[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1237 Reported in Senate (RS)]

                                                       Calendar No. 360
111th CONGRESS
  2d Session
                                S. 1237

                          [Report No. 111-175]

To amend title 38, United States Code, to expand the grant program for 
homeless veterans with special needs to include male homeless veterans 
      with minor dependents and to establish a grant program for 
  reintegration of homeless women veterans and homeless veterans with 
                   children, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             June 11, 2009

   Mrs. Murray (for herself, Mr. Johnson, Mr. Reed, Mr. Merkley, Mr. 
Specter, Mr. Baucus, and Mr. Byrd) introduced the following bill; which 
   was read twice and referred to the Committee on Veterans' Affairs

                             April 29, 2010

 Reported by Mr. Akaka, with an amendment and an amendment to the title
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
To amend title 38, United States Code, to expand the grant program for 
homeless veterans with special needs to include male homeless veterans 
      with minor dependents and to establish a grant program for 
  reintegration of homeless women veterans and homeless veterans with 
                   children, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Homeless Women Veterans and 
Homeless Veterans with Children Act of 2009''.</DELETED>

<DELETED>SEC. 2. EXPANSION OF GRANT PROGRAM FOR HOMELESS VETERANS WITH 
              SPECIAL NEEDS.</DELETED>

<DELETED>    (a) Inclusion Under Grant Program for Homeless Veterans 
With Special Needs of Entities Eligible for Comprehensive Service 
Program Grants and Per Diem Payments for Services to Homeless 
Veterans.--Subsection (a) of section 2061 of title 38, United States 
Code, is amended--</DELETED>
        <DELETED>    (1) by striking ``to grant and per diem 
        providers'' and inserting ``to entities eligible for grants and 
        per diem payments under sections 2011 and 2012 of this title''; 
        and</DELETED>
        <DELETED>    (2) by striking ``by those facilities and 
        providers'' and inserting ``by those facilities and 
        entities''.</DELETED>
<DELETED>    (b) Inclusion of Male Homeless Veterans With Minor 
Dependents.--Subsection (b) of such section is amended--</DELETED>
        <DELETED>    (1) in paragraph (1), by striking ``, including 
        women who have care of minor dependents'';</DELETED>
        <DELETED>    (2) in paragraph (3), by striking 
        ``or'';</DELETED>
        <DELETED>    (3) in paragraph (4), by striking the period at 
        the end and inserting ``; or''; and</DELETED>
        <DELETED>    (4) by adding at the end the following new 
        paragraph:</DELETED>
        <DELETED>    ``(5) veterans who have care of minor 
        dependents.''.</DELETED>
<DELETED>    (c) Authorization of Provision of Services to 
Dependents.--Such section is further amended--</DELETED>
        <DELETED>    (1) by redesignating subsection (c) as subsection 
        (d); and</DELETED>
        <DELETED>    (2) by inserting after subsection (b) the 
        following new subsection (c):</DELETED>
<DELETED>    ``(c) Provision of Services to Dependents.--A recipient of 
a grant under subsection (a) may use such grant to provide services 
directly to a dependent of a homeless veteran with special needs 
described in subsection (b) who is under the care of such homeless 
veteran while such homeless veteran receives services from the grant 
recipient under this section.''.</DELETED>

<DELETED>SEC. 3. GRANT PROGRAM FOR REINTEGRATION OF HOMELESS WOMEN 
              VETERANS AND HOMELESS VETERANS WITH CHILDREN.</DELETED>

<DELETED>    (a) In General.--Chapter 20 of title 38, United States 
Code, is amended by inserting after section 2021 the following new 
section:</DELETED>
<DELETED>``Sec. 2021A. Grant program for reintegration of homeless 
              women veterans and homeless veterans with 
              children</DELETED>
<DELETED>    ``(a) Grants.--Subject to the availability of 
appropriations provided for such purpose, the Secretary of Labor shall 
award grants to eligible programs and facilities to provide the 
services described in subsection (c) to expedite the reintegration into 
the labor force of the following:</DELETED>
        <DELETED>    ``(1) Homeless women veterans.</DELETED>
        <DELETED>    ``(2) Homeless veterans with children.</DELETED>
<DELETED>    ``(b) Eligible Programs and Facilities.--An eligible 
program or facility for purposes of this section is a program or 
facility that provides dedicated services for homeless women veterans 
or homeless veterans with children.</DELETED>
<DELETED>    ``(c) Services.--The services described in this subsection 
are the following:</DELETED>
        <DELETED>    ``(1) Job training.</DELETED>
        <DELETED>    ``(2) Counseling.</DELETED>
        <DELETED>    ``(3) Job placement services, including job 
        readiness, literacy, and skills training.</DELETED>
        <DELETED>    ``(4) Child care.</DELETED>
<DELETED>    ``(d) Monitoring of Use of Funds.--The Secretary of Labor 
shall monitor and evaluate the use of amounts granted under this 
section. In monitoring and evaluating the use of such amounts, the 
Secretary shall collect from grantees such information as the Secretary 
considers appropriate, including data on the results or outcomes of the 
services provided to each homeless veteran under this 
section.</DELETED>
<DELETED>    ``(e) Administration Through Assistant Secretary for 
Veterans' Employment and Training.--The Secretary of Labor shall carry 
out this section through the Assistant Secretary for Veterans' 
Employment and Training.</DELETED>
<DELETED>    ``(f) Biennial Report to Congress.--The Secretary of Labor 
shall include as part of the report required by section 2021(d) of this 
title an evaluation of the grant program under this section. The 
information included in such report under this subsection shall 
include--</DELETED>
        <DELETED>    ``(1) an evaluation of services furnished to 
        veterans under this section; and</DELETED>
        <DELETED>    ``(2) an analysis of the information collected 
        under subsection (d).</DELETED>
<DELETED>    ``(g) Authorization of Appropriations.--(1) There is 
authorized to be appropriated to carry out this section $10,000,000 for 
each of fiscal years 2010 through 2014.</DELETED>
<DELETED>    ``(2) The amount authorized to be appropriated by 
paragraph (1) is in addition to any amounts authorized to be 
appropriated by section 2021(e) of this title.</DELETED>
<DELETED>    ``(3) Funds appropriated to carry out this section shall 
remain available until expended. Funds obligated in any fiscal year to 
carry out this section may be expended in that fiscal year and the 
succeeding fiscal year.''.</DELETED>
<DELETED>    (b) 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 2021 the following new item:</DELETED>

<DELETED>``2021A. Grant program for reintegration of homeless women 
                            veterans and homeless veterans with 
                            children.''.

</DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Homeless Veterans 
and Other Veterans Health Care Authorities Act of 2010''.
    (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--HOMELESS VETERANS MATTERS

Sec. 101. Enhancement of comprehensive service programs.
Sec. 102. Grant program for workforce reintegration of homeless women 
                            veterans and homeless veterans with 
                            children.
Sec. 103. Expansion of grant program for homeless veterans with special 
                            needs.
Sec. 104. Program on prevention of veteran homelessness.
Sec. 105. Homeless Veterans Management Information System.
Sec. 106. Rental assistance for veterans through Department of Housing 
                            and Urban Development.
Sec. 107. Special Assistant for Veterans Affairs in Office of Secretary 
                            of Housing and Urban Development.
Sec. 108. Plan to end veteran homelessness.

                  TITLE II--TOXIC SUBSTANCES EXPOSURE

Sec. 201. Extension of eligibility for health care for veterans with 
                            disabilities who served in Persian Gulf War 
                            notwithstanding lack of evidence to 
                            conclude such disabilities are associated 
                            with such service.

                     TITLE III--HEALTH CARE MATTERS

Sec. 301. Increase in number of authorized Assistant Secretaries and 
                            Deputy Assistant Secretaries.
Sec. 302. Establishment of Director of Physician Assistant Services in 
                            Veterans Health Administration.
Sec. 303. Department of Veterans Affairs Medical Center Quality Report 
                            Card Initiative.
Sec. 304. Report on pay-for-performance compensation under health care 
                            services contracts.
Sec. 305. Expansion of State home care for parents of veterans who died 
                            while serving in the Armed Forces.
Sec. 306. Automatic enrollment of eligible demobilizing members of the 
                            National Guard and Reserve in health care 
                            and dental care programs of the Department 
                            of Veterans Affairs.
Sec. 307. Provision of chiropractic services to veterans enrolled in 
                            health care system of Department of 
                            Veterans Affairs.
Sec. 308. Name of Department of Veterans Affairs outpatient clinic, 
                            Alexandria, Minnesota.

                        TITLE IV--OTHER MATTERS

Sec. 401. Funding.

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--HOMELESS VETERANS MATTERS

SEC. 101. ENHANCEMENT OF COMPREHENSIVE SERVICE PROGRAMS.

    (a) Enhancement of Grants.--Section 2011 is amended--
            (1) in subsection (b)(1)(A), by striking ``expansion, 
        remodeling, or alteration of existing facilities, or 
        acquisition of facilities,'' and inserting ``new construction 
        of facilities, expansion, remodeling, or alteration of existing 
        facilities, or acquisition of facilities''; and
            (2) in subsection (c)--
                    (A) in the first sentence, by striking ``A grant'' 
                and inserting ``(1) A grant'';
                    (B) in the second sentence of paragraph (1), as 
                designated by subparagraph (A), by striking ``The 
                amount'' and inserting the following:
    ``(2) The amount''; and
                    (C) by adding at the end the following new 
                paragraph:
    ``(3)(A) The Secretary may not deny an application from an entity 
that seeks a grant under this section to carry out a project described 
in subsection (b)(1)(A) solely on the basis that the entity proposes to 
use funding from other private or public sources, if the entity 
demonstrates that a private nonprofit organization will provide 
oversight and site control for the project.
    ``(B) In this paragraph, the term `private nonprofit organization' 
means the following:
            ``(i) An incorporated private institution, organization, or 
        foundation--
                    ``(I) that has received, or has temporary clearance 
                to receive, tax-exempt status under paragraph (2), (3), 
                or (19) of section 501(c) of the Internal Revenue Code 
                of 1986;
                    ``(II) for which no part of the net earnings of the 
                institution, organization, or foundation inures to the 
                benefit of any member, founder, or contributor of the 
                institution, organization, or foundation; and
                    ``(III) that the Secretary determines is 
                financially responsible.
            ``(ii) A for-profit limited partnership or limited 
        liability company, the sole general partner or manager of which 
        is an organization that is described by subclauses (I) through 
        (III) of clause (i).
            ``(iii) A corporation wholly owned and controlled by an 
        organization that is described by subclauses (I) through (III) 
        of clause (i).''.
    (b) Grant and Per Diem Payments.--
            (1) Study and development of payment method.--Not later 
        than one year after the date of the enactment of this Act, the 
        Secretary of Veterans Affairs shall--
                    (A) complete a study of all matters relating to the 
                method used by the Secretary to make per diem payments 
                under section 2012(a) of title 38, United States Code; 
                and
                    (B) develop an improved method for adequately 
                reimbursing recipients of grants under section 2011 of 
                such title for services furnished to homeless veterans.
            (2) Consideration.--In developing the method required by 
        paragraph (1)(B), the Secretary may consider payments and 
        grants received by recipients of grants described in such 
        paragraph from other departments and agencies of Federal and 
        local governments and from private entities.
            (3) Report.--Not later than one year after the date of the 
        enactment of this Act, the Secretary shall submit to Congress a 
        report on--
                    (A) the findings of the Secretary with respect to 
                the study required by subparagraph (A) of paragraph 
                (1);
                    (B) the method developed under subparagraph (B) of 
                such paragraph; and
                    (C) any recommendations of the Secretary for 
                revising the method described in subparagraph (A) of 
                such paragraph and any legislative action the Secretary 
                considers necessary to implement such method.
    (c) Authorization of Appropriations.--Section 2013 is amended by 
striking ``subchapter $150,000,000'' and all that follows through the 
period and inserting the following: ``subchapter--
            ``(1) $150,000,000 for each of fiscal years 2007 through 
        2009;
            ``(2) $200,000,000 for fiscal year 2010; and
            ``(3) such sums as may be necessary for each of fiscal 
        years 2011 through 2014.''.
    (d) Minimum Funding in Rural Areas.--Section 2011 is amended by 
adding at the end the following new subsection:
    ``(i) Minimum Funding in Rural Areas.--The Secretary shall ensure 
that not less than five percent of the aggregate of the grant amounts 
awarded under this section in each fiscal year is awarded to eligible 
entities located in rural areas.''.

SEC. 102. GRANT PROGRAM FOR WORKFORCE REINTEGRATION OF HOMELESS WOMEN 
              VETERANS AND HOMELESS VETERANS WITH CHILDREN.

    (a) In General.--Subchapter III of chapter 20 is amended by 
inserting after section 2021 the following new section:
``Sec. 2021A. Grant program for reintegration of homeless women 
              veterans and homeless veterans with children
    ``(a) Grants.--Subject to the availability of appropriations for 
such purpose, the Secretary of Labor shall award grants to eligible 
programs and facilities to provide the services described in subsection 
(c) to expedite the reintegration into the labor force of the 
following:
            ``(1) Homeless women veterans.
            ``(2) Homeless veterans with children.
    ``(b) Eligible Programs and Facilities.--A program or facility is 
an eligible program or facility for purposes of this section if the 
program or facility provides dedicated services for homeless women 
veterans or homeless veterans with children.
    ``(c) Services.--The services described in this subsection are the 
following:
            ``(1) Job training.
            ``(2) Counseling.
            ``(3) Job placement services, including job readiness, 
        literacy, and skills training.
            ``(4) Child care.
    ``(d) Minimum.--The Secretary shall ensure that not less than five 
percent of the aggregate of the grant amounts awarded under this 
section in each fiscal year is awarded to eligible programs and 
facilities located in rural areas.
    ``(e) Monitoring of Use of Funds.--The Secretary of Labor shall 
monitor and evaluate the use of amounts granted under this section. In 
monitoring and evaluating the use of such amounts, the Secretary shall 
collect from grantees such information as the Secretary considers 
appropriate, including data on the results or outcomes of the services 
provided to each homeless veteran under this section.
    ``(f) Administration.--The Secretary of Labor shall carry out this 
section through the Assistant Secretary of Labor for Veterans' 
Employment and Training.
    ``(g) Biennial Report to Congress.--The Secretary of Labor shall 
include as part of the report required by section 2021(d) of this title 
an evaluation of the grant program under this section. The information 
included in such report under this subsection shall include--
            ``(1) an evaluation of services furnished to veterans under 
        this section; and
            ``(2) an analysis of the information collected under 
        subsection (d).
    ``(h) Authorization of Appropriations.--(1) There is authorized to 
be appropriated to carry out this section $10,000,000 for each of 
fiscal years 2010 through 2014.
    ``(2) The amount authorized to be appropriated by paragraph (1) is 
in addition to any amounts authorized to be appropriated by section 
2021(e) of this title.
    ``(3) Funds appropriated to carry out this section shall remain 
available until expended. Funds obligated in any fiscal year to carry 
out this section may be expended in that fiscal year and the succeeding 
fiscal year.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 20 is amended by inserting after the item relating to section 
2021 the following new item:

``2021A. Grant program for reintegration of homeless women veterans and 
                            homeless veterans with children.''.

SEC. 103. EXPANSION OF GRANT PROGRAM FOR HOMELESS VETERANS WITH SPECIAL 
              NEEDS.

    (a) Inclusion of Entities Eligible for Comprehensive Service 
Program Grants and Per Diem Payments for Services to Homeless 
Veterans.--Subsection (a) of section 2061 is amended--
            (1) by striking ``to grant and per diem providers'' and 
        inserting ``to entities eligible for grants and per diem 
        payments under sections 2011 and 2012 of this title''; and
            (2) by striking ``by those facilities and providers'' and 
        inserting ``by those facilities and entities''.
    (b) Inclusion of Male Homeless Veterans With Minor Dependents.--
Subsection (b) of such section is amended--
            (1) in paragraph (1), by striking ``, including women who 
        have care of minor dependents'';
            (2) in paragraph (3), by striking ``or'';
            (3) in paragraph (4), by striking the period at the end and 
        inserting ``; or''; and
            (4) by adding at the end the following new paragraph:
            ``(5) individuals who have care of minor dependents.''.
    (c) Authorization of Provision of Services to Dependents.--Such 
section is further amended--
            (1) by redesignating subsection (c) as subsection (d); and
            (2) by inserting after subsection (b) the following new 
        subsection (c):
    ``(c) Provision of Services to Dependents.--A recipient of a grant 
under subsection (a) may use amounts under the grant to provide 
services directly to a dependent of a homeless veteran with special 
needs who is under the care of such homeless veteran while such 
homeless veteran receives services from the grant recipient under this 
section.''.

SEC. 104. PROGRAM ON PREVENTION OF VETERAN HOMELESSNESS.

    (a) Program on Prevention of Veteran Homelessness.--
            (1) In general.--Subchapter VII of chapter 20 is amended by 
        adding at the end the following new section:
``Sec. 2067. Prevention of veteran homelessness
    ``(a) Prevention of Veteran Homelessness.--Not later than 180 days 
after the date of the enactment of this section, the Secretary shall 
establish a program to prevent veteran homelessness by--
            ``(1) identifying in a timely fashion any veteran who is 
        homeless or at imminent risk of becoming homeless; and
            ``(2) providing, directly or in conjunction with an 
        existing program, assistance to veterans identified under 
        paragraph (1).
    ``(b) Types of Assistance.--The assistance provided under 
subsection (a)(2) may include the following:
            ``(1) The provision of short-term or medium-term rental 
        assistance.
            ``(2) Housing relocation and stabilization services, 
        including housing search, mediation, and outreach to property 
        owners.
            ``(3) Services to resolve personal credit issues that have 
        led to negative credit reports.
            ``(4) Assistance with paying security or utility deposits 
        and utility payments.
            ``(5) Assistance with covering costs associated with 
        moving.
            ``(6) A referral to a program of another department or 
        agency of the Federal Government.
            ``(7) Such other activities as the Secretary considers 
        appropriate to prevent veterans homelessness.
    ``(c) No Duplication of Services.--The Secretary may provide 
assistance under subsection (a)(2) to a veteran receiving supportive 
services from an eligible entity receiving financial assistance under 
section 2044 of this title only to the extent that the assistance 
provided under subsection (a)(2) does not duplicate the supportive 
services provided to such veteran by such entity or by any other 
Federal, State, or local entity.
    ``(d) Protection From Abuse.--To protect the program established 
under subsection (a) from abuse, the Secretary may establish a limit on 
the number of times that a particular veteran may receive assistance 
under the program in a fiscal year.
    ``(e) Staffing.--The Secretary shall assign such employees at such 
locations as the Secretary considers necessary to carry out this 
section.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $50,000,000 for each of fiscal 
years 2010 through 2014.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 20 of such title is amended by adding at 
        the end the following new item:

``2067. Prevention of veteran homelessness.''.
    (b) Responsibilities of Homeless Veterans Program Coordinators.--
Section 2003(a) is amended--
            (1) in paragraph (3), by striking ``The housing'' and 
        inserting ``Any housing'';
            (2) by redesignating paragraph (7) as paragraph (8); and
            (3) by inserting after paragraph (6) the following new 
        paragraph (7):
            ``(7) The program under section 2067 of this title.''.
    (c) Report.--
            (1) In general.--Not later than 180 days after the date of 
        the establishment of the program required by section 2067 of 
        title 38, United States Code, as added by subsection (a), the 
        Secretary of Veterans Affairs shall submit to Congress a report 
        on the operation of such program.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) The types and sources of assistance provided 
                under such section 2067.
                    (B) An assessment of the effectiveness of the 
                services provided under such section.

SEC. 105. HOMELESS VETERANS MANAGEMENT INFORMATION SYSTEM.

    (a) In General.--Subchapter VII of chapter 20, as amended by 
section 104, is further amended by adding at the end the following new 
section:
``Sec. 2068. Homeless Veterans Management Information System
    ``(a) Method for Data Collection and Aggregation.--(1) Not later 
than one year after the date of the enactment of this section, the 
Secretary shall, in consultation with the Special Assistant for 
Veterans Affairs of the Department of Housing and Urban Development and 
the United States Interagency Council on Homelessness established under 
section 201 of the McKinney-Vento Homeless Assistance Act (42 U.S.C. 
11311), establish a method for the collection and aggregation of data 
on homeless veterans participating in programs of the Department of 
Veterans Affairs and the Department of Housing and Urban Development, 
including the following with respect to such veterans:
            ``(A) Age, race, sex, disability status, marital status, 
        income, employment history, and whether the veteran is a 
        parent.
            ``(B) If the veteran received assistance for housing, the 
        number of days that the veteran resided in such housing and the 
        type of such housing.
            ``(C) If the veteran is no longer participating in a 
        program of assistance for the homeless, the reason the veteran 
        left the program.
    ``(2) The method required by paragraph (1) shall ensure that each 
veteran is counted only once.
    ``(b) Annual Data Collection and Aggregation.--Not later than one 
year after the method is established under subsection (a), and annually 
thereafter, the Secretary shall collect and aggregate data using the 
method established under subsection (a).
    ``(c) Annual Reports.--Not later than two years after the date of 
enactment of this section and annually thereafter, the Secretary shall 
submit to Congress a report on the data collected and aggregated under 
subsection (b).
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section--
            ``(1) $10,000,000 for fiscal year 2010; and
            ``(2) such sums as may be necessary for fiscal years 2011 
        through 2014.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 20 is amended by adding at the end the following new item:

``2068. Homeless Veterans Management Information System.''.

SEC. 106. RENTAL ASSISTANCE FOR VETERANS THROUGH DEPARTMENT OF HOUSING 
              AND URBAN DEVELOPMENT.

    Section 8(o)(19) of the United States Housing Act of 1937 (42 
U.S.C. 1437f(o)(19)) is amended to read as follows:
            ``(19) Rental vouchers for veterans affairs supported 
        housing program.--
                    ``(A) Rental vouchers.--The Secretary shall make 
                available to public housing agencies described in 
                subparagraph (C) the amounts described in subparagraph 
                (B), to provide rental assistance through a supported 
                housing program administered in conjunction with the 
                Department of Veterans Affairs.
                    ``(B) Amount.--The amounts specified in this 
                subparagraph are the amounts necessary to ensure that--
                            ``(i) not more than 30,000 vouchers for 
                        rental assistance under this paragraph are 
                        outstanding at any one time during fiscal year 
                        2010;
                            ``(ii) not more than 40,000 vouchers for 
                        rental assistance under this paragraph are 
                        outstanding at any one time during fiscal year 
                        2011;
                            ``(iii) not more than 50,000 vouchers for 
                        rental assistance under this paragraph are 
                        outstanding at any one time during fiscal year 
                        2012; and
                            ``(iv) not more than 60,000 vouchers for 
                        rental assistance under this paragraph are 
                        outstanding at any one time during fiscal year 
                        2013 and each fiscal year thereafter.
                    ``(C) Public housing agencies.--A public housing 
                agency described in this subparagraph is a public 
                housing agency that--
                            ``(i) has a partnership with a Department 
                        of Veterans Affairs medical center or an entity 
                        determined to be appropriate by the Secretary 
                        of Veterans Affairs;
                            ``(ii) is located in an area that the 
                        Secretary of Veterans Affairs determines has a 
                        high concentration of veterans in need of 
                        assistance;
                            ``(iii) has demonstrated expertise in 
                        providing housing for homeless individuals; and
                            ``(iv) meets any other criteria that the 
                        Secretary, in consultation with the Secretary 
                        of Veterans Affairs may prescribe.
                    ``(D) Case management.--The Secretary of Veterans 
                Affairs shall ensure that the case managers described 
                in section 2003(b) of title 38, United States Code, 
                provide appropriate case management for each veteran 
                who receives rental assistance under this paragraph 
                that--
                            ``(i) assists the veteran in--
                                    ``(I) locating available housing;
                                    ``(II) working with the appropriate 
                                public housing agency;
                                    ``(III) accessing benefits and 
                                health services provided by the 
                                Department of Veterans Affairs and 
                                other departments and agencies of the 
                                Federal Government;
                                    ``(IV) negotiating with landlords; 
                                and
                                    ``(V) other areas, as the Secretary 
                                determines is necessary to help the 
                                veteran maintain housing or avoid 
                                homelessness; and
                            ``(ii) ensures that a veteran with a severe 
                        disability, including a veteran that has been 
                        homeless for a substantial period of time, is 
                        referred to sufficient supportive services to 
                        provide the veteran with stable housing, 
                        including--
                                    ``(I) mental health services, 
                                including treatment and recovery 
                                support services;
                                    ``(II) substance abuse treatment 
                                and recovery support services, 
                                including counseling, treatment 
                                planning, recovery coaching, and 
                                relapse prevention;
                                    ``(III) integrated, coordinated 
                                treatment and recovery support services 
                                for co-occurring disorders;
                                    ``(IV) health education, including 
                                referrals for medical and dental care;
                                    ``(V) services designed to help 
                                individuals make progress toward self-
                                sufficiency and recovery, including job 
                                training, assistance in seeking 
                                employment, benefits advocacy, money 
                                management, life-skills training, self-
                                help programs, and engagement and 
                                motivational interventions;
                                    ``(VI) parental skills and family 
                                support; and
                                    ``(VII) other supportive services 
                                that promote an end to chronic 
                                homelessness.''.

SEC. 107. SPECIAL ASSISTANT FOR VETERANS AFFAIRS IN OFFICE OF SECRETARY 
              OF HOUSING AND URBAN DEVELOPMENT.

    Section 4 of the Department of Housing and Urban Development Act 
(42 U.S.C. 3533) is amended by adding at the end the following new 
subsection:
    ``(g) Special Assistant for Veterans Affairs.--
            ``(1) Establishment.--There shall be in the Department a 
        Special Assistant for Veterans Affairs, who shall be in the 
        Office of the Secretary.
            ``(2) Appointment.--The Special Assistant for Veterans 
        Affairs shall be appointed by the Secretary, based solely on 
        merit and shall be covered under the provisions of title 5, 
        United States Code, governing appointments in the competitive 
        service.
            ``(3) Responsibilities.--The Special Assistant for Veterans 
        Affairs shall be responsible for--
                    ``(A) ensuring that veterans have access to housing 
                and homeless assistance under each program of the 
                Department providing such assistance;
                    ``(B) coordinating all programs and activities of 
                the Department relating to veterans; and
                    ``(C) carrying out such other duties as may be 
                assigned to the Special Assistant by the Secretary or 
                by law.''.

SEC. 108. PLAN TO END VETERAN HOMELESSNESS.

    (a) In General.--Not later than one year after the date of 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
to Congress a comprehensive plan to end homelessness among veterans 
that includes--
            (1) an analysis of programs of the Department of Veterans 
        Affairs and other departments and agencies of the Federal 
        Government that are designed to prevent homelessness among 
        veterans and assist veterans who are homeless;
            (2) an evaluation of whether and how partnerships between 
        the programs described in paragraph (1) would contribute to 
        ending homelessness among veterans;
            (3) recommendations for improving the programs described in 
        paragraph (1), creating partnerships between such programs, or 
        eliminating programs that are no longer effective;
            (4) recommendations for new programs to prevent and end 
        homelessness among veterans, including an estimation of the 
        cost of such programs;
            (5) a timeline for implementing the plan; and
            (6) such other information as the Secretary determines 
        necessary.
    (b) Consideration of Veterans Located in Rural Areas.--The 
analysis, evaluation, and recommendations included in the report 
required by subsection (a) shall include consideration of the 
circumstances and requirements that are unique to veterans located in 
rural areas.

                  TITLE II--TOXIC SUBSTANCES EXPOSURE

SEC. 201. EXTENSION OF ELIGIBILITY FOR HEALTH CARE FOR VETERANS WITH 
              DISABILITIES WHO SERVED IN PERSIAN GULF WAR 
              NOTWITHSTANDING LACK OF EVIDENCE TO CONCLUDE SUCH 
              DISABILITIES ARE ASSOCIATED WITH SUCH SERVICE.

    (a) In General.--Subsection (e)(3)(B) of section 1710 is amended by 
inserting after ``December 31, 2002'' the following: ``, except that 
such care and services may also be provided to such a veteran during 
the period beginning on the date of the enactment of the Homeless 
Veterans and Other Veterans Health Care Authorities Act of 2010 and 
ending on December 31, 2012''.
    (b) Technical Correction.--Subsection (a)(2)(F) of such section is 
amended by striking ``conditions'' and inserting ``occupational or 
environmental hazards''.

                     TITLE III--HEALTH CARE MATTERS

SEC. 301. INCREASE IN NUMBER OF AUTHORIZED ASSISTANT SECRETARIES AND 
              DEPUTY ASSISTANT SECRETARIES.

    (a) Increase in Number of Authorized Assistant Secretaries; 
Revision of Functions.--Section 308 is amended--
            (1) in subsection (a), by striking ``seven'' and inserting 
        ``eight'' in the first sentence; and
            (2) in subsection (b)--
                    (A) in paragraph (6), by striking ``Capital'' and 
                inserting ``Construction capital''; and
                    (B) in paragraph (10) by striking ``Procurement'' 
                and inserting ``Acquisition''.
    (b) Increase in Number of Authorized Deputy Assistant 
Secretaries.--Section 308(d)(1) is amended by striking ``19'' and 
inserting ``27'' in the first sentence.
    (c) Conforming Amendments to Title 38, United States Code.--Title 
38, United States Code, is amended as follows:
            (1) Section 312A is repealed.
            (2) The table of sections at the beginning of chapter 3 is 
        amended by striking the item relating to section 312A.
    (d) Conforming Amendment to Title 5, United States Code.--Section 
5315 of title 5, United States Code, is amended by striking ``Assistant 
Secretaries, Department of Veterans Affairs (7)'' and inserting 
``Assistant Secretaries, Department of Veterans Affairs (8)''.

SEC. 302. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN ASSISTANT SERVICES IN 
              VETERANS HEALTH ADMINISTRATION.

    (a) In General.--Section 7306(a) is amended by striking paragraph 
(9) and inserting the following new paragraph (9):
            ``(9) The Director of Physician Assistant Services, who 
        shall--
                    ``(A) serve in a full-time capacity at the Central 
                Office of the Department;
                    ``(B) be a qualified physician assistant; and
                    ``(C) be responsible and report directly to the 
                Chief Patient Care Services Officer of the Veterans 
                Health Administration on all matters relating to the 
                education and training, employment, appropriate 
                utilization, and optimal participation of physician 
                assistants within the programs and initiatives of the 
                Administration.''.
    (b) Deadline for Implementation.--The Secretary of Veterans Affairs 
shall ensure that an individual is serving as the Director of Physician 
Assistant Services under paragraph (9) of section 7306(a) of title 38, 
United States Code, as amended by subsection (a), by not later than 120 
days after the date of the enactment of this Act.

SEC. 303. DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER QUALITY REPORT 
              CARD INITIATIVE.

    (a) Purpose.--The purpose of this section is to provide for the 
establishment within the Department of Veterans Affairs of an 
initiative (to be known as the ``Medical Center Quality Report Card 
Initiative'') to ensure that information on the quality and performance 
of medical centers administered by the Secretary of Veterans Affairs is 
readily available and accessible for purposes as follows:
            (1) To inform patients and consumers about health care 
        quality in such medical centers.
            (2) To assist health care providers of the Department in 
        identifying opportunities for quality improvement and cost 
        containment.
            (3) To enhance the understanding of policy makers and 
        public officials of health care issues, raise public awareness 
        of medical center quality issues, and help constituents of such 
        policy makers and officials identify quality health care 
        options for the Department.
    (b) Establishment.--Subchapter I of chapter 17 is amended by 
inserting after section 1706 the following new section:
``Sec. 1706A. Management of health care: Medical Center Quality Report 
              Card Initiative
    ``(a) In General.--Not later than 18 months after the date of the 
enactment of the Homeless Veterans and Other Veterans Health Care 
Authorities Act of 2010, the Secretary shall establish and implement an 
initiative, to be known as the `Medical Center Quality Report Card 
Initiative' (in this section referred to as the `Initiative'), to 
publish information on health care quality in Department medical 
centers.
    ``(b) Publication of Information on Quality and Performance of 
Department Medical Centers.--(1)(A) Under the Initiative, not less 
frequently than twice each year, the Secretary shall make available to 
the public, on the Hospital Compare website of the Centers for Medicaid 
and Medicare Services, data consisting of the most current information 
on the quality and performance of each Department medical center. Such 
information shall include quality measures that allow for an assessment 
with respect to health care provided by Department medical centers, of 
the following:
            ``(i) Effectiveness.
            ``(ii) Safety.
            ``(iii) Timeliness.
            ``(iv) Efficiency.
            ``(v) Patient-centeredness.
            ``(vi) Patient satisfaction.
            ``(vii) Satisfaction of health professionals employed at 
        Department medical centers.
            ``(viii) The equity of care provided to various patient 
        populations, including female, geriatric, disabled, rural, 
        homeless, mentally ill, and racial and ethnic minority 
        populations.
    ``(B) For each quality measure made available under subparagraph 
(A), the Secretary shall include--
            ``(i) quality measures that are common to the health care 
        industry and are based on information reported in paragraph 
        (2); and
            ``(ii) such other information as the Secretary considers 
        appropriate.
    ``(C) The Secretary shall conduct focus groups with veterans to 
identify additional types of quality information and display formats 
regarding such quality measures that would be meaningful to the needs 
of veterans.
    ``(2)(A) In making data available pursuant to paragraph (1), the 
Secretary shall, except as provided in subparagraph (B), include to the 
maximum extent practicable information about Department medical centers 
using best available measures that reflect emerging quality and safety 
trends and the priorities of veteran-centered care.
    ``(B) In making data available to the public under paragraph (1), 
the Secretary may provide information in addition to the information 
required by subparagraph (A) or provide information in lieu of the 
information required by subparagraph (A) if the Secretary--
            ``(i) not later than 15 days before the date on which such 
        data is made available to the public, submits to the Committee 
        on Veterans' Affairs of the Senate and the Committee on 
        Veterans' Affairs of the House of Representatives a 
        certification in writing that such additional or substituted 
        information is more appropriate for purposes of carrying out 
        the requirement of paragraph (2)(B); and
            ``(ii) includes with such data and in such certification an 
        indication of which information has been added or substituted 
        under this subparagraph.
    ``(3)(A) In making data available as provided for under paragraph 
(1), the Secretary may make risk adjustments to quality measures to 
account for differences relating to--
            ``(i) the characteristics of a Department medical center, 
        such as licensed bed size, geography, and teaching hospital 
        status; and
            ``(ii) patient characteristics, such as health status, 
        severity of illness, and socioeconomic status.
    ``(B) If the Secretary makes data available under paragraph (1) 
using risk-adjusted quality measures, the Secretary shall establish 
procedures for making the unadjusted data available to the public in a 
manner determined appropriate by the Secretary.
    ``(4) Under the Initiative, the Secretary may verify data made 
available under this subsection to ensure accuracy and validity.
    ``(5) Before disclosing to the public any data under this 
subsection, the Secretary shall disclose the methodology for the 
publication of such data and the nature and scope of such data to--
            ``(A) each organization the Secretary considers relevant to 
        such data; and
            ``(B) each Department medical center that is the subject of 
        such data.
    ``(6)(A) 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 copy of each set of data made available to 
the public under paragraph (1).
    ``(B) The Secretary shall ensure that each set of data made 
available to the public under paragraph (1) is made available--
            ``(i) in an electronic format;
            ``(ii) in a manner that can be understood by individuals 
        who are not medical professionals and individuals with low 
        functional health literacy; and
            ``(iii) at each Department medical center covered by the 
        set of data.
    ``(C) The Secretary shall ensure that information on health care 
quality made available under paragraph (1) is made available in a 
manner that is conducive for comparisons with other local medical 
centers or regional medical centers, as appropriate.
    ``(D) The Secretary shall establish procedures for making the 
information included in the data made available to the public under 
paragraph (1) available to the public upon request in non-electronic 
format, such as through a toll-free telephone number.
    ``(7) The analytic methodologies and limitations on information 
sources utilized by the Secretary to develop and disseminate 
comparative information under this subsection shall be identified and 
acknowledged in a notice or disclaimer as part of the dissemination of 
such information, and include the appropriate and inappropriate uses of 
such information.
    ``(c) Identifying and Reporting Actions That Could Lead to False or 
Artificial Improvements in Quality Measurements.--Not less frequently 
than annually, the Secretary shall compare quality measures data 
submitted by each Department medical center to the Secretary with 
quality measures data submitted to the Secretary in the prior year or 
years by each such Department medical center in order to identify and 
report actions that could lead to false or artificial improvements in 
the quality measurements of such Department medical centers for 
purposes of this section.
    ``(d) Privacy and Security.--(1) The Secretary shall develop and 
implement effective safeguards to protect against the unauthorized use 
or disclosure of Department medical center data that is made available 
under this section.
    ``(2) The Secretary shall develop and implement effective 
safeguards to protect against the dissemination under this section of 
inconsistent, incomplete, invalid, inaccurate, or subjective Department 
medical center data.
    ``(3) The Secretary shall ensure that identifiable patient data is 
not released to the public under this section.
    ``(e) Reports.--(1) The Secretary shall periodically submit to 
Congress a report on the effectiveness of the Initiative.
    ``(2) Each report required by paragraph (1) shall include the 
following:
            ``(A) An assessment of the effectiveness of the Initiative 
        in meeting the purpose described in section 302(a) of the 
        Homeless Veterans and Other Veterans Health Care Authorities 
        Act of 2010.
            ``(B) If necessary, a description of the measures the 
        Secretary can undertake to ensure that the Initiative meets 
        such purpose.
    ``(3) The Secretary shall carry out each measure the Secretary 
includes in a report under paragraph (2)(B).
    ``(4) The Secretary shall make each report submitted under 
paragraph (1) available to the public.
    ``(f) Department Medical Center Defined.--In this section, the term 
`Department medical center' means a Department of Veterans Affairs 
Medical Center administered by the Secretary.
    ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2010 through 2018.''.
    (c) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1706 the following new item:

``1706A. Management of health care: Medical Center Quality Report Card 
                            Initiative.''.

SEC. 304. REPORT ON PAY-FOR-PERFORMANCE COMPENSATION UNDER HEALTH CARE 
              SERVICES CONTRACTS.

    (a) In General.--Not later than 180 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 
use by the Department of Veterans Affairs of pay-for-performance 
compensation mechanisms in the provision of health care services in 
contracts which compensate contractors of the Department for the 
provision of health care services through community based outpatient 
clinics.
    (b) Elements.--The report required by subsection (a) shall include 
the following:
            (1) An assessment of the feasibility and advisability of 
        utilizing pay-for-performance compensation mechanisms in the 
        provision of health care services by the Department in 
        contracts described in subsection (a).
            (2) The number of community based outpatient clinics of the 
        Department that were operating under a pay-for-performance 
        compensation mechanism in the provision of health care services 
        on the day before the date of the enactment of this Act and the 
        impact such mechanisms have had with respect to--
                    (A) providing incentives for community based 
                outpatient clinics to provide high quality health care; 
                and
                    (B) providing incentives to better assure patient 
                satisfaction.
    (c) Incorporation of Views and Experiences of Private Health Care 
Systems.--In meeting the requirements of this section the Secretary 
shall incorporate the views and experiences of representatives of at 
least two private health care systems that have utilized pay-for-
performance compensation mechanisms in the operation of medical clinics 
to ascertain whether such mechanisms have had an effect on the delivery 
of quality, timely, medical care in the private sector.

SEC. 305. EXPANSION OF STATE HOME CARE FOR PARENTS OF VETERANS WHO DIED 
              WHILE SERVING IN THE ARMED FORCES.

    In administering section 51.210(d) of title 38, Code of Federal 
Regulations, the Secretary of Veterans Affairs shall permit a State 
home to provide services to, in addition to non-veterans described in 
such subsection, a non-veteran any of whose children died while serving 
in the Armed Forces.

SEC. 306. AUTOMATIC ENROLLMENT OF ELIGIBLE DEMOBILIZING MEMBERS OF THE 
              NATIONAL GUARD AND RESERVE IN HEALTH CARE AND DENTAL CARE 
              PROGRAMS OF THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Automatic Enrollment.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall, in consultation and coordination with the Secretary of 
        Defense, take appropriate actions to provide for the automatic 
        enrollment of covered members in the health care or dental care 
        programs for veterans of the Department of Veterans Affairs for 
        which they will be eligible upon discharge or release from 
        active duty in the Armed Forces.
            (2) Covered members.--In this section, a covered member is 
        any member of a reserve component of the Armed Forces who is 
        being discharged or released from active duty in the Armed 
        Forces and who upon such discharge or release will be eligible 
        to participate in a health care or dental care program for 
        veterans of the Department of Veterans Affairs.
            (3) Enrollment during demobilization and discharge 
        process.--The Secretary of Veterans Affairs shall, in 
        consultation and coordination with the Secretary of Defense, 
        ensure that the automatic enrollment described in paragraph (1) 
        occurs during the participation of covered members in the 
        demobilization and discharge process used for members of the 
        reserve components of the Armed Forces.
    (b) Assistance.--
            (1) In general.--In providing for the enrollment of covered 
        members under subsection (a), the Secretary of Veterans Affairs 
        shall, in consultation and coordination with the Secretary of 
        Defense, provide covered members assistance in the completion 
        of any enrollment activities required under such subsection. 
        Such assistance shall be provided during the demobilization and 
        discharge process of such members utilizing such personnel of 
        the Department of Veterans Affairs, including personnel of the 
        Veterans Health Administration and the Veterans Benefits 
        Administration, as the Secretary shall assign for such 
        purposes.
            (2) Education and outreach.--In providing assistance under 
        paragraph (1) to covered members, the personnel of the 
        Department providing such assistance shall also provide such 
        members--
                    (A) information about the programs, benefits, and 
                services of the Department for which they may be 
                eligible, including--
                            (i) how such members can apply for and 
                        access such programs, benefits, and services; 
                        and
                            (ii) the advantages of enrolling in such 
                        programs, benefits, and services; and
                    (B) a list of Department of Veterans Affairs 
                medical facilities, including medical centers, 
                outpatient clinics, mental health centers, and benefits 
                offices located within 100 miles of the residence in 
                which the covered member will first reside after being 
                discharged or released from active duty in the Armed 
                Forces.
    (c) Personnel.--Beginning not later than 180 days after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall, in 
consultation and coordination with the Secretary of Defense and the 
appropriate officials of each State, ensure that sufficient personnel 
are present, including such personnel as are assigned under subsection 
(b)(1), at each demobilization and discharge event of a reserve 
component of the Armed Forces for the performance by covered members of 
any enrollment activities pursuant to subsection (a) and for any 
assistance in the performance of such activities under subsection (b).
    (d) Facilities and Other Resources.--Beginning not later than 180 
days after the date of the enactment of this Act, the Secretary of 
Defense shall ensure that the facilities and other resources (including 
space and computer facilities) for the demobilization and discharge 
process used for members of reserve components of the Armed Forces 
include adequate facilities and resources for the performance by 
covered members of any enrollment activities required under subsection 
(a) and for any assistance in the performance of such activities under 
subsection (b).
    (e) Protection of Privacy.--Any enrollment activities performed by 
covered members pursuant to subsection (a) shall provide appropriate 
protections for the privacy of such members and their personal 
information in accordance with applicable requirements of law.
    (f) Opt Out Provisions.--
            (1) Option not to enroll.--During the demobilization and 
        discharge process for a covered member and prior to enrolling 
        the member pursuant to subsection (a), the Secretary of 
        Veterans Affairs shall, in coordination with the Secretary of 
        Defense, provide the member with the option to decline such 
        enrollment.
            (2) Notice to secretary; prohibition on enrollment.--If a 
        covered member provides notice to the Secretary of Veterans 
        Affairs that the member declines enrollment under paragraph 
        (1), the Secretary may not enroll the member pursuant to 
        subsection (a).
    (g) Construction.--Nothing in this section shall be construed to 
require a member of a reserve component of the Armed Forces to 
participate in any health care or dental care program or use any 
service of the Department of Veterans Affairs.
    (h) Reports.--
            (1) In general.--Not later than one year after the date of 
        the enactment of this Act and each year thereafter for five 
        years, the Secretary of Veterans Affairs shall, in consultation 
        and coordination with the Secretary of Defense, submit a report 
        on the implementation of the requirements of this section to--
                    (A) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the House of 
                Representatives.
            (2) Elements.--Each report required by paragraph (1) shall 
        include the following:
                    (A) A description of the activities undertaken by 
                the Secretary of Veterans Affairs to carry out the 
                requirements of this section.
                    (B) An assessment of the effect of such activities 
                on--
                            (i) the enrollment of covered members in 
                        health care and dental care programs for 
                        veterans of the Department of Veterans Affairs; 
                        and
                            (ii) the participation of such members in 
                        such programs.
                    (C) An assessment of the potential budgetary impact 
                and demand for services that actions taken under 
                subsection (a) may have on the Department of Veterans 
                Affairs and any need for additional staff or resources 
                to meet that demand.
                    (D) Such recommendations for legislative or 
                administrative action as the Secretary of Veterans 
                Affairs considers appropriate in order to improve or 
                enhance the requirements of this section so as to 
                further facilitate the enrollment of covered members in 
                health care and dental care programs for veterans of 
                the Department of Veterans Affairs.
                    (E) Such other matters with respect to the 
                requirements of this section as the Secretary of 
                Veterans Affairs considers appropriate.
    (i) Definitions.--In this section:
            (1) Enrollment.--The term ``enrollment'', with respect to a 
        covered member in a health care or dental care program for 
        veterans of the Department of Veterans Affairs, means the 
        collection and recording of appropriate information on such 
        member in the recordkeeping system of the Department of 
        Veterans Affairs to facilitate participation of such member in 
        such program if such member is eligible for such participation 
        and elects such participation.
            (2) State.--The term ``State'' means each of the several 
        States of the United States, the District of Columbia, and any 
        commonwealth, territory, or possession of the United States.

SEC. 307. PROVISION OF CHIROPRACTIC SERVICES TO VETERANS ENROLLED IN 
              HEALTH CARE SYSTEM OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Comprehensive Policy on Chiropractic Services.--
            (1) In general.--Not later than October 1, 2010, the 
        Secretary of Veterans Affairs shall develop and implement a 
        comprehensive policy on the provision of chiropractic services 
        provided at the expense of the Department of Veterans Affairs 
        to veterans enrolled in the health care system of the 
        Department.
            (2) Scope of policy.--The policy required by paragraph (1) 
        shall cover each of the following:
                    (A) The Department-wide protocols governing 
                referrals for chiropractic services.
                    (B) The Department-wide protocols governing direct 
                access to chiropractic services.
                    (C) The Department-wide protocols governing the 
                scope of practice of chiropractic practitioners.
                    (D) The definition of chiropractic services to be 
                provided.
                    (E) The assurance of prompt and appropriate 
                chiropractic services by the Department, system-wide, 
                when medically appropriate.
                    (F) Department programs of education and training 
                for health care personnel of the Department regarding 
                the benefits of chiropractic services.
                    (G) Department programs of patient education for 
                veterans suffering from back pain and related 
                disorders.
            (3) Updates.--The Secretary shall revise the policy 
        required by paragraph (1) on a periodic basis in accordance 
        with experience and evolving best practice guidelines.
            (4) Consultation.--The Secretary shall develop the policy 
        required by paragraph (1), and revise such policy under 
        paragraph (3), in consultation with veterans service 
        organizations and other organizations with expertise regarding 
        the benefits of chiropractic services.
    (b) Locations for Provision of Chiropractic Services.--In carrying 
out the policy required by subsection (a), the Secretary shall provide 
chiropractic services at--
            (1) not less than two locations in each Veterans Integrated 
        Service Network (VISN); and
            (2) such locations as the Secretary considers appropriate 
        based on the Secretary's assessment of demand for chiropractic 
        services provided by the Department, including consideration of 
        the following:
                    (A) The average time a veteran seeking chiropractic 
                services from the Department is required to wait for 
                such services.
                    (B) Rates of fee-based care.
                    (C) Such other considerations as the Secretary 
                considers appropriate.
    (c) 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)(1) and on October 1 of every fiscal 
        year thereafter through fiscal year 2020, 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)(1).
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) A description of the policy developed and 
                implemented under paragraph (1) of subsection (a) and 
                any revisions to such policy under paragraph (3) of 
                such subsection.
                    (B) A description of the performance measures used 
                to determine the effectiveness of such policy in 
                improving the availability of chiropractic services for 
                veterans system-wide.
                    (C) An assessment of the adequacy of Department 
                chiropractic services based on a survey of patients 
                managed in Department clinics.
                    (D) An assessment of the training provided to 
                Department health care personnel with respect to the 
                benefits of chiropractic services and the appropriate 
                referral of patients for chiropractic services.
                    (E) An assessment of the patient pain care 
                education programs of the Department.
                    (F) The number of episodes of chiropractic services 
                (including referrals for chiropractic services to non-
                Department providers) granted in the preceding fiscal 
                year, disaggregated by facility.
    (d) 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.

SEC. 308. NAME OF DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT CLINIC, 
              ALEXANDRIA, MINNESOTA.

    (a) Designation.--The Department of Veterans Affairs outpatient 
clinic in Alexandria, Minnesota, shall after the date of the enactment 
of this Act be known and designated as the ``Max J. Beilke Department 
of Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the outpatient 
clinic referred to in subsection (a) shall be considered to be a 
reference to the Max J. Beilke Department of Veterans Affairs 
Outpatient Clinic.

                        TITLE IV--OTHER MATTERS

SEC. 401. FUNDING.

    (a) In General.--Subject to subsection (b), amounts to carry out 
this Act and the amendments made by this Act shall be derived, in whole 
or in part, from the following:
            (1) In fiscal years after fiscal year 2009, from amounts 
        appropriated or otherwise available for fiscal year 2009 for 
        the Department of Veterans Affairs for medical services that 
        remain available for obligation as of the date of the enactment 
        of this Act.
            (2) In fiscal years after fiscal year 2010, from amounts 
        appropriated or otherwise available for fiscal year 2010 for 
        the Department of Veterans Affairs for medical services that 
        remain available for obligation as of October 1, 2010.
    (b) Limitation.--Amounts described in subsection (a) shall not be 
available in accordance with that subsection to the extent, as 
determined by the Secretary, the availability of such amounts in 
accordance with that subsection would otherwise limit or impede the 
delivery of health care services to veterans.
            Amend the title so as to read: ``A bill to amend title 38, 
        United States Code, to improve the provision of assistance to 
        homeless veterans and the provision of health care to veterans, 
        and for other purposes.''.
                                                       Calendar No. 360

111th CONGRESS

  2d Session

                                S. 1237

                          [Report No. 111-175]

_______________________________________________________________________

                                 A BILL

To amend title 38, United States Code, to expand the grant program for 
homeless veterans with special needs to include male homeless veterans 
      with minor dependents and to establish a grant program for 
  reintegration of homeless women veterans and homeless veterans with 
                   children, and for other purposes.

_______________________________________________________________________

                             April 29, 2010

        Reported with an amendment and an amendment to the title