[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1963 Placed on Calendar Senate (PCS)]

                                                       Calendar No. 190
111th CONGRESS
  1st Session
                                S. 1963

    To amend title 38, United States Code, to provide assistance to 
  caregivers of veterans, to improve the provision of health care to 
                   veterans, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            October 28, 2009

 Mr. Akaka introduced the following bill; which was read the first time

                            October 29, 2009

            Read the second time and placed on the calendar

_______________________________________________________________________

                                 A BILL


 
    To amend title 38, United States Code, to provide assistance to 
  caregivers of veterans, to improve the provision of health care to 
                   veterans, 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 ``Caregivers and 
Veterans Omnibus Health Services Act of 2009''.
    (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--CAREGIVER SUPPORT

Sec. 101. Waiver of charges for humanitarian care provided to family 
                            members accompanying certain severely 
                            injured veterans as they receive medical 
                            care.
Sec. 102. Family caregiver assistance.
Sec. 103. Lodging and subsistence for attendants.
Sec. 104. Survey of informal caregivers.
              TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

Sec. 201. Report on barriers to receipt of health care for women 
                            veterans.
Sec. 202. Plan to improve provision of health care services to women 
                            veterans.
Sec. 203. Independent study on health consequences of women veterans of 
                            military service in Operation Iraqi Freedom 
                            and Operation Enduring Freedom.
Sec. 204. Training and certification for mental health care providers 
                            on care for veterans suffering from sexual 
                            trauma.
Sec. 205. Pilot program on counseling in retreat settings for women 
                            veterans newly separated from service in 
                            the Armed Forces.
Sec. 206. Report on full-time women veterans program managers at 
                            medical centers.
Sec. 207. Service on certain advisory committees of women recently 
                            separated from service in the Armed Forces.
Sec. 208. Pilot program on subsidies for child care for certain 
                            veterans receiving health care.
Sec. 209. Care for newborn children of women veterans receiving 
                            maternity care.
                  TITLE III--RURAL HEALTH IMPROVEMENTS

Sec. 301. Enhancement of Department of Veterans Affairs Education Debt 
                            Reduction Program.
Sec. 302. Visual impairment and orientation and mobility professionals 
                            education assistance program.
Sec. 303. Inclusion of Department of Veterans Affairs facilities in 
                            list of facilities eligible for assignment 
                            of participants in National Health Service 
                            Corps Scholarship Program.
Sec. 304. Teleconsultation and telemedicine.
Sec. 305. Demonstration projects on alternatives for expanding care for 
                            veterans in rural areas.
Sec. 306. Program on provision of readjustment and mental health care 
                            services to veterans who served in 
                            Operation Iraqi Freedom and Operation 
                            Enduring Freedom.
Sec. 307. Improvement of care of American Indian veterans.
Sec. 308. Travel reimbursement for veterans receiving treatment at 
                            facilities of the Department of Veterans 
                            Affairs.
Sec. 309. Office of Rural Health five-year strategic plan.
Sec. 310. Oversight of contract and fee-basis care.
Sec. 311. Enhancement of Vet Centers to meet needs of veterans of 
                            Operation Iraqi Freedom and Operation 
                            Enduring Freedom.
Sec. 312. Centers of excellence for rural health research, education, 
                            and clinical activities.
Sec. 313. Pilot program on incentives for physicians who assume 
                            inpatient responsibilities at community 
                            hospitals in health professional shortage 
                            areas.
Sec. 314. Annual report on matters related to care for veterans who 
                            live in rural areas.
Sec. 315. Transportation grants for rural veterans service 
                            organizations.
Sec. 316. Modification of eligibility for participation in pilot 
                            program of enhanced contract care authority 
                            for health care needs of certain veterans.
                  TITLE IV--MENTAL HEALTH CARE MATTERS

Sec. 401. Eligibility of members of the Armed Forces who serve in 
                            Operation Iraqi Freedom or Operation 
                            Enduring Freedom for counseling and 
                            services through Readjustment Counseling 
                            Service.
Sec. 402. Restoration of authority of Readjustment Counseling Service 
                            to provide referral and other assistance 
                            upon request to former members of the Armed 
                            Forces not authorized counseling.
Sec. 403. Study on suicides among veterans.
Sec. 404. Transfer of funds to Secretary of Health and Human Services 
                            for Graduate Psychology Education program.
                   TITLE V--OTHER HEALTH CARE MATTERS

Sec. 501. Repeal of certain annual reporting requirements.
Sec. 502. Modifications to annual Gulf War research report.
Sec. 503. Payment for care furnished to CHAMPVA beneficiaries.
Sec. 504. Disclosures from certain medical records.
Sec. 505. Disclosure to Secretary of health-plan contract information 
                            and social security number of certain 
                            veterans receiving care.
Sec. 506. Enhancement of quality management.
Sec. 507. Reports on improvements to Department health care quality 
                            management.
Sec. 508. Pilot program on use of community-based organizations and 
                            local and State government entities to 
                            ensure that veterans receive care and 
                            benefits for which they are eligible.
Sec. 509. Specialized residential care and rehabilitation for certain 
                            veterans.
Sec. 510. Expanded study on the health impact of Project Shipboard 
                            Hazard and Defense.
Sec. 511. Use of non-Department facilities for rehabilitation of 
                            individuals with traumatic brain injury.
Sec. 512. Inclusion of federally recognized tribal organizations in 
                            certain programs for State veterans homes.
Sec. 513. Pilot program on provision of dental insurance plans to 
                            veterans and survivors and dependents of 
                            veterans.
Sec. 514. Expansion of veteran eligibility for reimbursement by 
                            Secretary of Veterans Affairs for emergency 
                            treatment furnished in a non-Department 
                            facility.
Sec. 515. Prohibition on collection of copayments from veterans who are 
                            catastrophically disabled.
                 TITLE VI--DEPARTMENT PERSONNEL MATTERS

Sec. 601. Enhancement of authorities for retention of medical 
                            professionals.
Sec. 602. Limitations on overtime duty, weekend duty, and alternative 
                            work schedules for nurses.
Sec. 603. Improvements to certain educational assistance programs.
Sec. 604. Standards for appointment and practice of physicians in 
                            Department of Veterans Affairs medical 
                            facilities.
                  TITLE VII--HOMELESS VETERANS MATTERS

Sec. 701. Pilot program on financial support for entities that 
                            coordinate the provision of supportive 
                            services to formerly homeless veterans 
                            residing on certain military property.
Sec. 702. Pilot program on financial support of entities that 
                            coordinate the provision of supportive 
                            services to formerly homeless veterans 
                            residing in permanent housing.
Sec. 703. Pilot program on financial support of entities that provide 
                            outreach to inform certain veterans about 
                            pension benefits.
Sec. 704. Assessment of pilot programs.
       TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

Sec. 801. General authorities on establishment of corporations.
Sec. 802. Clarification of purposes of corporations.
Sec. 803. Modification of requirements for boards of directors of 
                            corporations.
Sec. 804. Clarification of powers of corporations.
Sec. 805. Redesignation of section 7364A of title 38, United States 
                            Code.
Sec. 806. Improved accountability and oversight of corporations.
               TITLE IX--CONSTRUCTION AND NAMING MATTERS

Sec. 901. Authorization of medical facility projects.
Sec. 902. Designation of Robley Rex Department of Veterans Affairs 
                            Medical Center.
Sec. 903. Merril Lundman Department of Veterans Affairs Outpatient 
                            Clinic.
Sec. 904. Modification on restriction of alienation of certain real 
                            property in Gulf Port, Mississippi.
                         TITLE X--OTHER MATTERS

Sec. 1001. Expansion of authority for Department of Veterans Affairs 
                            police officers.
Sec. 1002. Uniform allowance for Department of Veterans Affairs police 
                            officers.

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--CAREGIVER SUPPORT

SEC. 101. WAIVER OF CHARGES FOR HUMANITARIAN CARE PROVIDED TO FAMILY 
              MEMBERS ACCOMPANYING CERTAIN SEVERELY INJURED VETERANS AS 
              THEY RECEIVE MEDICAL CARE.

    The text of section 1784 is amended to read as follows:
    ``(a) In General.--The Secretary may furnish hospital care or 
medical services as a humanitarian service in emergency cases.
    ``(b) Reimbursement.--Except as provided in subsection (c), the 
Secretary shall charge for care and services provided under subsection 
(a) at rates prescribed by the Secretary.
    ``(c) Waiver of Charges.--(1) Except as provided in paragraph (2), 
the Secretary shall waive the charges required by subsection (b) for 
care or services provided under subsection (a) to an attendant of a 
covered veteran if such care or services are provided to such attendant 
for an emergency that occurs while such attendant is accompanying such 
veteran while such veteran is receiving approved inpatient or 
outpatient treatment at--
            ``(A) a Department facility; or
            ``(B) a non-Department facility--
                    ``(i) that is under contract with the Department; 
                or
                    ``(ii) at which the veteran is receiving fee-basis 
                care.
    ``(2) If an attendant is entitled to care or services under a 
health-plan contract (as that term is defined in section 1725(f) of 
this title) or other contractual or legal recourse against a third 
party that would, in part, extinguish liability for charges described 
by subsection (b), the amount of such charges waived under paragraph 
(1) shall be the amount by which such charges exceed the amount of such 
charges covered by the health-plan contract or other contractual or 
legal recourse against the third party.
    ``(d) Definitions.--In this section:
            ``(1) The term `attendant', with respect to a veteran, 
        includes the following:
                    ``(A) A family member of the veteran.
                    ``(B) An individual eligible to receive ongoing 
                family caregiver assistance under section 1717A(e)(1) 
                of this title for the provision of personal care 
                services to the veteran.
                    ``(C) Any other individual whom the Secretary 
                determines--
                            ``(i) has a relationship with the veteran 
                        sufficient to demonstrate a close affinity with 
                        the veteran; and
                            ``(ii) provides a significant portion of 
                        the veteran's care.
            ``(2) The term `covered veteran' means any veteran with a 
        severe injury incurred or aggravated in the line of duty in the 
        active military, naval, or air service on or after September 
        11, 2001.
            ``(3) The term `family member' shall have such meaning as 
        the Secretary shall determine by policy or regulation.
            ``(4) The term `severe injury', in the case of a covered 
        veteran, means any physiological, psychological, or 
        neurological condition that renders a veteran unable to live 
        independently as determined by the Secretary.''.

SEC. 102. FAMILY CAREGIVER ASSISTANCE.

    (a) Requirement.--
            (1) In general.--Subchapter II of chapter 17 is amended by 
        inserting after section 1717 the following new section:
``Sec. 1717A. Family caregiver assistance
    ``(a) In General.--(1) As part of home health services provided 
under section 1717 of this title, the Secretary shall, upon the joint 
application of an eligible veteran and a family member of such veteran 
(or other individual designated by such veteran), furnish to such 
family member (or designee) family caregiver assistance in accordance 
with this section. The purpose of providing family caregiver assistance 
under this section is--
            ``(A) to reduce the number of veterans who are receiving 
        institutional care, or who are in need of institutional care, 
        whose personal care service needs could be substantially 
        satisfied with the provision of such services by a family 
        member (or designee); and
            ``(B) to provide eligible veterans with additional options 
        so that they can choose the setting for the receipt of personal 
        care services that best suits their needs.
    ``(2) The Secretary shall only furnish family caregiver assistance 
under this section to a family member of an eligible veteran (or other 
individual designated by such veteran) if the Secretary determines it 
is in the best interest of the eligible veteran to do so.
    ``(b) Eligible Veterans.--For purposes of this section, an eligible 
veteran is a veteran (or member of the Armed Forces undergoing medical 
discharge from the Armed Forces)--
            ``(1) who has a serious injury (including traumatic brain 
        injury, psychological trauma, or other mental disorder) 
        incurred or aggravated in the line of duty in the active 
        military, naval, or air service on or after September 11, 2001; 
        and
            ``(2) whom the Secretary determines, in consultation with 
        the Secretary of Defense as necessary, is in need of personal 
        care services because of--
                    ``(A) an inability to perform one or more 
                independent activities of daily living;
                    ``(B) a need for supervision or protection based on 
                symptoms or residuals of neurological or other 
                impairment or injury; or
                    ``(C) such other matters as the Secretary shall 
                establish in consultation with the Secretary of Defense 
                as appropriate.
    ``(c) Evaluation of Eligible Veterans and Family Caregivers.--(1) 
The Secretary shall evaluate each eligible veteran who makes a joint 
application under subsection (a)(1)--
            ``(A) to identify the personal care services required by 
        such veteran; and
            ``(B) to determine whether such requirements could be 
        significantly or substantially satisfied with the provision of 
        personal care services from a family member (or other 
        individual designated by the veteran).
    ``(2) The Secretary shall evaluate each family member of an 
eligible veteran (or other individual designated by the veteran) who 
makes a joint application under subsection (a)(1) to determine--
            ``(A) the basic amount of instruction, preparation, and 
        training such family member (or designee) requires, if any, to 
        provide the personal care services required by such veteran; 
        and
            ``(B) the amount of additional instruction, preparation, 
        and training such family member (or designee) requires, if any, 
        to be the primary personal care attendant designated for such 
        veteran under subsection (e).
    ``(3) An evaluation carried out under paragraph (1) may be carried 
out--
            ``(A) at a Department facility;
            ``(B) at a non-Department facility determined appropriate 
        by the Secretary for purposes of such evaluation; and
            ``(C) at such other locations as the Secretary considers 
        appropriate.
    ``(d) Training and Approval.--(1) Except as provided in subsection 
(a)(2), the Secretary shall provide each family member of an eligible 
veteran (or other individual designated by the veteran) who makes a 
joint application under subsection (a)(1) the basic instruction, 
preparation, and training determined to be required by such family 
member (or designee) under subsection (c)(2)(A).
    ``(2) The Secretary may provide to a family member of an eligible 
veteran (or other individual designated by the veteran) the additional 
instruction, preparation, and training determined to be required by 
such family member (or designee) under subsection (c)(2)(B) if such 
family member (or designee)--
            ``(A) is approved as a personal care attendant for the 
        veteran under paragraph (3); and
            ``(B) requests, with concurrence of the veteran, such 
        additional instruction, preparation, and training.
    ``(3) Upon the successful completion by a family member of an 
eligible veteran (or other individual designated by the veteran) of 
basic instruction, preparation, and training provided under paragraph 
(1), the Secretary shall approve the family member as a personal care 
attendant for the veteran.
    ``(4) If the Secretary determines that a primary personal care 
attendant designated under subsection (e) requires additional training 
to maintain such designation, the Secretary shall make such training 
available to the primary personal care attendant.
    ``(5) The Secretary shall, subject to regulations the Secretary 
shall prescribe, provide for necessary travel, lodging, and per diem 
expenses incurred by a family member of an eligible veteran (or other 
individual designated by the veteran) in undergoing training under this 
subsection.
    ``(6) If the participation of a family member of an eligible 
veteran (or other individual designated by the veteran) in training 
under this subsection would interfere with the provision of personal 
care services to the veteran, the Secretary shall, subject to 
regulations as the Secretary shall prescribe and in consultation with 
the veteran, provide respite care to the veteran during the provision 
of such training to the family member so that such family caregiver (or 
designee) can participate in such training without interfering with the 
provision of such services.
    ``(e) Designation of Primary Personal Care Attendant.--(1) For each 
eligible veteran with at least one family member (or other individual 
designated by the veteran) who is described by subparagraphs (A) 
through (E) of paragraph (2), the Secretary shall designate one family 
member of such veteran (or other individual designated by the veteran) 
as the primary personal care attendant for such veteran to be the 
primary provider of personal care services for such veteran.
    ``(2) A primary personal care attendant designated for an eligible 
veteran under paragraph (1) shall be selected from among family members 
of such veteran (or other individuals designated by such veteran) who--
            ``(A) are approved under subsection (d)(3) as a personal 
        care attendant for such veteran;
            ``(B) complete all additional instruction, preparation, and 
        training, if any, provided under subsection (d)(2);
            ``(C) elect to provide the personal care services to such 
        veteran that the Secretary determines such veteran requires 
        under subsection (c)(1);
            ``(D) has the consent of such veteran to be the primary 
        provider of such services for such veteran; and
            ``(E) the Secretary considers competent to be the primary 
        provider of such services for such veteran.
    ``(3)(A) An eligible veteran receiving personal care services from 
a family member (or other individual designated by the veteran) 
designated as the primary personal care attendant for the veteran under 
paragraph (1) may revoke consent with respect to such family member (or 
designee) under paragraph (2)(D).
    ``(B) An eligible veteran may revoke the designation of a primary 
personal care attendant under subparagraph (A) at any time, except that 
such revocation may not occur more frequently than once every six 
months unless the Secretary determines it is in the best interest of 
the eligible veteran to permit such revocation to occur more 
frequently.
    ``(4) If an individual designated as the primary personal care 
attendant of an eligible veteran under paragraph (1) subsequently fails 
to meet the requirements set forth in paragraph (2), the Secretary--
            ``(A) shall immediately revoke the individual's designation 
        under paragraph (1); and
            ``(B) may designate, in consultation with the eligible 
        veteran or the eligible veteran's surrogate appointed under 
        subsection (g), a new primary personal care attendant for the 
        veteran under such paragraph.
    ``(5) The Secretary shall take such actions as may be necessary to 
ensure that the revocation of a designation under paragraph (1) does 
not interfere with the provision of personal care services required by 
a veteran.
    ``(f) Ongoing Family Caregiver Assistance.--(1) Except as provided 
in subsection (a)(2) and subject to the provisions of this subsection, 
the Secretary shall provide ongoing family caregiver assistance to 
family members of eligible veterans (or other individuals designated by 
such veterans) as follows:
            ``(A) To each family member of an eligible veteran (or 
        designee) who is approved under subsection (d)(3) as a personal 
        care attendant for the veteran the following:
                    ``(i) Direct technical support consisting of 
                information and assistance to timely address routine, 
                emergency, and specialized caregiving needs.
                    ``(ii) Counseling.
                    ``(iii) Access to an interactive Internet website 
                on caregiver services that addresses all aspects of the 
                provision of personal care services under this section.
            ``(B) To each family member of an eligible veteran (or 
        designee) who is designated as the primary personal care 
        attendant for the veteran under subsection (e) the following:
                    ``(i) The ongoing family caregiver assistance 
                described in subparagraph (A).
                    ``(ii) Mental health services.
                    ``(iii) Respite care of not less than 30 days 
                annually, including 24-hour per day care of the veteran 
                commensurate with the care provided by the family 
                caregiver to permit extended respite.
                    ``(iv) Medical care under section 1781 of this 
                title if such family member (or designee) is not 
                entitled to care or services under a health-plan 
                contract (as defined in section 1725(f) of this title).
                    ``(v) A monthly personal caregiver stipend.
    ``(2)(A) The Secretary shall provide respite care under paragraph 
(1)(B)(iii), at the election of the Secretary--
            ``(i) through facilities of the Department that are 
        appropriate for the veteran; or
            ``(ii) through contracts under section 1720B(c) of this 
        title.
    ``(B) If the primary personal care attendant of an eligible veteran 
designated under subsection (e)(1) determines in consultation with the 
veteran or the veteran's surrogate appointed under subsection (g), and 
the Secretary concurs, that the needs of the veteran cannot be 
accommodated through the facilities and contracts described in 
subparagraph (A), the Secretary shall, in consultation with the primary 
personal care attendant and the veteran (or the veteran's surrogate), 
provide respite care through other facilities or arrangements that are 
medically and age appropriate.
    ``(3) If the Secretary determines that the Department lacks the 
capacity to furnish medical care under clause (iv) of paragraph (1)(B), 
the Secretary may contract, in accordance with such regulations as the 
Secretary shall prescribe, for such insurance, medical services, or 
health plans as the Secretary considers appropriate to furnish such 
medical care.
    ``(4)(A) The Secretary shall provide monthly personal caregiver 
stipends under paragraph (1)(B)(v) in accordance with a schedule 
established by the Secretary that specifies stipends provided based 
upon the amount and degree of personal care services provided.
    ``(B) The Secretary shall ensure, to the extent practicable, that 
the schedule required by subparagraph (A) specifies that the amount of 
the personal caregiver stipend provided to a primary personal care 
attendant designated under subsection (e)(1) for the provision of 
personal care services to an eligible veteran is not less than the 
amount a commercial home health care entity would pay an individual in 
the geographic area of the veteran to provide equivalent personal care 
services to the veteran.
    ``(C) If personal care services are not available from a commercial 
provider in the geographic area of an eligible veteran, the Secretary 
may establish the schedule required by subparagraph (A) with respect to 
the veteran by considering the costs of commercial providers of 
personal care services in geographic areas other than the geographic 
area of the veteran with similar costs of living.
    ``(5) Provision of ongoing family caregiver assistance under this 
subsection for provision of personal care services to an eligible 
veteran shall terminate if the veteran no longer requires the personal 
care services.
    ``(g) Surrogates.--If an eligible veteran lacks the capacity to 
submit an application, provide consent, make a request, or concur with 
a request under this section, the Secretary may, in accordance with 
regulations and policies of the Department regarding the appointment of 
guardians or the use of powers of attorney, appoint a surrogate for the 
veteran who may submit applications, provide consent, make requests, or 
concur with requests on behalf of the veteran under this section.
    ``(h) Oversight.--(1) The Secretary shall enter into contracts with 
appropriate entities to provide oversight of the provision of personal 
care services under this section by primary personal care attendants 
designated under subsection (e)(1).
    ``(2) The Secretary shall ensure that each eligible veteran 
receiving personal care services under this section from a primary 
personal care attendant designated under subsection (e)(1) is visited 
in the veteran's home by an entity providing oversight under paragraph 
(1) at such frequency as the Secretary shall determine under paragraph 
(3).
    ``(3)(A) Except as provided in subparagraph (B), the Secretary 
shall determine the manner of oversight provided under paragraph (1) 
and the frequency of visits under paragraph (2) for an eligible veteran 
as the Secretary considers commensurate with the needs of such veteran.
    ``(B) The frequency of visits under paragraph (2) for an eligible 
veteran shall be not less frequent than once every six months.
    ``(4)(A) An entity visiting an eligible veteran under paragraph (2) 
shall submit to the Secretary the findings of the entity with respect 
to each visit, including whether the veteran is receiving the care the 
veteran requires.
    ``(B) If an entity finds under subparagraph (A) that an eligible 
veteran is not receiving the care the veteran requires, the entity 
shall submit to the Secretary a recommendation on the corrective 
actions that should be taken to ensure that the veteran receives the 
care the veteran requires, including, if the entity considers 
appropriate, a recommendation for revocation of a caregiver's approval 
under subsection (d)(3) or revocation of the designation of an 
individual under subsection (e)(1).
    ``(5) After receiving findings and recommendations, if any, under 
paragraph (4) with respect to an eligible veteran, the Secretary may 
take such actions as the Secretary considers appropriate to ensure that 
the veteran receives the care the veteran requires, including the 
following:
            ``(A) Revocation of a caregiver's approval under subsection 
        (d)(3).
            ``(B) Revocation of the designation of an individual under 
        subsection (e)(1).
    ``(6) If the Secretary terminates the provision of ongoing family 
caregiver assistance under subsection (f) to a family member of an 
eligible veteran (or other individual designated by the veteran) 
because of findings of an entity submitted to the Secretary under 
paragraph (4), the Secretary may not provide compensation to such 
entity for the provision of personal care services to such veteran, 
unless the Secretary determines it would be in the best interest of 
such veteran to provide compensation to such entity to provide such 
services.
    ``(i) Outreach.--The Secretary shall carry out a program of 
outreach to inform eligible veterans and their family members of the 
availability and nature of family caregiver assistance under this 
section.
    ``(j) Construction.--(1) A decision by the Secretary under this 
section affecting the furnishing of family caregiver assistance shall 
be considered a medical determination.
    ``(2) Nothing in this section shall be construed to create an 
employment relationship between the Secretary and an individual in 
receipt of family caregiver assistance under this section.
    ``(3) Nothing in this section shall be construed to create any 
entitlement to any services or stipends provided under this section.
    ``(k) Definitions.--In this section:
            ``(1) The term `family caregiver assistance' includes the 
        instruction, preparation, training, and approval provided under 
        subsection (d) and the ongoing family caregiver assistance 
        provided under subsection (f).
            ``(2) The term `family member' shall have such meaning as 
        the Secretary shall determine by policy or regulation.
            ``(3) The term `personal care services', with respect to a 
        veteran, includes the following:
                    ``(A) Supervision of the veteran.
                    ``(B) Protection of the veteran.
                    ``(C) Services to assist the veteran with one or 
                more independent activities of daily living.
                    ``(D) Such other services as the Secretary 
                considers appropriate.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 17 is amended by inserting after the item 
        related to section 1717 the following new item:

``1717A. Family caregiver assistance.''.
            (3) Authorization for provision of health care to personal 
        care attendants.--Section 1781(a) is amended--
                    (A) by redesignating paragraphs (2) and (3) as 
                paragraphs (3) and (4), respectively; and
                    (B) by inserting after paragraph (1) the following 
                new paragraph (2):
            ``(2) a family member of a veteran (or other individual 
        designated by the veteran) designated as the primary personal 
        care attendant for such veteran under section 1717A(e) of this 
        title who is not entitled to care or services under a health-
        plan contract (as defined in section 1725(f) of this title),''.
            (4) Construction.--Any family caregiver assistance 
        furnished under section 1717A of title 38, United States Code, 
        as added by paragraph (1), is in addition to any family 
        caregiver assistance furnished under other programs of the 
        Department of Veterans Affairs as of the date of the enactment 
        of this Act.
            (5) Effective date.--The amendments made by this subsection 
        shall take effect on the date that is 270 days after the date 
        of the enactment of this Act.
    (b) Implementation Plan and Report.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall--
                    (A) develop a plan for the implementation of 
                section 1717A of title 38, United States Code, as added 
                by subsection (a)(1); and
                    (B) 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 plan.
            (2) Consultation.--In developing the plan required by 
        paragraph (1)(A), the Secretary shall consult with the 
        following:
                    (A) Veterans described in section 1717A(b) of title 
                38, United States Code, as added by subsection (a)(1).
                    (B) Family members of veterans who provide personal 
                care services to such veterans.
                    (C) Veterans service organizations, as recognized 
                by the Secretary of Veterans Affairs for the 
                representation of veterans under section 5902 of title 
                38, United States Code.
                    (D) National organizations that specialize in the 
                provision of assistance to individuals with the types 
                of disabilities that personal care attendants will 
                encounter while providing personal care services under 
                section 1717A of title 38, United States Code, as so 
                added.
                    (E) Such other organizations with an interest in 
                the provision of care to veterans as the Secretary 
                considers appropriate.
                    (F) The Secretary of Defense with respect to 
                matters concerning personal care services for members 
                of the Armed Forces undergoing medical discharge from 
                the Armed Forces who are eligible to benefit from 
                family caregiver assistance furnished under section 
                1717A of title 38, United States Code, as so added.
            (3) Report contents.--The report required by paragraph 
        (1)(B) shall contain the following:
                    (A) The plan required by paragraph (1)(A).
                    (B) A description of the veterans, caregivers, and 
                organizations consulted by the Secretary under 
                paragraph (2).
                    (C) A description of such consultations.
                    (D) The recommendations of such veterans, 
                caregivers, and organizations, if any, that were not 
                incorporated into the plan required by paragraph 
                (1)(A).
                    (E) The reasons the Secretary did not incorporate 
                such recommendations into such plan.
    (c) Annual Evaluation Report.--
            (1) In general.--Not later than two years after the date 
        described in subsection (a)(5) and annually thereafter, 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 comprehensive report on the implementation 
        of section 1717A of title 38, United States Code, as added by 
        subsection (a)(1).
            (2) Contents.--The report required by paragraph (1) shall 
        include the following:
                    (A) The number of family members (or other 
                designated individuals) of veterans or members of the 
                Armed Forces that received family caregiver assistance 
                under such section 1717A.
                    (B) A description of the outreach activities 
                carried out by the Secretary in accordance with 
                subsection (i) of such section 1717A.
                    (C) The resources expended by the Secretary under 
                such section 1717A.
                    (D) An assessment of the manner in which resources 
                are expended by the Secretary under such section 1717A, 
                particularly with respect to the provision of monthly 
                personal caregiver stipends under subsection (f) of 
                such section.
                    (E) A description of the outcomes achieved by, and 
                any measurable benefits of, carrying out the 
                requirements of such section 1717A.
                    (F) A justification of any determination made under 
                subsection (b)(2) of such section 1717A.
                    (G) An assessment of the effectiveness and the 
                efficiency of the implementation of such section 1717A.
                    (H) An assessment of how the provision of family 
                caregiver assistance fits into the continuum of home 
                health care services and benefits provided to veterans 
                in need of such services and benefits.
                    (I) Such recommendations, including recommendations 
                for legislative or administrative action, as the 
                Secretary considers appropriate in light of carrying 
                out the requirements of such section 1717A.
    (d) Report on Feasibility and Advisability of Expanding Caregiver 
Assistance.--
            (1) In general.--Not later than two years after the date of 
        the enactment of the Caregivers and Veterans Omnibus Health 
        Services Act of 2009, 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 feasibility and advisability of expanding the provision 
        of family caregiver assistance under section 1717A of title 38, 
        United States Code, as added by subsection (a)(1), to family 
        members of veterans (or other individuals designated by such 
        veterans) who--
                    (A) have a serious injury described in subsection 
                (b)(1) of such section 1717A incurred or aggravated 
                before September 11, 2001; and
                    (B) are described in paragraph (2) of such 
                subsection.
            (2) Recommendations.--The report required by paragraph (1) 
        shall include such recommendations as the Secretary considers 
        appropriate with respect to the expansion described in such 
        paragraph.

SEC. 103. LODGING AND SUBSISTENCE FOR ATTENDANTS.

    Section 111(e) is amended--
            (1) by striking ``When any'' and inserting ``(1) When 
        any'';
            (2) in paragraph (1), as designated by paragraph (1) of 
        this subsection--
                    (A) by inserting ``(including lodging and 
                subsistence)'' after ``expenses of travel''; and
                    (B) by inserting before the period at the end the 
                following: ``for the period consisting of travel to and 
                from a treatment facility and the duration of the 
                treatment episode at that facility''; and
            (3) by adding at the end the following:
    ``(2) The Secretary may prescribe regulations to carry out this 
subsection. Such regulations may include provisions--
            ``(A) to limit the number of individuals that may receive 
        expenses of travel under paragraph (1) for a single treatment 
        episode of a person; and
            ``(B) to require attendants to use certain travel services.
    ``(3) In this subsection:
            ``(A) The term `attendant' includes, with respect to a 
        person described in paragraph (1), the following:
                    ``(i) A family member of the person.
                    ``(ii) An individual approved as a personal care 
                attendant under section 1717A(d)(3) of this title.
                    ``(iii) Any other individual whom the Secretary 
                determines--
                            ``(I) has a preexisting relationship with 
                        the person; and
                            ``(II) provides a significant portion of 
                        the person's care.
            ``(B) The term `family member' shall have such meaning as 
        the Secretary shall determine by policy or regulation.''.

SEC. 104. SURVEY OF INFORMAL CAREGIVERS.

    (a) In General.--The Secretary of Veterans Affairs shall, in 
collaboration with the Secretary of Defense, conduct a national survey 
of family caregivers of seriously disabled veterans and members of the 
Armed Forces to better understand the size and characteristics of the 
population of such caregivers and the types of care they provide such 
veterans and members.
    (b) Report.--Not later than 540 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall, in 
collaboration with the Secretary of Defense, submit to Congress a 
report containing the findings of the Secretary with respect to the 
survey conducted under subsection (a). Results of the survey shall be 
disaggregated by the following:
            (1) Veterans and members of the Armed Forces.
            (2) Veterans and members of the Armed Forces who served in 
        Operation Iraqi Freedom or Operation Enduring Freedom.
            (3) Veterans and members of the Armed Forces who live in 
        rural areas.

              TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

SEC. 201. REPORT ON BARRIERS TO RECEIPT OF HEALTH CARE FOR WOMEN 
              VETERANS.

    (a) Report.--Not later than June 1, 2010, 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 barriers to the receipt of 
comprehensive health care through the Department of Veterans Affairs 
that are encountered by women veterans, especially veterans of 
Operation Iraqi Freedom and Operation Enduring Freedom.
    (b) Elements.--The report required by subsection (a) shall include 
the following:
            (1) An identification and assessment of the following:
                    (A) Any stigma perceived or associated with seeking 
                mental health care services through the Department of 
                Veterans Affairs.
                    (B) The effect on access to care through the 
                Department of driving distance or availability of other 
                forms of transportation to the nearest appropriate 
                facility of the Department.
                    (C) The availability of child care.
                    (D) The receipt of health care through women's 
                health clinics, integrated primary care clinics, or 
                both.
                    (E) The extent of comprehension of eligibility 
                requirements for health care through the Department, 
                and the scope of health care services available through 
                the Department.
                    (F) The quality and nature of the reception of 
                women veterans by Department health care providers and 
                other staff.
                    (G) The perception of personal safety and comfort 
                of women veterans in inpatient, outpatient, and 
                behavioral health facilities of the Department.
                    (H) The sensitivity of Department health care 
                providers and other staff to issues that particularly 
                affect women.
                    (I) The effectiveness of outreach on health care 
                services of the Department that are available to women 
                veterans.
                    (J) Such other matters as the Secretary identifies 
                for purposes of the assessment.
            (2) Such recommendations for administrative and legislative 
        action as the Secretary considers appropriate in light of the 
        report.
    (c) Facility of the Department Defined.--In this section, the term 
``facility of the Department'' has the meaning given that term in 
section 1701 of title 38, United States Code.

SEC. 202. PLAN TO IMPROVE PROVISION OF HEALTH CARE SERVICES TO WOMEN 
              VETERANS.

    (a) Plan To Improve Services.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        develop a plan--
                    (A) to improve the provision of health care 
                services to women veterans; and
                    (B) to plan appropriately for the future health 
                care needs, including mental health care needs, of 
                women serving on active duty in the Armed Forces in the 
                combat theaters of Operation Iraqi Freedom and 
                Operation Enduring Freedom.
            (2) Required actions.--In developing the plan required by 
        this subsection, the Secretary of Veterans Affairs shall--
                    (A) identify the types of health care services to 
                be available to women veterans at each Department of 
                Veterans Affairs medical center; and
                    (B) identify the personnel and other resources 
                required to provide such services to women veterans 
                under the plan at each such medical center.
    (b) Submittal of Plan to Congress.--Not later than 18 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 the plan required by this section, along with such 
recommendations for administrative and legislative action as the 
Secretary considers appropriate in light of the plan.

SEC. 203. INDEPENDENT STUDY ON HEALTH CONSEQUENCES OF WOMEN VETERANS OF 
              MILITARY SERVICE IN OPERATION IRAQI FREEDOM AND OPERATION 
              ENDURING FREEDOM.

    (a) Study Required.--The Secretary of Veterans Affairs shall enter 
into an agreement with a non-Department of Veterans Affairs entity for 
the purpose of conducting a study on health consequences for women 
veterans of service on active duty in the Armed Forces in deployment in 
Operation Iraqi Freedom and Operation Enduring Freedom.
    (b) Specific Matters Studied.--The study under subsection (a) shall 
include the following:
            (1) A determination of any association of environmental and 
        occupational exposures and combat in Operation Iraqi Freedom or 
        Operation Enduring Freedom with the general health, mental 
        health, or reproductive health of women who served on active 
        duty in the Armed Forces in Operation Iraqi Freedom or 
        Operation Enduring Freedom.
            (2) A review and analysis of published literature on 
        environmental and occupational exposures of women while serving 
        in the Armed Forces, including combat trauma, military sexual 
        trauma, and exposure to potential teratogens associated with 
        reproductive problems and birth defects.
    (c) Report.--
            (1) In general.--Not later than 18 months after entering 
        into the agreement for the study under subsection (a), the 
        entity described in subsection (a) shall submit to the 
        Secretary of Veterans Affairs and to Congress a report on the 
        study containing such findings and determinations as the entity 
        considers appropriate.
            (2) Responsive report.--Not later than 90 days after the 
        receipt of the report under paragraph (1), the Secretary shall 
        submit to Congress a report setting forth the response of the 
        Secretary to the findings and determinations of the entity 
        described in subsection (a) in the report under paragraph (1).

SEC. 204. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE PROVIDERS 
              ON CARE FOR VETERANS SUFFERING FROM SEXUAL TRAUMA.

    (a) Program Required.--Section 1720D is amended--
            (1) by redesignating subsection (d) as subsection (f); and
            (2) by inserting after subsection (c) the following new 
        subsections:
    ``(d)(1) The Secretary shall implement a program for education, 
training, certification, and continuing medical education for mental 
health professionals to specialize in the provision of counseling and 
care to veterans eligible for services under subsection (a). In 
carrying out the program, the Secretary shall ensure that all such 
mental health professionals have been trained in a consistent manner 
and that such training includes principles of evidence-based treatment 
and care for sexual trauma.
    ``(2) The Secretary shall determine the minimum qualifications 
necessary for mental health professionals certified by the program 
under paragraph (1) to provide evidence-based treatment and therapy to 
veterans eligible for services under subsection (a) in facilities of 
the Department.
    ``(e) The Secretary shall submit to Congress each year a report on 
the counseling, care, and services provided to veterans under this 
section. Each report shall include data for the preceding year with 
respect to the following:
            ``(1) The number of mental health professionals and primary 
        care providers who have been certified under the program under 
        subsection (d), and the amount and nature of continuing medical 
        education provided under such program to professionals and 
        providers who have been so certified.
            ``(2) The number of women veterans who received counseling, 
        care, and services under subsection (a) from professionals and 
        providers who have been trained or certified under the program 
        under subsection (d).
            ``(3) The number of training, certification, and continuing 
        medical education programs operating under subsection (d).
            ``(4) The number of trained full-time equivalent employees 
        required in each facility of the Department to meet the needs 
        of veterans requiring treatment and care for sexual trauma.
            ``(5) Such other information as the Secretary considers 
        appropriate.''.
    (b) Standards for Personnel Providing Treatment for Sexual 
Trauma.--The Secretary of Veterans Affairs shall establish education, 
training, certification, and staffing standards for Department of 
Veterans Affairs health-care facilities for full-time equivalent 
employees who are trained to provide treatment and care to veterans for 
sexual trauma.

SEC. 205. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR WOMEN 
              VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED 
              FORCES.

    (a) Pilot Program Required.--
            (1) In general.--Commencing not later than 180 days after 
        the date of the enactment of this Act, the Secretary of 
        Veterans Affairs shall carry out, through the Readjustment 
        Counseling Service of the Veterans Health Administration, a 
        pilot program to evaluate the feasibility and advisability of 
        providing reintegration and readjustment services described in 
        subsection (b) in group retreat settings to women veterans who 
        are recently separated from service in the Armed Forces after a 
        prolonged deployment.
            (2) Participation at election of veteran.--The 
        participation of a veteran in the pilot program under this 
        section shall be at the election of the veteran.
    (b) Covered Services.--The services provided to a woman veteran 
under the pilot program shall include the following:
            (1) Information on reintegration into the veteran's family, 
        employment, and community.
            (2) Financial counseling.
            (3) Occupational counseling.
            (4) Information and counseling on stress reduction.
            (5) Information and counseling on conflict resolution.
            (6) Such other information and counseling as the Secretary 
        considers appropriate to assist a woman veteran under the pilot 
        program in reintegration into the veteran's family and 
        community.
    (c) Locations.--The Secretary shall carry out the pilot program at 
not fewer than five locations selected by the Secretary for purposes of 
the pilot program.
    (d) Duration.--The pilot program shall be carried out during the 
two-year period beginning on the date of the commencement of the pilot 
program.
    (e) Report.--Not later than 180 days after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program. The report shall contain the findings and conclusions of 
the Secretary as a result of the pilot program, and shall include such 
recommendations for the continuation or expansion of the pilot program 
as the Secretary considers appropriate.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary of Veterans Affairs for each of fiscal 
years 2010 and 2011, $2,000,000 to carry out the pilot program.

SEC. 206. REPORT ON FULL-TIME WOMEN VETERANS PROGRAM MANAGERS AT 
              MEDICAL CENTERS.

    The Secretary shall, acting through the Under Secretary for Health, 
submit to Congress a report on employment of full-time women veterans 
program managers at Department of Veterans Affairs medical centers to 
ensure that health care needs of women veterans are met. Such report 
should include an assessment of whether there is at least one full-time 
employee at each Department medical center who is a full-time women 
veterans program manager.

SEC. 207. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN RECENTLY 
              SEPARATED FROM SERVICE IN THE ARMED FORCES.

    (a) Advisory Committee on Women Veterans.--Section 542(a)(2)(A) is 
amended--
            (1) in clause (ii), by striking ``and'' at the end;
            (2) in clause (iii), by striking the period at the end and 
        inserting ``; and''; and
            (3) by inserting after clause (iii) the following new 
        clause:
            ``(iv) women veterans who are recently separated from 
        service in the Armed Forces.''.
    (b) Advisory Committee on Minority Veterans.--Section 544(a)(2)(A) 
is amended--
            (1) in clause (iii), by striking ``and'' at the end;
            (2) in clause (iv), by striking the period at the end and 
        inserting ``; and''; and
            (3) by inserting after clause (iv) the following new 
        clause:
            ``(v) women veterans who are minority group members and are 
        recently separated from service in the Armed Forces.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to appointments made on or after the date of the enactment of 
this Act.

SEC. 208. PILOT PROGRAM ON SUBSIDIES FOR CHILD CARE FOR CERTAIN 
              VETERANS RECEIVING HEALTH CARE.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasibility and 
advisability of providing, subject to subsection (b), subsidies to 
qualified veterans described in subsection (c) to obtain child care so 
that such veterans can receive health care services described in such 
subsection.
    (b) Limitation on Period of Payments.--A subsidy may only be 
provided to a qualified veteran under the pilot program for receipt of 
child care during the period that the qualified veteran--
            (1) receives the types of health care services referred to 
        in subsection (c) at a facility of the Department; and
            (2) requires to travel to and return from such facility for 
        the receipt of such health care services.
    (c) Qualified Veterans.--In this section, the term ``qualified 
veteran'' means a veteran who is the primary caretaker of a child or 
children and who is receiving from the Department one or more of the 
following health care services:
            (1) Regular mental health care services.
            (2) Intensive mental health care services.
            (3) Such other intensive health care services that the 
        Secretary determines that payment to the veteran for the 
        provision of child care would improve access to those health 
        care services by the veteran.
    (d) Locations.--The Secretary shall carry out the pilot program in 
no fewer than three Veterans Integrated Service Networks (VISNs) 
selected by the Secretary for purposes of the pilot program.
    (e) Duration.--The pilot program shall be carried out during the 
two-year period beginning on the date of the commencement of the pilot 
program.
    (f) Existing Model.--To the extent practicable, the Secretary shall 
model the pilot program after the Department of Veterans Affairs Child 
Care Subsidy Program that was established pursuant to section 630 of 
the Treasury and General Government Appropriations Act, 2002 (Public 
Law 107-67; 115 Stat. 552), using the same income eligibility standards 
and payment structure.
    (g) Report.--Not later than six months after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program. The report shall include the findings and conclusions of 
the Secretary as a result of the pilot program, and shall include such 
recommendations for the continuation or expansion of the pilot program 
as the Secretary considers appropriate.
    (h) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary of Veterans Affairs for each of fiscal 
years 2010 and 2011, $1,500,000 to carry out the pilot program.

SEC. 209. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING 
              MATERNITY CARE.

    (a) In General.--Subchapter VIII of chapter 17 is amended by adding 
at the end the following new section:

``SEC. 1786. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING 
              MATERNITY CARE.

    ``(a) In General.--The Secretary may furnish health care services 
described in subsection (b) to a newborn child of a woman veteran who 
is receiving maternity care furnished by the Department for not more 
than 7 days after the birth of the child if the veteran delivered the 
child in--
            ``(1) a facility of the Department; or
            ``(2) another facility pursuant to a Department contract 
        for services relating to such delivery.
    ``(b) Covered Health Care Services.--Health care services described 
in this subsection are all post-delivery care services, including 
routine care services, that a newborn requires.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1785 the following new item:

``1786. Care for newborn children of women veterans receiving maternity 
                            care.''.

                  TITLE III--RURAL HEALTH IMPROVEMENTS

SEC. 301. ENHANCEMENT OF DEPARTMENT OF VETERANS AFFAIRS EDUCATION DEBT 
              REDUCTION PROGRAM.

    (a) Enhanced Maximum Annual Amount.--Paragraph (1) of section 
7683(d) is amended by striking ``$44,000'' and all that follows through 
``fifth years of participation in the Program'' and inserting ``the 
total amount of principle and interest owed by the participant on loans 
referred to in subsection (a)''.
    (b) Notice to Potential Employees of Eligibility and Selection for 
Participation.--Section 7682 is amended by adding at the end the 
following new subsection:
    ``(d) Notice to Potential Employees.--In each offer of employment 
made by the Secretary to an individual who, upon acceptance of such 
offer would be treated as eligible to participate in the Education Debt 
Reduction Program, the Secretary shall, to the maximum extent 
practicable, include the following:
            ``(1) A notice that the individual will be treated as 
        eligible to participate in the Education Debt Reduction Program 
        upon the individual's acceptance of such offer.
            ``(2) A notice of the determination of the Secretary 
        whether or not the individual will be selected as a participant 
        in the Education Debt Reduction Program as of the individual's 
        acceptance of such offer.''.
    (c) Selection of Employees Who Receive Notice of Selection With 
Employment Offer.--Section 7683 is further amended by adding at the end 
the following new subsection:
    ``(e) Selection of Participants.--(1) The Secretary shall select 
for participation in the Education Debt Reduction Program each 
individual eligible for participation in the Education Debt Reduction 
Program who--
            ``(A) the Secretary provided notice with an offer of 
        employment under section 7682(d) of this title that indicated 
        the individual would, upon the individual's acceptance of such 
        offer of employment, be--
                    ``(i) eligible to participate in the Education Debt 
                Reduction Program; and
                    ``(ii) selected to participate in the Education 
                Debt Reduction Program; and
            ``(B) accepts such offer of employment.
    ``(2) The Secretary may select for participation in the Education 
Debt Reduction Program an individual eligible for participation in the 
Education Debt Reduction Program who is not described by subparagraphs 
(A) and (B) of paragraph (1).''.

SEC. 302. VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY PROFESSIONALS 
              EDUCATION ASSISTANCE PROGRAM.

    (a) Establishment of Program.--Part V is amended by inserting after 
chapter 74 the following new chapter:

     ``CHAPTER 75--VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY 
               PROFESSIONALS EDUCATION ASSISTANCE PROGRAM

``Sec.
``7501. Establishment of scholarship program; purpose.
``7502. Application and acceptance.
``7503. Amount of assistance; duration.
``7504. Agreement.
``7505. Repayment for failure to satisfy requirements of agreement.
``Sec. 7501. Establishment of scholarship program; purpose
    ``(a) Establishment.--Subject to the availability of 
appropriations, the Secretary shall establish and carry out a 
scholarship program to provide financial assistance in accordance with 
this chapter to an individual--
            ``(1) who is accepted for enrollment or currently enrolled 
        in a program of study leading to a degree or certificate in 
        visual impairment or orientation and mobility, or a dual degree 
        or certification in both such areas, at an accredited (as 
        determined by the Secretary) educational institution that is in 
        a State; and
            ``(2) who enters into an agreement with the Secretary as 
        described in section 7504 of this chapter.
    ``(b) Purpose.--The purpose of the scholarship program established 
under this chapter is to increase the supply of qualified blind 
rehabilitation specialists for the Department and the Nation.
    ``(c) Outreach.--The Secretary shall publicize the scholarship 
program established under this chapter to educational institutions 
throughout the United States, with an emphasis on disseminating 
information to such institutions with high numbers of Hispanic students 
and to Historically Black Colleges and Universities.
``Sec. 7502. Application and acceptance
    ``(a) Application.--(1) To apply and participate in the scholarship 
program under this chapter, an individual shall submit to the Secretary 
an application for such participation together with an agreement 
described in section 7504 of this chapter under which the participant 
agrees to serve a period of obligated service in the Department as 
provided in the agreement in return for payment of educational 
assistance as provided in the agreement.
    ``(2) In distributing application forms and agreement forms to 
individuals desiring to participate in the scholarship program, the 
Secretary shall include with such forms the following:
            ``(A) A fair summary of the rights and liabilities of an 
        individual whose application is approved (and whose agreement 
        is accepted) by the Secretary.
            ``(B) A full description of the terms and conditions that 
        apply to participation in the scholarship program and service 
        in the Department.
    ``(b) Approval.--(1) Upon the Secretary's approval of an 
individual's participation in the scholarship program, the Secretary 
shall, in writing, promptly notify the individual of that acceptance.
    ``(2) An individual becomes a participant in the scholarship 
program upon such approval by the Secretary.
``Sec. 7503. Amount of assistance; duration
    ``(a) Amount of Assistance.--The amount of the financial assistance 
provided for an individual under this chapter shall be the amount 
determined by the Secretary as being necessary to pay the tuition and 
fees of the individual. In the case of an individual enrolled in a 
program of study leading to a dual degree or certification in both the 
areas of study described in section 7501(a)(1) of this chapter, the 
tuition and fees shall not exceed the amounts necessary for the minimum 
number of credit hours to achieve such dual certification or degree.
    ``(b) Relationship to Other Assistance.--Financial assistance may 
be provided to an individual under this chapter to supplement other 
educational assistance to the extent that the total amount of 
educational assistance received by the individual during an academic 
year does not exceed the total tuition and fees for such academic year.
    ``(c) Maximum Amount of Assistance.--(1) In no case may the total 
amount of assistance provided under this chapter for an academic year 
to an individual who is a full-time student exceed $15,000.
    ``(2) In the case of an individual who is a part-time student, the 
total amount of assistance provided under this chapter shall bear the 
same ratio to the amount that would be paid under paragraph (1) if the 
participant were a full-time student in the program of study being 
pursued by the individual as the coursework carried by the individual 
to full-time coursework in that program of study.
    ``(3) In no case may the total amount of assistance provided to an 
individual under this chapter exceed $45,000.
    ``(d) Maximum Duration of Assistance.--The Secretary may provide 
financial assistance to an individual under this chapter for not more 
than six years.
``Sec. 7504. Agreement
    ``An agreement between the Secretary and a participant in the 
scholarship program under this chapter shall be in writing, shall be 
signed by the participant, and shall include--
            ``(1) the Secretary's agreement to provide the participant 
        with financial assistance as authorized under this chapter;
            ``(2) the participant's agreement--
                    ``(A) to accept such financial assistance;
                    ``(B) to maintain enrollment and attendance in the 
                program of study described in section 7501(a)(1) of 
                this chapter;
                    ``(C) while enrolled in such program, to maintain 
                an acceptable level of academic standing (as determined 
                by the educational institution offering such program 
                under regulations prescribed by the Secretary); and
                    ``(D) after completion of the program, to serve as 
                a full-time employee in the Department for a period of 
                three years, to be served within the first six years 
                after the participant has completed such program and 
                received a degree or certificate described in section 
                7501(a)(1) of this chapter; and
            ``(3) any other terms and conditions that the Secretary 
        determines appropriate for carrying out this chapter.
``Sec. 7505. Repayment for failure to satisfy requirements of agreement
    ``(a) In General.--An individual who receives educational 
assistance under this chapter shall repay to the Secretary an amount 
equal to the unearned portion of such assistance if the individual 
fails to satisfy the requirements of the agreement entered into under 
section 7504 of this chapter, except in circumstances authorized by the 
Secretary.
    ``(b) Amount of Repayment.--The Secretary shall establish, by 
regulations, procedures for determining the amount of the repayment 
required under this subsection and the circumstances under which an 
exception to the required repayment may be granted.
    ``(c) Waiver or Suspension of Compliance.--The Secretary shall 
prescribe regulations providing for the waiver or suspension of any 
obligation of an individual for service or payment under this chapter 
(or an agreement under this chapter) whenever noncompliance by the 
individual is due to circumstances beyond the control of the individual 
or whenever the Secretary determines that the waiver or suspension of 
compliance is in the best interest of the United States.
    ``(d) Obligation as Debt to United States.--An obligation to repay 
the Secretary under this section is, for all purposes, a debt owed the 
United States. A discharge in bankruptcy under title 11 does not 
discharge a person from such debt if the discharge order is entered 
less than five years after the date of the termination of the agreement 
or contract on which the debt is based.''.
    (b) Clerical Amendments.--The tables of chapters at the beginning 
of title 38, and of part V of title 38, are each amended by inserting 
after the item relating to chapter 74 the following new item:

``75. Visual Impairment and Orientation and Mobility           7501.''.
                            Professionals Education 
                            Assistance Program.
    (c) Effective Date.--The Secretary of Veterans Affairs shall 
implement chapter 75 of title 38, United States Code, as added by 
subsection (a), not later than six months after the date of the 
enactment of this Act.

SEC. 303. INCLUSION OF DEPARTMENT OF VETERANS AFFAIRS FACILITIES IN 
              LIST OF FACILITIES ELIGIBLE FOR ASSIGNMENT OF 
              PARTICIPANTS IN NATIONAL HEALTH SERVICE CORPS SCHOLARSHIP 
              PROGRAM.

    The Secretary of Veterans Affairs shall transfer $20,000,000 from 
accounts of the Veterans Health Administration to the Secretary of 
Health and Human Services to include facilities of the Department of 
Veterans Affairs in the list maintained by the Health Resources and 
Services Administration of facilities eligible for assignment of 
participants in the National Health Service Corps Scholarship Program.

SEC. 304. TELECONSULTATION AND TELEMEDICINE.

    (a) Teleconsultation and Teleretinal Imaging.--
            (1) In general.--Subchapter I of chapter 17 is amended by 
        adding at the end the following new section:
``Sec. 1709. Teleconsultation and teleretinal imaging
    ``(a) Teleconsultation.--(1) The Secretary shall carry out a 
program of teleconsultation for the provision of remote mental health 
and traumatic brain injury assessments in facilities of the Department 
that are not otherwise able to provide such assessments without 
contracting with third party providers or reimbursing providers through 
a fee-basis system.
    ``(2) The Secretary shall, in consultation with appropriate 
professional societies, promulgate technical and clinical care 
standards for the use of teleconsultation services within facilities of 
the Department.
    ``(b) Teleretinal Imaging.--The Secretary shall carry out a program 
of teleretinal imaging in each Veterans Integrated Services Network 
(VISN).
    ``(c) Annual Reports.--In each fiscal year beginning with fiscal 
year 2010 and ending with fiscal year 2015, the Secretary shall submit 
to Congress a report on the programs required by subsections (a) and 
(b). Such report shall include the following:
            ``(1) A description of the efforts made by the Secretary to 
        make teleconsultation available in rural areas and to utilize 
        teleconsultation in rural areas.
            ``(2) The rates of utilization of teleconsultation by 
        Veterans Integrated Services Network disaggregated by each 
        fiscal year for which a report is submitted under this 
        subsection.
    ``(d) Definitions.--In this section:
            ``(1) The term `teleconsultation' means the use by a health 
        care specialist of telecommunications to assist another health 
        care provider in rendering a diagnosis or treatment.
            ``(2) The term `teleretinal imaging' means the use by a 
        health care specialist of telecommunications, digital retinal 
        imaging, and remote image interpretation to provide eye 
        care.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 17 is amended by inserting after the item 
        related to section 1708 the following new item:

``1709. Teleconsultation and teleretinal imaging.''.
    (b) Training in Telemedicine.--The Secretary of Veterans Affairs 
shall require each Department of Veterans Affairs facility that is 
involved in the training of medical residents to work with each 
university concerned to develop an elective rotation in telemedicine 
for such residents.
    (c) Enhancement of VERA.--
            (1) Incentives for provision of teleconsultation, 
        teleretinal imaging, telemedicine, and telehealth services.--
        The Secretary of Veterans Affairs shall modify the Veterans 
        Equitable Resource Allocation system to provide Veterans 
        Integrated Services Networks with incentives to utilize 
        teleconsultation, teleretinal imaging, telemedicine, and 
        telehealth coordination services.
            (2) Inclusion of telemedicine visits in workload 
        reporting.--The Secretary shall modify the Veterans Equitable 
        Resource Allocation system to require the inclusion of all 
        telemedicine visits in the calculation of facility workload.
    (d) Definitions.--In this section:
            (1) The terms ``teleconsultation'' and ``teleretinal 
        imaging'' have the meanings given such terms in section 1709 of 
        title 38, United States Code, as added by subsection (a).
            (2) The term ``telemedicine'' means the use by a health 
        care provider of telecommunications to assist in the diagnosis 
        or treatment of a patient's medical condition.
            (3) The term ``telehealth'' means the use of 
        telecommunications to collect patient data remotely and send 
        data to a monitoring station for interpretation.

SEC. 305. DEMONSTRATION PROJECTS ON ALTERNATIVES FOR EXPANDING CARE FOR 
              VETERANS IN RURAL AREAS.

    (a) In General.--The Secretary of Veterans Affairs, through the 
Director of the Office of Rural Health, may carry out demonstration 
projects to examine the feasibility and advisability of alternatives 
for expanding care for veterans in rural areas, which may include the 
following:
            (1) Establishing a partnership between the Department of 
        Veterans Affairs and the Centers for Medicare and Medicaid 
        Services of the Department of Health and Human Services to 
        coordinate care for veterans in rural areas at critical access 
        hospitals (as designated or certified under section 1820 of the 
        Social Security Act (42 U.S.C. 1395i-4)).
            (2) Establishing a partnership between the Department of 
        Veterans Affairs and the Department of Health and Human 
        Services to coordinate care for veterans in rural areas at 
        community health centers.
            (3) Expanding coordination between the Department of 
        Veterans Affairs and the Indian Health Service to expand care 
        for Indian veterans.
    (b) Geographic Distribution.--The Secretary shall ensure that the 
demonstration projects carried out under subsection (a) are located at 
facilities that are geographically distributed throughout the United 
States.
    (c) Report.--Not later than two years after the date of the 
enactment of this Act, the Secretary shall submit a report on the 
results of the demonstration projects conducted under subsection (a) 
to--
            (1) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the Senate; and
            (2) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the House of Representatives.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for fiscal year 2010 
and each fiscal year thereafter.

SEC. 306. PROGRAM ON PROVISION OF READJUSTMENT AND MENTAL HEALTH CARE 
              SERVICES TO VETERANS WHO SERVED IN OPERATION IRAQI 
              FREEDOM AND OPERATION ENDURING FREEDOM.

    (a) Program Required.--Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall 
establish a program to provide--
            (1) to veterans of Operation Iraqi Freedom and Operation 
        Enduring Freedom, particularly veterans who served in such 
        operations while in the National Guard and the Reserves--
                    (A) peer outreach services;
                    (B) peer support services;
                    (C) readjustment counseling and services described 
                in section 1712A of title 38, United States Code; and
                    (D) mental health services; and
            (2) to members of the immediate family of such a veteran, 
        during the three-year period beginning on the date of the 
        return of such veteran from deployment in Operation Iraqi 
        Freedom or Operation Enduring Freedom, education, support, 
        counseling, and mental health services to assist in--
                    (A) the readjustment of such veteran to civilian 
                life;
                    (B) in the case such veteran has an injury or 
                illness incurred during such deployment, the recovery 
                of such veteran; and
                    (C) the readjustment of the family following the 
                return of such veteran.
    (b) Contracts With Community Mental Health Centers and Qualified 
Entities for Provision of Services.--In carrying out the program 
required by subsection (a), the Secretary shall contract with community 
mental health centers and other qualified entities to provide the 
services required by such subsection only in areas the Secretary 
determines are not adequately served by other health care facilities or 
vet centers of the Department of Veterans Affairs. Such contracts shall 
require each contracting community health center or entity--
            (1) to the extent practicable, to use telehealth services 
        for the delivery of services required by subsection (a);
            (2) to the extent practicable, to employ veterans trained 
        under subsection (c);
            (3) to participate in the training program conducted in 
        accordance with subsection (d);
            (4) to comply with applicable protocols of the Department 
        before incurring any liability on behalf of the Department for 
        the provision of the services required by subsection (a);
            (5) for each veteran for whom a community mental health 
        center or other qualified entity provides mental health 
        services under such contract, to provide the Department with 
        such clinical summary information as the Secretary shall 
        require;
            (6) to submit annual reports to the Secretary containing, 
        with respect to the program required by subsection (a) and for 
        the last full calendar year ending before the submission of 
        such report--
                    (A) the number of the veterans served, veterans 
                diagnosed, and courses of treatment provided to 
                veterans as part of the program required by subsection 
                (a); and
                    (B) demographic information for such services, 
                diagnoses, and courses of treatment; and
            (7) to meet such other requirements as the Secretary shall 
        require.
    (c) Training of Veterans for the Provision of Peer-outreach and 
Peer-support Services.--In carrying out the program required by 
subsection (a), the Secretary shall contract with a national not-for-
profit mental health organization to carry out a national program of 
training for veterans described in subsection (a) to provide the 
services described in subparagraphs (A) and (B) of paragraph (1) of 
such subsection.
    (d) Training of Clinicians for Provision of Services.--The 
Secretary shall conduct a training program for clinicians of community 
mental health centers or entities that have contracts with the 
Secretary under subsection (b) to ensure that such clinicians can 
provide the services required by subsection (a) in a manner that--
            (1) recognizes factors that are unique to the experience of 
        veterans who served on active duty in Operation Iraqi Freedom 
        or Operation Enduring Freedom (including their combat and 
        military training experiences); and
            (2) utilizes best practices and technologies.
    (e) Reports Required.--
            (1) Initial report on plan for implementation.--Not later 
        than 45 days 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 containing the plans of the 
        Secretary to implement the program required by subsection (a).
            (2) Status 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 
        on the implementation of the program. Such report shall include 
        the following:
                    (A) Information on the number of veterans who 
                received services as part of the program and the type 
                of services received during the last full calendar year 
                completed before the submission of such report.
                    (B) An evaluation of the provision of services 
                under paragraph (2) of subsection (a) and a 
                recommendation as to whether the period described in 
                such paragraph should be extended to a five-year 
                period.

SEC. 307. IMPROVEMENT OF CARE OF AMERICAN INDIAN VETERANS.

    (a) Indian Health Coordinators.--
            (1) In general.--Subchapter II of chapter 73 is amended by 
        adding at the end the following new section:
``Sec. 7330B. Indian Veterans Health Care Coordinators
    ``(a) In General.--(1) The Secretary shall assign at each of the 10 
Department Medical Centers that serve communities with the greatest 
number of Indian veterans per capita an official or employee of the 
Department to act as the coordinator of health care for Indian veterans 
at such Medical Center. The official or employee so assigned at a 
Department Medical Center shall be known as the `Indian Veterans Health 
Care Coordinator' for the Medical Center.
    ``(2) The Secretary shall, from time to time--
            ``(A) survey the Department Medical Centers for purposes of 
        identifying the 10 Department Medical Centers that currently 
        serve communities with the greatest number of Indian veterans 
        per capita; and
            ``(B) utilizing the results of the most recent survey 
        conducted under subparagraph (A), revise the assignment of 
        Indian Veterans Health Care Coordinators in order to assure the 
        assignment of such coordinators to appropriate Department 
        Medical Centers as required by paragraph (1).
    ``(b) Duties.--The duties of an Indian Veterans Health Care 
Coordinator shall include the following:
            ``(1) Improving outreach to tribal communities.
            ``(2) Coordinating the medical needs of Indian veterans on 
        Indian reservations with the Veterans Health Administration and 
        the Indian Health Service.
            ``(3) Expanding the access and participation of the 
        Department of Veterans Affairs, the Indian Health Service, and 
        tribal members in the Department of Veterans Affairs Tribal 
        Veterans Representative program.
            ``(4) Acting as an ombudsman for Indian veterans enrolled 
        in the health care system of the Veterans Health 
        Administration.
            ``(5) Advocating for the incorporation of traditional 
        medicine and healing in Department treatment plans for Indian 
        veterans in need of care and services provided by the 
        Department.
    ``(c) Indian Defined.--In this section, the term `Indian' has the 
meaning given the term in section 4 of the Indian Self-Determination 
and Education Assistance Act (25 U.S.C. 450b).''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 73 is amended by inserting after the item 
        relating to section 7330A the following new item:

``7330B. Indian Veterans Health Coordinators.''.
    (b) Integration of Electronic Health Records With Indian Health 
Service.--Not later than one year after the date of the enactment of 
this Act, the Secretary of Veterans Affairs and the Secretary of Health 
and Human Services shall enter into a memorandum of understanding to 
ensure that the health records of Indian veterans may be transferred 
electronically between facilities of the Indian Health Service and the 
Department of Veterans Affairs.
    (c) Transfer of Medical Equipment to the Indian Health Service.--
            (1) In general.--The Secretary of Veterans Affairs may 
        transfer to the Indian Health Service such surplus Department 
        of Veterans Affairs medical and information technology 
        equipment as the Secretary of Veterans Affairs and the 
        Secretary of Health and Human Services jointly consider 
        appropriate for purposes of the Indian Health Service.
            (2) Transportation and installation.--In transferring 
        medical or information technology equipment under this 
        subsection, the Secretary of Veterans Affairs may transport and 
        install such equipment in facilities of the Indian Health 
        Service.
    (d) Report on Joint Health Clinics With Indian Health Service.--Not 
later than one year after the date of the enactment of this Act, the 
Secretary of Veterans Affairs and the Secretary of Health and Human 
Services shall jointly submit to Congress a report on the feasability 
and advisability of the joint establishment and operation by the 
Veterans Health Administration and the Indian Health Service of health 
clinics on Indian reservations to serve the populations of such 
reservations, including Indian veterans.

SEC. 308. TRAVEL REIMBURSEMENT FOR VETERANS RECEIVING TREATMENT AT 
              FACILITIES OF THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Enhancement of Allowance Based Upon Mileage Traveled.--Section 
111 is amended--
            (1) in subsection (a), by striking ``traveled,'' and 
        inserting ``(at a rate of 41.5 cents per mile),''; and
            (2) by amending subsection (g) to read as follows:
    ``(g)(1) Beginning one year after the date of the enactment of the 
Caregivers and Veterans Omnibus Health Services Act of 2009, the 
Secretary may adjust the mileage rate described in subsection (a) to be 
equal to 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) If an adjustment in the mileage rate under paragraph (1) 
results in a lower mileage rate than the mileage rate otherwise 
specified in subsection (a), the Secretary shall, not later than 60 
days before the date of the implementation of the mileage rate as so 
adjusted, submit to Congress a written report setting forth the 
adjustment in the mileage rate under this subsection, together with a 
justification for the decision to make the adjustment in the mileage 
rate under this subsection.''.
    (b) Coverage of Cost of Transportation by Air.--Subsection (a) of 
section 111, as amended by subsection (a)(1), is further amended by 
inserting after the first sentence the following new sentence: ``Actual 
necessary expense of travel includes the reasonable costs of airfare if 
travel by air is the only practical way to reach a Department 
facility.''.
    (c) Elimination of Limitation Based on Maximum Annual Rate of 
Pension.--Subsection (b)(1)(D)(i) of such section is amended by 
inserting ``who is not traveling by air and'' before ``whose annual''.
    (d) Determination of Practicality.--Subsection (b) of such section 
is amended by adding at the end the following new paragraph:
    ``(4) In determining for purposes of subsection (a) whether travel 
by air is the only practical way for a veteran to reach a Department 
facility, the Secretary shall consider the medical condition of the 
veteran and any other impediments to the use of ground transportation 
by the veteran.''.
    (e) No Expansion of Eligibility for Beneficiary Travel.--The 
amendments made by subsections (b) and (d) of this section may not be 
construed as expanding or otherwise modifying eligibility for payments 
or allowances for beneficiary travel under section 111 of title 38, 
United States Code, as in effect on the day before the date of the 
enactment of this Act.
    (f) Clarification of Relation to Public Transportation in Veterans 
Health Administration Handbook.--Not later than 30 days after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
revise the Veterans Health Administration Handbook to clarify that an 
allowance for travel based on mileage paid under section 111(a) of 
title 38, United States Code, may exceed the cost of such travel by 
public transportation regardless of medical necessity.

SEC. 309. OFFICE OF RURAL HEALTH FIVE-YEAR STRATEGIC PLAN.

    (a) Strategic Plan.--Not later than 180 days after the date of the 
enactment of this Act, the Director of the Office of Rural Health of 
the Department of Veterans Affairs shall develop a five-year strategic 
plan for the Office of Rural Health.
    (b) Contents.--The plan required by subsection (a) shall include 
the following:
            (1) Specific goals for the recruitment and retention of 
        health care personnel in rural areas, developed in conjunction 
        with the Director of the Health Care Retention and Recruitment 
        Office of the Department of Veterans Affairs.
            (2) Specific goals for ensuring the timeliness and quality 
        of health care delivery in rural communities that are reliant 
        on contract and fee-basis care, developed in conjunction with 
        the Director of the Office of Quality and Performance of the 
        Department.
            (3) Specific goals for the expansion and implementation of 
        telemedicine services in rural areas, developed in conjunction 
        with the Director of the Office of Care Coordination Services 
        of the Department.
            (4) Incremental milestones describing specific actions to 
        be taken for the purpose of achieving the goals specified under 
        paragraphs (1) through (3).

SEC. 310. OVERSIGHT OF CONTRACT AND FEE-BASIS CARE.

    (a) In General.--Subchapter I of chapter 17 is amended by inserting 
after section 1703 the following new section:
``Sec. 1703A. Oversight of contract and fee-basis care
    ``(a) Rural Outreach Coordinators.--The Secretary shall designate a 
rural outreach coordinator at each Department community based 
outpatient clinic at which not less than 50 percent of the veterans 
enrolled at such clinic reside in a highly rural area. The coordinator 
at a clinic shall be responsible for coordinating care and 
collaborating with community contract and fee-basis providers with 
respect to the clinic.
    ``(b) Incentives To Obtain Accreditation of Medical Practice.--(1) 
The Secretary shall adjust the fee-basis compensation of providers of 
health care services under the Department to encourage such providers 
to obtain accreditation of their medical practice from recognized 
accrediting entities.
    ``(2) In making adjustments under paragraph (1), the Secretary 
shall consider the increased overhead costs of accreditation described 
in paragraph (1) and the costs of achieving and maintaining such 
accreditation.
    ``(c) Incentives for Participation in Peer Review.--(1) The 
Secretary shall adjust the fee-basis compensation of providers of 
health care services under the Department that do not provide such 
services as part of a medical practice accredited by a recognized 
accrediting entity to encourage such providers to participate in peer 
review under subsection (e).
    ``(2) The Secretary shall provide incentives under paragraph (1) to 
a provider of health care services under the Department in an amount 
which may reasonably be expected (as determined by the Secretary) to 
encourage participation in the voluntary peer review under subsection 
(d).
    ``(d) Peer Review.--(1) The Secretary shall provide for the 
voluntary peer review of providers of health care services under the 
Department who provide such services on a fee basis as part of a 
medical practice that is not accredited by a recognized accrediting 
entity.
    ``(2) Each year, beginning with the first fiscal year beginning 
after the date of the enactment of this section, the Chief Quality and 
Performance Officer in each Veterans Integrated Services Network (VISN) 
shall select a sample of patient records from each participating 
provider in the Officer's Veterans Integrated Services Network to be 
peer reviewed by a facility designated under paragraph (3).
    ``(3) The Chief Quality and Performance Officer in each Veterans 
Integrated Services Network shall designate Department facilities in 
such network for the peer review of patient records submitted under 
this subsection.
    ``(4) Each year, beginning with the first fiscal year beginning 
after the date of the enactment of this section, each provider who 
elects to participate in the program shall submit the patient records 
selected under paragraph (2) to a facility selected under paragraph (3) 
to be peer reviewed by such facility.
    ``(5) Each Department facility designated under paragraph (3) that 
receives patient records under paragraph (4) shall--
            ``(A) peer review such records in accordance with policies 
        and procedures established by the Secretary;
            ``(B) ensure that peer reviews are evaluated by the Peer 
        Review Committee; and
            ``(C) develop a mechanism for notifying the Under Secretary 
        for Health of problems identified through such peer review.
    ``(6) The Under Secretary for Health shall develop a mechanism by 
which the use of fee-basis providers of health care are terminated when 
quality of care concerns are identified with respect to such providers.
    ``(7) The Chief Quality and Performance Officer in each Veterans 
Integrated Services Network shall be responsible for the oversight of 
the program of peer review under this subsection in that network.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item related to section 
1703 the following new item:

``1703A. Oversight of contract and fee-basis care.''.

SEC. 311. ENHANCEMENT OF VET CENTERS TO MEET NEEDS OF VETERANS OF 
              OPERATION IRAQI FREEDOM AND OPERATION ENDURING FREEDOM.

    (a) Volunteer Counselors.--
            (1) In general.--Subsection (c) of section 1712A is 
        amended--
                    (A) by striking ``The Under Secretary'' and 
                inserting ``(1) The Under Secretary'';
                    (B) in paragraph (1), as designated by paragraph 
                (1), by striking ``, and, in carrying'' and all that 
                follows through ``screening activities''; and
                    (C) by adding at the end the following new 
                paragraphs:
    ``(2) In carrying out this section, the Under Secretary may utilize 
the services of the following:
            ``(A) Paraprofessionals, individuals who are volunteers 
        working without compensation, and individuals who are veteran-
        students (as described in section 3485 of this title) in 
        initial intake and screening activities.
            ``(B) Eligible volunteer counselors in the provision of 
        counseling and related mental health services.
    ``(3) For purposes of this subsection, an eligible volunteer 
counselor is an individual--
            ``(A) who--
                    ``(i) provides counseling services without 
                compensation at a center;
                    ``(ii) is a licensed psychologist or social worker;
                    ``(iii) has never been named in a tort claim 
                arising from professional activities; and
                    ``(iv) has never had, and has no pending, 
                disciplinary action taken with respect to any license 
                or certification qualifying that individual to provide 
                counseling services; or
            ``(B) who is otherwise credentialed and privileged to 
        perform counseling services by the Secretary.
    ``(4) Eligible volunteer counselors shall be issued credentials and 
privileges for the provision of counseling and related mental health 
services under this section on an expedited basis in accordance with 
such procedures as the Secretary shall establish. Such procedures shall 
provide for the completion by the Secretary of the processing of an 
application for such credentials and privileges not later than 60 days 
after receipt of the application.''.
            (2) Procedures for issuing credentials and privileges to 
        volunteer counselors.--Not later than one year after the date 
        of the enactment of this Act, the Secretary of Veterans Affairs 
        shall establish the procedures described in section 
        1712A(c)(4), as added by paragraph (1).
    (b) Outreach.--Subsection (e) of such section is amended--
            (1) by striking ``The Secretary'' and inserting ``(1) The 
        Secretary''; and
            (2) by adding at the end the following new paragraph:
    ``(2) Each center shall develop an outreach plan to ensure that the 
community served by the center is aware of the services offered by the 
center.''.

SEC. 312. CENTERS OF EXCELLENCE FOR RURAL HEALTH RESEARCH, EDUCATION, 
              AND CLINICAL ACTIVITIES.

    (a) In General.--Subchapter II of chapter 73, as amended by section 
307 of this Act, is further amended by adding at the end the following 
new section:
``Sec. 7330C. Centers of excellence for rural health research, 
              education, and clinical activities
    ``(a) Establishment of Centers.--The Secretary, through the 
Director of the Office of Rural Health, shall establish and operate at 
least one and not more than five centers of excellence for rural health 
research, education, and clinical activities, which shall--
            ``(1) conduct research on the furnishing of health services 
        in rural areas;
            ``(2) develop specific models to be used by the Department 
        in furnishing health services to veterans in rural areas;
            ``(3) provide education and training for health care 
        professionals of the Department on the furnishing of health 
        services to veterans in rural areas; and
            ``(4) develop and implement innovative clinical activities 
        and systems of care for the Department for the furnishing of 
        health services to veterans in rural areas.
    ``(b) Use of Rural Health Resource Centers.--In selecting locations 
for the establishment of centers of excellence under subsection (a), 
the Secretary may select a rural health resource center that meets the 
requirements of subsection (a).
    ``(c) Geographic Dispersion.--The Secretary shall ensure that the 
centers established under this section are located at health care 
facilities that are geographically dispersed throughout the United 
States.
    ``(d) Funding.--(1) There are authorized to be appropriated to the 
Medical Care Account and the Medical and Prosthetics Research Account 
of the Department of Veterans Affairs such sums as may be necessary for 
the support of the research and education activities of the centers 
operated under this section.
    ``(2) There shall be allocated to the centers operated under this 
section, from amounts authorized to be appropriated to the Medical Care 
Account and the Medical and Prosthetics Research Account by paragraph 
(1), such amounts as the Under Secretary of health considers 
appropriate for such centers. Such amounts shall be allocated through 
the Director of the Office of Rural Health.
    ``(3) Activities of clinical and scientific investigation at each 
center operated under this section--
            ``(A) shall be eligible to compete for the award of funding 
        from funds appropriated for the Medical and Prosthetics 
        Research Account; and
            ``(B) shall receive priority in the award of funding from 
        such account to the extent that funds are awarded to projects 
        for research in the care of rural veterans.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73, as amended by section 307 of this Act, is further amended 
by inserting after the item relating to section 7330B the following new 
item:

``7330C. Centers of excellence for rural health research, education, 
                            and clinical activities.''.

SEC. 313. PILOT PROGRAM ON INCENTIVES FOR PHYSICIANS WHO ASSUME 
              INPATIENT RESPONSIBILITIES AT COMMUNITY HOSPITALS IN 
              HEALTH PROFESSIONAL SHORTAGE AREAS.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasability and 
advisability of each of the following:
            (1) The provision of financial incentives to eligible 
        physicians who obtain and maintain inpatient privileges at 
        community hospitals in health professional shortage areas in 
        order to facilitate the provision by such physicians of primary 
        care and mental health services to veterans at such hospitals.
            (2) The collection of payments from third-party providers 
        for care provided by eligible physicians to nonveterans while 
        discharging inpatient responsibilities at community hospitals 
        in the course of exercising the privileges described in 
        paragraph (1).
    (b) Eligible Physicians.--For purposes of this section, an eligible 
physician is a primary care or mental health physician employed by the 
Department of Veterans Affairs on a full-time basis.
    (c) Duration of Program.--The pilot program shall be carried out 
during the three-year period beginning on the date of the commencement 
of the pilot program.
    (d) Locations.--
            (1) In general.--The pilot program shall be carried out at 
        not less than five community hospitals in each of not less than 
        two Veterans Integrated Services Networks (VISNs). The 
        hospitals shall be selected by the Secretary utilizing the 
        results of the survey required under subsection (e).
            (2) Qualifying community hospitals.--A community hospital 
        may be selected by the Secretary as a location for the pilot 
        program if--
                    (A) the hospital is located in a health 
                professional shortage area; and
                    (B) the number of eligible physicians willing to 
                assume inpatient responsibilities at the hospital (as 
                determined utilizing the result of the survey) is 
                sufficient for purposes of the pilot program.
    (e) Survey of Physician Interest in Participation.--
            (1) In general.--Not later than 120 days after the date of 
        the enactment of this Act, the Secretary shall conduct a survey 
        of eligible physicians to determine the extent of the interest 
        of such physicians in participating in the pilot program.
            (2) Elements.--The survey shall disclose the type, amount, 
        and nature of the financial incentives to be provided under 
        subsection (h) to physicians participating in the pilot 
        program.
    (f) Physician Participation.--
            (1) In general.--The Secretary shall select physicians for 
        participation in the pilot program from among eligible 
        physicians who--
                    (A) express interest in participating in the pilot 
                program in the survey conducted under subsection (e);
                    (B) are in good standing with the Department; and
                    (C) primarily have clinical responsibilities with 
                the Department.
            (2) Voluntary participation.--Participation in the pilot 
        program shall be voluntary. Nothing in this section shall be 
        construed to require a physician working for the Department to 
        assume inpatient responsibilities at a community hospital 
        unless otherwise required as a term or condition of employment 
        with the Department.
    (g) Assumption of Inpatient Physician Responsibilities.--
            (1) In general.--Each eligible physician selected for 
        participation in the pilot program shall assume and maintain 
        inpatient responsibilities, including inpatient 
        responsibilities with respect to nonveterans, at one or more 
        community hospitals selected by the Secretary for participation 
        in the pilot program under subsection (d).
            (2) Coverage under federal tort claims act.--If an eligible 
        physician participating in the pilot program carries out on-
        call responsibilities at a community hospital where privileges 
        to practice at such hospital are conditioned upon the provision 
        of services to individuals who are not veterans while the 
        physician is on call for such hospital, the provision of such 
        services by the physician shall be considered an action within 
        the scope of the physician's office or employment for purposes 
        of chapter 171 of title 28, United States Code (commonly 
        referred to as the ``Federal Tort Claims Act'').
    (h) Compensation.--
            (1) In general.--The Secretary shall provide each eligible 
        physician participating in the pilot program with such 
        compensation (including pay and other appropriate compensation) 
        as the Secretary considers appropriate to compensate such 
        physician for the discharge of any inpatient responsibilities 
        by such physician at a community hospital for which such 
        physician would not otherwise be compensated by the Department 
        as a full-time employee of the Department.
            (2) Written agreement.--The amount of any compensation to 
        be provided a physician under the pilot program shall be 
        specified in a written agreement entered into by the Secretary 
        and the physician for purposes of the pilot program.
            (3) Treatment of compensation.--The Secretary shall consult 
        with the Director of the Office of Personnel Management on the 
        inclusion of a provision in the written agreement required 
        under paragraph (2) that describes the treatment under Federal 
        law of any compensation provided a physician under the pilot 
        program, including treatment for purposes of retirement under 
        the civil service laws.
    (i) Collections From Third Parties.--In carrying out the pilot 
program for the purpose described in subsection (a)(2), the Secretary 
shall implement a variety and range of requirements and mechanisms for 
the collection from third-party payors of amounts to reimburse the 
Department for health care services provided to nonveterans under the 
pilot program by eligible physicians discharging inpatient 
responsibilities under the pilot program.
    (j) Inpatient Responsibilities Defined.--In this section, the term 
``inpatient responsibilities'' means on-call responsibilities 
customarily required of a physician by a community hospital as a 
condition of granting privileges to the physician to practice in the 
hospital.
    (k) Report.--Not later than one year after the date of the 
enactment of this Act and annually thereafter, the Secretary shall 
submit to Congress a report on the pilot program, including the 
following:
            (1) The findings of the Secretary with respect to the pilot 
        program.
            (2) The number of veterans and nonveterans provided 
        inpatient care by physicians participating in the pilot 
        program.
            (3) The amounts collected and payable under subsection (i).
    (l) Health Professional Shortage Area Defined.--In this section, 
the term ``health professional shortage area'' has the meaning given 
the term in section 332(a) of the Public Health Service Act (42 U.S.C. 
254e(a)).

SEC. 314. ANNUAL REPORT ON MATTERS RELATED TO CARE FOR VETERANS WHO 
              LIVE IN RURAL AREAS.

    (a) Annual Report.--The Secretary of Veterans Affairs shall submit 
to Congress each year, together with documents submitted to Congress in 
support of the budget of the President for the fiscal year beginning in 
such year (as submitted pursuant to section 1105 of title 31, United 
States Code), an assessment, current as of the fiscal year ending in 
the year before such report is submitted, of the following:
            (1) The implementation of the provisions of sections 209 
        through 213, including the amendments made by such sections.
            (2) The establishment and functions of the Office of Rural 
        Health under section 7308 of title 38, United States Code.
    (b) Additional Requirements for Initial Report.--The first report 
submitted under subsection (a) shall also include the following:
            (1) The assessment of fee-basis health-care program 
        required by section 212(b) of the Veterans Benefits, Health 
        Care, and Information Technology Act of 2006 (Public Law 109-
        461; 120 Stat. 3422).
            (2) An assessment of the outreach program required by 
        section 213 of such Act (120 Stat. 3422; 38 U.S.C. 6303 note).

SEC. 315. TRANSPORTATION GRANTS FOR RURAL VETERANS SERVICE 
              ORGANIZATIONS.

    (a) Grants Authorized.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        establish a grant program to provide innovative transportation 
        options to veterans in highly rural areas.
            (2) Eligible recipients.--The following may be awarded a 
        grant under this section:
                    (A) State veterans service agencies.
                    (B) Veterans service organizations.
            (3) Use of funds.--A State veterans service agency or 
        veterans service organization awarded a grant under this 
        section may use the grant amount to--
                    (A) assist veterans in highly rural areas to travel 
                to Department of Veterans Affairs medical centers; and
                    (B) otherwise assist in providing medical care to 
                veterans in highly rural areas.
            (4) Maximum amount.--The amount of a grant under this 
        section may not exceed $50,000.
            (5) No matching requirement.--The recipient of a grant 
        under this section shall not be required to provide matching 
        funds as a condition for receiving such grant.
    (b) Regulations.--The Secretary shall prescribe regulations for--
            (1) evaluating grant applications under this section; and
            (2) otherwise administering the program established by this 
        section.
    (c) Definitions.--In this section:
            (1) Highly rural.--The term ``highly rural'', in the case 
        of an area, means that the area consists of a county or 
        counties having a population of less than seven persons per 
        square mile.
            (2) Veterans service organization.--The term ``veterans 
        service organization'' means any organization recognized by the 
        Secretary of Veterans Affairs for the representation of 
        veterans under section 5902 of title 38, United States Code.
    (d) Authorization of Appropriations.--There are authorized to be 
appropriated $3,000,000 for each of fiscal years 2010 through 2014 to 
carry out this section.

SEC. 316. MODIFICATION OF ELIGIBILITY FOR PARTICIPATION IN PILOT 
              PROGRAM OF ENHANCED CONTRACT CARE AUTHORITY FOR HEALTH 
              CARE NEEDS OF CERTAIN VETERANS.

    Section 403(b) of the Veterans' Mental Health and other Care 
Improvements Act of 2008 (Public Law 110-387; 122 Stat. 4125; 38 U.S.C. 
1703 note) is amended to read as follows:
    ``(b) Covered Veterans.--For purposes of the pilot program under 
this section, a covered veteran is any veteran who--
            ``(1) is--
                    ``(A) enrolled in the system of patient enrollment 
                established under section 1705(a) of title 38, United 
                States Code, as of the date of the commencement of the 
                pilot program under subsection (a)(2); or
                    ``(B) eligible for health care under section 
                1710(e)(3)(C) of title 38, United States Code; and
            ``(2) resides in a location that is--
                    ``(A) more than 60 minutes driving distance from 
                the nearest Department health care facility providing 
                primary care services, if the veteran is seeking such 
                services;
                    ``(B) more than 120 minutes driving distance from 
                the nearest Department health care facility providing 
                acute hospital care, if the veteran is seeking such 
                care; or
                    ``(C) more than 240 minutes driving distance from 
                the nearest Department health care facility providing 
                tertiary care, if the veteran is seeking such care.''.

                  TITLE IV--MENTAL HEALTH CARE MATTERS

SEC. 401. ELIGIBILITY OF MEMBERS OF THE ARMED FORCES WHO SERVE IN 
              OPERATION IRAQI FREEDOM OR OPERATION ENDURING FREEDOM FOR 
              COUNSELING AND SERVICES THROUGH READJUSTMENT COUNSELING 
              SERVICE.

    (a) In General.--Any member of the Armed Forces, including a member 
of the National Guard or Reserve, who serves on active duty in the 
Armed Forces in Operation Iraqi Freedom or Operation Enduring Freedom 
is eligible for readjustment counseling and related mental health 
services under section 1712A of title 38, United States Code, through 
the Readjustment Counseling Service of the Veterans Health 
Administration.
    (b) No Requirement for Current Active Duty Service.--A member of 
the Armed Forces who meets the requirements for eligibility for 
counseling and services under subsection (a) is entitled to counseling 
and services under that subsection regardless of whether or not the 
member is currently on active duty in the Armed Forces at the time of 
receipt of counseling and services under that subsection.
    (c) Regulations.--The eligibility of members of the Armed Forces 
for counseling and services under subsection (a) shall be subject to 
such regulations as the Secretary of Defense and the Secretary of 
Veterans Affairs shall jointly prescribe for purposes of this section.
    (d) Subject to Availability of Appropriations.--The provision of 
counseling and services under subsection (a) shall be subject to the 
availability of appropriations for such purpose.

SEC. 402. RESTORATION OF AUTHORITY OF READJUSTMENT COUNSELING SERVICE 
              TO PROVIDE REFERRAL AND OTHER ASSISTANCE UPON REQUEST TO 
              FORMER MEMBERS OF THE ARMED FORCES NOT AUTHORIZED 
              COUNSELING.

    Section 1712A is amended--
            (1) by redesignating subsections (c) through (f) as 
        subsections (d) through (g), respectively; and
            (2) by inserting after subsection (b) the following new 
        subsection (c):
    ``(c) Upon receipt of a request for counseling under this section 
from any individual who has been discharged or released from active 
military, naval, or air service but who is not otherwise eligible for 
such counseling, the Secretary shall--
            ``(1) provide referral services to assist such individual, 
        to the maximum extent practicable, in obtaining mental health 
        care and services from sources outside the Department; and
            ``(2) if pertinent, advise such individual of such 
        individual's rights to apply to the appropriate military, 
        naval, or air service, and to the Department, for review of 
        such individual's discharge or release from such service.''.

SEC. 403. STUDY ON SUICIDES AMONG VETERANS.

    (a) Study Required.--The Secretary of Veterans Affairs shall 
conduct a study to determine the number of veterans who died by suicide 
between January 1, 1999, and the date of the enactment of this Act.
    (b) Coordination.--In carrying out the study under subsection (a) 
the Secretary of Veterans Affairs shall coordinate with--
            (1) the Secretary of Defense;
            (2) Veterans Service Organizations;
            (3) the Centers for Disease Control and Prevention; and
            (4) State public health offices and veterans agencies.
    (c) Report to Congress.--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 study required under subsection (a) and the findings of the 
Secretary.
    (d) Authorization of Appropriations.--There are authorized to be 
appropriated such sums as may be necessary to carry out this section.

SEC. 404. TRANSFER OF FUNDS TO SECRETARY OF HEALTH AND HUMAN SERVICES 
              FOR GRADUATE PSYCHOLOGY EDUCATION PROGRAM.

    (a) Transfer of Funds.--Not later than September 30, 2010, the 
Secretary of Veterans Affairs shall transfer $5,000,000 from accounts 
of the Veterans Health Administration to the Secretary of Health and 
Human Services for the Graduate Psychology Education program 
established under section 755(b)(1)(J) of the Public Health Service Act 
(42 U.S.C. 294e(b)(1)(J)).
    (b) Use of Funds Transferred.--Funds transferred under subsection 
(a) shall be used to award grants to support the training of 
psychologists in the treatment of veterans with post traumatic stress 
disorder, traumatic brain injury, and other combat-related disorders.
    (c) Preference for Department of Veterans Affairs Health Care 
Facilities.--In the awarding of grants under subsection (b), the 
Graduate Psychology Education program shall give preference to health 
care facilities of the Department of Veterans Affairs and graduate 
programs of education that are affiliated with such facilities.

                   TITLE V--OTHER HEALTH CARE MATTERS

SEC. 501. REPEAL OF CERTAIN ANNUAL REPORTING REQUIREMENTS.

    (a) Nurse Pay Report.--Section 7451 is amended--
            (1) by striking subsection (f); and
            (2) by redesignating subsection (g) as subsection (f).
    (b) Long-term Planning Report.--
            (1) In general.--Section 8107 is repealed.
            (2) Conforming amendment.--The table of sections at the 
        beginning of chapter 81 is amended by striking the item 
        relating to section 8107.

SEC. 502. MODIFICATIONS TO ANNUAL GULF WAR RESEARCH REPORT.

    Section 707(c)(1) of the Persian Gulf War Veterans' Health Status 
Act (title VII of Public Law 102-585; 38 U.S.C. 527 note) is amended by 
striking ``Not later than March 1 of each year'' and inserting ``Not 
later than July 1, 2010, and July 1 of each of the five following 
years''.

SEC. 503. PAYMENT FOR CARE FURNISHED TO CHAMPVA BENEFICIARIES.

    Section 1781 is amended at the end by adding the following new 
subsection:
    ``(e) Payment by the Secretary under this section on behalf of a 
covered beneficiary for medical care shall constitute payment in full 
and extinguish any liability on the part of the beneficiary for that 
care.''.

SEC. 504. DISCLOSURES FROM CERTAIN MEDICAL RECORDS.

    Section 7332(b)(2) is amended by adding at the end the following 
new subparagraph:
            ``(F)(i) To a representative of a patient who lacks 
        decision-making capacity, when a practitioner deems the content 
        of the given record necessary for that representative to make 
        an informed decision regarding the patient's treatment.
            ``(ii) In this subparagraph, the term `representative' 
        means an individual, organization, or other body authorized 
        under section 7331 of this title and its implementing 
        regulations to give informed consent on behalf of a patient who 
        lacks decision-making capacity.''.

SEC. 505. DISCLOSURE TO SECRETARY OF HEALTH-PLAN CONTRACT INFORMATION 
              AND SOCIAL SECURITY NUMBER OF CERTAIN VETERANS RECEIVING 
              CARE.

    (a) In General.--Subchapter I of chapter 17 is amended by adding at 
the end the following new section:
``Sec. 1709. Disclosure to Secretary of health-plan contract 
              information and social security number of certain 
              veterans receiving care
    ``(a) Required Disclosure of Health-plan Contracts.--(1) Any 
individual who applies for or is in receipt of care described in 
paragraph (2) shall, at the time of such application, or otherwise when 
requested by the Secretary, submit to the Secretary such current 
information as the Secretary may require to identify any health-plan 
contract (as defined in section 1729(i) of this title) under which such 
individual is covered, to include, as applicable--
            ``(A) the name, address, and telephone number of such 
        health-plan contract;
            ``(B) the name of the individual's spouse, if the 
        individual's coverage is under the spouse's health-plan 
        contract;
            ``(C) the plan number; and
            ``(D) the plan's group code.
    ``(2) The care described in this paragraph is--
            ``(A) hospital, nursing home, or domiciliary care;
            ``(B) medical, rehabilitative, or preventive health 
        services; or
            ``(C) other medical care under laws administered by the 
        Secretary.
    ``(b) Required Disclosure of Social Security Number.--(1) Any 
individual who applies for or is in receipt of care described in 
paragraph (2) shall, at the time of such application, or otherwise when 
requested by the Secretary, submit to the Secretary--
            ``(A) the individual's social security number; and
            ``(B) the social security number of any dependent or 
        Department beneficiary on whose behalf, or based upon whom, 
        such individual applies for or is in receipt of such care.
    ``(2) The care described in this paragraph is--
            ``(A) hospital, nursing home, or domiciliary care;
            ``(B) medical, rehabilitative, or preventive health 
        services; or
            ``(C) other medical care under laws administered by the 
        Secretary.
    ``(3) This subsection does not require an individual to furnish the 
Secretary with a social security number for any individual to whom a 
social security number has not been assigned.
    ``(c) Failure To Disclose Social Security Number.--(1) The 
Secretary shall deny an individual's application for, or may terminate 
an individual's enrollment in, the system of patient enrollment 
established by the Secretary under section 1705 of this title, if such 
individual does not provide the social security number required or 
requested to be submitted pursuant to subsection (b).
    ``(2) Following a denial or termination under paragraph (1) with 
respect to an individual, the Secretary may, upon receipt of the 
information required or requested under subsection (b), approve such 
individual's application or reinstate such individual's enrollment (if 
otherwise in order), for such medical care and services provided on and 
after the date of such receipt of information.
    ``(d) Construction.--Nothing in this section shall be construed as 
authority to deny medical care and treatment to an individual in a 
medical emergency.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter 17 is amended by inserting after the item relating to 
section 1708 the following new item:

``1709. Disclosure to Secretary of health-plan contract information and 
                            social security number of certain veterans 
                            receiving care.''.

SEC. 506. ENHANCEMENT OF QUALITY MANAGEMENT.

    (a) Enhancement of Quality Management Through Quality Management 
Officers.--
            (1) In general.--Subchapter II of chapter 73 is amended by 
        inserting after section 7311 the following new section:
``Sec. 7311A. Quality management officers
    ``(a) National Quality Management Officer.--(1) The Under Secretary 
for Health shall designate an official of the Veterans Health 
Administration to act as the principal quality management officer for 
the quality-assurance program required by section 7311 of this title. 
The official so designated may be known as the `National Quality 
Management Officer of the Veterans Health Administration' (in this 
section referred to as the `National Quality Management Officer').
    ``(2) The National Quality Management Officer shall report directly 
to the Under Secretary for Health in the discharge of responsibilities 
and duties of the Officer under this section.
    ``(3) The National Quality Management Officer shall be the official 
within the Veterans Health Administration who is principally 
responsible for the quality-assurance program referred to in paragraph 
(1). In carrying out that responsibility, the Officer shall be 
responsible for the following:
            ``(A) Establishing and enforcing the requirements of the 
        program referred to in paragraph (1).
            ``(B) Developing an aggregate quality metric from existing 
        data sources, such as the Inpatient Evaluation Center of the 
        Department, the National Surgical Quality Improvement Program, 
        and the External Peer Review Program of the Veterans Health 
        Administration, that could be used to assess reliably the 
        quality of care provided at individual Department medical 
        centers and associated community based outpatient clinics.
            ``(C) Ensuring that existing measures of quality, including 
        measures from the Inpatient Evaluation Center, the National 
        Surgical Quality Improvement Program, System-Wide Ongoing 
        Assessment and Review reports of the Department, and Combined 
        Assessment Program reviews of the Office of Inspector General 
        of the Department, are monitored routinely and analyzed in a 
        manner that ensures the timely detection of quality of care 
        issues.
            ``(D) Encouraging research and development in the area of 
        quality metrics for the purposes of improving how the 
        Department measures quality in individual facilities.
            ``(E) Carrying out such other responsibilities and duties 
        relating to quality management in the Veterans Health 
        Administration as the Under Secretary for Health shall specify.
    ``(4) The requirements under paragraph (3) shall include 
requirements regarding the following:
            ``(A) A confidential system for the submittal of reports by 
        Veterans Health Administration personnel regarding quality 
        management at Department facilities.
            ``(B) Mechanisms for the peer review of the actions of 
        individuals appointed in the Veterans Health Administration in 
        the position of physician.
    ``(b) Quality Management Officers for VISNs.--(1) The Regional 
Director of each Veterans Integrated Services Network (VISN) shall 
appoint an official of the Network to act as the quality management 
officer of the Network.
    ``(2) The quality management officer for a Veterans Integrated 
Services Network shall report to the Regional Director of the Veterans 
Integrated Services Network, and to the National Quality Management 
Officer, regarding the discharge of the responsibilities and duties of 
the officer under this section.
    ``(3) The quality management officer for a Veterans Integrated 
Services Network shall--
            ``(A) direct the quality management office in the Network; 
        and
            ``(B) coordinate, monitor, and oversee the quality 
        management programs and activities of the Administration 
        medical facilities in the Network in order to ensure the 
        thorough and uniform discharge of quality management 
        requirements under such programs and activities throughout such 
        facilities.
    ``(c) Quality Management Officers for Medical Facilities.--(1) The 
director of each Veterans Health Administration medical facility shall 
appoint a quality management officer for that facility.
    ``(2) The quality management officer for a facility shall report 
directly to the director of the facility, and to the quality management 
officer of the Veterans Integrated Services Network in which the 
facility is located, regarding the discharge of the responsibilities 
and duties of the quality management officer under this section.
    ``(3) The quality management officer for a facility shall be 
responsible for designing, disseminating, and implementing quality 
management programs and activities for the facility that meet the 
requirements established by the National Quality Management Officer 
under subsection (a).
    ``(d) Authorization of Appropriations.--(1) Except as provided in 
paragraph (2), there are authorized to be appropriated such sums as may 
be necessary to carry out this section.
    ``(2) There are authorized to be appropriated to carry out the 
provisions of subparagraphs (B), (C), and (D) of subsection (a)(3), 
$25,000,000 for the two-year period of fiscal years beginning after the 
date of the enactment of this section.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 73 is amended by inserting after the item 
        relating to section 7311 the following new item:

``7311A. Quality management officers.''.
    (b) Reports on Quality Concerns Under Quality-assurance Program.--
Section 7311(b) is amended by adding at the end the following new 
paragraph:
    ``(4) As part of the quality-assurance program, the Under Secretary 
for Health shall establish mechanisms through which employees of 
Veterans Health Administration facilities may submit reports, on a 
confidential basis, on matters relating to quality of care in Veterans 
Health Administration facilities to the quality management officers of 
such facilities under section 7311A(b) of this title. The mechanisms 
shall provide for the prompt and thorough review of any reports so 
submitted by the receiving officials.''.
    (c) Review of Current Health Care Quality Safeguards.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        conduct a comprehensive review of all current policies and 
        protocols of the Department of Veterans Affairs for maintaining 
        health care quality and patient safety at Department medical 
        facilities. The review shall include a review and assessment of 
        the National Surgical Quality Improvement Program (NSQIP), 
        including an assessment of--
                    (A) the efficacy of the quality indicators under 
                the program;
                    (B) the efficacy of the data collection methods 
                under the program;
                    (C) the efficacy of the frequency with which 
                regular data analyses are performed under the program; 
                and
                    (D) the extent to which the resources allocated to 
                the program are adequate to fulfill the stated function 
                of the program.
            (2) Report.--Not later than 60 days after the date of the 
        enactment of this Act, the Secretary shall submit to Congress a 
        report on the review conducted under paragraph (1), including 
        the findings of the Secretary as a result of the review and 
        such recommendations as the Secretary considers appropriate in 
        light of the review.

SEC. 507. REPORTS ON IMPROVEMENTS TO DEPARTMENT HEALTH CARE QUALITY 
              MANAGEMENT.

    (a) Report.--Not later than December 15, 2010, and each year 
thereafter through 2012, the Secretary of Veterans Affairs shall submit 
to the congressional veterans affairs committees a report on the 
implementation of sections 604 and 506 of this Act and the amendments 
made by such sections during the preceding fiscal year. Each report 
shall include, for the fiscal year covered by such report, the 
following:
            (1) A comprehensive description of the implementation of 
        sections 604 and 506 of this Act and the amendments made by 
        such sections.
            (2) Such recommendations as the Secretary considers 
        appropriate for legislative or administrative action to improve 
        the authorities and requirements in such sections and the 
        amendments made by such sections or to otherwise improve the 
        quality of health care and the quality of the physicians in the 
        Veterans Health Administration.
    (b) Congressional Veterans Affairs Committees Defined.--In this 
section, the term ``congressional veterans affairs committees'' means--
            (1) the Committees on Veterans' Affairs and Appropriations 
        of the Senate; and
            (2) the Committees on Veterans' Affairs and Appropriations 
        of the House of Representatives.

SEC. 508. PILOT PROGRAM ON USE OF COMMUNITY-BASED ORGANIZATIONS AND 
              LOCAL AND STATE GOVERNMENT ENTITIES TO ENSURE THAT 
              VETERANS RECEIVE CARE AND BENEFITS FOR WHICH THEY ARE 
              ELIGIBLE.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasibility and 
advisability of using community-based organizations and local and State 
government entities--
            (1) to increase the coordination of community, local, 
        State, and Federal providers of health care and benefits for 
        veterans to assist veterans who are transitioning from military 
        service to civilian life in such transition;
            (2) to increase the availability of high quality medical 
        and mental health services to veterans transitioning from 
        military service to civilian life;
            (3) to provide assistance to families of veterans who are 
        transitioning from military service to civilian life to help 
        such families adjust to such transition; and
            (4) to provide outreach to veterans and their families to 
        inform them about the availability of benefits and connect them 
        with appropriate care and benefit programs.
    (b) Duration of Program.--The pilot program shall be carried out 
during the two-year period beginning on the date of the enactment of 
this Act.
    (c) Program Locations.--
            (1) In general.--The pilot program shall be carried out at 
        five locations selected by the Secretary for purposes of the 
        pilot program.
            (2) Considerations.--In selecting locations for the pilot 
        program, the Secretary shall consider the advisability of 
        selecting locations in--
                    (A) rural areas;
                    (B) areas with populations that have a high 
                proportion of minority group representation;
                    (C) areas with populations that have a high 
                proportion of individuals who have limited access to 
                health care; and
                    (D) areas that are not in close proximity to an 
                active duty military installation.
    (d) Grants.--The Secretary shall carry out the pilot program 
through the award of grants to community-based organizations and local 
and State government entities.
    (e) Selection of Grant Recipients.--
            (1) In general.--A community-based organization or local or 
        State government entity seeking a grant under the pilot program 
        shall submit to the Secretary of Veterans Affairs an 
        application therefor in such form and in such manner as the 
        Secretary considers appropriate.
            (2) Elements.--Each application submitted under paragraph 
        (1) shall include the following:
                    (A) A description of how the proposal was developed 
                in consultation with the Department of Veterans 
                Affairs.
                    (B) A plan to coordinate activities under the pilot 
                program, to the greatest extent possible, with the 
                local, State, and Federal providers of services for 
                veterans to reduce duplication of services and to 
                increase the effect of such services.
    (f) Use of Grant Funds.--The Secretary shall prescribe appropriate 
uses of grant funds received under the pilot program.
    (g) Report on Program.--
            (1) In general.--Not later than 180 days after the 
        completion of the pilot program, the Secretary shall submit to 
        Congress a report on the pilot program.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) The findings and conclusions of the Secretary 
                with respect to the pilot program.
                    (B) An assessment of the benefits to veterans of 
                the pilot program.
                    (C) The recommendations of the Secretary as to the 
                advisability of continuing the pilot program.

SEC. 509. SPECIALIZED RESIDENTIAL CARE AND REHABILITATION FOR CERTAIN 
              VETERANS.

    Section 1720 is amended by adding at the end the following new 
subsection:
    ``(g) The Secretary may contract with appropriate entities to 
provide specialized residential care and rehabilitation services to a 
veteran of Operation Enduring Freedom or Operation Iraqi Freedom who 
the Secretary determines suffers from a traumatic brain injury, has an 
accumulation of deficits in activities of daily living and instrumental 
activities of daily living, and because of these deficits, would 
otherwise require admission to a nursing home even though such care 
would generally exceed the veteran's nursing needs.''.

SEC. 510. EXPANDED STUDY ON THE HEALTH IMPACT OF PROJECT SHIPBOARD 
              HAZARD AND DEFENSE.

    (a) In General.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall enter 
into a contract with the Institute of Medicine of the National 
Academies to conduct an expanded study on the health impact of Project 
Shipboard Hazard and Defense (Project SHAD).
    (b) Covered Veterans.--The study required by subsection (a) shall 
include, to the extent practicable, all veterans who participated in 
Project Shipboard Hazard and Defense.
    (c) Utilization of Existing Studies.--The study required by 
subsection (a) may use results from the study covered in the report 
entitled ``Long-Term Health Effects of Participation in Project SHAD'' 
of the Institute of Medicine of the National Academies.

SEC. 511. USE OF NON-DEPARTMENT FACILITIES FOR REHABILITATION OF 
              INDIVIDUALS WITH TRAUMATIC BRAIN INJURY.

    Section 1710E is amended--
            (1) by redesignating subsection (b) as subsection (c);
            (2) by inserting after subsection (a) the following new 
        subsection (b):
    ``(b) Covered Individuals.--The care and services provided under 
subsection (a) shall be made available to an individual--
            ``(1) who is described in section 1710C(a) of this title; 
        and
            ``(2)(A) to whom the Secretary is unable to provide such 
        treatment or services at the frequency or for the duration 
        prescribed in such plan; or
            ``(B) for whom the Secretary determines that it is optimal 
        with respect to the recovery and rehabilitation for such 
        individual.''; and
            (3) by adding at the end the following new subsection:
    ``(d) Standards.--The Secretary may not provide treatment or 
services as described in subsection (a) at a non-Department facility 
under such subsection unless such facility maintains standards for the 
provision of such treatment or services established by an independent, 
peer-reviewed organization that accredits specialized rehabilitation 
programs for adults with traumatic brain injury.''.

SEC. 512. INCLUSION OF FEDERALLY RECOGNIZED TRIBAL ORGANIZATIONS IN 
              CERTAIN PROGRAMS FOR STATE VETERANS HOMES.

    (a) Treatment of Tribal Organization Health Facilities as State 
Homes.--Section 8138 is amended--
            (1) by redesignating subsection (e) as subsection (f); and
            (2) by inserting after subsection (d) the following new 
        subsection (e):
    ``(e)(1) A health facility (or certain beds in a health facility) 
of a tribal organization is treatable as a State home under subsection 
(a) in accordance with the provisions of that subsection.
    ``(2) Except as provided in paragraph (3), the provisions of this 
section shall apply to a health facility (or certain beds in such 
facility) treated as a State home under subsection (a) by reason of 
this subsection to the same extent as health facilities (or beds) 
treated as a State home under subsection (a).
    ``(3) Subsection (f) shall not apply to the treatment of health 
facilities (or certain beds in such facilities) of tribal organizations 
as a State home under subsection (a).''.
    (b) State Home Facilities for Domiciliary, Nursing, and Other 
Care.--
            (1) In general.--Chapter 81 is further amended--
                    (A) in section 8131, by adding at the end the 
                following new paragraph:
            ``(5) The term `tribal organization' has the meaning given 
        such term in section 3765 of this title.'';
                    (B) in section 8132, by inserting ``and tribal 
                organizations'' after ``the several States''; and
                    (C) by inserting after section 8133 the following 
                new section:
``Sec. 8133A. Tribal organizations
    ``(a) Authority To Award Grants.--The Secretary may award a grant 
to a tribal organization under this subchapter in order to carry out 
the purposes of this subchapter.
    ``(b) Manner and Condition of Grant Awards.--(1) Grants to tribal 
organizations under this section shall be awarded in the same manner, 
and under the same conditions, as grants awarded to the several States 
under the provisions of this subchapter, subject to such exceptions as 
the Secretary shall prescribe for purposes of this subchapter to take 
into account the unique circumstances of tribal organizations.
    ``(2) For purposes of according priority under subsection (c)(2) of 
section 8135 of this title to an application submitted under subsection 
(a) of such section, an application submitted under such subsection (a) 
by a tribal organization of a State that has previously applied for 
award of a grant under this subchapter for construction or acquisition 
of a State nursing home shall be considered under subparagraph (C) of 
such subsection (c)(2) an application from a tribal organization that 
has previously applied for such a grant.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 81 is amended by inserting after the item 
        relating to section 8133 the following new item:

``8133A. Tribal organizations.''.

SEC. 513. PILOT PROGRAM ON PROVISION OF DENTAL INSURANCE PLANS TO 
              VETERANS AND SURVIVORS AND DEPENDENTS OF VETERANS.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasibility and 
advisability of providing a dental insurance plan to veterans and 
survivors and dependents of veterans described in subsection (b).
    (b) Covered Veterans and Survivors and Dependents.--The veterans 
and survivors and dependents of veterans described in this subsection 
are as follows:
            (1) Any veteran who is enrolled in the system of annual 
        patient enrollment under section 1705 of this title.
            (2) Any survivor or dependent of a veteran who is eligible 
        for medical care under section 1781 of this title.
    (c) Duration of Program.--The pilot program shall be carried out 
during the three-year period beginning on the date of the enactment of 
this Act.
    (d) Pilot Program Locations.--The pilot program shall be carried 
out in not less than two and not more than four Veterans Integrated 
Services Networks (VISNs) selected by the Secretary of Veterans Affairs 
for purposes of the pilot program.
    (e) Administration.--The Secretary of Veterans Affairs shall 
contract with a dental insurer to administer the dental plan provided 
under the pilot program.
    (f) Benefits.--The dental insurance plan under the pilot program 
shall provide such benefits for dental care and treatment as the 
Secretary considers appropriate for the dental insurance plan, 
including diagnostic services, preventative services, endodontics and 
other restorative services, surgical services, and emergency services.
    (g) Enrollment.--
            (1) Voluntary.--Enrollment in the dental insurance plan 
        under this section shall be voluntary.
            (2) Minimum period.--Enrollment in the dental insurance 
        plan shall be for such minimum period as the Secretary shall 
        prescribe for purposes of this section.
    (h) Premiums.--
            (1) In general.--Premiums for coverage under the dental 
        insurance plan under the pilot program shall be in such amount 
        or amounts as the Secretary of Veterans Affairs shall prescribe 
        to cover all costs associated with the pilot program.
            (2) Annual adjustment.--The Secretary shall adjust the 
        premiums payable under the pilot program for coverage under the 
        dental insurance plan on an annual basis. Each individual 
        covered by the dental insurance plan at the time of such an 
        adjustment shall be notified of the amount and effective date 
        of such adjustment.
            (3) Responsibility for payment.--Each individual covered by 
        the dental insurance plan shall pay the entire premium for 
        coverage under the dental insurance plan, in addition to the 
        full cost of any copayments.
    (i) Voluntary Disenrollment.--
            (1) In general.--With respect to enrollment in the dental 
        insurance plan under the pilot program, the Secretary shall--
                    (A) permit the voluntary disenrollment of an 
                individual in the dental insurance plan if the 
                disenrollment occurs during the 30-day period beginning 
                on the date of the enrollment of the individual in the 
                dental insurance plan; and
                    (B) permit the voluntary disenrollment of an 
                individual in the dental insurance plan for such 
                circumstances as the Secretary shall prescribe for 
                purposes of this subsection, but only to the extent 
                such disenrollment does not jeopardize the fiscal 
                integrity of the dental insurance plan.
            (2) Allowable circumstances.--The circumstances prescribed 
        under paragraph (1)(B) shall include the following:
                    (A) If an individual enrolled in the dental 
                insurance plan relocates to a location outside the 
                jurisdiction of the dental insurance plan that prevents 
                utilization of the benefits under the dental insurance 
                plan.
                    (B) If an individual enrolled in the dental 
                insurance plan is prevented by a serious medical 
                condition from being able to obtain benefits under the 
                dental insurance plan.
                    (C) Such other circumstances as the Secretary shall 
                prescribe for purposes of this subsection.
            (3) Establishment of procedures.--The Secretary shall 
        establish procedures for determinations on the permissibility 
        of voluntary disenrollments under paragraph (1)(B). Such 
        procedures shall ensure timely determinations on the 
        permissibility of such disenrollments.
    (j) Relationship to Dental Care Provided by Secretary.--Nothing in 
this section shall affect the responsibility of the Secretary to 
provide dental care under section 1712 of title 38, United States Code, 
and the participation of an individual in the dental insurance plan 
under the pilot program shall not affect the individual's entitlement 
to outpatient dental services and treatment, and related dental 
appliances, under that section.
    (k) Regulations.--The dental insurance plan under the pilot program 
shall be administered under such regulations as the Secretary shall 
prescribe.

SEC. 514. EXPANSION OF VETERAN ELIGIBILITY FOR REIMBURSEMENT BY 
              SECRETARY OF VETERANS AFFAIRS FOR EMERGENCY TREATMENT 
              FURNISHED IN A NON-DEPARTMENT FACILITY.

    (a) Expansion of Eligibility.--Subsection (b)(3)(C) of section 1725 
is amended by striking ``, in whole or in part,''.
    (b) Limitations on Reimbursement.--Section 1725 is further 
amended--
            (1) in subsection (c), by adding at the end the following 
        new paragraph:
    ``(4)(A) If the veteran has contractual or legal recourse against a 
third party that would, in part, extinguish the veteran's liability to 
the provider of the emergency treatment and payment for the treatment 
may be made both under subsection (a) and by the third party, the 
amount payable for such treatment under such subsection shall be the 
amount by which the costs for the emergency treatment exceed the amount 
payable or paid by the third party, except that the amount payable may 
not exceed the maximum amount payable established under paragraph 
(1)(A).
    ``(B) In any case in which a third party is financially responsible 
for part of the veteran's emergency treatment expenses, the Secretary 
shall be the secondary payer.
    ``(C) A payment in the amount payable under subparagraph (A) shall 
be considered payment in full and shall extinguish the veteran's 
liability to the provider.
    ``(D) The Secretary may not reimburse a veteran under this section 
for any copayment or similar payment that the veteran owes the third 
party or for which the veteran is responsible under a health-plan 
contract.''; and
            (2) in subsection (f)(3)--
                    (A) in subparagraph (A), by inserting before the 
                period at the end the following: ``, including the 
                Secretary of Health and Human Services with respect to 
                the Medicare program under title XVIII of the Social 
                Security Act (42 U.S.C. 1395 et seq.) and the Medicaid 
                program under title XIX of such Act (42 U.S.C. 1396 et 
                seq.)''; and
                    (B) in subparagraph (B), by inserting before the 
                period at the end the following: ``, including a State 
                Medicaid agency with respect to payments made under a 
                State plan for medical assistance approved under title 
                XIX of such Act (42 U.S.C. 1396 et seq.)''.
    (c) Effective Date.--
            (1) In general.--The amendments made by subsections (a) and 
        (b) shall take effect on the date of the enactment of this Act, 
        and shall apply with respect to emergency treatment furnished 
        on or after that date.
            (2) Reimbursement for treatment before effective date.--The 
        Secretary of Veterans Affairs may provide reimbursement under 
        section 1725 of title 38, United States Code, as amended by 
        this subsection, for emergency treatment furnished before the 
        date of the enactment of this Act if the Secretary determines 
        that, under the circumstances applicable with respect to the 
        veteran, it is appropriate to do so.

SEC. 515. PROHIBITION ON COLLECTION OF COPAYMENTS FROM VETERANS WHO ARE 
              CATASTROPHICALLY DISABLED.

    (a) In General.--Subchapter III of chapter 17 is amended by adding 
at the end the following new section:
``Sec. 1730A. Prohibition on collection of copayments from 
              catastrophically disabled veterans
    ``Notwithstanding subsections (f) and (g) of section 1710 and 
section 1722A(a) of this title or any other provision of law, the 
Secretary may not require a veteran who is catastrophically disabled to 
make any copayment for the receipt of hospital care or medical services 
under the laws administered by the Secretary.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1730 the following new item:

``1730A. Prohibition on collection of copayments from catastrophically 
                            disabled veterans.''.

                 TITLE VI--DEPARTMENT PERSONNEL MATTERS

SEC. 601. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL 
              PROFESSIONALS.

    (a) Secretarial Authority To Extend Title 38 Status to Additional 
Positions.--
            (1) In general.--Paragraph (3) of section 7401 is amended 
        by striking ``and blind rehabilitation outpatient 
        specialists.'' and inserting the following: ``blind 
        rehabilitation outpatient specialists, and such other classes 
        of health care occupations as the Secretary considers necessary 
        for the recruitment and retention needs of the Department 
        subject to the following requirements:
                    ``(A) Such other classes of health care 
                occupations--
                            ``(i) are not occupations relating to 
                        administrative, clerical, or physical plant 
                        maintenance and protective services;
                            ``(ii) that would otherwise receive basic 
                        pay in accordance with the General Schedule 
                        under section 5332 of title 5;
                            ``(iii) provide, as determined by the 
                        Secretary, direct patient care services or 
                        services incident to direct patient services; 
                        and
                            ``(iv) would not otherwise be available to 
                        provide medical care or treatment for veterans.
                    ``(B) Not later than 45 days before the Secretary 
                appoints any personnel for a class of health care 
                occupations that is not specifically listed in this 
                paragraph, the Secretary shall submit to the Committee 
                on Veterans' Affairs of the Senate, the Committee on 
                Veterans' Affairs of the House of Representatives, and 
                the Office of Management and Budget notice of such 
                appointment.
                    ``(C) Before submitting notice under subparagraph 
                (B), the Secretary shall solicit comments from any 
                labor organization representing employees in such class 
                and include such comments in such notice.''.
            (2) Appointment of nurse assistants.--Such paragraph is 
        further amended by inserting ``nurse assistants,'' after 
        ``licensed practical or vocational nurses,''.
    (b) Probationary Periods for Registered Nurses.--Section 7403(b) is 
amended--
            (1) in paragraph (1), by striking ``Appointments'' and 
        inserting ``Except as otherwise provided in this subsection, 
        appointments'';
            (2) by redesignating paragraph (2) as paragraph (4); and
            (3) by inserting after paragraph (1) the following new 
        paragraphs:
    ``(2) With respect to the appointment of a registered nurse under 
this chapter, paragraph (1) shall apply with respect to such 
appointment regardless of whether such appointment is on a full-time 
basis or a part-time basis.
    ``(3) An appointment described in subsection (a) on a part-time 
basis of a person who has previously served on a full-time basis for 
the probationary period for the position concerned shall be without a 
probationary period.''.
    (c) Prohibition on Temporary Part-time Registered Nurse 
Appointments in Excess of Two Years.--Section 7405 is amended by adding 
at the end the following new subsection:
    ``(g)(1) Except as provided in paragraph (3), employment of a 
registered nurse on a temporary part-time basis under subsection (a)(1) 
shall be for a probationary period of two years.
    ``(2) Except as provided in paragraph (3), upon completion by a 
registered nurse of the probationary period described in paragraph 
(1)--
            ``(A) the employment of such nurse shall--
                    ``(i) no longer be considered temporary; and
                    ``(ii) be considered an appointment described in 
                section 7403(a) of this title; and
            ``(B) the nurse shall be considered to have served the 
        probationary period required by section 7403(b).
    ``(3) This subsection shall not apply to appointments made on a 
term limited basis of less than or equal to three years of--
            ``(A) nurses with a part-time appointment resulting from an 
        academic affiliation or teaching position in a nursing academy 
        of the Department;
            ``(B) nurses appointed as a result of a specific research 
        proposal or grant; or
            ``(C) nurses who are not citizens of the United States and 
        appointed under section 7407(a) of this title.''.
    (d) Waiver of Offset From Pay for Certain Reemployed Annuitants.--
            (1) In general.--Section 7405, as amended by subsection 
        (c), is further amended by adding at the end the following new 
        subsection:
    ``(h)(1) The Secretary may waive the application of sections 8344 
and 8468 of title 5 (relating to annuities and pay on reemployment) or 
any other similar provision of law under a Government retirement system 
on a case-by-case basis for an annuitant reemployed on a temporary 
basis under the authority of subsection (a) in a position described 
under paragraph (1) of that subsection.
    ``(2) An annuitant to whom a waiver under paragraph (1) is in 
effect shall not be considered an employee for purposes of any 
Government retirement system.
    ``(3) An annuitant to whom a waiver under paragraph (1) is in 
effect shall be subject to the provisions of chapter 71 of title 5 
(including all labor authority and labor representative collective 
bargaining agreements) applicable to the position to which appointed.
    ``(4) In this subsection:
            ``(A) The term `annuitant' means an annuitant under a 
        Government retirement system.
            ``(B) The term `employee' has the meaning under section 
        2105 of title 5.
            ``(C) The term `Government retirement system' means a 
        retirement system established by law for employees of the 
        Government of the United States.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect on the date that is 180 days after the date 
        of the enactment of this Act, and shall apply to pay periods 
        beginning on or after such effective date.
    (e) Rate of Basic Pay for Appointees to the Office of the Under 
Secretary for Health Set to Rate of Basic Pay for Senior Executive 
Service Positions.--
            (1) In general.--Section 7404(a) is amended--
                    (A) by striking ``The annual'' and inserting ``(1) 
                The annual'';
                    (B) by striking ``The pay'' and inserting the 
                following:
    ``(2) The pay'';
                    (C) by striking ``under the preceding sentence'' 
                and inserting ``under paragraph (1)''; and
                    (D) by adding at the end the following new 
                paragraph:
    ``(3)(A) The rate of basic pay for a position to which an Executive 
order applies under paragraph (1) and is not described by paragraph (2) 
shall be set in accordance with section 5382 of title 5 as if such 
position were a Senior Executive Service position (as such term is 
defined in section 3132(a) of title 5).
    ``(B) A rate of basic pay for a position may not be set under 
subparagraph (A) in excess of--
            ``(i) in the case the position is not described in clause 
        (ii), the rate of basic pay payable for level III of the 
        Executive Schedule; or
            ``(ii) in the case that the position is covered by a 
        performance appraisal system that meets the certification 
        criteria established by regulation under section 5307(d) of 
        title 5, the rate of basic pay payable for level II of the 
        Executive Schedule.
    ``(C) Notwithstanding the provisions of subsection (d) of section 
5307 of title 5, the Secretary may make any certification under that 
subsection instead of the Office of Personnel Management and without 
concurrence of the Office of Management and Budget.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall take effect on the first day of the first pay period 
        beginning after the day that is 180 days after the date of the 
        enactment of this Act.
    (f) Special Incentive Pay for Department Pharmacist Executives.--
Section 7410 is amended--
            (1) by striking ``The Secretary may'' and inserting the 
        following:
    ``(a) In General.--The Secretary may''; and
            (2) by adding at the end the following new subsection:
    ``(b) Special Incentive Pay for Department Pharmacist Executives.--
(1) In order to recruit and retain highly qualified Department 
pharmacist executives, the Secretary may authorize the Under Secretary 
for Health to pay special incentive pay of not more than $40,000 per 
year to an individual of the Veterans Health Administration who is a 
pharmacist executive.
    ``(2) In determining whether and how much special pay to provide to 
such individual, the Under Secretary shall consider the following:
            ``(A) The grade and step of the position of the individual.
            ``(B) The scope and complexity of the position of the 
        individual.
            ``(C) The personal qualifications of the individual.
            ``(D) The characteristics of the labor market concerned.
            ``(E) Such other factors as the Secretary considers 
        appropriate.
    ``(3) Special incentive pay under paragraph (1) for an individual 
is in addition to all other pay (including basic pay) and allowances to 
which the individual is entitled.
    ``(4) Except as provided in paragraph (5), special incentive pay 
under paragraph (1) for an individual shall be considered basic pay for 
all purposes, including retirement benefits under chapters 83 and 84 of 
title 5, and other benefits.
    ``(5) Special incentive pay under paragraph (1) for an individual 
shall not be considered basic pay for purposes of adverse actions under 
subchapter V of this chapter.
    ``(6) Special incentive pay under paragraph (1) may not be awarded 
to an individual in an amount that would result in an aggregate amount 
of pay (including bonuses and awards) received by such individual in a 
year under this title that is greater than the annual pay of the 
President.''.
    (g) Pay for Physicians and Dentists.--
            (1) Non-foreign cost of living adjustment allowance.--
        Section 7431(b) is amended by adding at the end the following 
        new paragraph:
            ``(5) The non-foreign cost of living adjustment allowance 
        authorized under section 5941 of title 5 for physicians and 
        dentists whose pay is set under this section shall be 
        determined as a percentage of base pay only.''.
            (2) Market pay determinations for physicians and dentists 
        in administrative or executive leadership positions.--Section 
        7431(c)(4)(B)(i) is amended by adding at the end the following: 
        ``The Secretary may exempt physicians and dentists occupying 
        administrative or executive leadership positions from the 
        requirements of the previous sentence.''.
            (3) Exception to prohibition on reduction of market pay.--
        Section 7431(c)(7) is amended by striking ``concerned.'' and 
        inserting ``concerned, unless there is a change in board 
        certification or reduction of privileges.''.
    (h) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) is 
amended by striking ``level V'' and inserting ``level IV''.
    (i) Exemption for Certified Registered Nurse Anesthetists From 
Limitation on Authorized Competitive Pay.--Section 7451(c)(2) is 
further amended by adding at the end the following new sentence: ``The 
maximum rate of basic pay for a grade for the position of certified 
registered nurse anesthetist pursuant to an adjustment under subsection 
(d) may exceed the maximum rate otherwise provided in the preceding 
sentence.''.
    (j) Increased Limitation on Special Pay for Nurse Executives.--
Section 7452(g)(2) is amended by striking ``$25,000'' and inserting 
``$100,000''.
    (k) Locality Pay Scale Computations.--
            (1) Education, training, and support for facility directors 
        in wage surveys.--Section 7451(d)(3) is amended by adding at 
        the end the following new subparagraph:
    ``(F) The Under Secretary for Health shall provide appropriate 
education, training, and support to directors of Department health care 
facilities in the conduct and use of surveys, including the use of 
third-party surveys, under this paragraph.''.
            (2) Information on methodology used in wage surveys.--
        Section 7451(e)(4) is amended--
                    (A) by redesignating subparagraph (D) as 
                subparagraph (E); and
                    (B) by inserting after subparagraph (C) the 
                following new subparagraph (D):
            ``(D) In any case in which the director conducts such a 
        wage survey during the period covered by the report and makes 
        adjustment in rates of basic pay applicable to one or more 
        covered positions at the facility, information on the 
        methodology used in making such adjustment or adjustments.''.
            (3) Disclosure of information to persons in covered 
        positions.--Section 7451(e), as amended by paragraph (2) of 
        this subsection, is further amended by adding at the end the 
        following new paragraph:
    ``(6)(A) Upon the request of an individual described in 
subparagraph (B) for a report provided under paragraph (4) with respect 
to a Department health-care facility, the Under Secretary for Health or 
the director of such facility shall provide to the individual the most 
current report for such facility provided under such paragraph.
    ``(B) An individual described in this subparagraph is--
            ``(i) an individual in a covered position at a Department 
        health-care facility; or
            ``(ii) a representative of the labor organization 
        representing that individual who is designated by that 
        individual to make the request.''.
    (l) Eligibility of Part-Time Nurses for Additional Nurse Pay.--
            (1) In general.--Section 7453 is amended--
                    (A) in subsection (a), by striking ``a nurse'' and 
                inserting ``a full-time nurse or part-time nurse'';
                    (B) in subsection (b)--
                            (i) in the first sentence--
                                    (I) by striking ``on a tour of 
                                duty'';
                                    (II) by striking ``service on such 
                                tour'' and inserting ``such service''; 
                                and
                                    (III) by striking ``of such tour'' 
                                and inserting ``of such service''; and
                            (ii) in the second sentence, by striking 
                        ``of such tour'' and inserting ``of such 
                        service'';
                    (C) in subsection (c)--
                            (i) by striking ``on a tour of duty''; and
                            (ii) by striking ``service on such tour'' 
                        and inserting ``such service''; and
                    (D) in subsection (e)--
                            (i) in paragraph (1), by striking ``eight 
                        hours in a day'' and inserting ``eight 
                        consecutive hours''; and
                            (ii) in paragraph (5)(A), by striking 
                        ``tour of duty'' and inserting ``period of 
                        service''.
            (2) Exclusion of application of additional nurse pay 
        provisions to certain additional employees.--Paragraph (3) of 
        section 7454(b) is amended to read as follows:
    ``(3) Employees appointed under section 7408 of this title 
performing service on a tour of duty, any part of which is within the 
period commencing at midnight Friday and ending at midnight Sunday, 
shall receive additional pay in addition to the rate of basic pay 
provided such employees for each hour of service on such tour at a rate 
equal to 25 percent of such employee's hourly rate of basic pay.''.
    (m) Enhanced Authority To Increase Rates of Basic Pay To Obtain or 
Retain Services of Certain Persons.--Section 7455(c) is amended to read 
as follows:
    ``(c)(1) Subject to paragraph (2), the amount of any increase under 
subsection (a) in the minimum rate for any grade may not (except in the 
case of nurse anesthetists, licensed practical nurses, licensed 
vocational nurses, nursing positions otherwise covered by title 5, 
pharmacists, and licensed physical therapists) exceed the maximum rate 
of basic pay (excluding any locality-based comparability payment under 
section 5304 of title 5 or similar provision of law) for the grade or 
level by more than 30 percent.
    ``(2) No rate may be established under this section in excess of 
the rate of basic pay payable for level IV of the Executive 
Schedule.''.

SEC. 602. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND ALTERNATIVE 
              WORK SCHEDULES FOR NURSES.

    (a) Overtime Duty.--
            (1) In general.--Subchapter IV of chapter 74 is amended by 
        adding at the end the following new section:
``Sec. 7459. Nursing staff: special rules for overtime duty
    ``(a) Limitation.--Except as provided in subsection (c), the 
Secretary may not require nursing staff to work more than 40 hours (or 
24 hours if such staff is covered under section 7456 of this title) in 
an administrative work week or more than eight consecutive hours (or 12 
hours if such staff is covered under section 7456 or 7456A of this 
title).
    ``(b) Voluntary Overtime.--(1) Nursing staff may on a voluntary 
basis elect to work hours otherwise prohibited by subsection (a).
    ``(2) The refusal of nursing staff to work hours prohibited by 
subsection (a) shall not be grounds to discriminate (within the meaning 
of section 704(a) of the Civil Rights Act of 1964 (42 U.S.C. 2000e-
3(a))) against the staff, dismissal or discharge of the staff, or any 
other adverse personnel action against the staff.
    ``(c) Overtime Under Emergency Circumstances.--(1) Subject to 
paragraph (2), the Secretary may require nursing staff to work hours 
otherwise prohibited by subsection (a) if--
            ``(A) the work is a consequence of an emergency that could 
        not have been reasonably anticipated;
            ``(B) the emergency is non-recurring and is not caused by 
        or aggravated by the inattention of the Secretary or lack of 
        reasonable contingency planning by the Secretary;
            ``(C) the Secretary has exhausted all good faith, 
        reasonable attempts to obtain voluntary workers;
            ``(D) the nurse staff have critical skills and expertise 
        that are required for the work; and
            ``(E) the work involves work for which the standard of care 
        for a patient assignment requires continuity of care through 
        completion of a case, treatment, or procedure.
    ``(2) Nursing staff may not be required to work hours under this 
subsection after the requirement for a direct role by the staff in 
responding to medical needs resulting from the emergency ends.
    ``(d) Nursing Staff Defined.--In this section, the term `nursing 
staff' includes the following;
            ``(1) A registered nurse.
            ``(2) A licensed practical or vocational nurse.
            ``(3) A nurse assistant appointed under this chapter or 
        title 5.
            ``(4) Any other nurse position designated by the Secretary 
        for purposes of this section.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 74 is amended by inserting after the item 
        relating to section 7458 the following new item:

``7459. Nursing staff: special rules for overtime duty.''.
    (b) Weekend Duty.--Section 7456 is amended--
            (1) by striking subsection (c); and
            (2) by redesignating subsection (d) as subsection (c).
    (c) Alternate Work Schedules.--
            (1) In general.--Section 7456A(b)(1)(A) is amended by 
        striking ``three regularly scheduled'' and all that follows 
        through the period at the end and inserting ``six regularly 
        scheduled 12-hour tours of duty within a 14-day period shall be 
        considered for all purposes to have worked a full 80-hour pay 
        period.''.
            (2) Conforming amendments.--Section 7456A(b) is amended--
                    (A) in the subsection heading, by striking ``36/
                40'' and inserting ``72/80'';
                    (B) in paragraph (2)--
                            (i) in subparagraph (A), by striking ``40-
                        hour basic work week'' and inserting ``80-hour 
                        pay period'';
                            (ii) in subparagraph (B), by striking 
                        ``regularly scheduled 36-hour tour of duty 
                        within the work week'' and inserting 
                        ``scheduled 72-hour tour of duty within the bi-
                        weekly pay period'';
                            (iii) in subparagraph (C)--
                                    (I) in clause (i), by striking 
                                ``regularly scheduled 36-hour tour of 
                                duty within an administrative work 
                                week'' and inserting ``scheduled 72-
                                hour tour of duty within an 
                                administrative pay period'';
                                    (II) in clause (ii), by striking 
                                ``regularly''; and
                                    (III) in clause (iii), by striking 
                                ``regularly scheduled 36-hour tour of 
                                duty work week'' and inserting 
                                ``scheduled 72-hour tour of duty pay 
                                period''; and
                            (iv) in subparagraph (D), by striking 
                        ``regularly''; and
                    (C) in paragraph (3), by striking ``regularly''.

SEC. 603. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE PROGRAMS.

    (a) Reinstatement of Health Professionals Educational Assistance 
Scholarship Program.--
            (1) In general.--Section 7618 is amended by striking 
        ``December 31, 1998'' and inserting ``December 31, 2014''.
            (2) Expansion of eligibility requirements.--Section 
        7612(b)(2) is amended by striking ``(under section'' and all 
        that follows through ``or vocational nurse.'' and inserting the 
        following: ``as an appointee under paragraph (1) or (3) of 
        section 7401 of this title.''.
    (b) Improvements to Education Debt Reduction Program.--
            (1) Inclusion of employee retention as purpose of 
        program.--Section 7681(a)(2) is amended by inserting ``and 
        retention'' after ``recruitment'' the first time it appears.
            (2) Eligibility.--Section 7682 is amended--
                    (A) in subsection (a)(1), by striking ``a recently 
                appointed'' and inserting ``an''; and
                    (B) by striking subsection (c).
    (c) Loan Repayment Program for Clinical Researchers From 
Disadvantaged Backgrounds.--
            (1) In general.--The Secretary of Veterans Affairs may, in 
        consultation with the Secretary of Health and Human Services, 
        utilize the authorities available in section 487E of the Public 
        Health Service Act (42 U.S.C. 288-5) for the repayment of the 
        principal and interest of educational loans of appropriately 
        qualified health professionals who are from disadvantaged 
        backgrounds in order to secure clinical research by such 
        professionals for the Veterans Health Administration.
            (2) Limitations.--The exercise by the Secretary of Veterans 
        Affairs of the authorities referred to in paragraph (1) shall 
        be subject to the conditions and limitations specified in 
        paragraphs (2) and (3) of section 487E(a) of the Public Health 
        Service Act (42 U.S.C. 288-5(a)(2) and (3)).
            (3) Funding.--Amounts for the repayment of principal and 
        interest of educational loans under this subsection shall be 
        derived from amounts available to the Secretary of Veterans 
        Affairs for the Veterans Health Administration for Medical 
        Services.

SEC. 604. STANDARDS FOR APPOINTMENT AND PRACTICE OF PHYSICIANS IN 
              DEPARTMENT OF VETERANS AFFAIRS MEDICAL FACILITIES.

    (a) Standards.--
            (1) In general.--Subchapter I of chapter 74 is amended by 
        inserting after section 7402 the following new section:
``Sec. 7402A. Appointment and practice of physicians: standards
    ``(a) In General.--The Secretary shall, acting through the Under 
Secretary for Health, prescribe standards to be met by individuals in 
order to qualify for appointment in the Veterans Health Administration 
in the position of physician and to practice as a physician in medical 
facilities of the Administration. The standards shall incorporate the 
requirements of this section.
    ``(b) Disclosure of Certain Information Before Appointment.--Each 
individual seeking appointment in the Veterans Health Administration in 
the position of physician shall do the following:
            ``(1) Provide the Secretary a full and complete explanation 
        of the following:
                    ``(A) Each lawsuit, civil action, or other claim 
                (whether open or closed) brought against the individual 
                for medical malpractice or negligence.
                    ``(B) Each payment made by or on behalf of the 
                individual to settle any lawsuit, action, or claim 
                covered by subparagraph (A).
                    ``(C) Each investigation or disciplinary action 
                taken against the individual relating to the 
                individual's performance as a physician.
            ``(2) Provide the Secretary a written authorization that 
        permits the State licensing board of each State in which the 
        individual holds or has held a license to practice medicine to 
        disclose to the Secretary any information in the records of 
        such State on the following:
                    ``(A) Each lawsuit, civil action, or other claim 
                brought against the individual for medical malpractice 
                or negligence covered by paragraph (1)(A) that occurred 
                in such State.
                    ``(B) Each payment made by or on behalf of the 
                individual to settle any lawsuit, action, or claim 
                covered by subparagraph (A).
                    ``(C) Each medical malpractice judgment against the 
                individual by the courts or administrative agencies or 
                bodies of such State.
                    ``(D) Each disciplinary action taken or under 
                consideration against the individual by an 
                administrative agency or body of such State.
                    ``(E) Any change in the status of the license to 
                practice medicine issued the individual by such State, 
                including any voluntary or nondisciplinary surrendering 
                of such license by the individual.
                    ``(F) Any open investigation of the individual by 
                an administrative agency or body of such State, or any 
                outstanding allegation against the individual before 
                such an administrative agency or body.
                    ``(G) Any written notification by the State to the 
                individual of potential termination of a license for 
                cause or otherwise.
    ``(c) Disclosure of Certain Information Following Appointment.--(1) 
Each individual appointed in the Veterans Health Administration in the 
position of physician after the date of the enactment of this section 
shall, as a condition of service under the appointment, disclose to the 
Secretary, not later than 30 days after the occurrence of such event, 
the following:
            ``(A) A judgment against the individual for medical 
        malpractice or negligence.
            ``(B) A payment made by or on behalf of the individual to 
        settle any lawsuit, action, or claim disclosed under paragraph 
        (1) or (2) of subsection (b).
            ``(C) Any disposition of or material change in a matter 
        disclosed under paragraph (1) or (2) of subsection (b).
            ``(D) Any lawsuit, disciplinary action, or claim filed or 
        undertaken after the date of the disclosures under subsection 
        (b).
    ``(2) Each individual appointed in the Veterans Health 
Administration in the position of physician as of the date of the 
enactment of this section shall do the following:
            ``(A) Not later than the end of the 60-day period beginning 
        on the date of the enactment of this section and as a condition 
        of service under the appointment after the end of that period, 
        submit the request and authorization described in subsection 
        (b)(2).
            ``(B) Agree, as a condition of service under the 
        appointment, to disclose to the Secretary, not later than 30 
        days after the occurrence of such event, the following:
                    ``(i) A judgment against the individual for medical 
                malpractice or negligence.
                    ``(ii) A payment made by or on behalf of the 
                individual to settle any lawsuit, action, or claim 
                disclosed pursuant to subparagraph (A) or under this 
                subparagraph.
                    ``(iii) Any disposition of or material change in a 
                matter disclosed pursuant to subparagraph (A) or under 
                this subparagraph.
    ``(3) Each individual appointed in the Veterans Health 
Administration in the position of physician shall, as part of the 
biennial review of the performance of the physician under the 
appointment, submit the request and authorization described in 
subsection (b)(2). The requirement of this paragraph is in addition to 
the requirements of paragraph (1) or (2), as applicable.
    ``(d) Investigation of Disclosed Matters.--(1) The Director of the 
Veterans Integrated Services Network (VISN) in which an individual is 
seeking appointment in the Veterans Health Administration in the 
position of physician shall perform an investigation (in such manner as 
the standards required by this section shall specify) of each matter 
disclosed under subsection (b) with respect to the individual.
    ``(2) The Director of the Veterans Integrated Services Network in 
which an individual is appointed in the Veterans Health Administration 
in the position of physician shall perform an investigation (in a 
manner so specified) of each matter disclosed under subsection (c) with 
respect to the individual.
    ``(3) The results of each investigation performed under this 
subsection shall be fully documented.
    ``(e) Approval of Appointments by Directors of VISNs.--(1) An 
individual may not be appointed in the Veterans Health Administration 
in the position of physician without the approval of the Director of 
the Veterans Integrated Services Network in which the individual will 
first serve under the appointment, unless the medical center director 
and credentialing and privileging manager of the facility hiring the 
physician certify in writing that--
            ``(A) a full investigation was carried out in compliance 
        with section 104 of this title; and
            ``(B) an investigation did not disclose any actions 
        described in subsections (b), (c), and (d) of such section.
    ``(2) In approving the appointment under this subsection of an 
individual for whom any matters have been disclosed under subsection 
(b), a Director shall--
            ``(A) certify in writing the completion of the performance 
        of the investigation under subsection (d)(1) of each such 
        matter, including the results of such investigation; and
            ``(B) provide a written justification why any matters 
        raised in the course of such investigation do not disqualify 
        the individual from appointment.
    ``(f) Enrollment of Physicians With Practice Privileges in 
Proactive Disclosure Service.--Each medical facility of the Department 
at which physicians are extended the privileges of practice shall 
enroll each physician extended such privileges in the Proactive 
Disclosure Service of the National Practitioner Data Bank.
    ``(g) Encouraging Hiring of Physicians With Board Certification.--
(1) The Secretary shall, for each performance contract with a Director 
of a Veterans Integrated Services Network (VISN), include in such 
contract a provision that encourages such director to hire physicians 
who are board eligible or board certified in the specialty in which the 
physicians will practice.
    ``(2) The Secretary may determine the nature and manner of the 
provision described in paragraph (1).''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 74 is amended by inserting after the item 
        relating to section 7402 the following new item:

``7402A. Appointment and practice of physicians: standards.''.
    (b) Effective Date and Applicability.--
            (1) Effective date.--Except as provided in paragraphs (2) 
        and (3), the amendments made by subsection (a) shall take 
        effect on the date of the enactment of this Act.
            (2) Applicability of certain requirements to physicians 
        practicing on effective date.--In the case of an individual 
        appointed to the Veterans Health Administration in the position 
        of physician as of the date of the enactment of this Act, the 
        requirements of section 7402A(f) of title 38, United States 
        Code, as added by subsection (a) of this section, shall take 
        effect on the date that is 60 days after the date of the 
        enactment of this Act.
            (3) Applicability of requirements related to hiring of 
        physicians with board certification.--The requirement of 
        section 7402A(g) of such title, as added by subsection (a), 
        shall begin with the first cycle of performance contracts for 
        directors of Veterans Integrated Services Networks beginning 
        after the date of the enactment of this Act.

                  TITLE VII--HOMELESS VETERANS MATTERS

SEC. 701. PILOT PROGRAM ON FINANCIAL SUPPORT FOR ENTITIES THAT 
              COORDINATE THE PROVISION OF SUPPORTIVE SERVICES TO 
              FORMERLY HOMELESS VETERANS RESIDING ON CERTAIN MILITARY 
              PROPERTY.

    (a) Establishment.--
            (1) In general.--Subject to the availability of 
        appropriations for such purpose, the Secretary of Veterans 
        Affairs may carry out a pilot program to make grants to public 
        and nonprofit organizations (including faith-based and 
        community organizations) to coordinate the provision of 
        supportive services available in the local community to very 
        low income, formerly homeless veterans residing in permanent 
        housing that is located on qualifying property described in 
        subsection (b).
            (2) Number of grants.--The Secretary may make grants at up 
        to 10 qualifying properties under the pilot program.
    (b) Qualifying Property.--Qualifying property under the pilot 
program is property that--
            (1) was part of a military installation that was closed in 
        accordance with--
                    (A) decisions made as part of the 2005 round of 
                defense base closure and realignment under the Defense 
                Base Closure and Realignment Act of 1990 (part A of 
                title XXIX of Public Law 101-510; 10 U.S.C. 2687 note); 
                and
                    (B) subchapter III of chapter 5 of title 40, United 
                States Code; and
            (2) the Secretary of Defense determines, after considering 
        any redevelopment plans of any local redevelopment authority 
        relating to such property, may be used to assist the homeless 
        in accordance with such redevelopment plan.
    (c) Criteria for Grants.--The Secretary shall prescribe criteria 
and requirements for grants under this section and shall publish such 
criteria and requirements in the Federal Register.
    (d) Duration of Program.--The authority of the Secretary to provide 
grants under a pilot program under this section shall cease on the date 
that is five years after the date of the commencement of the pilot 
program.
    (e) Very Low Income Defined.--In this section, the term ``very low 
income'' has the meaning given that term in the Resident 
Characteristics Report issued annually by the Department of Housing and 
Urban Development.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated from amounts made available under the heading ``General 
Operating Expenses'', not more than $3,000,000 in each of fiscal years 
2010 through 2014 to carry out the purposes of this section.

SEC. 702. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT 
              COORDINATE THE PROVISION OF SUPPORTIVE SERVICES TO 
              FORMERLY HOMELESS VETERANS RESIDING IN PERMANENT HOUSING.

    (a) Establishment of Pilot Program.--
            (1) In general.--Subject to the availability of 
        appropriations for such purpose, the Secretary of Veterans 
        Affairs may carry out a pilot program to make grants to public 
        and nonprofit organizations (including faith-based and 
        community organizations) to coordinate the provision of 
        supportive services available in the local community to very 
        low income, formerly homeless veterans residing in permanent 
        housing.
            (2) Number of grants.--The Secretary may make grants at up 
        to 10 qualifying properties under the pilot program.
    (b) Qualifying Property.--Qualifying property under the pilot 
program is any property in the United States on which permanent housing 
is provided or afforded to formerly homeless veterans, as determined by 
the Secretary.
    (c) Criteria for Grants.--The Secretary shall prescribe criteria 
and requirements for grants under this section and shall publish such 
criteria and requirements in the Federal Register.
    (d) Duration of Pilot Program.--The authority of the Secretary to 
provide grants under a pilot program under this section shall cease on 
the date that is five years after the date of the commencement of the 
pilot program.
    (e) Very Low Income Defined.--In this section, the term ``very low 
income'' has the meaning given that term in the Resident 
Characteristics Report issued annually by the Department of Housing and 
Urban Development.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated from amounts made available under the heading ``General 
Operating Expenses'', not more than $3,000,000 in each of fiscal years 
2010 through 2014 to carry out the purposes of this section.

SEC. 703. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT PROVIDE 
              OUTREACH TO INFORM CERTAIN VETERANS ABOUT PENSION 
              BENEFITS.

    (a) Authority To Make Grants.--In addition to the outreach 
authority provided to the Secretary of Veterans Affairs by section 6303 
of title 38, United States Code, the Secretary may carry out a pilot 
program to make grants to public and nonprofit organizations (including 
faith-based and community organizations) for services to provide 
outreach to inform low-income and elderly veterans and their spouses 
who reside in rural areas of benefits for which they may be eligible 
under chapter 15 of such title.
    (b) Criteria for Grants.--The Secretary shall prescribe criteria 
and requirements for grants under this section and shall publish such 
criteria and requirements in the Federal Register.
    (c) Duration of Pilot Program.--The authority of the Secretary to 
provide grants under a pilot program under this section shall cease on 
the date that is five years after the date of the commencement of the 
pilot program.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated from amounts made available under the heading ``General 
Operating Expenses'', not more than $1,275,000 in each of fiscal years 
2010 through 2014 to carry out the purposes of this section.

SEC. 704. ASSESSMENT OF PILOT PROGRAMS.

    (a) Progress Reports.--Not less than one year before the expiration 
of the authority to carry out a pilot program authorized by sections 
501 through 503, the Secretary of Veterans Affairs shall submit to 
Congress a progress report on such pilot program.
    (b) Contents.--Each progress report submitted for a pilot program 
under subsection (a) shall include the following:
            (1) The lessons learned by the Secretary of Veterans 
        Affairs with respect to such pilot program that can be applied 
        to other programs with similar purposes.
            (2) The recommendations of the Secretary on whether to 
        continue such pilot program.
            (3) The number of veterans and dependents served by such 
        pilot program.
            (4) An assessment of the quality of service provided to 
        veterans and dependents under such pilot program.
            (5) The amount of funds provided to grant recipients under 
        such pilot program.
            (6) The names of organizations that have received grants 
        under such pilot program.

       TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

SEC. 801. GENERAL AUTHORITIES ON ESTABLISHMENT OF CORPORATIONS.

    (a) Authorization of Multi-medical Center Research Corporations.--
            (1) In general.--Section 7361 is amended--
                    (A) by redesignating subsection (b) as subsection 
                (e); and
                    (B) by inserting after subsection (a) the following 
                new subsection (b):
    ``(b)(1) Subject to paragraph (2), a corporation established under 
this subchapter may facilitate the conduct of research, education, or 
both at more than one medical center. Such a corporation shall be known 
as a `multi-medical center research corporation'.
    ``(2) The board of directors of a multi-medical center research 
corporation under this subsection shall include the official at each 
Department medical center concerned who is, or who carries out the 
responsibilities of, the medical center director of such center as 
specified in section 7363(a)(1)(A)(i) of this title.
    ``(3) In facilitating the conduct of research, education, or both 
at more than one Department medical center under this subchapter, a 
multi-medical center research corporation may administer receipts and 
expenditures relating to such research, education, or both, as 
applicable, performed at the Department medical centers concerned.''.
            (2) Expansion of existing corporations to multi-medical 
        center research corporations.--Such section is further amended 
        by adding at the end the following new subsection:
    ``(f) A corporation established under this subchapter may act as a 
multi-medical center research corporation under this subchapter in 
accordance with subsection (b) if--
            ``(1) the board of directors of the corporation approves a 
        resolution permitting facilitation by the corporation of the 
        conduct of research, education, or both at the other Department 
        medical center or medical centers concerned; and
            ``(2) the Secretary approves the resolution of the 
        corporation under paragraph (1).''.
    (b) Restatement and Modification of Authorities on Applicability of 
State Law.--
            (1) In general.--Section 7361, as amended by subsection (a) 
        of this section, is further amended by inserting after 
        subsection (b) the following new subsection (c):
    ``(c) Any corporation established under this subchapter shall be 
established in accordance with the nonprofit corporation laws of the 
State in which the applicable Department medical center is located and 
shall, to the extent not inconsistent with any Federal law, be subject 
to the laws of such State. In the case of any multi-medical center 
research corporation that facilitates the conduct of research, 
education, or both at Department medical centers located in different 
States, the corporation shall be established in accordance with the 
nonprofit corporation laws of the State in which one of such Department 
medical centers is located.''.
            (2) Conforming amendment.--Section 7365 is repealed.
    (c) Clarification of Status of Corporations.--Section 7361, as 
amended by this section, is further amended--
            (1) in subsection (a), by striking the second sentence; and
            (2) by inserting after subsection (c) the following new 
        subsection (d):
    ``(d)(1) Except as otherwise provided in this subchapter or under 
regulations prescribed by the Secretary, any corporation established 
under this subchapter, and its officers, directors, and employees, 
shall be required to comply only with those Federal laws, regulations, 
and executive orders and directives that apply generally to private 
nonprofit corporations.
    ``(2) A corporation under this subchapter is not--
            ``(A) owned or controlled by the United States; or
            ``(B) an agency or instrumentality of the United States.''.
    (d) Reinstatement of Requirement for 501(c)(3) Status of 
Corporations.--Subsection (e) of section 7361, as redesignated by 
subsection (a)(1) of this section, is further amended by inserting 
``section 501(c)(3) of'' after ``exempt from taxation under''.

SEC. 802. CLARIFICATION OF PURPOSES OF CORPORATIONS.

    (a) Clarification of Purposes.--Subsection (a) of section 7362 is 
amended--
            (1) in the first sentence--
                    (A) by striking ``Any corporation'' and all that 
                follows through ``facilitate'' and inserting ``A 
                corporation established under this subchapter shall be 
                established to provide a flexible funding mechanism for 
                the conduct of approved research and education at one 
                or more Department medical centers and to facilitate 
                functions related to the conduct of''; and
                    (B) by inserting before the period at the end the 
                following: ``or centers''; and
            (2) in the second sentence, by inserting ``or centers'' 
        after ``at the medical center''.
    (b) Modification of Defined Term Relating to Education and 
Training.--Subsection (b) of such section is amended in the matter 
preceding paragraph (1) by striking ``the term `education and 
training''' and inserting ``the term `education' includes education and 
training and''.
    (c) Repeal of Role of Corporations With Respect to Fellowships.--
Paragraph (1) of subsection (b) of such section is amended by striking 
the flush matter following subparagraph (C).
    (d) Availability of Education for Families of Veteran Patients.--
Paragraph (2) of subsection (b) of such section is amended by striking 
``to patients and to the families'' and inserting ``and includes 
education and training for patients and families''.

SEC. 803. MODIFICATION OF REQUIREMENTS FOR BOARDS OF DIRECTORS OF 
              CORPORATIONS.

    (a) Requirements for Department Board Members.--Paragraph (1) of 
section 7363(a) is amended to read as follows:
            ``(1) with respect to the Department medical center--
                    ``(A)(i) the director (or directors of each 
                Department medical center, in the case of a multi-
                medical center research corporation);
                    ``(ii) the chief of staff; and
                    ``(iii) as appropriate for the activities of such 
                corporation, the associate chief of staff for research 
                and the associate chief of staff for education; or
                    ``(B) in the case of a Department medical center at 
                which one or more of the positions referred to in 
                subparagraph (A) do not exist, the official or 
                officials who are responsible for carrying out the 
                responsibilities of such position or positions at the 
                Department medical center; and''.
    (b) Requirements for Non-Department Board Members.--Paragraph (2) 
of such section is amended--
            (1) by inserting ``not less than two'' before ``members''; 
        and
            (2) by striking ``and who'' and all that follows through 
        the period at the end and inserting ``and who have backgrounds, 
        or business, legal, financial, medical, or scientific 
        expertise, of benefit to the operations of the corporation.''.
    (c) Conflicts of Interest.--Subsection (c) of section 7363 is 
amended by striking ``, employed by, or have any other financial 
relationship with'' and inserting ``or employed by''.

SEC. 804. CLARIFICATION OF POWERS OF CORPORATIONS.

    (a) In General.--Section 7364 is amended to read as follows:
``Sec. 7364. General powers
    ``(a) In General.--(1) A corporation established under this 
subchapter may, solely to carry out the purposes of this subchapter--
            ``(A) accept, administer, retain, and spend funds derived 
        from gifts, contributions, grants, fees, reimbursements, and 
        bequests from individuals and public and private entities;
            ``(B) enter into contracts and agreements with individuals 
        and public and private entities;
            ``(C) subject to paragraph (2), set fees for education and 
        training facilitated under section 7362 of this title, and 
        receive, retain, administer, and spend funds in furtherance of 
        such education and training;
            ``(D) reimburse amounts to the applicable appropriation 
        account of the Department for the Office of General Counsel for 
        any expenses of that Office in providing legal services 
        attributable to research and education agreements under this 
        subchapter; and
            ``(E) employ such employees as the corporation considers 
        necessary for such purposes and fix the compensation of such 
        employees.
    ``(2) Fees charged under paragraph (1)(C) for education and 
training described in that paragraph to individuals who are officers or 
employees of the Department may not be paid for by any funds 
appropriated to the Department.
    ``(3) Amounts reimbursed to the Office of General Counsel under 
paragraph (1)(D) shall be available for use by the Office of the 
General Counsel only for staff and training, and related travel, for 
the provision of legal services described in that paragraph and shall 
remain available for such use without fiscal year limitation.
    ``(b) Transfer and Administration of Funds.--(1) Except as provided 
in paragraph (2), any funds received by the Secretary for the conduct 
of research or education at a Department medical center or centers, 
other than funds appropriated to the Department, may be transferred to 
and administered by a corporation established under this subchapter for 
such purposes.
    ``(2) A Department medical center may reimburse the corporation for 
all or a portion of the pay, benefits, or both of an employee of the 
corporation who is assigned to the Department medical center if the 
assignment is carried out pursuant to subchapter VI of chapter 33 of 
title 5.
    ``(3) A Department medical center may retain and use funds provided 
to it by a corporation established under this subchapter. Such funds 
shall be credited to the applicable appropriation account of the 
Department and shall be available, without fiscal year limitation, for 
the purposes of that account.
    ``(c) Research Projects.--Except for reasonable and usual 
preliminary costs for project planning before its approval, a 
corporation established under this subchapter may not spend funds for a 
research project unless the project is approved in accordance with 
procedures prescribed by the Under Secretary for Health for research 
carried out with Department funds. Such procedures shall include a 
scientific review process.
    ``(d) Education Activities.--Except for reasonable and usual 
preliminary costs for activity planning before its approval, a 
corporation established under this subchapter may not spend funds for 
an education activity unless the activity is approved in accordance 
with procedures prescribed by the Under Secretary for Health.
    ``(e) Policies and Procedures.--The Under Secretary for Health may 
prescribe policies and procedures to guide the spending of funds by 
corporations established under this subchapter that are consistent with 
the purpose of such corporations as flexible funding mechanisms and 
with Federal and State laws and regulations, and executive orders, 
circulars, and directives that apply generally to the receipt and 
expenditure of funds by nonprofit organizations exempt from taxation 
under section 501(c)(3) of the Internal Revenue Code of 1986.''.
    (b) Conforming Amendment.--Section 7362(a), as amended by section 
802(a)(1) of this Act, is further amended by striking the last 
sentence.

SEC. 805. REDESIGNATION OF SECTION 7364A OF TITLE 38, UNITED STATES 
              CODE.

    (a) Redesignation.--Section 7364A is redesignated as section 7365.
    (b) Clerical Amendments.--The table of sections at the beginning of 
chapter 73 is amended--
            (1) by striking the item relating to section 7364A; and
            (2) by striking the item relating to section 7365 and 
        inserting the following new item:

``7365. Coverage of employees under certain Federal tort claims 
                            laws.''.

SEC. 806. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF CORPORATIONS.

    (a) Additional Information in Annual Reports.--Subsection (b) of 
section 7366 is amended to read as follows:
    ``(b)(1) Each corporation shall submit to the Secretary each year a 
report providing a detailed statement of the operations, activities, 
and accomplishments of the corporation during that year.
    ``(2)(A) A corporation with revenues in excess of $300,000 for any 
year shall obtain an audit of the corporation for that year.
    ``(B) A corporation with annual revenues between $10,000 and 
$300,000 shall obtain an audit of the corporation at least once every 
three years.
    ``(C) Any audit under this paragraph shall be performed by an 
independent auditor.
    ``(3) The corporation shall include in each report to the Secretary 
under paragraph (1) the following:
            ``(A) The most recent audit of the corporation under 
        paragraph (2).
            ``(B) The most recent Internal Revenue Service Form 990 
        `Return of Organization Exempt from Income Tax' or equivalent 
        and the applicable schedules under such form.''.
    (b) Confirmation of Application of Conflict of Interest Regulations 
to Appropriate Corporation Positions.--Subsection (c) of such section 
is amended--
            (1) by striking ``laws and'' each place it appears;
            (2) in paragraph (1)--
                    (A) by inserting ``each officer and'' after ``under 
                this subchapter,''; and
                    (B) by striking ``, and each employee of the 
                Department'' and all that follows through ``during any 
                year''; and
            (3) in paragraph (2)--
                    (A) by inserting ``, officer,'' after ``verifying 
                that each director''; and
                    (B) by striking ``in the same manner'' and all that 
                follows before the period at the end.
    (c) Establishment of Appropriate Payee Reporting Threshold.--
Subsection (d)(3)(C) of such section is amended by striking ``$35,000'' 
and inserting ``$50,000''.

               TITLE IX--CONSTRUCTION AND NAMING MATTERS

SEC. 901. AUTHORIZATION OF MEDICAL FACILITY PROJECTS.

    (a) Authorization of Fiscal Year 2010 Major Medical Facility 
Projects.--The Secretary of Veterans Affairs may carry out the 
following major medical facility projects in fiscal year 2010, with 
each project to be carried out in the amount specified for each 
project:
            (1) Construction (including acquisition of land) for the 
        realignment of services and closure projects at the Department 
        of Veterans Affairs Medical Center in Livermore, California, in 
        an amount not to exceed $55,430,000.
            (2) Construction of a Multi-Specialty Care Facility in 
        Walla Walla, Washington, in an amount not to exceed 
        $71,400,000.
            (3) Construction (including acquisition of land) for a new 
        medical facility at the Department of Veterans Affairs Medical 
        Center in Louisville, Kentucky, in an amount not to exceed 
        $75,000,000.
            (4) Construction (including acquisition of land) for a 
        clinical expansion for a Mental Health Facility at the 
        Department of Veterans Affairs Medical Center in Dallas, Texas, 
        in an amount not to exceed $15,640,000.
            (5) Construction (including acquisition of land) for a 
        replacement bed tower and clinical expansion at the Department 
        of Veterans Affairs Medical Center in St. Louis, Missouri, in 
        an amount not to exceed $43,340,000.
    (b) Extension of Authorization for Major Medical Facility 
Construction Projects Previously Authorized.--The Secretary of Veterans 
Affairs may carry out the following major medical facility projects in 
fiscal year 2010, as follows with each project to be carried out in the 
amount specified for that project:
            (1) Replacement of the existing Department of Veterans 
        Affairs Medical Center in Denver, Colorado, in an amount not to 
        exceed $800,000,000.
            (2) Construction of Outpatient and Inpatient Improvements 
        in Bay Pines, Florida, in an amount not to exceed $194,400,000.
    (c) Authorization of Appropriations.--
            (1) Authorization of appropriations for construction.--
        There is authorized to be appropriated to the Secretary of 
        Veterans Affairs for fiscal year 2010, or the year in which 
        funds are appropriated, for the Construction, Major Projects 
        account--
                    (A) $260,810,000 for the projects authorized in 
                subsection (a); and
                    (B) $994,400,000 for the projects authorized in 
                subsection (b).
            (2) Limitation.--The projects authorized in subsections (a) 
        and (b) may only be carried out using--
                    (A) funds appropriated for fiscal year 2010 
                pursuant to the authorization of appropriations in 
                paragraph (1) of this section;
                    (B) funds available for Construction, Major 
                Projects for a fiscal year before fiscal year 2010 that 
                remain available for obligation;
                    (C) funds available for Construction, Major 
                Projects for a fiscal year after fiscal year 2010 that 
                remain available for obligation;
                    (D) funds appropriated for Construction, Major 
                Projects for fiscal year 2010 for a category of 
                activity not specific to a project;
                    (E) funds appropriated for Construction, Major 
                Projects for a fiscal year before 2010 for a category 
                of activity not specific to a project; and
                    (F) funds appropriated for Construction, Major 
                Projects for a fiscal year after 2010 for a category of 
                activity not specific to a project.

SEC. 902. DESIGNATION OF ROBLEY REX DEPARTMENT OF VETERANS AFFAIRS 
              MEDICAL CENTER.

    (a) Designation.--The Department of Veterans Affairs Medical Center 
in Louisville, Kentucky, and any successor to such medical center, 
shall after the date of the enactment of this Act be known and 
designated as the ``Robley Rex Department of Veterans Affairs Medical 
Center''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the medical 
center referred to in subsection (a) shall be considered to be a 
reference to the Robley Rex Department of Veterans Affairs Medical 
Center.

SEC. 903. MERRIL LUNDMAN DEPARTMENT OF VETERANS AFFAIRS OUTPATIENT 
              CLINIC.

    (a) In General.--The Department of Veterans Affairs outpatient 
clinic in Havre, Montana, shall after the date of the enactment of this 
Act be known and designated as the ``Merril Lundman 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 Merril Lundman Department of Veterans Affairs 
Outpatient Clinic.

SEC. 904. MODIFICATION ON RESTRICTION OF ALIENATION OF CERTAIN REAL 
              PROPERTY IN GULF PORT, MISSISSIPPI.

    (a) In General.--Section 2703(b) of the Emergency Supplemental 
Appropriations Act for Defense, the Global War on Terror, and Hurricane 
Recovery, 2006 (Public Law 109-234; 120 Stat. 469), as amended by 
section 231 of the Military Construction and Veterans Affairs and 
Related Agencies Appropriations Act, 2009 (division E of Public Law 
110-329; 122 Stat. 3713), is further amended by inserting after ``the 
City of Gulfport'' the following: ``, or its urban renewal agency,''.
    (b) Memorialization of Modification.--The Secretary of Veterans 
Affairs shall take appropriate actions to modify the quitclaim deeds 
executed to effectuate the conveyance authorized by section 2703 of the 
Emergency Supplemental Appropriations Act for Defense, the Global War 
on Terror, and Hurricane Recovery, 2006 (Public Law 109-234) in order 
to accurately reflect and memorialize the amendment made by subsection 
(a).

                         TITLE X--OTHER MATTERS

SEC. 1001. EXPANSION OF AUTHORITY FOR DEPARTMENT OF VETERANS AFFAIRS 
              POLICE OFFICERS.

    Section 902 is amended--
            (1) in subsection (a)--
                    (A) by amending paragraph (1) to read as follows:
            ``(1) Employees of the Department who are Department police 
        officers shall, with respect to acts occurring on Department 
        property--
                    ``(A) enforce Federal laws;
                    ``(B) enforce the rules prescribed under section 
                901 of this title;
                    ``(C) enforce traffic and motor vehicle laws of a 
                State or local government (by issuance of a citation 
                for violation of such laws) within the jurisdiction of 
                which such Department property is located as authorized 
                by an express grant of authority under applicable State 
                or local law;
                    ``(D) carry the appropriate Department-issued 
                weapons, including firearms, while off Department 
                property in an official capacity or while in an 
                official travel status;
                    ``(E) conduct investigations, on and off Department 
                property, of offenses that may have been committed on 
                property under the original jurisdiction of Department, 
                consistent with agreements or other consultation with 
                affected local, State, or Federal law enforcement 
                agencies; and
                    ``(F) carry out, as needed and appropriate, the 
                duties described in subparagraphs (A) through (E) of 
                this paragraph when engaged in duties authorized by 
                other Federal statutes.'';
                    (B) by striking paragraph (2) and redesignating 
                paragraph (3) as paragraph (2); and
                    (C) in paragraph (2), as redesignated by 
                subparagraph (B) of this paragraph, by inserting ``, 
                and on any arrest warrant issued by competent judicial 
                authority'' before the period; and
            (2) by amending subsection (c) to read as follows:
    ``(c) The powers granted to Department police officers designated 
under this section shall be exercised in accordance with guidelines 
approved by the Secretary and the Attorney General.''.

SEC. 1002. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS AFFAIRS POLICE 
              OFFICERS.

    Section 903 is amended--
            (1) by amending subsection (b) to read as follows:
    ``(b)(1) The amount of the allowance that the Secretary may pay 
under this section is the lesser of--
            ``(A) the amount currently allowed as prescribed by the 
        Office of Personnel Management; or
            ``(B) estimated costs or actual costs as determined by 
        periodic surveys conducted by the Department.
    ``(2) During any fiscal year no officer shall receive more for the 
purchase of a uniform described in subsection (a) than the amount 
established under this subsection.''; and
            (2) by striking subsection (c) and inserting the following 
        new subsection (c):
    ``(c) The allowance established under subsection (b) shall be paid 
at the beginning of a Department police officer's employment for those 
appointed on or after October 1, 2008. In the case of any other 
Department police officer, an allowance in the amount established under 
subsection (b) shall be paid upon the request of the officer.''.
                                                       Calendar No. 190

111th CONGRESS

  1st Session

                                S. 1963

_______________________________________________________________________

                                 A BILL

    To amend title 38, United States Code, to provide assistance to 
  caregivers of veterans, to improve the provision of health care to 
                   veterans, and for other purposes.

_______________________________________________________________________

                            October 29, 2009

            Read the second time and placed on the calendar