[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2162 Engrossed in Senate (ES)]
110th CONGRESS
2d Session
S. 2162
_______________________________________________________________________
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--HEALTH CARE MATTERS
Sec. 101. Veterans beneficiary travel program.
Sec. 102. Mandatory reimbursement of veterans receiving emergency
treatment in non-Department of Veterans
Affairs facilities until transfer to
Department facilities.
Sec. 103. Epilepsy centers of excellence.
Sec. 104. Establishment of qualifications for peer specialist
appointees.
TITLE II--PAIN CARE
Sec. 201. Comprehensive policy on pain management.
TITLE III--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE
Sec. 301. Findings on substance use disorders and mental health.
Sec. 302. Expansion of substance use disorder treatment services
provided by Department of Veterans Affairs.
Sec. 303. Care for veterans with mental health and substance use
disorders.
Sec. 304. National centers of excellence on post-traumatic stress
disorder and substance use disorders.
Sec. 305. Report on residential mental health care facilities of the
Veterans Health Administration.
Sec. 306. Tribute to Justin Bailey.
TITLE IV--MENTAL HEALTH ACCESSIBILITY ENHANCEMENTS
Sec. 401. Pilot program on peer outreach and support for veterans and
use of community mental health centers and
Indian Health Service facilities.
TITLE V--MENTAL HEALTH RESEARCH
Sec. 501. Research program on comorbid post-traumatic stress disorder
and substance use disorders.
Sec. 502. Extension of authorization for Special Committee on Post-
Traumatic Stress Disorder.
TITLE VI--ASSISTANCE FOR FAMILIES OF VETERANS
Sec. 601. Clarification of authority of Secretary of Veterans Affairs
to provide mental health services to
families of veterans.
Sec. 602. Pilot program on provision of readjustment and transition
assistance to veterans and their families
in cooperation with Vet Centers.
TITLE VII--HOMELESS VETERANS MATTERS
Sec. 701. Repeal of authority for adjustments to per diem payments to
homeless veterans service centers for
receipt of other sources of income.
Sec. 702. Expansion and extension of authority for program of referral
and counseling services for at-risk
veterans transitioning from certain
institutions.
Sec. 703. Availability of grant funds to service centers for personnel.
Sec. 704. Permanent authority for domiciliary services for homeless
veterans and enhancement of capacity of
domiciliary care programs for female
veterans.
Sec. 705. Financial assistance for supportive services for very low-
income veteran families in permanent
housing.
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--HEALTH CARE MATTERS
SEC. 101. 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. 102. 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. 103. 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 this section, the Secretary shall, upon
the recommendation of the Under Secretary for Health, designate not
less than six Department health-care facilities as the locations for
epilepsy centers of excellence.
``(2) Subject to the availability of appropriations for such
purpose, the Secretary shall establish and operate epilepsy centers of
excellence at the locations designated pursuant to paragraph (1).
``(b) Designation of Facilities.--(1) The Secretary may not
designate a Department health-care facility as a location for an
epilepsy center of excellence under subsection (a)(1) 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.
``(2) In choosing from among the facilities meeting the
requirements of paragraph (1), the Secretary shall also consider
appropriate geographic distribution when designating the epilepsy
centers of excellence under subsection (a)(1).
``(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 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 Department 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 coordinate (as part of an
integrated national system) education, clinical care, and
research activities within all facilities with such centers.
``(6) The capability to develop jointly a 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. Such consortium should include a designated
epilepsy referral clinic in each Veterans Integrated Service
Network.
``(7) 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.
``(8) The capability to assist in the expansion of the
Department telehealth program to develop, transmit, monitor,
and review neurological diagnostic tests.
``(9) 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 regular evaluations of the epilepsy
centers of excellence to ensure compliance with the
requirements of this section.
``(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. 104. 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).''.
TITLE II--PAIN CARE
SEC. 201. COMPREHENSIVE POLICY ON PAIN MANAGEMENT.
(a) Comprehensive Policy Required.--Not later than October 1, 2008,
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 other
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) A 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 III--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE
SEC. 301. 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, with
similar rates of acknowledged problems with alcohol use among
members of the National Guard.
(2) The effects of substance abuse 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 abuse treatment services decreased 18 percent during
that time. No comparable decrease in the national rate of
substance abuse 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 the Government Accountability Office, the
Department of Veterans Affairs significantly reduced its
substance use disorder treatment and rehabilitation services
between 1996 and 2006, and has made little progress since in
restoring these services to their pre-1996 levels.
SEC. 302. 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) Short term motivational counseling services.
(2) Intensive outpatient or residential care services.
(3) Relapse prevention services.
(4) Ongoing aftercare and outpatient counseling services.
(5) Opiate substitution therapy services.
(6) Pharmacological treatments aimed at reducing craving
for drugs and alcohol.
(7) Detoxification and stabilization services.
(8) Such other services as the Secretary considers
appropriate.
(b) Provision of Services.--The services and treatments described
in subsection (a) may be provided to a veteran described in such
subsection--
(1) at Department of Veterans Affairs medical centers or
clinics;
(2) by referral to other facilities of the Department that
are accessible to such veteran; or
(3) 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 treatments as are medically appropriate.
(d) Report.--Not later than one year after the date of the
enactment of this Act, 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 setting forth, for each
medical facility of the Department, the availability of the following:
(1) Medically supervised withdrawal management.
(2) Programs for treatment of alcohol and other substance
use disorders that are--
(A) integrated with primary health care services;
or
(B) available as specialty substance use disorder
services.
(3) Specialty programs for the treatment of post-traumatic
stress disorder.
(4) Programs to treat veterans who are diagnosed with both
a substance use disorder and a mental health disorder.
SEC. 303. 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. 304. NATIONAL CENTERS OF EXCELLENCE ON POST-TRAUMATIC STRESS
DISORDER AND SUBSTANCE USE DISORDERS.
(a) In General.--Subchapter II of chapter 73, as amended by
sections 210 and 303 of this Act, is further amended by adding at the
end the following new section:
``Sec. 7330C. National centers of excellence on post-traumatic stress
disorder and substance use disorders
``(a) Establishment of Centers.--(1) The Secretary shall establish
not less than six national centers of excellence on post-traumatic
stress disorder and substance use disorders.
``(2) The purpose of the centers established under this section is
to serve as Department facilities that provide comprehensive inpatient
or residential treatment and recovery services for veterans diagnosed
with both post-traumatic stress disorder and a substance use disorder.
``(b) Location.--Each center established in accordance with
subsection (a) shall be located at a medical center of the Department
that--
``(1) provides specialized care for veterans with post-
traumatic stress disorder and a substance use disorder; and
``(2) is geographically situated in an area with a high
number of veterans that have been diagnosed with both post-
traumatic stress disorder and substance use disorder.
``(c) Process of Referral and Transition to Step Down Diagnosis
Rehabilitation Treatment Programs.--The Secretary shall establish a
process to refer and aid the transition of veterans from the national
centers of excellence on post-traumatic stress disorder and substance
use disorders established pursuant to subsection (a) to programs that
provide step down rehabilitation treatment for individuals with post-
traumatic stress disorder and substance use disorders.
``(d) Collaboration With the National Center for Post-Traumatic
Stress Disorder.--The centers established under this section shall
collaborate in the research of the National Center for Post-Traumatic
Stress Disorder.''.
(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:
``7330C. National centers of excellence on post-traumatic stress
disorder and substance use disorders.''.
SEC. 305. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES OF THE
VETERANS HEALTH ADMINISTRATION.
(a) Reviews.--The Secretary of Veterans Affairs shall, acting
through the Office of Mental Health Services of the Department of
Veterans Affairs--
(1) not later than six months after the date of the
enactment of this Act, conduct a review of all residential
mental health care facilities, including domiciliary
facilities, of the Veterans Health Administration; and
(2) not later than two years after the date of the
completion of the review required by paragraph (1), conduct a
follow-up review of such facilities to evaluate any
improvements made or problems remaining since the review under
paragraph (1) was completed.
(b) Report.--Not later than 90 days after the completion of the
review required by subsection (a)(1), 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 such
review. The report shall include the following:
(1) A description of the availability of care in
residential mental health care facilities in each Veterans
Integrated Service Network (VISN).
(2) An assessment of the supervision and support provided
in the residential mental health care facilities of the
Veterans Health Administration.
(3) The ratio of staff members at each residential mental
health care facility to patients at such facility.
(4) An assessment of the appropriateness of rules and
procedures for the prescription and administration of
medications to patients in such residential mental health care
facilities.
(5) A description of the protocols at each residential
mental health care facility for handling missed appointments.
(6) Any recommendations the Secretary considers appropriate
for improvements to such residential mental health care
facilities and the care provided in such facilities.
SEC. 306. 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.
TITLE IV--MENTAL HEALTH ACCESSIBILITY ENHANCEMENTS
SEC. 401. 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 or other
entities under contracts or other agreements for the provision
of such services that are entered into for purposes of the
pilot program.
(2) Through the Indian Health Service pursuant to a
memorandum of understanding entered into by the Secretary of
Veterans Affairs and the Secretary of Health and Human 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 two Veterans Integrated Service
Networks (VISN).
(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
are available 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 V--MENTAL HEALTH RESEARCH
SEC. 501. RESEARCH PROGRAM ON COMORBID POST-TRAUMATIC STRESS DISORDER
AND SUBSTANCE USE DISORDERS.
(a) Program Required.--The Secretary of Veterans Affairs shall
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 and to facilitate cumulative clinical
progress of such veterans over time.
(d) Funding.--
(1) Authorization of appropriations.--There is authorized
to be appropriated for the Department of Veterans Affairs for
each of fiscal years 2008 through 2011, $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. 502. 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 VI--ASSISTANCE FOR FAMILIES OF VETERANS
SEC. 601. 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 subsections (a) and (b) of section 1782, by
inserting ``marriage and family counseling,'' after
``professional counseling,''.
(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. 602. 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) Duration of Pilot Program.--The pilot program shall be carried
out during the three-year period beginning on the date of the enactment
of this Act, and may be carried out for additional one-year periods
thereafter.
(e) Location of Pilot Program.--
(1) In general.--The Secretary of Veterans Affairs 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.
(f) Participation of Centers.--A center described in subsection (a)
that is designated under subsection (e) 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.
(g) Additional Support.--In carrying out the pilot program, the
Secretary of Veterans Affairs 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.
(h) Report on Pilot Program.--
(1) Report required.--Not later than six months after the
date of the conclusion of the pilot program, 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.
(i) 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 VII--HOMELESS VETERANS MATTERS
SEC. 701. REPEAL OF AUTHORITY FOR ADJUSTMENTS TO PER DIEM PAYMENTS TO
HOMELESS VETERANS SERVICE CENTERS FOR RECEIPT OF OTHER
SOURCES OF INCOME.
Section 2012(a)(2) is amended--
(1) by striking subparagraphs (B) and (D);
(2) in subparagraph (A)--
(A) by striking ``The rate'' and inserting ``Except
as provided in subparagraph (B), the rate'';
(B) by striking ``adjusted by the Secretary under
subparagraph (B)''; and
(C) by designating the second sentence as
subparagraph (B) and indenting the margin of such
subparagraph, as so designated, two ems from the left
margin; and
(3) in subparagraph (C), by striking ``to make the
adjustment under subparagraph (B)''.
SEC. 702. 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. 703. AVAILABILITY OF GRANT FUNDS TO SERVICE CENTERS FOR PERSONNEL.
Section 2011 is amended by adding at the end the following new
subsection:
``(i) Availability of Grant Funds for Service Center Personnel.--A
grant under this section for a service center for homeless veterans may
be used to provide funding for staff as necessary in order for the
center to meet the service availability requirements of subsection
(g)(1).''.
SEC. 704. 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. 705. 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 of title 38,
United States Code, 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 2008 through 2010 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 of such title 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).
Passed the Senate June 3, 2008.
Attest:
Secretary.
110th CONGRESS
2d Session
S. 2162
_______________________________________________________________________
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.