided by Department of Veterans Affairs.
Sec. 104. Care for veterans with mental health and substance use 
          disorders.
Sec. 105. Pilot program for Internet-based substance use disorder 
          treatment for veterans of Operation Iraqi Freedom and 
          Operation Enduring Freedom.
Sec. 106. Report on residential mental health care facilities of the 
          Veterans Health Administration.
Sec. 107. Pilot program on peer outreach and support for veterans and 
          use of community mental health centers and Indian Health 
          Service facilities.

                    TITLE II--MENTAL HEALTH RESEARCH

Sec. 201. Research program on comorbid post-traumatic stress disorder 
          and substance use disorders.
Sec. 202. Extension of authorization for Special Committee on Post-
          Traumatic Stress Disorder.

             TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

Sec. 301. Clarification of authority of Secretary of Veterans Affairs to 
          provide mental health services to families of veterans.
Sec. 302. Pilot program on provision of readjustment and transition 
          assistance to veterans and their families in cooperation with 
          Vet Centers.

                      TITLE IV--HEALTH CARE MATTERS

Sec. 401. Veterans beneficiary travel program.
Sec. 402. Mandatory reimbursement of veterans receiving emergency 
          treatment in non-Department of Veterans Affairs facilities 
          until transfer to Department facilities.
Sec. 403. Pilot program of enhanced contract care authority for health 
          care needs of veterans in highly rural areas.
Sec. 404. Epilepsy centers of excellence.
Sec. 405. Establishment of qualifications for peer specialist 
          appointees.
Sec. 406. Establishment of consolidated patient accounting centers.
Sec. 407. Repeal of limitation on authority to conduct widespread HIV 
          testing program.
Sec. 408. Provision of comprehensive health care by Secretary of 
          Veterans Affairs to children of Vietnam veterans born with 
          Spina Bifida.
Sec. 409. Exemption from copayment requirement for veterans receiving 
          hospice care.

                           TITLE V--PAIN CARE

Sec. 501. Comprehensive policy on pain management.

                   TITLE VI--HOMELESS VETERANS MATTERS

Sec. 601. Increased authorization of appropriations for comprehensive 
          service programs.
Sec. 602. Expansion and extension of authority for program of referral 
          and counseling services for at-risk veterans transitioning 
          from certain institutions.
Sec. 603. Permanent authority for domiciliary services for homeless 
          veterans and enhancement of capacity of domiciliary care 
          programs for female veterans.
Sec. 604. Financial assistance for supportive services for very low-
          income veteran families in permanent housing.

TITLE VII--AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND MAJOR MEDICAL 
                             FACILITY LEASES

Sec. 701. Authorization for fiscal year 2009 major medical facility 
          projects.
Sec. 702. Modification of authorization amounts for certain major 
          medical facility construction projects previously authorized.
Sec. 703. Authorization of fiscal year 2009 major medical facility 
          leases.
Sec. 704. Authorization of appropriations.
Sec. 705. Increase in threshold for major medical facility leases 
          requiring Congressional approval.
Sec. 706. Conveyance of certain non-Federal land by City of Aurora, 
          Colorado, to Secretary of Veterans Affairs for construction of 
          veterans medical facility.
Sec. 707. Report on facilities administration.
Sec. 708. Annual report on outpatient clinics.
Sec. 709. Name of Department of Veterans Affairs spinal cord injury 
          center, Tampa, Florida.

              TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

Sec. 801. Repeal of sunset on inclusion of noninstitutional extended 
          care services in definition of medical services.
Sec. 802. Extension of recovery audit authority.
Sec. 803. Permanent authority for provision of hospital care, medical 
          services, and nursing home care to veterans who participated 
          in certain chemical and biological testing conducted by the 
          Department of Defense.
Sec. 804. Extension of expiring collections authorities.
Sec. 805. Extension of nursing home care.
Sec. 806. Permanent authority to establish research corporations.
Sec. 807. Extension of requirement to submit annual report on the 
          Committee on Care of Severely Chronically Mentally Ill 
          Veterans.
Sec. 808. Permanent requirement for biannual report on Women's Advisory 
          Committee.
Sec. 809. Extension of pilot program on improvement of caregiver 
          assistance services.

                         TITLE IX--OTHER MATTERS

Sec. 901. Technical amendments.
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.
    Except as otherwise expressly provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or repeal 
of, a section or other provision, the reference shall be considered to 
be made to a section or other provision of title 38, United States 
Code.

        TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

    SEC. 101. TRIBUTE TO JUSTIN BAILEY.
    This title is enacted in tribute to Justin Bailey, who, after 
returning to the United States from service as a member of the Armed 
Forces in Operation Iraqi Freedom, died in a domiciliary facility of 
the Department of Veterans Affairs while receiving care for post-
traumatic stress disorder and a substance use disorder.
    SEC. 102. FINDINGS ON SUBSTANCE USE DISORDERS AND MENTAL HEALTH.
    Congress makes the following findings:
        (1) More than 1,500,000 members of the Armed Forces have been 
    deployed in Operation Iraqi Freedom and Operation Enduring Freedom. 
    The 2005 Department of Defense Survey of Health Related Behaviors 
    Among Active Duty Personnel reports that 23 percent of members of 
    the Armed Forces on active duty acknowledge a significant problem 
    with alcohol use disorder, with similar rates of acknowledged 
    problems with alcohol use disorder among members of the National 
    Guard.
        (2) The effects of substance use disorder are wide ranging, 
    including significantly increased risk of suicide, exacerbation of 
    mental and physical health disorders, breakdown of family support, 
    and increased risk of unemployment and homelessness.
        (3) While veterans suffering from mental health conditions, 
    chronic physical illness, and polytrauma may be at increased risk 
    for development of a substance use disorder, treatment for these 
    veterans is complicated by the need to address adequately the 
    physical and mental symptoms associated with these conditions 
    through appropriate medical intervention.
        (4) While the Veterans Health Administration has dramatically 
    increased health services for veterans from 1996 through 2006, the 
    number of veterans receiving specialized substance use disorder 
    treatment services decreased 18 percent during that time. No 
    comparable decrease in the national rate of substance use disorder 
    has been observed during that time.
        (5) While some facilities of the Veterans Health Administration 
    provide exemplary substance use disorder treatment services, the 
    availability of such treatment services throughout the health care 
    system of the Veterans Health Administration is inconsistent.
        (6) According to a 2006 report by the Government Accountability 
    Office, the Department of Veterans Affairs significantly reduced 
    its substance use disorder treatment and rehabilitation services 
    between 1996 and 2006, and the Fiscal Year 2007 National Mental 
    Health Program Monitoring System report shows that little progress 
    has been made in restoring these services to their pre-1996 levels.
    SEC. 103. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT SERVICES 
      PROVIDED BY DEPARTMENT OF VETERANS AFFAIRS.
    (a) In General.--The Secretary of Veterans Affairs shall ensure the 
provision of such services and treatment to each veteran enrolled in 
the health care system of the Department of Veterans Affairs who is in 
need of services and treatments for a substance use disorder as 
follows:
        (1) Screening for substance use disorder in all settings, 
    including primary care settings.
        (2) Short term motivational counseling services.
        (3) Marital and family counseling.
        (4) Intensive outpatient or residential care services.
        (5) Relapse prevention services.
        (6) Ongoing aftercare and outpatient counseling services.
        (7) Opiate substitution therapy services.
        (8) Pharmacological treatments aimed at reducing craving for 
    drugs and alcohol.
        (9) Detoxification and stabilization services.
        (10) Coordination with groups providing peer to peer 
    counseling.
        (11) Such other services as the Secretary considers 
    appropriate.
    (b) Provision of Services.--
        (1) Allocation of resources for provision of services.--The 
    Secretary shall ensure that amounts made available for care, 
    treatment, and services provided under this section are allocated 
    in such a manner that a full continuum of care, treatment, and 
    services described in subsection (a) is available to veterans 
    seeking such care, treatment, or services, without regard to the 
    location of the residence of any such veterans.
        (2) Manner of provision.--The services and treatment described 
    in subsection (a) may be provided to a veteran described in such 
    subsection--
            (A) at Department of Veterans Affairs medical centers or 
        clinics;
            (B) by referral to other facilities of the Department that 
        are accessible to such veteran; or
            (C) by contract or fee-for-service payments with community-
        based organizations for the provision of such services and 
        treatments.
    (c) Alternatives in Case of Services Denied Due to Clinical 
Necessity.--If the Secretary denies the provision to a veteran of 
services or treatment for a substance use disorder due to clinical 
necessity, the Secretary shall provide the veteran such other services 
or treatment as are medically appropriate.
    SEC. 104. CARE FOR VETERANS WITH MENTAL HEALTH AND SUBSTANCE USE 
      DISORDERS.
    (a) In General.--If the Secretary of Veterans Affairs provides a 
veteran inpatient or outpatient care for a substance use disorder and a 
comorbid mental health disorder, the Secretary shall ensure that 
treatment for such disorders is provided concurrently--
        (1) through a service provided by a clinician or health 
    professional who has training and expertise in treatment of 
    substance use disorders and mental health disorders;
        (2) by separate substance use disorder and mental health 
    disorder treatment services when there is appropriate coordination, 
    collaboration, and care management between such treatment services; 
    or
        (3) by a team of clinicians with appropriate expertise.
    (b) Team of Clinicians With Appropriate Expertise Defined.--In this 
section, the term ``team of clinicians with appropriate expertise'' 
means a team consisting of the following:
        (1) Clinicians and health professionals with expertise in 
    treatment of substance use disorders and mental health disorders 
    who act in coordination and collaboration with each other.
        (2) Such other professionals as the Secretary considers 
    appropriate for the provision of treatment to veterans for 
    substance use and mental health disorders.
    SEC. 105. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE USE DISORDER 
      TREATMENT FOR VETERANS OF OPERATION IRAQI FREEDOM AND OPERATION 
      ENDURING FREEDOM.
    (a) Findings.--Congress makes the following findings:
        (1) Stigma associated with seeking treatment for mental health 
    disorders has been demonstrated to prevent some veterans from 
    seeking such treatment at a medical facility operated by the 
    Department of Defense or the Department of Veterans Affairs.
        (2) There is a significant incidence among veterans of post-
    deployment mental health problems, especially among members of a 
    reserve component who return as veterans to civilian life.
        (3) Computer-based self-guided training has been demonstrated 
    to be an effective strategy for supplementing the care of 
    psychological conditions.
        (4) Younger veterans, especially those who served in Operation 
    Enduring Freedom or Operation Iraqi Freedom, are comfortable with 
    and proficient at computer-based technology.
        (5) Veterans living in rural areas may find access to treatment 
    for substance use disorder limited.
        (6) Self-assessment and treatment options for substance use 
    disorders through an Internet website may reduce stigma and 
    provides additional access for individuals seeking care and 
    treatment for such disorders.
    (b) In General.--Not later than October 1, 2009, the Secretary of 
Veterans Affairs shall carry out a pilot program to assess the 
feasibility and advisability of providing veterans who seek treatment 
for substance use disorders access to a computer-based self-assessment, 
education, and specified treatment program through a secure Internet 
website operated by the Secretary. Participation in the pilot program 
shall be available on a voluntary basis for those veterans who have 
served in Operation Enduring Freedom or Operation Iraqi Freedom.
    (c) Elements of Pilot Program.--
        (1) In general.--In carrying out the pilot program under this 
    section, the Secretary shall ensure that--
            (A) access to the Internet website and the programs 
        available on the website by a veteran (or family member) does 
        not involuntarily generate an identifiable medical record of 
        that access by that veteran in any medical database maintained 
        by the Department of Veterans Affairs;
            (B) the Internet website is accessible from remote 
        locations, especially rural areas; and
            (C) the Internet website includes a self-assessment tool 
        for substance use disorders, self-guided treatment and 
        educational materials for such disorders, and appropriate 
        information and materials for family members of veterans.
        (2) Consideration of similar projects.--In designing the pilot 
    program under this section, the Secretary shall consider similar 
    pilot projects of the Department of Defense for the early diagnosis 
    and treatment of post-traumatic stress disorder and other mental 
    health conditions established under section 741 of the John Warner 
    National Defense Authorization Act of Fiscal Year 2007 (Public Law 
    109-364; 120 Stat. 2304).
        (3) Location of pilot program.--The Secretary shall carry out 
    the pilot program through those medical centers of the Department 
    of Veterans Affairs that have established Centers for Excellence 
    for Substance Abuse Treatment and Education or that have 
    established a Substance Abuse Program Evaluation and Research 
    Center.
        (4) Contract authority.--The Secretary may enter into contracts 
    with qualified entities or organizations to carry out the pilot 
    program required under this section.
    (d) Duration of Pilot Program.--The pilot program required by 
subsection (a) shall be carried out during the two-year period 
beginning on the date of the commencement of the pilot program.
    (e) Report.--Not later than six months after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program, and shall include in that report--an assessment of the 
feasibility and advisability of continuing or expanding the pilot 
program, of any cost savings or other benefits associated with the 
pilot program, and any other recommendations.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary of Veterans Affairs $1,500,000 for each 
of fiscal years 2010 and 2011 to carry out the pilot program under this 
section.
    SEC. 106. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES OF 
      THE VETERANS HEALTH ADMINISTRATION.
    (a) Review.--
        (1) In general.--Not later than six months after the date of 
    the enactment of this Act, the Secretary of Veterans Affairs shall, 
    acting through the Inspector General of the Department of Veterans 
    Affairs, complete a review of all residential mental health care 
    facilities, including domiciliary facilities, of the Veterans 
    Health Administration.
        (2) Assessment.--As part of the review required by paragraph 
    (1), the Secretary, acting through the Inspector General, shall 
    assess the following:
            (A) The availability of care in residential mental health 
        care facilities in each Veterans Integrated Service Network 
        (VISN).
            (B) The supervision and support provided in the residential 
        mental health care facilities of the Veterans Health 
        Administration.
            (C) The ratio of staff members at each residential mental 
        health care facility to patients at such facility.
            (D) The appropriateness of rules and procedures for the 
        prescription and administration of medications to patients in 
        such residential mental health care facilities.
            (E) The protocols at each residential mental health care 
        facility for handling missed appointments.
        (3) Recommendations.--As part of the review required by 
    paragraph (1), the Secretary, acting through the Inspector General, 
    shall develop such recommendations as the Secretary considers 
    appropriate for improvements to residential mental health care 
    facilities of the Veterans Health Administration and the care 
    provided in such facilities.
    (b) Follow-up Review.--Not later than two years after the date of 
the completion of the review required by subsection (a), the Secretary 
of Veterans Affairs shall, acting through the Inspector General of the 
Department of Veterans Affairs, complete a follow-up review of the 
facilities reviewed under subsection (a) to evaluate any improvements 
made or problems remaining since the review under subsection (a) was 
completed.
    (c) Report.--Not later than 90 days after the completion of the 
review required by subsection (a), the Secretary of Veterans Affairs 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
report on the findings of the Secretary with respect to such review.
    SEC. 107. PILOT PROGRAM ON PEER OUTREACH AND SUPPORT FOR VETERANS 
      AND USE OF COMMUNITY MENTAL HEALTH CENTERS AND INDIAN HEALTH 
      SERVICE FACILITIES.
    (a) Pilot Program Required.--Commencing not later than 180 days 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall carry out a pilot program to assess the feasability and 
advisability of providing to veterans of Operation Iraqi Freedom and 
Operation Enduring Freedom, and, in particular, veterans who served in 
such operations as a member of the National Guard or Reserve, the 
following:
        (1) Peer outreach services.
        (2) Peer support services provided by licensed providers of 
    peer support services or veterans who have personal experience with 
    mental illness.
        (3) Readjustment counseling services described in section 1712A 
    of title 38, United States Code.
        (4) Other mental health services.
    (b) Provision of Certain Services.--In providing services described 
in paragraphs (3) and (4) of subsection (a) under the pilot program to 
veterans who reside in rural areas and do not have adequate access 
through the Department of Veterans Affairs to the services described in 
such paragraphs, the Secretary shall, acting through the Office of 
Mental Health Services and the Office of Rural Health, provide such 
services as follows:
        (1) Through community mental health centers under contracts or 
    other agreements if entered into by the Secretary of Veterans 
    Affairs and the Secretary of Health and Human Services for the 
    provision of such services for purposes of the pilot program.
        (2) Through the Indian Health Service, or an Indian tribe or 
    tribal organization that has entered into an agreement with the 
    Indian Health Service pursuant to the Indian Self-Determination and 
    Education Assistance Act (25 U.S.C. 450 et seq.), if a memorandum 
    of understanding is entered into by the Secretary of Veterans 
    Affairs and the Secretary of Health and Human Services for purposes 
    of the pilot program.
        (3) Through other appropriate entities under contracts or other 
    agreements entered into by the Secretary of Veterans Affairs for 
    the provision of such services for purposes of the pilot program.
    (c) Duration.--The pilot program shall be carried out during the 
three-year period beginning on the date of the commencement of the 
pilot program.
    (d) Program Locations.--
        (1) In general.--The pilot program shall be carried out within 
    areas selected by the Secretary for the purpose of the pilot 
    program in at least three Veterans Integrated Service Networks 
    (VISNs).
        (2) Rural geographic locations.--The locations selected shall 
    be in rural geographic locations that, as determined by the 
    Secretary, lack access to comprehensive mental health services 
    through the Department of Veterans Affairs.
        (3) Qualified providers.--In selecting locations for the pilot 
    program, the Secretary shall select locations in which an adequate 
    number of licensed mental health care providers with credentials 
    equivalent to those of Department mental health care providers are 
    available in Indian Health Service facilities, community mental 
    health centers, and other entities for participation in the pilot 
    program.
    (e) Participation in Program.--Each community mental health center, 
facility of the Indian Health Service, or other entity participating in 
the pilot program under subsection (b) shall--
        (1) provide the services described in paragraphs (3) and (4) of 
    subsection (a) to eligible veterans, including, to the extent 
    practicable, telehealth services that link the center or facility 
    with Department of Veterans Affairs clinicians;
        (2) use the clinical practice guidelines of the Veterans Health 
    Administration or the Department of Defense in the provision of 
    such services; and
        (3) meet such other requirements as the Secretary shall 
    require.
    (f) Compliance With Department Protocols.--Each community mental 
health center, facility of the Indian Health Service, or other entity 
participating in the pilot program under subsection (b) shall comply 
with--
        (1) applicable protocols of the Department before incurring any 
    liability on behalf of the Department for the provision of services 
    as part of the pilot program; and
        (2) access and quality standards of the Department relevant to 
    the provision of services as part of the pilot program.
    (g) Provision of Clinical Information.--Each community mental 
health center, facility of the Indian Health Service, or other entity 
participating in the pilot program under subsection (b) shall, in a 
timely fashion, provide the Secretary with such clinical information on 
each veteran for whom such health center or facility provides mental 
health services under the pilot program as the Secretary shall require.
    (h) Training.--
        (1) Training of veterans.--As part of the pilot program, the 
    Secretary shall carry out a program of training for veterans 
    described in subsection (a) to provide the services described in 
    paragraphs (1) and (2) of such subsection.
        (2) Training of clinicians.--
            (A) In general.--The Secretary shall conduct a training 
        program for clinicians of community mental health centers, 
        Indian Health Service facilities, or other entities 
        participating in the pilot program under subsection (b) to 
        ensure that such clinicians can provide the services described 
        in paragraphs (3) and (4) of subsection (a) in a manner that 
        accounts for factors that are unique to the experiences of 
        veterans who served on active duty in Operation Iraqi Freedom 
        or Operation Enduring Freedom (including their combat and 
        military training experiences).
            (B) Participation in training.--Personnel of each community 
        mental health center, facility of the Indian Health Service, or 
        other entity participating in the pilot program under 
        subsection (b) shall participate in the training program 
        conducted pursuant to subparagraph (A).
    (i) Annual Reports.--Each community mental health center, facility 
of the Indian Health Service, or other entity participating in the 
pilot program under subsection (b) shall submit to the Secretary on an 
annual basis a report containing, with respect to the provision of 
services under subsection (b) and for the last full calendar year 
ending before the submission of such report--
        (1) the number of--
            (A) veterans served; and
            (B) courses of treatment provided; and
        (2) demographic information for such services, diagnoses, and 
    courses of treatment.
    (j) Program Evaluation.--
        (1) In general.--The Secretary shall, through Department of 
    Veterans Affairs Mental Health Services investigators and in 
    collaboration with relevant program offices of the Department, 
    design and implement a strategy for evaluating the pilot program.
        (2) Elements.--The strategy implemented under paragraph (1) 
    shall assess the impact that contracting with community mental 
    health centers, the Indian Health Service, and other entities 
    participating in the pilot program under subsection (b) has on the 
    following:
            (A) Access to mental health care by veterans in need of 
        such care.
            (B) The use of telehealth services by veterans for mental 
        health care needs.
            (C) The quality of mental health care and substance use 
        disorder treatment services provided to veterans in need of 
        such care and services.
            (D) The coordination of mental health care and other 
        medical services provided to veterans.
    (k) Definitions.--In this section:
        (1) The term ``community mental health center'' has the meaning 
    given such term in section 410.2 of title 42, Code of Federal 
    Regulations (as in effect on the day before the date of the 
    enactment of this Act).
        (2) The term ``eligible veteran'' means a veteran in need of 
    mental health services who--
            (A) is enrolled in the Department of Veterans Affairs 
        health care system; and
            (B) has received a referral from a health professional of 
        the Veterans Health Administration to a community mental health 
        center, a facility of the Indian Health Service, or other 
        entity for purposes of the pilot program.
        (3) The term ``Indian Health Service'' means the organization 
    established by section 601(a) of the Indian Health Care Improvement 
    Act (25 U.S.C. 1661(a)).
    (l) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out the provisions 
of this section.

                    TITLE II--MENTAL HEALTH RESEARCH

    SEC. 201. RESEARCH PROGRAM ON COMORBID POST-TRAUMATIC STRESS 
      DISORDER AND SUBSTANCE USE DISORDERS.
    (a) Program Required.--The Secretary of Veterans Affairs shall, 
through the Office of Research and Development, carry out a program of 
research into comorbid post-traumatic stress disorder (PTSD) and 
substance use disorder.
    (b) Discharge Through National Center for Posttraumatic Stress 
Disorder.--The research program required by subsection (a) shall be 
carried out by the National Center for Posttraumatic Stress Disorder. 
In carrying out the program, the Center shall--
        (1) develop protocols and goals with respect to research under 
    the program; and
        (2) coordinate research, data collection, and data 
    dissemination under the program.
    (c) Research.--The program of research required by subsection (a) 
shall address the following:
        (1) Comorbid post-traumatic stress disorder and substance use 
    disorder.
        (2) The systematic integration of treatment for post-traumatic 
    stress disorder with treatment for substance use disorder.
        (3) The development of protocols to evaluate care of veterans 
    with comorbid post-traumatic stress disorder and substance use 
    disorder.
    (d) Funding.--
        (1) Authorization of appropriations.--There is authorized to be 
    appropriated for the Department of Veterans Affairs for each of 
    fiscal years 2009 through 2012, $2,000,000 to carry out this 
    section.
        (2) Availability.--Amounts authorized to be appropriated by 
    paragraph (1) shall be made available to the National Center on 
    Posttraumatic Stress Disorder for the purpose specified in that 
    paragraph.
        (3) Supplement not supplant.--Any amount made available to the 
    National Center on Posttraumatic Stress Disorder for a fiscal year 
    under paragraph (2) is in addition to any other amounts made 
    available to the National Center on Posttraumatic Stress Disorder 
    for such year under any other provision of law.
    SEC. 202. EXTENSION OF AUTHORIZATION FOR SPECIAL COMMITTEE ON POST-
      TRAUMATIC STRESS DISORDER.
    Section 110(e)(2) of the Veterans' Health Care Act of 1984 (38 
U.S.C. 1712A note; Public Law 98-528) is amended by striking ``through 
2008'' and inserting ``through 2012''.

             TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

    SEC. 301. CLARIFICATION OF AUTHORITY OF SECRETARY OF VETERANS 
      AFFAIRS TO PROVIDE MENTAL HEALTH SERVICES TO FAMILIES OF 
      VETERANS.
    (a) In General.--Chapter 17 is amended--
        (1) in section 1701(5)(B)--
            (A) by inserting ``marriage and family counseling,'' after 
        ``professional counseling,''; and
            (B) by striking ``as may be essential to'' and inserting 
        ``as the Secretary considers appropriate for''; and
        (2) in section 1782--
            (A) in subsection (a), by inserting ``marriage and family 
        counseling,'' after ``professional counseling,''; and
            (B) in subsection (b)--
                (i) by inserting ``marriage and family counseling,'' 
            after ``professional counseling,''; and
                (ii) by striking ``if--'' and all that follows and 
            inserting a period.
    (b) Location.--Paragraph (5) of section 1701 of title 38, United 
States Code, shall not be construed to prevent the Secretary of 
Veterans Affairs from providing services described in subparagraph (B) 
of such paragraph to individuals described in such subparagraph in 
centers under section 1712A of such title (commonly referred to as 
``Vet Centers''), Department of Veterans Affairs medical centers, 
community-based outpatient clinics, or in such other facilities of the 
Department of Veterans Affairs as the Secretary considers necessary.
    SEC. 302. PILOT PROGRAM ON PROVISION OF READJUSTMENT AND TRANSITION 
      ASSISTANCE TO VETERANS AND THEIR FAMILIES IN COOPERATION WITH VET 
      CENTERS.
    (a) Pilot Program.--The Secretary of Veterans Affairs shall carry 
out, through a non-Department of Veterans Affairs entity, a pilot 
program to assess the feasability and advisability of providing 
readjustment and transition assistance described in subsection (b) to 
veterans and their families in cooperation with centers under section 
1712A of title 38, United States Code (commonly referred to as ``Vet 
Centers'').
    (b) Readjustment and Transition Assistance.--Readjustment and 
transition assistance described in this subsection is assistance as 
follows:
        (1) Readjustment and transition assistance that is preemptive, 
    proactive, and principle-centered.
        (2) Assistance and training for veterans and their families in 
    coping with the challenges associated with making the transition 
    from military to civilian life.
    (c) Non-Department of Veterans Affairs Entity.--
        (1) In general.--The Secretary shall carry out the pilot 
    program through any for-profit or non-profit organization selected 
    by the Secretary for purposes of the pilot program that has 
    demonstrated expertise and experience in the provision of 
    assistance and training described in subsection (b).
        (2) Contract or agreement.--The Secretary shall carry out the 
    pilot program through a non-Department entity described in 
    paragraph (1) pursuant to a contract or other agreement entered 
    into by the Secretary and the entity for purposes of the pilot 
    program.
    (d) Commencement of Pilot Program.--The pilot program shall 
commence not later than 180 days after the date of the enactment of 
this Act.
    (e) Duration of Pilot Program.--The pilot program shall be carried 
out during the three-year period beginning on the date of the 
commencement of the pilot program, and may be carried out for 
additional one-year periods thereafter.
    (f) Location of Pilot Program.--
        (1) In general.--The Secretary shall provide assistance under 
    the pilot program in cooperation with 10 centers described in 
    subsection (a) designated by the Secretary for purposes of the 
    pilot program.
        (2) Designations.--In designating centers described in 
    subsection (a) for purposes of the pilot program, the Secretary 
    shall designate centers so as to provide a balanced geographical 
    representation of such centers throughout the United States, 
    including the District of Columbia, the Commonwealth of Puerto 
    Rico, tribal lands, and other territories and possessions of the 
    United States.
    (g) Participation of Centers.--A center described in subsection (a) 
that is designated under subsection (f) for participation in the pilot 
program shall participate in the pilot program by promoting awareness 
of the assistance and training available to veterans and their families 
through--
        (1) the facilities and other resources of such center;
        (2) the non-Department of Veterans Affairs entity selected 
    pursuant to subsection (c); and
        (3) other appropriate mechanisms.
    (h) Additional Support.--In carrying out the pilot program, the 
Secretary may enter into contracts or other agreements, in addition to 
the contract or agreement described in subsection (c), with such other 
non-Department of Veterans Affairs entities meeting the requirements of 
subsection (c) as the Secretary considers appropriate for purposes of 
the pilot program.
    (i) Report on Pilot Program.--
        (1) Report required.--Not later than three years after the date 
    of the enactment of this Act, the Secretary shall submit to the 
    congressional veterans affairs committees a report on the pilot 
    program.
        (2) Elements.--Each report under paragraph (1) shall include 
    the following:
            (A) A description of the activities under the pilot program 
        as of the date of such report, including the number of veterans 
        and families provided assistance under the pilot program and 
        the scope and nature of the assistance so provided.
            (B) A current assessment of the effectiveness of the pilot 
        program.
            (C) Any recommendations that the Secretary considers 
        appropriate for the extension or expansion of the pilot 
        program.
        (3) Congressional veterans affairs committees defined.--In this 
    subsection, the term ``congressional veterans affairs committees'' 
    means--
            (A) the Committees on Veterans' Affairs and Appropriations 
        of the Senate; and
            (B) the Committees on Veterans' Affairs and Appropriations 
        of the House of Representatives.
    (j) Authorization of Appropriations.--
        (1) In general.--There is authorized to be appropriated for the 
    Department of Veterans Affairs for each of fiscal years 2009 
    through 2011 $1,000,000 to carry out this section.
        (2) Availability.--Amounts authorized to be appropriated by 
    paragraph (1) shall remain available until expended.

                     TITLE IV--HEALTH CARE MATTERS

    SEC. 401. VETERANS BENEFICIARY TRAVEL PROGRAM.
    (a) Repeal of Requirement To Adjust Amounts Deducted From Payments 
or Allowances for Beneficiary Travel.--
        (1) In general.--Section 111(c) is amended--
            (A) by striking paragraph (5); and
            (B) in paragraph (2), by striking ``, except as provided in 
        paragraph (5) of this subsection,''.
        (2) Reinstatement of amount of deduction specified by 
    statute.--Notwithstanding any adjustment made by the Secretary of 
    Veterans Affairs under paragraph (5) of section 111(c) of title 38, 
    United States Code, as such paragraph was in effect before the date 
    of the enactment of this Act, the amount deducted under paragraph 
    (1) of such section 111(c) on or after such date shall be the 
    amount specified in such paragraph.
    (b) Determination of Mileage Reimbursement Rate.--Section 111(g) is 
amended--
        (1) by amending paragraph (1) to read as follows:
    ``(1) Subject to paragraph (3), in determining the amount of 
allowances or reimbursement to be paid under this section, the 
Secretary shall use the mileage reimbursement rate for the use of 
privately owned vehicles by Government employees on official business 
(when a Government vehicle is available), as prescribed by the 
Administrator of General Services under section 5707(b) of title 5.'';
        (2) by striking paragraphs (3) and (4); and
        (3) by inserting after paragraph (2) the following new 
    paragraph (3):
    ``(3) Subject to the availability of appropriations, the Secretary 
may modify the amount of allowances or reimbursement to be paid under 
this section using a mileage reimbursement rate in excess of that 
prescribed under paragraph (1).''.
    (c) Report.--Not later than 14 months after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to the Committee on Veterans' Affairs of the Senate and the Committee 
on Veterans' Affairs of the House of Representatives a report 
containing an estimate of the additional costs incurred by the 
Department of Veterans Affairs because of this section, including--
        (1) any costs resulting from increased utilization of 
    healthcare services by veterans eligible for travel allowances or 
    reimbursements under section 111 of title 38, United States Code; 
    and
        (2) the additional costs that would be incurred by the 
    Department should the Secretary exercise the authority described in 
    subsection (g)(3) of such section.
    (d) Effective Date.--The amendments made by this section shall 
apply with respect to travel expenses incurred after the expiration of 
the 90-day period that begins on the date of the enactment of this Act.
    SEC. 402. MANDATORY REIMBURSEMENT OF VETERANS RECEIVING EMERGENCY 
      TREATMENT IN NON-DEPARTMENT OF VETERANS AFFAIRS FACILITIES UNTIL 
      TRANSFER TO DEPARTMENT FACILITIES.
    (a) Certain Veterans Without Service-Connected Disability.--Section 
1725 is amended--
        (1) in subsection (a)(1), by striking ``may reimburse'' and 
    inserting ``shall reimburse''; and
        (2) in subsection (f)(1), by striking subparagraph (C) and 
    inserting the following new subparagraph (C):
            ``(C) until--
                ``(i) such time as the veteran can be transferred 
            safely to a Department facility or other Federal facility 
            and such facility is capable of accepting such transfer; or
                ``(ii) such time as a Department facility or other 
            Federal facility accepts such transfer if--

                    ``(I) at the time the veteran could have been 
                transferred safely to a Department facility or other 
                Federal facility, no Department facility or other 
                Federal facility agreed to accept such transfer; and
                    ``(II) the non-Department facility in which such 
                medical care or services was furnished made and 
                documented reasonable attempts to transfer the veteran 
                to a Department facility or other Federal facility.''.

    (b) Certain Veterans With Service-Connected Disability.--Section 
1728 is amended--
        (1) by striking subsection (a) and inserting the following new 
    subsection (a):
    ``(a) The Secretary shall, under such regulations as the Secretary 
prescribes, reimburse veterans eligible for hospital care or medical 
services under this chapter for the customary and usual charges of 
emergency treatment (including travel and incidental expenses under the 
terms and conditions set forth in section 111 of this title) for which 
such veterans have made payment, from sources other than the 
Department, where such emergency treatment was rendered to such 
veterans in need thereof for any of the following:
        ``(1) An adjudicated service-connected disability.
        ``(2) A non-service-connected disability associated with and 
    held to be aggravating a service-connected disability.
        ``(3) Any disability of a veteran if the veteran has a total 
    disability permanent in nature from a service-connected disability.
        ``(4) Any illness, injury, or dental condition of a veteran 
    who--
            ``(A) is a participant in a vocational rehabilitation 
        program (as defined in section 3101(9) of this title); and
            ``(B) is medically determined to have been in need of care 
        or treatment to make possible the veteran's entrance into a 
        course of training, or prevent interruption of a course of 
        training, or hasten the return to a course of training which 
        was interrupted because of such illness, injury, or dental 
        condition.'';
        (2) in subsection (b), by striking ``care or services'' both 
    places it appears and inserting ``emergency treatment''; and
        (3) by adding at the end the following new subsection:
    ``(c) In this section, the term `emergency treatment' has the 
meaning given such term in section 1725(f)(1) of this title.''.
    SEC. 403. PILOT PROGRAM OF ENHANCED CONTRACT CARE AUTHORITY FOR 
      HEALTH CARE NEEDS OF VETERANS IN HIGHLY RURAL AREAS.
    (a) Pilot Program Required.--
        (1) In general.--The Secretary of Veterans Affairs shall 
    conduct a pilot program under which the Secretary provides covered 
    health services to covered veterans through qualifying non-
    Department of Veterans Affairs health care providers.
        (2) Commencement.--The Secretary shall commence the conduct of 
    the pilot program on the date that is 120 days after the date of 
    the enactment of this Act.
        (3) Termination.--A veteran may receive health services under 
    the pilot program only during the three-year period beginning on 
    the date of the commencement of the pilot program under paragraph 
    (2).
        (4) Program locations.--The pilot program shall be carried out 
    within areas selected by the Secretary for the purposes of the 
    pilot program in at least five Veterans Integrated Service Networks 
    (VISNs). Of the Veterans Integrated Service Networks so selected--
            (A) not less than four such networks shall include at least 
        three highly rural counties, as determined by the Secretary 
        upon consideration of the most recent decennial census;
            (B) not less than one such network, not including a network 
        selected under subparagraph (A), shall include only one highly 
        rural county, as determined by the Secretary upon consideration 
        of the most recent decennial census;
            (C) all such networks shall include area within the borders 
        of at least four States; and
            (D) no such networks shall be participants in the 
        Healthcare Effectiveness through Resource Optimization pilot 
        program of the Department of Veterans Affairs.
    (b) Covered Veterans.--
        (1) In general.--For purposes of the pilot program under this 
    section, a covered veteran is any highly rural veteran who is--
            (A) enrolled in the system of patient enrollment 
        established under section 1705(a) of title 38, United States 
        Code, as of the date of the commencement of the pilot program 
        under subsection (a)(2); or
            (B) eligible for health care under section 1710(e)(3)(C) of 
        title 38, United States Code.
        (2) Highly rural veterans.--For purposes of this subsection, a 
    highly rural veteran is any veteran who--
            (A) resides in a location that is--
                (i) more than 60 miles driving distance from the 
            nearest Department health care facility providing primary 
            care services, if the veteran is seeking such services;
                (ii) more than 120 miles driving distance from the 
            nearest Department health care facility providing acute 
            hospital care, if the veteran is seeking such care; or
                (iii) more than 240 miles driving distance from the 
            nearest Department health care facility providing tertiary 
            care, if the veteran is seeking such care; or
            (B) in the case of a veteran who resides in a location less 
        than the distance specified in clause (i), (ii), or (iii) of 
        subparagraph (A), as applicable, experiences such hardship or 
        other difficulties in travel to the nearest appropriate 
        Department health care facility that such travel is not in the 
        best interest of the veteran, as determined by the Secretary 
        pursuant to regulations prescribed for purposes of this 
        subsection.
    (c) Covered Health Services.--For purposes of the pilot program 
under this section, a covered health service with respect to a covered 
veteran is any hospital care, medical service, rehabilitative service, 
or preventative health service that is authorized to be provided by the 
Secretary to the veteran under chapter 17 of title 38, United States 
Code, or any other provision of law.
    (d) Qualifying Non-Department Health Care Providers.--For purposes 
of the pilot program under this section, an entity or individual is a 
qualifying non-Department health care provider of a covered health 
service if the Secretary determines that the entity or individual is 
qualified to furnish such service to veterans under the pilot program.
    (e) Election.--A covered veteran seeking to be provided covered 
health services under the pilot program under this section shall submit 
to the Secretary an application therefor in such form, and containing 
such information as the Secretary shall specify for purposes of the 
pilot program.
    (f) Provision of Services Through Contract.--The Secretary shall 
provide covered health services to veterans under the pilot program 
under this section through contracts with qualifying non-Department 
health care providers for the provision of such services.
    (g) Exchange of Medical Information.--In conducting the pilot 
program under this section, the Secretary shall develop and utilize a 
functional capability to provide for the exchange of appropriate 
medical information between the Department and non-Department health 
care providers providing health services under the pilot program.
    (h) Reports.--Not later than the 30 days after the end of each year 
in which the pilot program under this section is conducted, the 
Secretary shall submit to the Committee of Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report which includes--
        (1) the assessment of the Secretary of the pilot program during 
    the preceding year, including its cost, volume, quality, patient 
    satisfaction, benefit to veterans, and such other findings and 
    conclusions with respect to pilot program as the Secretary 
    considers appropriate; and
        (2) such recommendations as the Secretary considers appropriate 
    regarding--
            (A) the continuation of the pilot program;
            (B) extension of the pilot program to other or all Veterans 
        Integrated Service Networks of the Department;
            (C) making the pilot program permanent.
    SEC. 404. EPILEPSY CENTERS OF EXCELLENCE.
    (a) In General.--Subchapter II of chapter 73 is amended by adding 
at the end the following new section:
``Sec. 7330A. Epilepsy centers of excellence
    ``(a) Establishment of Centers.--(1) Not later than 120 days after 
the date of the enactment of the Veterans' Mental Health and Other Care 
Improvements Act of 2008, the Secretary shall designate at least four 
but not more than six Department health care facilities as locations 
for epilepsy centers of excellence for the Department.
    ``(2) Of the facilities designated under paragraph (1), not less 
than two shall be centers designated under section 7327 of this title.
    ``(3) Of the facilities designated under paragraph (1), not less 
than two shall be facilities that are not centers designated under 
section 7327 of this title.
    ``(4) Subject to the availability of appropriations for such 
purpose, the Secretary shall establish and operate an epilepsy center 
of excellence at each location designated under paragraph (1).
    ``(b) Designation of Facilities.--(1) In designating locations for 
epilepsy centers of excellence under subsection (a), the Secretary 
shall solicit proposals from Department health care facilities seeking 
designation as a location for an epilepsy center of excellence.
    ``(2) The Secretary may not designate a facility as a location for 
an epilepsy center of excellence under subsection (a) unless the peer 
review panel established under subsection (c) has determined under that 
subsection that the proposal submitted by such facility seeking 
designation as a location for an epilepsy center of excellence is among 
those proposals that meet the highest competitive standards of 
scientific and clinical merit.
    ``(3) In choosing from among the facilities meeting the 
requirements of paragraph (2), the Secretary shall also consider 
appropriate geographic distribution when designating the epilepsy 
centers of excellence under subsection (a).
    ``(c) Peer Review Panel.--(1) The Under Secretary for Health shall 
establish a peer review panel to assess the scientific and clinical 
merit of proposals that are submitted to the Secretary for the 
designation of epilepsy centers of excellence under this section.
    ``(2)(A) The membership of the peer review panel shall consist of 
experts on epilepsy, including post-traumatic epilepsy.
    ``(B) Members of the peer review panel shall serve for a period of 
no longer than two years, except as specified in subparagraph (C).
    ``(C) Of the members first appointed to the panel, one half shall 
be appointed for a period of three years and one half shall be 
appointed for a period of two years, as designated by the Under 
Secretary at the time of appointment.
    ``(3) The peer review panel shall review each proposal submitted to 
the panel by the Under Secretary for Health and shall submit its views 
on the relative scientific and clinical merit of each such proposal to 
the Under Secretary.
    ``(4) The peer review panel shall, in conjunction with the national 
coordinator designated under subsection (e), conduct regular 
evaluations of each epilepsy center of excellence established and 
operated under subsection (a) to ensure compliance with the 
requirements of this section.
    ``(5) The peer review panel shall not be subject to the Federal 
Advisory Committee Act.
    ``(d) Epilepsy Center of Excellence Defined.--In this section, the 
term `epilepsy center of excellence' means a health care facility that 
has (or in the foreseeable future can develop) the necessary capacity 
to function as a center of excellence in research, education, and 
clinical care activities in the diagnosis and treatment of epilepsy and 
has (or may reasonably be anticipated to develop) each of the 
following:
        ``(1) An affiliation with an accredited medical school that 
    provides education and training in neurology, including an 
    arrangement with such school under which medical residents receive 
    education and training in the diagnosis and treatment of epilepsy 
    (including neurosurgery).
        ``(2) The ability to attract the participation of scientists 
    who are capable of ingenuity and creativity in health care research 
    efforts.
        ``(3) An advisory committee composed of veterans and 
    appropriate health care and research representatives of the 
    facility and of the affiliated school or schools to advise the 
    directors of such facility and such center on policy matters 
    pertaining to the activities of the center during the period of the 
    operation of such center.
        ``(4) The capability to conduct effectively evaluations of the 
    activities of such center.
        ``(5) The capability to assist in the expansion of the 
    Department's use of information systems and databases to improve 
    the quality and delivery of care for veterans enrolled within the 
    Department's health care system.
        ``(6) The capability to assist in the expansion of the 
    Department telehealth program to develop, transmit, monitor, and 
    review neurological diagnostic tests.
        ``(7) The ability to perform epilepsy research, education, and 
    clinical care activities in collaboration with Department medical 
    facilities that have centers for research, education, and clinical 
    care activities on complex multi-trauma associated with combat 
    injuries established under section 7327 of this title.
    ``(e) National Coordinator for Epilepsy Programs.--(1) To assist 
the Secretary and the Under Secretary for Health in carrying out this 
section, the Secretary shall designate an individual in the Veterans 
Health Administration to act as a national coordinator for epilepsy 
programs of the Veterans Health Administration.
    ``(2) The duties of the national coordinator for epilepsy programs 
shall include the following:
        ``(A) To supervise the operation of the centers established 
    pursuant to this section.
        ``(B) To coordinate and support the national consortium of 
    providers with interest in treating epilepsy at Department health 
    care facilities lacking such centers in order to ensure better 
    access to state-of-the-art diagnosis, research, clinical care, and 
    education for traumatic brain injury and epilepsy throughout the 
    health care system of the Department.
        ``(C) To conduct, in conjunction with the peer review panel 
    established under subsection (c), regular evaluations of the 
    epilepsy centers of excellence to ensure compliance  with the 
    requirements of this section.
        ``(D) To coordinate (as part of an integrated national system) 
    education, clinical care, and research activities within all 
    facilities with an epilepsy center of excellence.
        ``(E) To develop jointly a national consortium of providers 
    with interest in treating epilepsy at Department health care 
    facilities lacking an epilepsy center of excellence in order to 
    ensure better access to state-of-the-art diagnosis, research, 
    clinical care, and education for traumatic brain injury and 
    epilepsy throughout the health care system of the Department. Such 
    consortium should include a designated epilepsy referral clinic in 
    each Veterans Integrated Service Network.
    ``(3) In carrying out duties under this subsection, the national 
coordinator for epilepsy programs shall report to the official of the 
Veterans Health Administration responsible for neurology.
    ``(f) Authorization of Appropriations.--(1) There are authorized to 
be appropriated $6,000,000 for each of fiscal years 2009 through 2013 
for the support of the clinical care, research, and education 
activities of the epilepsy centers of excellence established and 
operated pursuant to subsection (a)(2).
    ``(2) There are authorized to be appropriated for each fiscal year 
after fiscal year 2013 such sums as may be necessary for the support of 
the clinical care, research, and education activities of the epilepsy 
centers of excellence established and operated pursuant to subsection 
(a)(2).
    ``(3) The Secretary shall ensure that funds for such centers are 
designated for the first three years of operation as a special purpose 
program for which funds are not allocated through the Veterans 
Equitable Resource Allocation system.
    ``(4) In addition to amounts authorized to be appropriated under 
paragraphs (1) and (2) for a fiscal year, the Under Secretary for 
Health shall allocate to such centers from other funds appropriated 
generally for the Department medical services account and medical and 
prosthetics research account, as appropriate, such amounts as the Under 
Secretary for Health determines appropriate.
    ``(5) In addition to amounts authorized to be appropriated under 
paragraphs (1) and (2) for a fiscal year, there are authorized to be 
appropriated such sums as may be necessary to fund the national 
coordinator established by subsection (e).''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 is amended by inserting after the item relating to section 
7330 the following new item:

``7330A. Epilepsy centers of excellence.''.
    SEC. 405. ESTABLISHMENT OF QUALIFICATIONS FOR PEER SPECIALIST 
      APPOINTEES.
    (a) In General.--Section 7402(b) is amended--
        (1) by redesignating the paragraph (11) relating to other 
    health care positions as paragraph (14); and
        (2) by inserting after paragraph (12) the following new 
    paragraph (13):
    ``(13) Peer Specialist.--To be eligible to be appointed to a peer 
specialist position, a person must--
        ``(A) be a veteran who has recovered or is recovering from a 
    mental health condition; and
        ``(B) be certified by--
            ``(i) a not-for-profit entity engaged in peer specialist 
        training as having met such criteria as the Secretary shall 
        establish for a peer specialist position; or
            ``(ii) a State as having satisfied relevant State 
        requirements for a peer specialist position.''.
    (b) Peer Specialist Training.--Section 7402 is amended by adding at 
the end the following new subsection:
    ``(g) The Secretary may enter into contracts with not-for-profit 
entities to provide--
        ``(1) peer specialist training to veterans; and
        ``(2) certification for veterans under subsection 
    (b)(13)(B)(i).''.
    SEC. 406. ESTABLISHMENT OF CONSOLIDATED PATIENT ACCOUNTING CENTERS.
    (a) Establishment of Centers.--Chapter 17 is amended by inserting 
after section 1729A the following new section:
``Sec. 1729B. Consolidated patient accounting centers
    ``(a) In General.--Not later than five years after the date of the 
enactment of this section, the Secretary of Veterans Affairs shall 
establish not more than seven consolidated patient accounting centers 
for conducting industry-modeled regionalized billing and collection 
activities of the Department.
    ``(b) Functions.--The centers shall carry out the following 
functions:
        ``(1) Reengineer and integrate all business processes of the 
    revenue cycle of the Department.
        ``(2) Standardize and coordinate all activities of the 
    Department related to the revenue cycle for all health care 
    services furnished to veterans for non-service-connected medical 
    conditions.
        ``(3) Apply commercial industry standards for measures of 
    access, timeliness, and performance metrics with respect to revenue 
    enhancement of the Department.
        ``(4) Apply other requirements with respect to such revenue 
    cycle improvement as the Secretary may specify.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1729A the following:

``1729B. Consolidated patient accounting centers.''.
    SEC. 407. REPEAL OF LIMITATION ON AUTHORITY TO CONDUCT WIDESPREAD 
      HIV TESTING PROGRAM.
    Section 124 of the Veterans' Benefits and Services Act of 1988 
(title I of Public Law 100-322, as amended; 38 U.S.C. 7333 note) is 
repealed.
    SEC. 408. PROVISION OF COMPREHENSIVE HEALTH CARE BY SECRETARY OF 
      VETERANS AFFAIRS TO CHILDREN OF VIETNAM VETERANS BORN WITH SPINA 
      BIFIDA.
    (a) Provision of Comprehensive Health Care.--Section 1803(a) is 
amended by striking ``such health care as the Secretary determines is 
needed by the child for the spina bifida or any disability that is 
associated with such condition'' and inserting ``health care under this 
section''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to care furnished after the date of the enactment of 
this Act.
    SEC. 409. EXEMPTION FROM COPAYMENT REQUIREMENT FOR VETERANS 
      RECEIVING HOSPICE CARE.
    Section 1710 is amended--
        (1) in subsection (f)(1), by inserting ``(except if such care 
    constitutes hospice care)'' after ``nursing home care''; and
        (2) in subsection (g)(1), by inserting ``(except if such care 
    constitutes hospice care)'' after ``medical services''.

                           TITLE V--PAIN CARE

    SEC. 501. COMPREHENSIVE POLICY ON PAIN MANAGEMENT.
    (a) Comprehensive Policy Required.--Not later than October 1, 2009, 
the Secretary of Veterans Affairs shall develop and implement a 
comprehensive policy on the management of pain experienced by veterans 
enrolled for health care services provided by the Department of 
Veterans Affairs.
    (b) Scope of Policy.--The policy required by subsection (a) shall 
cover each of the following:
        (1) The Department-wide management of acute and chronic pain 
    experienced by veterans.
        (2) The standard of care for pain management to be used 
    throughout the Department.
        (3) The consistent application of pain assessments to be used 
    throughout the Department.
        (4) The assurance of prompt and appropriate pain care treatment 
    and management by the Department, system-wide, when medically 
    necessary.
        (5) Department programs of research related to acute and 
    chronic pain suffered by veterans, including pain attributable to 
    central and peripheral nervous system damage characteristic of 
    injuries incurred in modern warfare.
        (6) Department programs of pain care education and training for 
    health care personnel of the Department.
        (7) Department programs of patient education for veterans 
    suffering from acute or chronic pain and their families.
    (c) Updates.--The Secretary shall revise the policy required by 
subsection (a) on a periodic basis in accordance with experience and 
evolving best practice guidelines.
    (d) Consultation.--The Secretary shall develop the policy required 
by subsection (a), and revise such policy under subsection (c), in 
consultation with veterans service organizations and organizations with 
expertise in the assessment, diagnosis, treatment, and management of 
pain.
    (e) Annual Report.--
        (1) In general.--Not later than 180 days after the date of the 
    completion and initial implementation of the policy required by 
    subsection (a) and on October 1 of every fiscal year thereafter 
    through fiscal year 2018, the Secretary shall submit to the 
    Committee on Veterans' Affairs of the Senate and the Committee on 
    Veterans' Affairs of the House of Representatives a report on the 
    implementation of the policy required by subsection (a).
        (2) Contents.--The report required by paragraph (1) shall 
    include the following:
            (A) A description of the policy developed and implemented 
        under subsection (a) and any revisions to such policy under 
        subsection (c).
            (B) A description of the performance measures used to 
        determine the effectiveness of such policy in improving pain 
        care for veterans system-wide.
            (C) An assessment of the adequacy of Department pain 
        management services based on a survey of patients managed in 
        Department clinics.
            (D) An assessment of the research projects of the 
        Department relevant to the treatment of the types of acute and 
        chronic pain suffered by veterans.
            (E) An assessment of the training provided to Department 
        health care personnel with respect to the diagnosis, treatment, 
        and management of acute and chronic pain.
            (F) An assessment of the patient pain care education 
        programs of the Department.
    (f) Veterans Service Organization Defined.--In this section, the 
term ``veterans service organization'' means any organization 
recognized by the Secretary for the representation of veterans under 
section 5902 of title 38, United States Code.

                  TITLE VI--HOMELESS VETERANS MATTERS

    SEC. 601. INCREASED AUTHORIZATION OF APPROPRIATIONS FOR 
      COMPREHENSIVE SERVICE PROGRAMS.
    Section 2013 is amended by striking ``$130,000,000'' and inserting 
``$150,000,000''.
    SEC. 602. EXPANSION AND EXTENSION OF AUTHORITY FOR PROGRAM OF 
      REFERRAL AND COUNSELING SERVICES FOR AT-RISK VETERANS 
      TRANSITIONING FROM CERTAIN INSTITUTIONS.
    (a) Program Authority.--Subsection (a) of section 2023 is amended 
by striking ``a demonstration program for the purpose of determining 
the costs and benefits of providing'' and inserting ``a program of''.
    (b) Scope of Program.--Subsection (b) of such section is amended--
        (1) by striking ``Demonstration'' in the subsection heading;
        (2) by striking ``demonstration''; and
        (3) by striking ``in at least six locations'' and inserting 
    ``in at least 12 locations''.
    (c) Extension of Authority.--Subsection (d) of such section is 
amended by striking ``shall cease'' and all that follows and inserting 
``shall cease on September 30, 2012.''.
    (d) Conforming Amendments.--
        (1) Subsection (c)(1) of such section is amended by striking 
    ``demonstration''.
        (2) The heading of such section is amended to read as follows:
``Sec. 2023. Referral and counseling services: veterans at risk of 
    homelessness who are transitioning from certain institutions''.
        (3) Section 2022(f)(2)(C) of such title is amended by striking 
    ``demonstration''.
    (e) Clerical Amendment.--The table of sections at the beginning of 
chapter 20 is amended by striking the item relating to section 2023 and 
inserting the following:

``2023. Referral and counseling services: veterans at risk of 
          homelessness who are transitioning from certain 
          institutions.''.
    SEC. 603. PERMANENT AUTHORITY FOR DOMICILIARY SERVICES FOR HOMELESS 
      VETERANS AND ENHANCEMENT OF CAPACITY OF DOMICILIARY CARE PROGRAMS 
      FOR FEMALE VETERANS.
    Subsection (b) of section 2043 is amended to read as follows:
    ``(b) Enhancement of Capacity of Domiciliary Care Programs for 
Female Veterans.--The Secretary shall take appropriate actions to 
ensure that the domiciliary care programs of the Department are 
adequate, with respect to capacity and with respect to safety, to meet 
the needs of veterans who are women.''.
    SEC. 604. FINANCIAL ASSISTANCE FOR SUPPORTIVE SERVICES FOR VERY 
      LOW-INCOME VETERAN FAMILIES IN PERMANENT HOUSING.
    (a) Purpose.--The purpose of this section is to facilitate the 
provision of supportive services for very low-income veteran families 
in permanent housing.
    (b) Financial Assistance.--
        (1) In general.--Subchapter V of chapter 20 is amended by 
    adding at the end the following new section:
``Sec. 2044. Financial assistance for supportive services for very low-
    income veteran families in permanent housing
    ``(a) Distribution of Financial Assistance.--(1) The Secretary 
shall provide financial assistance to eligible entities approved under 
this section to provide and coordinate the provision of supportive 
services described in subsection (b) for very low-income veteran 
families occupying permanent housing.
    ``(2) Financial assistance under this section shall consist of 
grants for each such family for which an approved eligible entity is 
providing or coordinating the provision of supportive services.
    ``(3)(A) The Secretary shall provide such grants to each eligible 
entity that is providing or coordinating the provision of supportive 
services.
    ``(B) The Secretary is authorized to establish intervals of payment 
for the administration of such grants and establish a maximum amount to 
be awarded, in accordance with the services being provided and their 
duration.
    ``(4) In providing financial assistance under paragraph (1), the 
Secretary shall give preference to entities providing or coordinating 
the provision of supportive services for very low-income veteran 
families who are transitioning from homelessness to permanent housing.
    ``(5) The Secretary shall ensure that, to the extent practicable, 
financial assistance under this subsection is equitably distributed 
across geographic regions, including rural communities and tribal 
lands.
    ``(6) Each entity receiving financial assistance under this section 
to provide supportive services to a very low-income veteran family 
shall notify that family that such services are being paid for, in 
whole or in part, by the Department.
    ``(7) The Secretary may require entities receiving financial 
assistance under this section to submit a report to the Secretary that 
describes the projects carried out with such financial assistance.
    ``(b) Supportive Services.--The supportive services referred to in 
subsection (a) are the following:
        ``(1) Services provided by an eligible entity or a 
    subcontractor of an eligible entity that address the needs of very 
    low-income veteran families occupying permanent housing, 
    including--
            ``(A) outreach services;
            ``(B) case management services;
            ``(C) assistance in obtaining any benefits from the 
        Department which the veteran may be eligible to receive, 
        including, but not limited to, vocational and rehabilitation 
        counseling, employment and training service, educational 
        assistance, and health care services; and
            ``(D) assistance in obtaining and coordinating the 
        provision of other public benefits provided in federal, State, 
        or local agencies, or any organization defined in subsection 
        (f), including--
                ``(i) health care services (including obtaining health 
            insurance);
                ``(ii) daily living services;
                ``(iii) personal financial planning;
                ``(iv) transportation services;
                ``(v) income support services;
                ``(vi) fiduciary and representative payee services;
                ``(vii) legal services to assist the veteran family 
            with issues that interfere with the family's ability to 
            obtain or retain housing or supportive services;
                ``(viii) child care;
                ``(ix) housing counseling; and
                ``(x) other services necessary for maintaining 
            independent living.
        ``(2) Services described in paragraph (1) that are delivered to 
    very low-income veteran families who are homeless and who are 
    scheduled to become residents of permanent housing within 90 days 
    pending the location or development of housing suitable for 
    permanent housing.
        ``(3) Services described in paragraph (1) for very low-income 
    veteran families who have voluntarily chosen to seek other housing 
    after a period of tenancy in permanent housing, that are provided, 
    for a period of 90 days after such families exit permanent housing 
    or until such families commence receipt of other housing services 
    adequate to meet their current needs, but only to the extent that 
    services under this paragraph are designed to support such families 
    in their choice to transition into housing that is responsive to 
    their individual needs and preferences.
    ``(c) Application for Financial Assistance.--(1) An eligible entity 
seeking financial assistance under subsection (a) shall submit to the 
Secretary an application therefor in such form, in such manner, and 
containing such commitments and information as the Secretary determines 
to be necessary to carry out this section.
    ``(2) Each application submitted by an eligible entity under 
paragraph (1) shall contain--
        ``(A) a description of the supportive services proposed to be 
    provided by the eligible entity and the identified needs for those 
    services;
        ``(B) a description of the types of very low-income veteran 
    families proposed to be provided such services;
        ``(C) an estimate of the number of very low-income veteran 
    families proposed to be provided such services;
        ``(D) evidence of the experience of the eligible entity in 
    providing supportive services to very low-income veteran families; 
    and
        ``(E) a description of the managerial capacity of the eligible 
    entity--
            ``(i) to coordinate the provision of supportive services 
        with the provision of permanent housing by the eligible entity 
        or by other organizations;
            ``(ii) to assess continuously the needs of very low-income 
        veteran families for supportive services;
            ``(iii) to coordinate the provision of supportive services 
        with the services of the Department;
            ``(iv) to tailor supportive services to the needs of very 
        low-income veteran families; and
            ``(v) to seek continuously new sources of assistance to 
        ensure the long-term provision of supportive services to very 
        low-income veteran families.
    ``(3) The Secretary shall establish criteria for the selection of 
eligible entities to be provided financial assistance under this 
section.
    ``(d) Technical Assistance.--(1) The Secretary shall provide 
training and technical assistance to participating eligible entities 
regarding the planning, development, and provision of supportive 
services to very low-income veteran families occupying permanent 
housing, through the Technical Assistance grants program in section 
2064 of this title.
    ``(2) The Secretary may provide the training described in paragraph 
(1) directly or through grants or contracts with appropriate public or 
nonprofit private entities.
    ``(e) Funding.--(1) From amounts appropriated to the Department for 
Medical Services, there shall be available to carry out subsection (a), 
(b), and (c) amounts as follows:
        ``(A) $15,000,000 for fiscal year 2009.
        ``(B) $20,000,000 for fiscal year 2010.
        ``(C) $25,000,000 for fiscal year 2011.
    ``(2) Not more than $750,000 may be available under paragraph (1) 
in any fiscal year to provide technical assistance under subsection 
(d).
    ``(3) There is authorized to be appropriated $1,000,000 for each of 
the fiscal year 2009 through 2011 to carry out the provisions of 
subsection (d).
    ``(f) Definitions.--In this section:
        ``(1) The term `consumer cooperative' has the meaning given 
    such term in section 202 of the Housing Act of 1959 (12 U.S.C. 
    1701q).
        ``(2) The term `eligible entity' means--
            ``(A) a private nonprofit organization; or
            ``(B) a consumer cooperative.
        ``(3) The term `homeless' has the meaning given that term in 
    section 103 of the McKinney-Vento Homeless Assistance Act (42 
    U.S.C. 11302).
        ``(4) The term `permanent housing' means community-based 
    housing without a designated length of stay.
        ``(5) The term `private nonprofit organization' means any of 
    the following:
            ``(A) Any incorporated private institution or foundation--
                ``(i) no part of the net earnings of which inures to 
            the benefit of any member, founder, contributor, or 
            individual;
                ``(ii) which has a governing board that is responsible 
            for the operation of the supportive services provided under 
            this section; and
                ``(iii) which is approved by the Secretary as to 
            financial responsibility.
            ``(B) A for-profit limited partnership, the sole general 
        partner of which is an organization meeting the requirements of 
        clauses (i), (ii), and (iii) of subparagraph (A).
            ``(C) A corporation wholly owned and controlled by an 
        organization meeting the requirements of clauses (i), (ii), and 
        (iii) of subparagraph (A).
            ``(D) A tribally designated housing entity (as defined in 
        section 4 of the Native American Housing Assistance and Self-
        Determination Act of 1996 (25 U.S.C. 4103)).
        ``(6)(A) Subject to subparagraphs (B) and (C), the term `very 
    low-income veteran family' means a veteran family whose income does 
    not exceed 50 percent of the median income for an area specified by 
    the Secretary for purposes of this section, as determined by the 
    Secretary in accordance with this paragraph.
        ``(B) The Secretary shall make appropriate adjustments to the 
    income requirement under subparagraph (A) based on family size.
        ``(C) The Secretary may establish an income ceiling higher or 
    lower than 50 percent of the median income for an area if the 
    Secretary determines that such variations are necessary because the 
    area has unusually high or low construction costs, fair market 
    rents (as determined under section 8 of the United States Housing 
    Act of 1937 (42 U.S.C. 1437f)), or family incomes.
        ``(7) The term `veteran family' includes a veteran who is a 
    single person and a family in which the head of household or the 
    spouse of the head of household is a veteran.''.
        (2) Clerical amendment.--The table of sections at the beginning 
    of chapter 20 is amended by inserting after the item relating to 
    section 2043 the following new item:

``2044. Financial assistance for supportive services for very low-income 
          veteran families in permanent housing.''.

    (c) Study of Effectiveness of Permanent Housing Program.--
        (1) In general.--For fiscal years 2009 and 2010, the Secretary 
    shall conduct a study of the effectiveness of the permanent housing 
    program under section 2044 of title 38, United States Code, as 
    added by subsection (b), in meeting the needs of very low-income 
    veteran families, as that term is defined in that section.
        (2) Comparison.--In the study required by paragraph (1), the 
    Secretary shall compare the results of the program referred to in 
    that subsection with other programs of the Department of Veterans 
    Affairs dedicated to the delivery of housing and services to 
    veterans.
        (3) Criteria.--In making the comparison required in paragraph 
    (2), the Secretary shall examine the following:
            (A) The satisfaction of veterans targeted by the programs 
        described in paragraph (2).
            (B) The health status of such veterans.
            (C) The housing provided such veterans under such programs.
            (D) The degree to which such veterans are encouraged to 
        productive activity by such programs.
        (4) Report.--Not later than March 31, 2011, the Secretary shall 
    submit to the Committee on Veterans' Affairs of the Senate and the 
    Committee on Veterans' Affairs of the House of Representatives a 
    report on the results of the study required by paragraph (1).

TITLE VII--AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND MAJOR MEDICAL 
                            FACILITY LEASES

    SEC. 701. AUTHORIZATION FOR FISCAL YEAR 2009 MAJOR MEDICAL FACILITY 
      PROJECTS.
    The Secretary of Veterans Affairs may carry out the following major 
medical facility projects in fiscal year 2009 in the amount specified 
for each project:
        (1) Seismic corrections, Building 2, at the Department of 
    Veterans Affairs Palo Alto Health Care System, Palo Alto Division 
    Palo Alto, California, in an amount not to exceed $54,000,000.
        (2) Construction of a polytrauma healthcare and rehabilitation 
    center at the Department of Veterans Affairs Medical Center, San 
    Antonio, Texas, in an amount not to exceed $66,000,000.
        (3) Seismic corrections, Building 1, at the Department of 
    Veterans Affairs Medical Center, San Juan, Puerto Rico, in an 
    amount not to exceed $225,900,000.
    SEC. 702. MODIFICATION OF AUTHORIZATION AMOUNTS FOR CERTAIN MAJOR 
      MEDICAL FACILITY CONSTRUCTION PROJECTS PREVIOUSLY AUTHORIZED.
    (a) Modification of Major Medical Facility Authorizations.--Section 
801(a) of the Veterans Benefits, Health Care, and Information 
Technology Act of 2006 (Public Law 109-461) is amended--
        (1) in paragraph (1)--
            (A) by striking ``$300,000,000'' and inserting 
        ``$625,000,000''; and
            (B) by striking the second sentence; and
        (2) in paragraph (3), by striking ``$98,000,000'' and inserting 
    ``$568,400,000''.
    (b) Modification of Authorization for Certain Major Medical 
Facility Construction Projects Previously Authorized in Connection With 
Capital Asset Realignment Initiative.--
        (1) Correction of patient privacy deficiencies at the 
    department of veterans affairs medical center, gainesville, 
    florida.--Paragraph (5) of section 802 of the Veterans Benefits, 
    Health Care, and Information Technology Act of 2006 (Public Law 
    109-461) is amended by striking ``$85,200,000'' and inserting 
    ``$136,700,000''.
        (2) Construction of a new medical center facility at the 
    department of veterans affairs medical center, las vegas, nevada.--
    Paragraph (7) of such section is amended by striking 
    ``$406,000,000'' and inserting ``$600,400,000''.
        (3) Construction of a new outpatient clinic, lee county, 
    florida.--Paragraph (8) of such section is amended--
            (A) by striking ``ambulatory'' and all that follows through 
        ``purchase,'' and inserting ``outpatient clinic in''; and
            (B) by striking ``$65,100,000'' and inserting 
        ``$131,800,000''.
        (4) Construction of a new medical center facility, orlando, 
    florida.--Paragraph (11) of such section is amended by striking 
    ``$377,700,000'' and inserting ``$656,800,000''.
        (5) Consolidation of campuses at the university drive and h. 
    john heinz iii divisions, pittsburgh, pennsylvania.--Paragraph (12) 
    of such section is amended by striking ``$189,205,000'' and 
    inserting ``$295,600,000''.
    SEC. 703. AUTHORIZATION OF FISCAL YEAR 2009 MAJOR MEDICAL FACILITY 
      LEASES.
    The Secretary of Veterans Affairs may carry out the following major 
medical facility leases in fiscal year 2009 at the locations specified, 
and in an amount for each lease not to exceed the amount shown for such 
location:
        (1) For an outpatient clinic, Brandon, Florida, $4,326,000.
        (2) For an outpatient clinic, Colorado Springs, Colorado, 
    $10,300,000.
        (3) For an outpatient clinic, Eugene, Oregon, $5,826,000.
        (4) For the expansion of an outpatient clinic, Green Bay, 
    Wisconsin, $5,891,000.
        (5) For an outpatient clinic, Greenville, South Carolina, 
    $3,731,000.
        (6) For an outpatient clinic, Mansfield, Ohio, $2,212,000.
        (7) For an outpatient clinic, Mayaguez, Puerto Rico, 
    $6,276,000.
        (8) For an outpatient clinic, Mesa, Arizona, $5,106,000.
        (9) For interim research space, Palo Alto, California, 
    $8,636,000.
        (10) For the expansion of an outpatient clinic, Savannah, 
    Georgia, $3,168,000.
        (11) For an outpatient clinic, Sun City, Arizona, $2,295,000.
        (12) For a primary care annex, Tampa, Florida, $8,652,000.
        (13) For an outpatient clinic, Peoria, Illinois, $3,600,000.
    SEC. 704. AUTHORIZATION OF APPROPRIATIONS.
    (a) Authorization of Appropriations for Fiscal Year 2009 Major 
Medical Facility Projects.--There is authorized to be appropriated for 
the Secretary of Veterans Affairs for fiscal year 2009 for the 
Construction, Major Projects, account--
        (1) $345,900,000 for the projects authorized in section 701; 
    and
        (2) $1,493,495,000 for the increased amounts authorized for 
    projects whose authorizations are modified by section 702.
    (b) Authorization For Appropriations For Fiscal Year 2009 Major 
Medical Facility Leases.--There is authorized to be appropriated for 
the Secretary of Veterans Affairs for fiscal year 2009 for the Medical 
Facilities account, $70,019,000, for the leases authorized in section 
703.
    SEC. 705. INCREASE IN THRESHOLD FOR MAJOR MEDICAL FACILITY LEASES 
      REQUIRING CONGRESSIONAL APPROVAL.
    Section 8104(a)(3)(B) is amended by striking ``$600,000'' and 
inserting ``$1,000,000''.
    SEC. 706. CONVEYANCE OF CERTAIN NON-FEDERAL LAND BY CITY OF AURORA, 
      COLORADO, TO SECRETARY OF VETERANS AFFAIRS FOR CONSTRUCTION OF 
      VETERANS MEDICAL FACILITY.
    Section 410 of title IV of division I of the Consolidated 
Appropriations Act, 2008 (Public Law 110-161; 121 Stat. 2276) is 
amended to read as follows:
    ``SEC. 410. CONVEYANCE OF CERTAIN NON-FEDERAL LAND.
    ``(a) Definitions.--In this section:
        ``(1) City.--The term `City' means the City of Aurora, 
    Colorado.
        ``(2) Deed.--The term `deed' means the quitclaim deed--
            ``(A) conveyed to the City by the Secretary (acting through 
        the Director of the National Park Service); and
            ``(B) dated May 24, 1999.
        ``(3) Non-federal land.--The term `non-Federal land' means--
            ``(A) parcel I of the former United States Army Garrison 
        Fitzsimons, Adams County, Colorado, as more specifically 
        described in the deed; and
            ``(B) the parcel of land described in the deed.
        ``(4) Secretary.--The term `Secretary' means the Secretary of 
    the Interior.
    ``(b) Duty of Secretary.--To allow the City to convey by donation 
to the United States the non-Federal land to be used by the Secretary 
of Veterans Affairs for the construction of a veterans medical 
facility, not later than 60 days after the date of enactment of this 
section, the Secretary shall execute each instrument that is necessary 
to release all rights, conditions, and restrictions retained by the 
United States in and to the non-Federal land conveyed in the deed.''.
    SEC. 707. REPORT ON FACILITIES ADMINISTRATION.
    Not later than 60 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on the progress of the 
Secretary in complying with section 312A of title 38, United States 
Code.
    SEC. 708. ANNUAL REPORT ON OUTPATIENT CLINICS.
    (a) Annual Report Required.--Subchapter I of chapter 81 is amended 
by adding at the end the following new section:
``Sec. 8119. Annual report on outpatient clinics
    ``(a) Annual Report Required.--The Secretary shall submit to the 
committees an annual report on community-based outpatient clinics and 
other outpatient clinics of the Department. The report shall be 
submitted each year not later than the date on which the budget for the 
next fiscal year is submitted to the Congress under section 1105 of 
title 31.
    ``(b) Contents of Report.--Each report required under subsection 
(a) shall include the following:
        ``(1) A list of each community-based outpatient clinic and 
    other outpatient clinic of the Department, and for each such 
    clinic, the type of clinic, location, size, number of health 
    professionals employed by the clinic, workload, whether the clinic 
    is leased or constructed and operated by the Secretary, and the 
    annual cost of operating the clinic.
        ``(2) A list of community-based outpatient clinics and other 
    outpatient clinics that the Secretary opened during the fiscal year 
    preceding the fiscal year during which the report is submitted and 
    a list of clinics the Secretary proposes opening during the fiscal 
    year during which the report is submitted and the subsequent fiscal 
    year, together with the cost of activating each such clinic and the 
    information required to be provided under paragraph (1) for each 
    such clinic and proposed clinic.
        ``(3) A list of proposed community-based outpatient clinics and 
    other outpatient clinics that are, as of the date of the submission 
    of the report, under review by the National Review Panel and a list 
    of possible locations for future clinics identified in the 
    Department's strategic planning process, including any identified 
    locations in rural and underserved areas.
        ``(4) A prioritized list of sites of care identified by the 
    Secretary that the Secretary could establish without carrying out 
    construction or entering into a lease, including--
            ``(A) any such sites that could be expanded by hiring 
        additional staff or allocating staff to Federal facilities or 
        facilities operating in collaboration with the Federal 
        Government; and
            ``(B) any sites established, or able to be established, 
        under sections 8111 and 8153 of this title.''.
    (b) Deadline for First Annual Report.--The Secretary of Veterans 
Affairs shall submit the first report required under section 8119(a) of 
title 38, United States Code, as added by subsection (a), by not later 
than 90 days after the date of the enactment of this Act.
    (c) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end of the items relating to 
subchapter I the following new item:

``8119. Annual report on outpatient clinics.''.
    SEC. 709. NAME OF DEPARTMENT OF VETERANS AFFAIRS SPINAL CORD INJURY 
      CENTER, TAMPA, FLORIDA.
    The spinal cord injury center located at the James A. Haley 
Department of Veterans Affairs Medical Center in Tampa, Florida, shall 
after the date of the enactment of this Act be known and designated as 
the ``Michael Bilirakis Department of Veterans Affairs Spinal Cord 
Injury Center''. Any reference to such center in any law, regulation, 
map, document, record, or other paper of the United States shall be 
considered to be a reference to the ``Michael Bilirakis Department of 
Veterans Affairs Spinal Cord Injury Center''.

              TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

    SEC. 801. REPEAL OF SUNSET ON INCLUSION OF NONINSTITUTIONAL 
      EXTENDED CARE SERVICES IN DEFINITION OF MEDICAL SERVICES.
    Section 1701 is amended--
        (1) by striking paragraph (10); and
        (2) in paragraph (6)--
            (A) by redesignating subparagraphs (E) and (F) as 
        subparagraphs (F) and (G), respectively; and
            (B) by inserting after subparagraph (D) the following new 
        subparagraph (E):
            ``(E) Noninstitutional extended care services, including 
        alternatives to institutional extended care that the Secretary 
        may furnish directly, by contract, or through provision of case 
        management by another provider or payer.''.
    SEC. 802. EXTENSION OF RECOVERY AUDIT AUTHORITY.
    Section 1703(d)(4) is amended by striking ``September 30, 2008'' 
and inserting ``September 30, 2013''.
    SEC. 803. PERMANENT AUTHORITY FOR PROVISION OF HOSPITAL CARE, 
      MEDICAL SERVICES, AND NURSING HOME CARE TO VETERANS WHO 
      PARTICIPATED IN CERTAIN CHEMICAL AND BIOLOGICAL TESTING CONDUCTED 
      BY THE DEPARTMENT OF DEFENSE.
    (a) Permanent Authority.--Subsection (e)(3) of section 1710 is 
amended--
        (1) in subparagraph (B), by inserting ``and'' after the 
    semicolon;
        (2) in subparagraph (C), by striking ``; and'' and inserting a 
    period; and
        (3) by striking subparagraph (D).
    (b) Conforming Amendment.--Subsection (e)(1)(E) of such section is 
amended by striking ``paragraphs (2) and (3)'' and inserting 
``paragraph (2)''.
    SEC. 804. EXTENSION OF EXPIRING COLLECTIONS AUTHORITIES.
    (a) Health Care Copayments.--Section 1710(f)(2)(B) is amended by 
striking ``September 30, 2008'' and inserting ``September 30, 2010''.
    (b) Medical Care Cost Recovery.--Section 1729(a)(2)(E) is amended 
by striking ``October 1, 2008'' and inserting ``October 1, 2010''.
    SEC. 805. EXTENSION OF NURSING HOME CARE.
    Section 1710A(d) is amended by striking ``December 31, 2008'' and 
inserting ``December 31, 2013''.
    SEC. 806. PERMANENT AUTHORITY TO ESTABLISH RESEARCH CORPORATIONS.
    (a) Repeal.--Chapter 73 is amended by striking section 7368.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by striking the item relating to section 7368.
    SEC. 807. EXTENSION OF REQUIREMENT TO SUBMIT ANNUAL REPORT ON THE 
      COMMITTEE ON CARE OF SEVERELY CHRONICALLY MENTALLY ILL VETERANS.
    Section 7321(d)(2) is amended by striking ``through 2008'' and 
inserting ``through 2012''.
    SEC. 808. PERMANENT REQUIREMENT FOR BIANNUAL REPORT ON WOMEN'S 
      ADVISORY COMMITTEE.
    Section 542(c)(1) is amended by striking ``through 2008''.
    SEC. 809. EXTENSION OF PILOT PROGRAM ON IMPROVEMENT OF CAREGIVER 
      ASSISTANCE SERVICES.
    Section 214 of the Veterans Benefits, Health Care, and Information 
Technology Act of 2006 (Public Law 109-461; 38 U.S.C. 1710B note) is 
amended--
        (1) in subsection (b), by striking ``two-year period'' and 
    inserting ``three-year period''; and
        (2) in subsection (d), by striking ``fiscal years 2007 and 
    2008'' and inserting ``fiscal years 2007 through 2009''.

                        TITLE IX--OTHER MATTERS

    SEC. 901. TECHNICAL AMENDMENTS.
    (a) Title 38.--Title 38, United States Code, is amended--
        (1) in section 1712A--
            (A) by striking subsection (g);
            (B) by redesignating subsections (d) through (i) as 
        subsections (c) through (f), respectively; and
            (C) in subsection (f), as so redesignated, by striking 
        ``(including a Resource Center designated under subsection 
        (h)(3)(A) of this section)'';
        (2) in section 2065(b)(3)(C), by striking ``)'';
        (3) in the table of sections at the beginning of chapter 36, by 
    striking the item relating to section 3684A and inserting the 
    following new item:

``3684A. Procedures relating to computer matching program.'';

        (4) in section 4110(c)(1), by striking ``15'' and inserting 
    ``16'';
        (5) in the table of sections at the beginning of chapter 51, by 
    striking the item relating to section 5121 and inserting the 
    following new item:

``5121. Payment of certain accrued benefits upon death of a 
          beneficiary.'';

        (6) in section 7458(b)(2), by striking ``pro rated'' and 
    inserting ``pro-rated'';
        (7) in section 8117(a)(1), by striking ``such such'' and 
    inserting ``such''; and
        (8) in each of sections 1708(d), 7314(f), 7320(j)(2), 
    7325(i)(2), and 7328(i)(2), by striking ``medical care account'' 
    and inserting ``medical services account''.
    (b) Veterans Benefits, Health Care, and Information Technology Act 
of 2006.--Section 807(e) of the Veterans Benefits, Health Care, and 
Information Technology Act of 2006 (Public Law 109-461) is amended by 
striking ``Medical Care'' each place it appears and inserting ``Medical 
Facilities''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.