[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 252 Reported in Senate (RS)]
Calendar No. 128
111th CONGRESS
1st Session
S. 252
[Report No. 111-60]
To amend title 38, United States Code, to enhance the capacity of the
Department of Veterans Affairs to recruit and retain nurses and other
critical health-care professionals, to improve the provision of health
care to veterans, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 15, 2009
Mr. Akaka (for himself, Mr. Durbin, Mrs. Murray, Mr. Burr, Mr. Begich,
and Mr. Vitter) introduced the following bill; which was read twice and
referred to the Committee on Veterans' Affairs
July 24, 2009
Reported by Mr. Akaka, with an amendment
[Strike out all after the enacting clause and insert the part printed
in italic]
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to enhance the capacity of the
Department of Veterans Affairs to recruit and retain nurses and other
critical health-care professionals, 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,
<DELETED>SECTION 1. SHORT TITLE; TABLE OF CONTENTS.</DELETED>
<DELETED> (a) Short Title.--This Act may be cited as the ``Veterans
Health Care Authorization Act of 2009''.</DELETED>
<DELETED> (b) Table of Contents.--The table of contents for this Act
is as follows:</DELETED>
<DELETED>Sec. 1. Short title; table of contents.
<DELETED>Sec. 2. References to title 38, United States Code.
<DELETED>TITLE I--DEPARTMENT PERSONNEL MATTERS
<DELETED>Sec. 101. Enhancement of authorities for retention of medical
professionals.
<DELETED>Sec. 102. Limitations on overtime duty, weekend duty, and
alternative work schedules for nurses.
<DELETED>Sec. 103. Improvements to certain educational assistance
programs.
<DELETED>Sec. 104. Standards for appointment and practice of physicians
in Department of Veterans Affairs medical
facilities.
<DELETED>TITLE II--HEALTH CARE MATTERS
<DELETED>Sec. 201. Repeal of certain annual reporting requirements.
<DELETED>Sec. 202. Modifications to annual Gulf War research report.
<DELETED>Sec. 203. Payment for care furnished to CHAMPVA beneficiaries.
<DELETED>Sec. 204. Payor provisions for care furnished to certain
children of Vietnam veterans.
<DELETED>Sec. 205. Disclosures from certain medical records.
<DELETED>Sec. 206. Disclosure to Secretary of health-plan contract
information and social security number of
certain veterans receiving care.
<DELETED>Sec. 207. Enhancement of quality management.
<DELETED>Sec. 208. Reports on improvements to Department health care
quality management.
<DELETED>Sec. 209. Pilot program on training and certification for
family caregiver personal care attendants
for veterans and members of the Armed
Forces with traumatic brain injury.
<DELETED>Sec. 210. Pilot program on provision of respite care to
members of the Armed Forces and veterans
with traumatic brain injury by students in
graduate programs of education related to
mental health or rehabilitation.
<DELETED>Sec. 211. 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.
<DELETED>Sec. 212. Specialized residential care and rehabilitation for
certain veterans.
<DELETED>Sec. 213. Authority to disclose medical records to third party
for collection of charges for provision of
certain care.
<DELETED>Sec. 214. Expanded study on the health impact of Project
Shipboard Hazard and Defense.
<DELETED>Sec. 215. Use of non-Department facilities for rehabilitation
of individuals with traumatic brain injury.
<DELETED>Sec. 216. Inclusion of federally recognized tribal
organizations in certain programs for State
veterans homes.
<DELETED>Sec. 217. Pilot program on provision of dental insurance plans
to veterans and survivors and dependents of
veterans.
<DELETED>TITLE III--WOMEN VETERANS HEALTH CARE
<DELETED>Sec. 301. Report on barriers to receipt of health care for
women veterans.
<DELETED>Sec. 302. Plan to improve provision of health care services to
women veterans.
<DELETED>Sec. 303. Independent study on health consequences of women
veterans of military service in Operation
Iraqi Freedom and Operation Enduring
Freedom.
<DELETED>Sec. 304. Training and certification for mental health care
providers on care for veterans suffering
from sexual trauma.
<DELETED>Sec. 305. Pilot program on counseling in retreat settings for
women veterans newly separated from service
in the Armed Forces.
<DELETED>Sec. 306. Report on full-time women veterans program managers
at medical centers.
<DELETED>Sec. 307. Service on certain advisory committees of women
recently separated from service in the
Armed Forces.
<DELETED>Sec. 308. Pilot program on subsidies for child care for
certain veterans receiving health care.
<DELETED>Sec. 309. Care for newborn children of women veterans
receiving maternity care.
<DELETED>TITLE IV--MENTAL HEALTH CARE
<DELETED>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.
<DELETED>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.
<DELETED>Sec. 403. Study on suicides among veterans.
<DELETED>Sec. 404. Transfer of funds to Secretary of Health and Human
Services for Graduate Psychology Education
program.
<DELETED>TITLE V--HOMELESS VETERANS
<DELETED>Sec. 501. Pilot program on financial support for entities that
coordinate the provision of supportive
services to formerly homeless veterans
residing on certain military property.
<DELETED>Sec. 502. Pilot program on financial support of entities that
coordinate the provision of supportive
services to formerly homeless veterans
residing in permanent housing.
<DELETED>Sec. 503. Pilot program on financial support of entities that
provide outreach to inform certain veterans
about pension benefits.
<DELETED>Sec. 504. Pilot program on financial support of entities that
provide transportation assistance, child
care assistance, and clothing assistance to
veterans entitled to a rehabilitation
program.
<DELETED>Sec. 505. Assessment of pilot programs.
<DELETED>TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS
<DELETED>Sec. 601. General authorities on establishment of
corporations.
<DELETED>Sec. 602. Clarification of purposes of corporations.
<DELETED>Sec. 603. Modification of requirements for boards of directors
of corporations.
<DELETED>Sec. 604. Clarification of powers of corporations.
<DELETED>Sec. 605. Redesignation of section 7364A of title 38, United
States Code.
<DELETED>Sec. 606. Improved accountability and oversight of
corporations.
<DELETED>TITLE VII--MISCELLANEOUS PROVISIONS
<DELETED>Sec. 701. Expansion of authority for Department of Veterans
Affairs police officers.
<DELETED>Sec. 702. Uniform allowance for Department of Veterans Affairs
police officers.
<DELETED>SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.</DELETED>
<DELETED> Except as otherwise expressly provided, whenever in this
Act an amendment or repeal is expressed in terms of an amendment or
repeal to 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.</DELETED>
<DELETED>TITLE I--DEPARTMENT PERSONNEL MATTERS</DELETED>
<DELETED>SEC. 101. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL
PROFESSIONALS.</DELETED>
<DELETED> (a) Secretarial Authority To Extend Title 38 Status to
Additional Positions.--</DELETED>
<DELETED> (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:</DELETED>
<DELETED> ``(A) 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.</DELETED>
<DELETED> ``(B) Before submitting notice under
subparagraph (A), the Secretary shall solicit comments
from any labor organization representing employees in
such class and include such comments in such
notice.''.</DELETED>
<DELETED> (2) Appointment of nurse assistants.--Such
paragraph is further amended by inserting ``nurse assistants,''
after ``licensed practical or vocational nurses,''.</DELETED>
<DELETED> (b) Probationary Periods for Registered Nurses.--Section
7403(b) is amended--</DELETED>
<DELETED> (1) in paragraph (1), by striking ``Appointments''
and inserting ``Except as otherwise provided in this
subsection, appointments'';</DELETED>
<DELETED> (2) by redesignating paragraph (2) as paragraph
(4); and</DELETED>
<DELETED> (3) by inserting after paragraph (1) the following
new paragraphs:</DELETED>
<DELETED> ``(2) An appointment of a registered nurse under this
chapter, whether on a full-time basis or a part-time basis, shall be
for a probationary period ending upon the completion by the person so
appointed of a number of hours of work pursuant to such appointment
that the Secretary considers appropriate for such appointment but not
more than 4,180 hours.</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (c) Prohibition on Temporary Part-time Registered Nurse
Appointments in Excess of 4,180 Hours.--Section 7405 is amended by
adding at the end the following new subsection:</DELETED>
<DELETED> ``(g)(1) Employment of a registered nurse on a temporary
part-time basis under subsection (a)(1) shall be for a probationary
period ending upon the completion by the person so employed of a number
of hours of work pursuant to such employment that the Secretary
considers appropriate for such employment but not more than 4,180
hours.</DELETED>
<DELETED> ``(2) Upon completion by a registered nurse of the
probationary period described in paragraph (1)--</DELETED>
<DELETED> ``(A) the employment of such nurse shall--
</DELETED>
<DELETED> ``(i) no longer be considered temporary;
and</DELETED>
<DELETED> ``(ii) be considered an appointment
described in section 7403(a) of this title;
and</DELETED>
<DELETED> ``(B) the nurse shall be considered to have served
the probationary period required by section
7403(b).''.</DELETED>
<DELETED> (d) Waiver of Offset From Pay for Certain Reemployed
Annuitants.--</DELETED>
<DELETED> (1) In general.--Section 7405, as amended by
subsection (c), is further amended by adding at the end the
following new subsection:</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(4) In this subsection:</DELETED>
<DELETED> ``(A) The term `annuitant' means an annuitant
under a Government retirement system.</DELETED>
<DELETED> ``(B) The term `employee' has the meaning under
section 2105 of title 5.</DELETED>
<DELETED> ``(C) The term `Government retirement system'
means a retirement system established by law for employees of
the Government of the United States.''.</DELETED>
<DELETED> (2) Effective date.--The amendment made by
paragraph (1) shall take effect on the date that is six months
after the date of the enactment of this Act, and shall apply to
pay periods beginning on or after such effective
date.</DELETED>
<DELETED> (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.--</DELETED>
<DELETED> (1) In general.--Section 7404(a) is amended--
</DELETED>
<DELETED> (A) by striking ``The annual'' and
inserting ``(1) The annual'';</DELETED>
<DELETED> (B) by striking ``The pay'' and inserting
the following:</DELETED>
<DELETED> ``(2) The pay'';</DELETED>
<DELETED> (C) by striking ``under the preceding
sentence'' and inserting ``under paragraph (1)'';
and</DELETED>
<DELETED> (D) by adding at the end the following new
paragraph:</DELETED>
<DELETED> ``(3) 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).''.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (f) Comparability Pay Program for Appointees to the Office
of the Under Secretary for Health.--Section 7410 is amended--</DELETED>
<DELETED> (1) by striking ``The Secretary may'' and
inserting ``(a) In General.--The Secretary may''; and</DELETED>
<DELETED> (2) by adding at the end the following new
subsection:</DELETED>
<DELETED> ``(b) Comparability Pay for Appointees to the Office of
the Under Secretary for Health.--(1) The Secretary may authorize the
Under Secretary for Health to provide comparability pay of not more
than $100,000 per year to individuals of the Veterans Health
Administration appointed under section 7306 of this title who are not
physicians or dentists and to individuals who are appointed to Senior
Executive Service positions (as such term is defined in section 3132(a)
of title 5) to achieve annual pay levels for such individuals that are
comparable with annual pay levels of individuals with similar positions
in the private sector.</DELETED>
<DELETED> ``(2) Comparability pay under paragraph (1) for an
individual is in addition to all other pay, awards, and performance
bonuses paid to such individual under this title.</DELETED>
<DELETED> ``(3) Except as provided in paragraph (4), comparability
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.</DELETED>
<DELETED> ``(4) Comparability pay under paragraph (1) for an
individual shall not be considered basic pay for purposes of adverse
actions under subchapter V of this chapter.</DELETED>
<DELETED> ``(5) Comparability 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.''.</DELETED>
<DELETED> (g) Special Incentive Pay for Department Pharmacist
Executives.--Section 7410, as amended by subsection (f) of this
section, is further amended by adding at the end the following new
subsection:</DELETED>
<DELETED> ``(c) 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.</DELETED>
<DELETED> ``(2) In determining whether and how much special pay to
provide to such individual, the Under Secretary shall consider the
following:</DELETED>
<DELETED> ``(A) The grade and step of the position of the
individual.</DELETED>
<DELETED> ``(B) The scope and complexity of the position of
the individual.</DELETED>
<DELETED> ``(C) The personal qualifications of the
individual.</DELETED>
<DELETED> ``(D) The characteristics of the labor market
concerned.</DELETED>
<DELETED> ``(E) Such other factors as the Secretary
considers appropriate.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (h) Pay for Physicians and Dentists.--</DELETED>
<DELETED> (1) Non-foreign cost of living adjustment
allowance.--Section 7431(b) is amended by adding at the end the
following new paragraph:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (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.''.</DELETED>
<DELETED> (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.''.</DELETED>
<DELETED> (i) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2)
is amended by striking ``level V'' and inserting ``level
IV''.</DELETED>
<DELETED> (j) 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.''.</DELETED>
<DELETED> (k) Locality Pay Scale Computations.--</DELETED>
<DELETED> (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:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (2) Information on methodology used in wage
surveys.--Section 7451(e)(4) is amended--</DELETED>
<DELETED> (A) by redesignating subparagraph (D) as
subparagraph (E); and</DELETED>
<DELETED> (B) by inserting after subparagraph (C)
the following new subparagraph (D):</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(B) An individual described in this subparagraph is--
</DELETED>
<DELETED> ``(i) an individual in a covered position at a
Department health-care facility; or</DELETED>
<DELETED> ``(ii) a representative of the labor organization
representing that individual who is designated by that
individual to make the request.''.</DELETED>
<DELETED> (l) Increased Limitation on Special Pay for Nurse
Executives.--Section 7452(g)(2) is amended by striking ``$25,000'' and
inserting ``$100,000''.</DELETED>
<DELETED> (m) Eligibility of Part-time Nurses for Additional Nurse
Pay.--</DELETED>
<DELETED> (1) In general.--Section 7453 is amended--
</DELETED>
<DELETED> (A) in subsection (a), by striking ``a
nurse'' and inserting ``a full-time nurse or part-time
nurse'';</DELETED>
<DELETED> (B) in subsection (b)--</DELETED>
<DELETED> (i) in the first sentence--
</DELETED>
<DELETED> (I) by striking ``on a
tour of duty'';</DELETED>
<DELETED> (II) by striking ``service
on such tour'' and inserting ``such
service''; and</DELETED>
<DELETED> (III) by striking ``of
such tour'' and inserting ``of such
service''; and</DELETED>
<DELETED> (ii) in the second sentence, by
striking ``of such tour'' and inserting ``of
such service'';</DELETED>
<DELETED> (C) in subsection (c)--</DELETED>
<DELETED> (i) by striking ``on a tour of
duty''; and</DELETED>
<DELETED> (ii) by striking ``service on such
tour'' and inserting ``such service'';
and</DELETED>
<DELETED> (D) in subsection (e)--</DELETED>
<DELETED> (i) in paragraph (1), by striking
``eight hours in a day'' and inserting ``eight
consecutive hours''; and</DELETED>
<DELETED> (ii) in paragraph (5)(A), by
striking ``tour of duty'' and inserting
``period of service''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (n) Exemption of Additional Nurse Positions From
Limitation on Increase in Rates of Basic Pay.--Section 7455(c)(1) is
amended by inserting after ``nurse anesthetists,'' the following:
``licensed practical nurses, licensed vocational nurses, and nursing
positions otherwise covered by title 5,''.</DELETED>
<DELETED>SEC. 102. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND
ALTERNATIVE WORK SCHEDULES FOR NURSES.</DELETED>
<DELETED> (a) Overtime Duty.--</DELETED>
<DELETED> (1) In general.--Subchapter IV of chapter 74 is
amended by adding at the end the following new
section:</DELETED>
<DELETED>``Sec. 7459. Nursing staff: special rules for overtime
duty</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(b) Voluntary Overtime.--(1) Nursing staff may on a
voluntary basis elect to work hours otherwise prohibited by subsection
(a).</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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--</DELETED>
<DELETED> ``(A) the work is a consequence of an emergency
that could not have been reasonably anticipated;</DELETED>
<DELETED> ``(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;</DELETED>
<DELETED> ``(C) the Secretary has exhausted all good faith,
reasonable attempts to obtain voluntary workers;</DELETED>
<DELETED> ``(D) the nurse staff have critical skills and
expertise that are required for the work; and</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(d) Nursing Staff Defined.--In this section, the term
`nursing staff' includes the following;</DELETED>
<DELETED> ``(1) A registered nurse.</DELETED>
<DELETED> ``(2) A licensed practical or vocational
nurse.</DELETED>
<DELETED> ``(3) A nurse assistant appointed under this
chapter or title 5.</DELETED>
<DELETED> ``(4) Any other nurse position designated by the
Secretary for purposes of this section.''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED>``7459. Nursing staff: special rules for overtime duty.''.
<DELETED> (b) Weekend Duty.--Section 7456 is amended--</DELETED>
<DELETED> (1) by striking subsection (c); and</DELETED>
<DELETED> (2) by redesignating subsection (d) as subsection
(c).</DELETED>
<DELETED> (c) Alternate Work Schedules.--</DELETED>
<DELETED> (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 periods of service within a pay period shall
be considered for all purposes to have worked a full 80-hour
pay period.''.</DELETED>
<DELETED> (2) Conforming amendments.--Section 7456A(b) is
amended--</DELETED>
<DELETED> (A) in the subsection heading, by striking
``36/40'' and inserting ``72/80'';</DELETED>
<DELETED> (B) in paragraph (2)--</DELETED>
<DELETED> (i) in subparagraph (A), by
striking ``40-hour basic work week'' and
inserting ``80-hour pay period'';</DELETED>
<DELETED> (ii) in subparagraph (B), by
striking ``regularly scheduled 36-hour tour of
duty within the work week'' and inserting
``scheduled 72-hour period of service within
the bi-weekly pay period'';</DELETED>
<DELETED> (iii) in subparagraph (C)--
</DELETED>
<DELETED> (I) in clause (i), by
striking ``regularly scheduled 36-hour
tour of duty within an administrative
work week'' and inserting ``scheduled
72-hour period of service within an
administrative pay period'';</DELETED>
<DELETED> (II) in clause (ii), by
striking ``regularly scheduled 12-hour
tour of duty'' and inserting
``scheduled 12-hour period of
service''; and</DELETED>
<DELETED> (III) in clause (iii), by
striking ``regularly scheduled 36-hour
tour of duty work week'' and inserting
``scheduled 72-hour period of service
pay period''; and</DELETED>
<DELETED> (iv) in subparagraph (D), by
striking ``regularly scheduled 12-hour tour of
duty'' and inserting ``scheduled 12-hour period
of service''; and</DELETED>
<DELETED> (C) in paragraph (3), by striking
``regularly scheduled 12-hour tour of duty'' and
inserting ``scheduled 12-hour period of
service''.</DELETED>
<DELETED>SEC. 103. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE
PROGRAMS.</DELETED>
<DELETED> (a) Reinstatement of Health Professionals Educational
Assistance Scholarship Program.--</DELETED>
<DELETED> (1) In general.--Section 7618 is amended by
striking ``December 31, 1998'' and inserting ``December 31,
2014''.</DELETED>
<DELETED> (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.''.</DELETED>
<DELETED> (b) Improvements to Education Debt Reduction Program.--
</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (2) Eligibility.--Section 7682 is amended--
</DELETED>
<DELETED> (A) in subsection (a)(1), by striking ``a
recently appointed'' and inserting ``an'';
and</DELETED>
<DELETED> (B) by striking subsection (c).</DELETED>
<DELETED> (3) Maximum amounts of assistance.--Section
7683(d)(1) is amended--</DELETED>
<DELETED> (A) by striking ``$44,000'' and inserting
``$60,000''; and</DELETED>
<DELETED> (B) by striking ``$10,000'' and inserting
``$12,000''.</DELETED>
<DELETED> (c) Loan Repayment Program for Clinical Researchers From
Disadvantaged Backgrounds.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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)).</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 104. STANDARDS FOR APPOINTMENT AND PRACTICE OF PHYSICIANS
IN DEPARTMENT OF VETERANS AFFAIRS MEDICAL
FACILITIES.</DELETED>
<DELETED> (a) Standards.--</DELETED>
<DELETED> (1) In general.--Subchapter I of chapter 74 is
amended by inserting after section 7402 the following new
section:</DELETED>
<DELETED>``Sec. 7402A. Appointment and practice of physicians:
standards</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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:</DELETED>
<DELETED> ``(1) Provide the Secretary a full and complete
explanation of the following:</DELETED>
<DELETED> ``(A) Each lawsuit, civil action, or other
claim (whether open or closed) brought against the
individual for medical malpractice or negligence (other
than a lawsuit, action, or claim closed without any
judgment against or payment by or on behalf of the
individual).</DELETED>
<DELETED> ``(B) Each payment made by or on behalf of
the individual to settle any lawsuit, action, or claim
covered by subparagraph (A).</DELETED>
<DELETED> ``(C) Each investigation or disciplinary
action taken against the individual relating to the
individual's performance as a physician.</DELETED>
<DELETED> ``(2) Submit a written request and authorization
to 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:</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(B) Each payment made by or on behalf of
the individual to settle any lawsuit, action, or claim
covered by subparagraph (A).</DELETED>
<DELETED> ``(C) Each medical malpractice judgment
against the individual by the courts or administrative
agencies or bodies of such State.</DELETED>
<DELETED> ``(D) Each disciplinary action taken or
under consideration against the individual by an
administrative agency or body of such State.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(G) Any written notification by the
State to the individual of potential termination of a
license for cause or otherwise.</DELETED>
<DELETED> ``(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:</DELETED>
<DELETED> ``(A) A judgment against the individual for
medical malpractice or negligence.</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(C) Any disposition of or material change in a
matter disclosed under paragraph (1) or (2) of subsection
(b).</DELETED>
<DELETED> ``(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:</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(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:</DELETED>
<DELETED> ``(i) A judgment against the individual
for medical malpractice or negligence.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(iii) Any disposition of or material
change in a matter disclosed pursuant to subparagraph
(A) or under this subparagraph.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(3) The results of each investigation performed under
this subsection shall be fully documented.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(2) In approving the appointment under this subsection
of an individual for whom any matters have been disclosed under
subsection (b), a Director shall--</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(B) provide a written justification why any
matters raised in the course of such investigation do not
disqualify the individual from appointment.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(2) The Secretary may determine the nature and manner of
the provision described in paragraph (1).''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED>``7402A. Appointment and practice of physicians: standards.''.
<DELETED> (b) Effective Date and Applicability.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>TITLE II--HEALTH CARE MATTERS</DELETED>
<DELETED>SEC. 201. REPEAL OF CERTAIN ANNUAL REPORTING
REQUIREMENTS.</DELETED>
<DELETED> (a) Nurse Pay Report.--Section 7451 is amended--</DELETED>
<DELETED> (1) by striking subsection (f); and</DELETED>
<DELETED> (2) by redesignating subsection (g) as subsection
(f).</DELETED>
<DELETED> (b) Long-term Planning Report.--</DELETED>
<DELETED> (1) In general.--Section 8107 is
repealed.</DELETED>
<DELETED> (2) Conforming amendment.--The table of sections
at the beginning of chapter 81 is amended by striking the item
relating to section 8107.</DELETED>
<DELETED>SEC. 202. MODIFICATIONS TO ANNUAL GULF WAR RESEARCH
REPORT.</DELETED>
<DELETED> 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, 2008, and July 1 of each of the five
following years''.</DELETED>
<DELETED>SEC. 203. PAYMENT FOR CARE FURNISHED TO CHAMPVA
BENEFICIARIES.</DELETED>
<DELETED> Section 1781 is amended at the end by adding the following
new subsection:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED>SEC. 204. PAYOR PROVISIONS FOR CARE FURNISHED TO CERTAIN
CHILDREN OF VIETNAM VETERANS.</DELETED>
<DELETED> (a) Children of Vietnam Veterans Born With Spina Bifida.--
Section 1803 is amended--</DELETED>
<DELETED> (1) by redesignating subsection (c) as subsection
(d); and</DELETED>
<DELETED> (2) by inserting after subsection (b) the
following new subsection (c):</DELETED>
<DELETED> ``(c) Where payment by the Secretary under this section is
less than the amount of the charges billed, the health care provider or
agent of the health care provider may seek payment for the difference
between the amount billed and the amount paid by the Secretary from a
responsible third party to the extent that the provider or agent
thereof would be eligible to receive payment for such care or services
from such third party, but--</DELETED>
<DELETED> ``(1) the health care provider or agent for the
health care provider may not impose any additional charge on
the beneficiary who received the medical care, or the family of
such beneficiary, for any service or item for which the
Secretary has made payment under this section;</DELETED>
<DELETED> ``(2) the total amount of payment a provider or
agent of the provider may receive for care and services
furnished under this section may not exceed the amount billed
to the Secretary; and</DELETED>
<DELETED> ``(3) the Secretary, upon request, shall disclose
to such third party information received for the purposes of
carrying out this section.''.</DELETED>
<DELETED> (b) Children of Women Vietnam Veterans Born With Birth
Defects.--Section 1813 is amended--</DELETED>
<DELETED> (1) by redesignating subsection (c) as subsection
(d); and</DELETED>
<DELETED> (2) by inserting after subsection (b) the
following new subsection (c):</DELETED>
<DELETED> ``(c) Seeking Payment From Third Parties.--Where payment
by the Secretary under this section is less than the amount of the
charges billed, the health care provider or agent of the health care
provider may seek payment for the difference between the amount billed
and the amount paid by the Secretary from a responsible third party to
the extent that the health care provider or agent thereof would be
eligible to receive payment for such care or services from such third
party, but--</DELETED>
<DELETED> ``(1) the health care provider or agent for the
health care provider may not impose any additional charge on
the beneficiary who received medical care, or the family of
such beneficiary, for any service or item for which the
Secretary has made payment under this section;</DELETED>
<DELETED> ``(2) the total amount of payment a provider or
agent of the provider may receive for care and services
furnished under this section may not exceed the amount billed
to the Secretary; and</DELETED>
<DELETED> ``(3) the Secretary, upon request, shall disclose
to such third party information received for the purposes of
carrying out this section.''.</DELETED>
<DELETED>SEC. 205. DISCLOSURES FROM CERTAIN MEDICAL RECORDS.</DELETED>
<DELETED> Section 7332(b)(2) is amended by adding at the end the
following new subparagraph:</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED>SEC. 206. DISCLOSURE TO SECRETARY OF HEALTH-PLAN CONTRACT
INFORMATION AND SOCIAL SECURITY NUMBER OF CERTAIN
VETERANS RECEIVING CARE.</DELETED>
<DELETED> (a) In General.--Subchapter I of chapter 17 is amended by
adding at the end the following new section:</DELETED>
<DELETED>``Sec. 1709. Disclosure to Secretary of health-plan contract
information and social security number of certain
veterans receiving care</DELETED>
<DELETED> ``(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--</DELETED>
<DELETED> ``(A) the name, address, and telephone number of
such health-plan contract;</DELETED>
<DELETED> ``(B) the name of the individual's spouse, if the
individual's coverage is under the spouse's health-plan
contract;</DELETED>
<DELETED> ``(C) the plan number; and</DELETED>
<DELETED> ``(D) the plan's group code.</DELETED>
<DELETED> ``(2) The care described in this paragraph is--</DELETED>
<DELETED> ``(A) hospital, nursing home, or domiciliary
care;</DELETED>
<DELETED> ``(B) medical, rehabilitative, or preventive
health services; or</DELETED>
<DELETED> ``(C) other medical care under laws administered
by the Secretary.</DELETED>
<DELETED> ``(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--</DELETED>
<DELETED> ``(A) the individual's social security number;
and</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(2) The care described in this paragraph is--</DELETED>
<DELETED> ``(A) hospital, nursing home, or domiciliary
care;</DELETED>
<DELETED> ``(B) medical, rehabilitative, or preventive
health services; or</DELETED>
<DELETED> ``(C) other medical care under laws administered
by the Secretary.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(d) Construction.--Nothing in this section shall be
construed as authority to deny medical care and treatment to an
individual in a medical emergency.''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED>``1709. Disclosure to Secretary of health-plan contract
information and social security number of
certain veterans receiving care.''.
<DELETED>SEC. 207. ENHANCEMENT OF QUALITY MANAGEMENT.</DELETED>
<DELETED> (a) Enhancement of Quality Management Through Quality
Management Officers.--</DELETED>
<DELETED> (1) In general.--Subchapter II of chapter 73 is
amended by inserting after section 7311 the following new
section:</DELETED>
<DELETED>``Sec. 7311A. Quality management officers</DELETED>
<DELETED> ``(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').</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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:</DELETED>
<DELETED> ``(A) Establishing and enforcing the requirements
of the program referred to in paragraph (1).</DELETED>
<DELETED> ``(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 of the American College of Surgeons, 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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(D) Encouraging research and development in the
area of quality metrics for the purposes of improving how the
Department measures quality in individual facilities.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(4) The requirements under paragraph (3) shall include
requirements regarding the following:</DELETED>
<DELETED> ``(A) A confidential system for the submittal of
reports by Veterans Health Administration personnel regarding
quality management at Department facilities.</DELETED>
<DELETED> ``(B) Mechanisms for the peer review of the
actions of individuals appointed in the Veterans Health
Administration in the position of physician.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(3) The quality management officer for a Veterans
Integrated Services Network shall--</DELETED>
<DELETED> ``(A) direct the quality management office in the
Network; and</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED>``7311A. Quality management officers.''.
<DELETED> (b) Reports on Quality Concerns Under Quality-assurance
Program.--Section 7311(b) is amended by adding at the end the following
new paragraph:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (c) Review of Current Health Care Quality Safeguards.--
</DELETED>
<DELETED> (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--
</DELETED>
<DELETED> (A) the efficacy of the quality indicators
under the program;</DELETED>
<DELETED> (B) the efficacy of the data collection
methods under the program;</DELETED>
<DELETED> (C) the efficacy of the frequency with
which regular data analyses are performed under the
program; and</DELETED>
<DELETED> (D) the extent to which the resources
allocated to the program are adequate to fulfill the
stated function of the program.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 208. REPORTS ON IMPROVEMENTS TO DEPARTMENT HEALTH CARE
QUALITY MANAGEMENT.</DELETED>
<DELETED> (a) Report.--Not later than December 15, 2009, 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 104 and 207 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:</DELETED>
<DELETED> (1) A comprehensive description of the
implementation of sections 104 and 207 of this Act and the
amendments made by such sections.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (b) Congressional Veterans Affairs Committees Defined.--In
this section, the term ``congressional veterans affairs committees''
means--</DELETED>
<DELETED> (1) the Committees on Veterans' Affairs and
Appropriations of the Senate; and</DELETED>
<DELETED> (2) the Committees on Veterans' Affairs and
Appropriations of the House of Representatives.</DELETED>
<DELETED>SEC. 209. PILOT PROGRAM ON TRAINING AND CERTIFICATION FOR
FAMILY CAREGIVER PERSONAL CARE ATTENDANTS FOR VETERANS
AND MEMBERS OF THE ARMED FORCES WITH TRAUMATIC BRAIN
INJURY.</DELETED>
<DELETED> (a) Pilot Program Authorized.--The Secretary of Veterans
Affairs shall, in collaboration with the Secretary of Defense, carry
out a pilot program to assess the feasibility and advisability of
providing training and certification for family caregivers of veterans
and members of the Armed Forces with traumatic brain injury as personal
care attendants of such veterans and members.</DELETED>
<DELETED> (b) Duration of Program.--The pilot program required by
subsection (a) shall be carried out during the three-year period
beginning on the date of the commencement of the pilot
program.</DELETED>
<DELETED> (c) Locations.--</DELETED>
<DELETED> (1) In general.--The pilot program under this
section shall be carried out--</DELETED>
<DELETED> (A) in three medical facilities of the
Department of Veterans Affairs; and</DELETED>
<DELETED> (B) if determined appropriate by the
Secretary of Veterans Affairs and the Secretary of
Defense, one medical facility of the Department of
Defense.</DELETED>
<DELETED> (2) Emphasis on polytrauma centers.--In selecting
the locations of the pilot program at facilities of the
Department of Veterans Affairs, the Secretary of Veterans
Affairs shall give special emphasis to the polytrauma centers
of the Department of Veterans Affairs designated as Tier I
polytrauma centers.</DELETED>
<DELETED> (d) Training Curricula.--</DELETED>
<DELETED> (1) In general.--The Secretary of Veterans Affairs
shall develop curricula for the training of personal care
attendants under the pilot program under this section. Such
curricula shall incorporate--</DELETED>
<DELETED> (A) applicable standards and protocols
utilized by certification programs of national brain
injury care specialist organizations; and</DELETED>
<DELETED> (B) best practices recognized by
caregiving organizations.</DELETED>
<DELETED> (2) Use of existing curricula.--In developing the
curricula required by paragraph (1), the Secretary of Veterans
Affairs shall, to the extent practicable, utilize and expand
upon training curricula developed pursuant to section 744(b) of
the John Warner National Defense Authorization Act for Fiscal
Year 2007 (Public Law 109-364; 120 Stat. 2308).</DELETED>
<DELETED> (e) Participation in Programs.--</DELETED>
<DELETED> (1) In general.--The Secretary of Veterans Affairs
shall determine the eligibility of a family member of a veteran
or member of the Armed Forces for participation in the pilot
program under this section.</DELETED>
<DELETED> (2) Basis for determination.--A determination made
under paragraph (1) shall be based on the needs of the veteran
or member of the Armed Forces concerned, as determined by the
physician of such veteran or member.</DELETED>
<DELETED> (f) Eligibility for Compensation.--A family caregiver of a
veteran or member of the Armed Forces who receives certification as a
personal care attendant under the pilot program under this section
shall be eligible for compensation from the Department of Veterans
Affairs for care provided to such veteran or member.</DELETED>
<DELETED> (g) Costs of Training.--</DELETED>
<DELETED> (1) Training of families of veterans.--Any costs
of training provided under the pilot program under this section
for family members of veterans shall be borne by the Secretary
of Veterans Affairs.</DELETED>
<DELETED> (2) Training of families of members of the armed
forces.--The Secretary of Defense shall reimburse the Secretary
of Veterans Affairs for any costs of training provided under
the pilot program for family members of members of the Armed
Forces.</DELETED>
<DELETED> (h) Assessment of Family Caregiver Needs.--</DELETED>
<DELETED> (1) In general.--The Secretary of Veterans Affairs
may provide to a family caregiver who receives training under
the pilot program under this section--</DELETED>
<DELETED> (A) an assessment of their needs with
respect to their role as a family caregiver;
and</DELETED>
<DELETED> (B) a referral to services and support
that--</DELETED>
<DELETED> (i) are relevant to any needs
identified in such assessment; and</DELETED>
<DELETED> (ii) are provided in the community
where the family caregiver resides, including
such services and support provided by
community-based organizations, publicly funded
programs, and the Department of Veterans
Affairs.</DELETED>
<DELETED> (2) Use of existing tools.--In developing and
administering an assessment under paragraph (1), the Secretary
shall, to the extent practicable, use and expand upon caregiver
assessment tools already developed and in use by the
Department.</DELETED>
<DELETED> (i) Report.--Not later than 2 years after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall submit
to Congress a report on the pilot program carried out under this
section, including the recommendations of the Secretary with respect to
expansion or modification of the pilot program.</DELETED>
<DELETED> (j) Construction.--Nothing in this section shall be
construed--</DELETED>
<DELETED> (1) to establish a mandate or right for a family
caregiver to be trained and certified under this section;
and</DELETED>
<DELETED> (2) to prohibit the Secretary from considering or
adopting the preference of a veteran or member of the Armed
Forces for services provided by a personal care attendant who
is not a family caregiver.</DELETED>
<DELETED> (k) Family Caregiver Defined.--In this section, with
respect to member of the Armed Forces or a veteran with traumatic brain
injury, the term ``family caregiver'' means a family member of such
member or veteran, or such other individual of similar affinity to such
member or veteran as the Secretary proscribes, who is providing care to
such member or veteran for such traumatic brain injury.</DELETED>
<DELETED>SEC. 210. PILOT PROGRAM ON PROVISION OF RESPITE CARE TO
MEMBERS OF THE ARMED FORCES AND VETERANS WITH TRAUMATIC
BRAIN INJURY BY STUDENTS IN GRADUATE PROGRAMS OF
EDUCATION RELATED TO MENTAL HEALTH OR
REHABILITATION.</DELETED>
<DELETED> (a) Pilot Program Authorized.--The Secretary of Veterans
Affairs shall, in collaboration with the Secretary of Defense, carry
out a pilot program to assess the feasibility and advisability of
providing respite care to members of the Armed Forces and veterans
described in subsection (c) through students enrolled in graduate
programs of education described in subsection (d)(1) to provide--
</DELETED>
<DELETED> (1) relief to the family caregivers of such
members and veterans from the responsibilities associated with
providing care to such members and veterans; and</DELETED>
<DELETED> (2) socialization and cognitive skill development
to such members and veterans.</DELETED>
<DELETED> (b) Duration of Program.--The pilot program required by
subsection (a) shall be carried out during the three-year period
beginning on the date of the commencement of the pilot
program.</DELETED>
<DELETED> (c) Covered Members and Veterans.--The members of the
Armed Forces and veterans described in this subsection are the
individuals as follows:</DELETED>
<DELETED> (1) Members of the Armed Forces who have been
diagnosed with traumatic brain injury, including limitations of
ambulatory mobility, cognition, and verbal abilities.</DELETED>
<DELETED> (2) Veterans who have been so diagnosed.</DELETED>
<DELETED> (d) Program Locations.--</DELETED>
<DELETED> (1) In general.--The pilot program shall be
carried out at not more than 10 locations selected by the
Secretary of Veterans Affairs for purposes of the pilot
program. Each location so selected shall be a medical facility
of the Department of Veterans Affairs that is in close
proximity to, or that has a relationship, affiliation, or
established partnership with, an institution of higher
education that has a graduate program in an appropriate mental
health or rehabilitation related field, such as social work,
nursing, psychology, occupational therapy, physical therapy, or
interdisciplinary training programs.</DELETED>
<DELETED> (2) Considerations.--In selecting medical
facilities of the Department for the pilot program, the
Secretary shall give special consideration to the
following:</DELETED>
<DELETED> (A) The polytrauma centers of the
Department designated as Tier I polytrauma
centers.</DELETED>
<DELETED> (B) Facilities of the Department in
regions with a high concentration of veterans with
traumatic brain injury.</DELETED>
<DELETED> (e) Scope of Assistance.--</DELETED>
<DELETED> (1) Use of graduate students.--In carrying out the
pilot program, the Secretary shall--</DELETED>
<DELETED> (A) recruit students enrolled in a
graduate program of education selected by the Secretary
under subsection (d)(1) to provide respite care to the
members of the Armed Forces and veterans described in
subsection (c);</DELETED>
<DELETED> (B) train such students to provide respite
care to such members and veterans; and</DELETED>
<DELETED> (C) match such students with such members
and veterans in the student's local area for the
provision of individualized respite care to such
members and veterans.</DELETED>
<DELETED> (2) Determinations in conjunction with heads of
graduate programs of education.--The Secretary shall determine,
in collaboration with the head of the graduate program of
education chosen to participate in the pilot program under
subsection (d)(1), the following:</DELETED>
<DELETED> (A) The amount of training that a student
shall complete before providing respite care under the
pilot program.</DELETED>
<DELETED> (B) The number of hours of respite care to
be provided by the students who participate in the
pilot program.</DELETED>
<DELETED> (C) The requirements for successful
participation by a student in the pilot
program.</DELETED>
<DELETED> (f) Training Standards and Best Practices.--In providing
training under subsection (e)(1)(B), the Secretary shall use--
</DELETED>
<DELETED> (1) applicable standards and protocols used by
certification programs of national brain injury care specialist
organizations in the provision of respite care training;
and</DELETED>
<DELETED> (2) best practices recognized by caregiving
organizations.</DELETED>
<DELETED> (g) Definitions.--In this section:</DELETED>
<DELETED> (1) Family caregiver.--With respect to member of
the Armed Forces or a veteran with traumatic brain injury, the
term ``family caregiver'' means a relative, partner, or friend
of such member or veteran who is providing care to such member
or veteran for such traumatic brain injury.</DELETED>
<DELETED> (2) Respite care.--The term ``respite care'' means
the temporary provision of care to an individual to provide
relief to the regular caregiver of the individual from the
ongoing responsibility of providing care to such
individual.</DELETED>
<DELETED>SEC. 211. 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.</DELETED>
<DELETED> (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--</DELETED>
<DELETED> (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;</DELETED>
<DELETED> (2) to increase the availability of high quality
medical and mental health services to veterans transitioning
from military service to civilian life;</DELETED>
<DELETED> (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</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (c) Program Locations.--</DELETED>
<DELETED> (1) In general.--The pilot program shall be
carried out at five locations selected by the Secretary for
purposes of the pilot program.</DELETED>
<DELETED> (2) Considerations.--In selecting locations for
the pilot program, the Secretary shall consider the
advisability of selecting locations in--</DELETED>
<DELETED> (A) rural areas;</DELETED>
<DELETED> (B) areas with populations that have a
high proportion of minority group
representation;</DELETED>
<DELETED> (C) areas with populations that have a
high proportion of individuals who have limited access
to health care; and</DELETED>
<DELETED> (D) areas that are not in close proximity
to an active duty military installation.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (e) Selection of Grant Recipients.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (2) Elements.--Each application submitted under
paragraph (1) shall include the following:</DELETED>
<DELETED> (A) A description of how the proposal was
developed in consultation with the Department of
Veterans Affairs.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (f) Use of Grant Funds.--The Secretary shall prescribe
appropriate uses of grant funds received under the pilot
program.</DELETED>
<DELETED> (g) Report on Program.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (2) Elements.--The report required by paragraph
(1) shall include the following:</DELETED>
<DELETED> (A) The findings and conclusions of the
Secretary with respect to the pilot program.</DELETED>
<DELETED> (B) An assessment of the benefits to
veterans of the pilot program.</DELETED>
<DELETED> (C) The recommendations of the Secretary
as to the advisability of continuing the pilot
program.</DELETED>
<DELETED>SEC. 212. SPECIALIZED RESIDENTIAL CARE AND REHABILITATION FOR
CERTAIN VETERANS.</DELETED>
<DELETED> Section 1720 is amended by adding at the end the following
new subsection:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED>SEC. 213. AUTHORITY TO DISCLOSE MEDICAL RECORDS TO THIRD PARTY
FOR COLLECTION OF CHARGES FOR PROVISION OF CERTAIN
CARE.</DELETED>
<DELETED> (a) Limited Exception to Confidentiality of Medical
Records.--Section 5701 is amended by adding at the end the following
new subsection:</DELETED>
<DELETED> ``(l) Under regulations that the Secretary shall
prescribe, the Secretary may disclose the name or address, or both, of
any individual who is a present or former member of the Armed Forces,
or who is a dependent of a present or former member of the Armed
Forces, to a third party, as defined in section 1729(i)(3)(D) of this
title, in order to enable the Secretary to collect reasonable charges
under section 1729(a)(2)(E) of this title for care or services provided
for a non-service-connected disability.''.</DELETED>
<DELETED> (b) Disclosures From Certain Medical Records.--Section
7332(b)(2), as amended by section 205 of this Act, is further amended
by adding at the end the following new subparagraph:</DELETED>
<DELETED> ``(G) To a third party, as defined in section
1729(i)(3)(D) of this title, to collect reasonable charges
under section 1729(a)(2)(E) of this title for care or services
provided for a non-service-connected disability.''.</DELETED>
<DELETED>SEC. 214. EXPANDED STUDY ON THE HEALTH IMPACT OF PROJECT
SHIPBOARD HAZARD AND DEFENSE.</DELETED>
<DELETED> (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).</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 215. USE OF NON-DEPARTMENT FACILITIES FOR REHABILITATION
OF INDIVIDUALS WITH TRAUMATIC BRAIN INJURY.</DELETED>
<DELETED> Section 1710E is amended--</DELETED>
<DELETED> (1) by redesignating subsection (b) as subsection
(c);</DELETED>
<DELETED> (2) by inserting after subsection (a) the
following new subsection (b):</DELETED>
<DELETED> ``(b) Covered Individuals.--The care and services provided
under subsection (a) shall be made available to an individual--
</DELETED>
<DELETED> ``(1) who is described in section 1710C(a) of this
title; and</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(B) for whom the Secretary determines that it is
optimal with respect to the recovery and rehabilitation for
such individual.''; and</DELETED>
<DELETED> (3) by adding at the end the following new
subsection:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED>SEC. 216. INCLUSION OF FEDERALLY RECOGNIZED TRIBAL
ORGANIZATIONS IN CERTAIN PROGRAMS FOR STATE VETERANS
HOMES.</DELETED>
<DELETED> (a) Treatment of Tribal Organization Health Facilities as
State Homes.--Section 8138 is amended--</DELETED>
<DELETED> (1) by redesignating subsection (e) as subsection
(f); and</DELETED>
<DELETED> (2) by inserting after subsection (d) the
following new subsection (e):</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(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).''.</DELETED>
<DELETED> (b) State Home Facilities for Domiciliary, Nursing, and
Other Care.--</DELETED>
<DELETED> (1) In general.--Chapter 81 is further amended--
</DELETED>
<DELETED> (A) in section 8131, by adding at the end
the following new paragraph:</DELETED>
<DELETED> ``(5) The term `tribal organization' has the
meaning given such term in section 3765 of this
title.'';</DELETED>
<DELETED> (B) in section 8132, by inserting ``and
tribal organizations'' after ``the several States'';
and</DELETED>
<DELETED> (C) by inserting after section 8133 the
following new section:</DELETED>
<DELETED>``Sec. 8133A. Tribal organizations</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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 not previously applied for such a
grant.''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED>``8133A. Tribal organizations.''.
<DELETED>SEC. 217. PILOT PROGRAM ON PROVISION OF DENTAL INSURANCE PLANS
TO VETERANS AND SURVIVORS AND DEPENDENTS OF
VETERANS.</DELETED>
<DELETED> (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).</DELETED>
<DELETED> (b) Covered Veterans and Survivors and Dependents.--The
veterans and survivors and dependents of veterans described in this
subsection are as follows:</DELETED>
<DELETED> (1) Any veteran who is enrolled in the system of
annual patient enrollment under section 1705 of this
title.</DELETED>
<DELETED> (2) Any survivor or dependent of a veteran who is
eligible for medical care under section 1781 of this
title.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (e) Administration.--The Secretary of Veterans Affairs
shall contract with a dental insurer to administer the dental plan
provided under the pilot program.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (g) Enrollment.--</DELETED>
<DELETED> (1) Voluntary.--Enrollment in the dental insurance
plan under this section shall be voluntary.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (h) Premiums.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (i) Voluntary Disenrollment.--</DELETED>
<DELETED> (1) In general.--With respect to enrollment in the
dental insurance plan under the pilot program, the Secretary
shall--</DELETED>
<DELETED> (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</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (2) Allowable circumstances.--The circumstances
prescribed under paragraph (1)(B) shall include the
following:</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (C) Such other circumstances as the
Secretary shall prescribe for purposes of this
subsection.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (k) Regulations.--The dental insurance plan under the
pilot program shall be administered under such regulations as the
Secretary shall prescribe.</DELETED>
<DELETED>TITLE III--WOMEN VETERANS HEALTH CARE</DELETED>
<DELETED>SEC. 301. REPORT ON BARRIERS TO RECEIPT OF HEALTH CARE FOR
WOMEN VETERANS.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (b) Elements.--The report required by subsection (a) shall
include the following:</DELETED>
<DELETED> (1) An identification and assessment of the
following:</DELETED>
<DELETED> (A) Any stigma perceived or associated
with seeking mental health care services through the
Department of Veterans Affairs.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (C) The availability of child
care.</DELETED>
<DELETED> (D) The receipt of health care through
women's health clinics, integrated primary care
clinics, or both.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (F) The quality and nature of the
reception of women veterans by Department health care
providers and other staff.</DELETED>
<DELETED> (G) The perception of personal safety and
comfort of women veterans in inpatient, outpatient, and
behavioral health facilities of the
Department.</DELETED>
<DELETED> (H) The sensitivity of Department health
care providers and other staff to issues that
particularly affect women.</DELETED>
<DELETED> (I) The effectiveness of outreach on
health care services of the Department that are
available to women veterans.</DELETED>
<DELETED> (J) Such other matters as the Secretary
identifies for purposes of the assessment.</DELETED>
<DELETED> (2) Such recommendations for administrative and
legislative action as the Secretary considers appropriate in
light of the report.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 302. PLAN TO IMPROVE PROVISION OF HEALTH CARE SERVICES TO
WOMEN VETERANS.</DELETED>
<DELETED> (a) Plan To Improve Services.--</DELETED>
<DELETED> (1) In general.--The Secretary of Veterans Affairs
shall develop a plan--</DELETED>
<DELETED> (A) to improve the provision of health
care services to women veterans; and</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (2) Required actions.--In developing the plan
required by this subsection, the Secretary of Veterans Affairs
shall--</DELETED>
<DELETED> (A) identify the types of health care
services to be available to women veterans at each
Department of Veterans Affairs medical center;
and</DELETED>
<DELETED> (B) identify the personnel and other
resources required to provide such services to women
veterans under the plan at each such medical
center.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 303. INDEPENDENT STUDY ON HEALTH CONSEQUENCES OF WOMEN
VETERANS OF MILITARY SERVICE IN OPERATION IRAQI FREEDOM
AND OPERATION ENDURING FREEDOM.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (b) Specific Matters Studied.--The study under subsection
(a) shall include the following:</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (c) Report.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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).</DELETED>
<DELETED>SEC. 304. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE
PROVIDERS ON CARE FOR VETERANS SUFFERING FROM SEXUAL
TRAUMA.</DELETED>
<DELETED> (a) Program Required.--Section 1720D is amended--
</DELETED>
<DELETED> (1) by redesignating subsection (d) as subsection
(f); and</DELETED>
<DELETED> (2) by inserting after subsection (c) the
following new subsections:</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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:</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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).</DELETED>
<DELETED> ``(3) The number of training, certification, and
continuing medical education programs operating under
subsection (d).</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(5) Such other information as the Secretary
considers appropriate.''.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 305. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR
WOMEN VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED
FORCES.</DELETED>
<DELETED> (a) Pilot Program Required.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (b) Covered Services.--The services provided to a woman
veteran under the pilot program shall include the following:</DELETED>
<DELETED> (1) Information on reintegration into the
veteran's family, employment, and community.</DELETED>
<DELETED> (2) Financial counseling.</DELETED>
<DELETED> (3) Occupational counseling.</DELETED>
<DELETED> (4) Information and counseling on stress
reduction.</DELETED>
<DELETED> (5) Information and counseling on conflict
resolution.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 306. REPORT ON FULL-TIME WOMEN VETERANS PROGRAM MANAGERS
AT MEDICAL CENTERS.</DELETED>
<DELETED> 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.</DELETED>
<DELETED>SEC. 307. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN
RECENTLY SEPARATED FROM SERVICE IN THE ARMED
FORCES.</DELETED>
<DELETED> (a) Advisory Committee on Women Veterans.--Section
542(a)(2)(A) is amended--</DELETED>
<DELETED> (1) in clause (ii), by striking ``and'' at the
end;</DELETED>
<DELETED> (2) in clause (iii), by striking the period at the
end and inserting ``; and''; and</DELETED>
<DELETED> (3) by inserting after clause (iii) the following
new clause:</DELETED>
<DELETED> ``(iv) women veterans who are recently separated
from service in the Armed Forces.''.</DELETED>
<DELETED> (b) Advisory Committee on Minority Veterans.--Section
544(a)(2)(A) is amended--</DELETED>
<DELETED> (1) in clause (iii), by striking ``and'' at the
end;</DELETED>
<DELETED> (2) in clause (iv), by striking the period at the
end and inserting ``; and''; and</DELETED>
<DELETED> (3) by inserting after clause (iv) the following
new clause:</DELETED>
<DELETED> ``(v) women veterans who are minority group
members and are recently separated from service in the Armed
Forces.''.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 308. PILOT PROGRAM ON SUBSIDIES FOR CHILD CARE FOR
CERTAIN VETERANS RECEIVING HEALTH CARE.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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--</DELETED>
<DELETED> (1) receives the types of health care services
referred to in subsection (c) at a facility of the Department;
and</DELETED>
<DELETED> (2) requires to travel to and return from such
facility for the receipt of such health care
services.</DELETED>
<DELETED> (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:</DELETED>
<DELETED> (1) Regular mental health care services.</DELETED>
<DELETED> (2) Intensive mental health care
services.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 309. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS
RECEIVING MATERNITY CARE.</DELETED>
<DELETED> (a) In General.--Subchapter VIII of chapter 17 is amended
by adding at the end the following new section:</DELETED>
<DELETED>``SEC. 1786. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS
RECEIVING MATERNITY CARE.</DELETED>
<DELETED> ``(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--</DELETED>
<DELETED> ``(1) a facility of the Department; or</DELETED>
<DELETED> ``(2) another facility pursuant to a Department
contract for services relating to such delivery.</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED>``1786. Care for newborn children of women veterans receiving
maternity care.''.
<DELETED>TITLE IV--MENTAL HEALTH CARE</DELETED>
<DELETED>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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>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.</DELETED>
<DELETED> Section 1712A is amended--</DELETED>
<DELETED> (1) by redesignating subsections (c) through (f)
as subsections (d) through (g), respectively; and</DELETED>
<DELETED> (2) by inserting after subsection (b) the
following new subsection (c):</DELETED>
<DELETED> ``(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--</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED>SEC. 403. STUDY ON SUICIDES AMONG VETERANS.</DELETED>
<DELETED> (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, 1997, and the date of the enactment of this
Act.</DELETED>
<DELETED> (b) Coordination.--In carrying out the study under
subsection (b) the Secretary of Veterans Affairs shall coordinate
with--</DELETED>
<DELETED> (1) the Secretary of Defense;</DELETED>
<DELETED> (2) Veterans Service Organizations;</DELETED>
<DELETED> (3) the Centers for Disease Control and
Prevention; and</DELETED>
<DELETED> (4) State public health offices and veterans
agencies.</DELETED>
<DELETED> (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 (b) and the findings of
the Secretary.</DELETED>
<DELETED> (d) Authorization of Appropriations.--There are authorized
to be appropriated such sums as may be necessary to carry out this
section.</DELETED>
<DELETED>SEC. 404. TRANSFER OF FUNDS TO SECRETARY OF HEALTH AND HUMAN
SERVICES FOR GRADUATE PSYCHOLOGY EDUCATION
PROGRAM.</DELETED>
<DELETED> (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)).</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>TITLE V--HOMELESS VETERANS</DELETED>
<DELETED>SEC. 501. PILOT PROGRAM ON FINANCIAL SUPPORT FOR ENTITIES THAT
COORDINATE THE PROVISION OF SUPPORTIVE SERVICES TO
FORMERLY HOMELESS VETERANS RESIDING ON CERTAIN MILITARY
PROPERTY.</DELETED>
<DELETED> (a) Establishment.--</DELETED>
<DELETED> (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).</DELETED>
<DELETED> (2) Number of grants.--The Secretary may make
grants at up to 10 qualifying properties under the pilot
program.</DELETED>
<DELETED> (b) Qualifying Property.--Qualifying property under the
pilot program is property that--</DELETED>
<DELETED> (1) was part of a military installation that was
closed in accordance with--</DELETED>
<DELETED> (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</DELETED>
<DELETED> (B) subchapter III of chapter 5 of title
40, United States Code; and</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 502. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT
COORDINATE THE PROVISION OF SUPPORTIVE SERVICES TO
FORMERLY HOMELESS VETERANS RESIDING IN PERMANENT
HOUSING.</DELETED>
<DELETED> (a) Establishment of Pilot Program.--</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (2) Number of grants.--The Secretary may make
grants at up to 10 qualifying properties under the pilot
program.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 503. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT
PROVIDE OUTREACH TO INFORM CERTAIN VETERANS ABOUT PENSION
BENEFITS.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 504. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT
PROVIDE TRANSPORTATION ASSISTANCE, CHILD CARE ASSISTANCE,
AND CLOTHING ASSISTANCE TO VETERANS ENTITLED TO A
REHABILITATION PROGRAM.</DELETED>
<DELETED> (a) Pilot Program Authorized.--</DELETED>
<DELETED> (1) In general.--Subject to the availability of
appropriations authorized under subsection (g), the Secretary
of Veterans Affairs may carry out a pilot program to assess the
feasibility and advisability of providing financial assistance
to eligible entities to establish new programs or activities,
or expand or modify existing programs or activities, to provide
to each eligible transitioning individual who is entitled and
eligible for a rehabilitation program under chapter 31 of title
38, United States Code, the following assistance:</DELETED>
<DELETED> (A) Transportation assistance to
facilitate such eligible transitioning individual's
participation in such rehabilitation program or related
activity. Such assistance may include--</DELETED>
<DELETED> (i) providing
transportation;</DELETED>
<DELETED> (ii) paying for or reimbursing
transportation costs; and</DELETED>
<DELETED> (iii) paying for or reimbursing
other transportation-related expenses
(including orientation on the use of
transportation).</DELETED>
<DELETED> (B) Child care assistance to facilitate
such eligible transitioning individual's participation
in such rehabilitation program or related activity.
Such assistance may include--</DELETED>
<DELETED> (i) child care services;
or</DELETED>
<DELETED> (ii) reimbursement of expenses
related to child care.</DELETED>
<DELETED> (C) Clothing assistance, which may include
personal services in selecting, and payment of a
monetary allowance to cover the cost of purchasing,
clothing and accessories suitable for a job interview
or related activity consistent with such eligible
transitioning individual's participation in such
rehabilitation program or related activity.</DELETED>
<DELETED> (2) Eligible transitioning individual.--For
purposes of this section, an eligible transitioning individual
is a person--</DELETED>
<DELETED> (A) described in section 3102 of title 38,
United States Code; or</DELETED>
<DELETED> (B) who was separated or released from
active duty in the Armed Forces on or after October 1,
2006, because of a service-connected
disability.</DELETED>
<DELETED> (b) Duration of Program.--The authority of the Secretary
to provide grants under a pilot program established under subsection
(a)(1) shall cease on the date that is three years after the date of
the commencement of the pilot program.</DELETED>
<DELETED> (c) Grants.--</DELETED>
<DELETED> (1) In general.--The Secretary of Veterans Affairs
shall carry out the pilot program through the award of grants
to eligible entities to establish new programs or activities,
or to expand or modify existing programs or activities, as
described in subsection (a)(1).</DELETED>
<DELETED> (2) Grant criteria.--</DELETED>
<DELETED> (A) In general.--The Secretary shall
establish criteria and requirements for grants under
the pilot program, including criteria for eligible
entities to receive such grants. The criteria
established under this subparagraph shall include the
following:</DELETED>
<DELETED> (i) Specification as to the kinds
of projects or activities for which grants are
available.</DELETED>
<DELETED> (ii) Specification as to the
number of projects or activities for which
grants are available.</DELETED>
<DELETED> (iii) Provisions to ensure that
grants awarded under the pilot program do not
result in duplication of ongoing
services.</DELETED>
<DELETED> (B) Publication of criteria in federal
register.--The Secretary shall publish the criteria and
requirements established under subparagraph (A) in the
Federal Register.</DELETED>
<DELETED> (3) Funding limitation.--A grant under the pilot
program may not be used to support the operational costs of an
eligible entity.</DELETED>
<DELETED> (d) Eligible Entities.--For purposes of this section, an
eligible entity is a public or nonprofit organization (including a
faith-based or community organization) that--</DELETED>
<DELETED> (1) has the capacity to administer effectively a
grant under the pilot program, as determined by the Secretary
of Veterans Affairs;</DELETED>
<DELETED> (2) demonstrates that adequate financial support
will be available to establish new programs or activities, or
to expand or modify existing programs or activities, as
described in subsection (a)(1) consistent with the plans,
specifications, and schedule submitted by the applicant to the
Secretary under subsection (e)(2);</DELETED>
<DELETED> (3) agrees to meet the applicable criteria and
requirements established under subsection (c)(2) and described
in subsection (e)(2)(C); and</DELETED>
<DELETED> (4) has the capacity, as determined by the
Secretary, to meet the criteria and requirements described in
paragraph (3).</DELETED>
<DELETED> (e) Selection of Grant Recipients.--</DELETED>
<DELETED> (1) Application.--An eligible 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.</DELETED>
<DELETED> (2) Elements.--Each application submitted under
paragraph (1) shall include the following:</DELETED>
<DELETED> (A) The amount of the grant sought for the
project or activity.</DELETED>
<DELETED> (B) Plans, specifications, and the
schedule for implementation of the project or activity
in accordance with criteria and requirements prescribed
by the Secretary under subsection (c)(2).</DELETED>
<DELETED> (C) An agreement--</DELETED>
<DELETED> (i) to provide the services for
which the grant is sought at locations
accessible to eligible transitioning
individuals;</DELETED>
<DELETED> (ii) to ensure the confidentiality
of records maintained on eligible transitioning
individuals receiving services through the
pilot program; and</DELETED>
<DELETED> (iii) to establish such procedures
for fiscal control and fund accounting as may
be necessary to ensure proper disbursement and
accounting with respect to the grant and to
such payments as may be made under this
section.</DELETED>
<DELETED> (3) Applicant agreement.--The Secretary may not
select an eligible entity for a grant under the pilot program
unless the eligible entity agrees to the provisions listed in
paragraph (2)(C).</DELETED>
<DELETED> (f) Recovery of Unused Grant Amounts.--</DELETED>
<DELETED> (1) In general.--The United States shall be
entitled to recover from a grant recipient under this section
the total of all unused grant amounts made under this section
to such recipient in connection with such program if such grant
recipient--</DELETED>
<DELETED> (A) does not establish a program or
activity in accordance with this section; or</DELETED>
<DELETED> (B) ceases to furnish services under such
a program for which the grant was made.</DELETED>
<DELETED> (2) Obligation.--Any amount recovered by the
United States under paragraph (1) may be obligated by the
Secretary of Veterans Affairs without fiscal year limitation to
carry out provisions of this section.</DELETED>
<DELETED> (3) Limitation on recovery.--An amount may not be
recovered under paragraph (1)(A) as an unused grant amount
before the end of the three-year period beginning on the date
on which the grant is made.</DELETED>
<DELETED> (g) Authorization of Appropriations.--There is authorized
to be appropriated from amounts made available under the heading
``General Operating Expenses'', not more than $5,000,000 in each of
fiscal years 2010 through 2012 to carry out this section.</DELETED>
<DELETED>SEC. 505. ASSESSMENT OF PILOT PROGRAMS.</DELETED>
<DELETED> (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 504, the Secretary of Veterans Affairs shall
submit to Congress a progress report on such pilot program.</DELETED>
<DELETED> (b) Contents.--Each progress report submitted for a pilot
program under subsection (a) shall include the following:</DELETED>
<DELETED> (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.</DELETED>
<DELETED> (2) The recommendations of the Secretary on
whether to continue such pilot program.</DELETED>
<DELETED> (3) The number of veterans and dependents served
by such pilot program.</DELETED>
<DELETED> (4) An assessment of the quality of service
provided to veterans and dependents under such pilot
program.</DELETED>
<DELETED> (5) The amount of funds provided to grant
recipients under such pilot program.</DELETED>
<DELETED> (6) The names of organizations that have received
grants under such pilot program.</DELETED>
<DELETED>TITLE VI--NONPROFIT RESEARCH AND EDUCATION
CORPORATIONS</DELETED>
<DELETED>SEC. 601. GENERAL AUTHORITIES ON ESTABLISHMENT OF
CORPORATIONS.</DELETED>
<DELETED> (a) Authorization of Multi-medical Center Research
Corporations.--</DELETED>
<DELETED> (1) In general.--Section 7361 is amended--
</DELETED>
<DELETED> (A) by redesignating subsection (b) as
subsection (e); and</DELETED>
<DELETED> (B) by inserting after subsection (a) the
following new subsection (b):</DELETED>
<DELETED> ``(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'.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (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:</DELETED>
<DELETED> ``(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--</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(2) the Secretary approves the resolution of the
corporation under paragraph (1).''.</DELETED>
<DELETED> (b) Restatement and Modification of Authorities on
Applicability of State Law.--</DELETED>
<DELETED> (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):</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (2) Conforming amendment.--Section 7365 is
repealed.</DELETED>
<DELETED> (c) Clarification of Status of Corporations.--Section
7361, as amended by this section, is further amended--</DELETED>
<DELETED> (1) in subsection (a), by striking the second
sentence; and</DELETED>
<DELETED> (2) by inserting after subsection (c) the
following new subsection (d):</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(2) A corporation under this subchapter is not--
</DELETED>
<DELETED> ``(A) owned or controlled by the United States;
or</DELETED>
<DELETED> ``(B) an agency or instrumentality of the United
States.''.</DELETED>
<DELETED> (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''.</DELETED>
<DELETED>SEC. 602. CLARIFICATION OF PURPOSES OF CORPORATIONS.</DELETED>
<DELETED> (a) Clarification of Purposes.--Subsection (a) of section
7362 is amended--</DELETED>
<DELETED> (1) in the first sentence--</DELETED>
<DELETED> (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</DELETED>
<DELETED> (B) by inserting before the period at the
end the following: ``or centers''; and</DELETED>
<DELETED> (2) in the second sentence, by inserting ``or
centers'' after ``at the medical center''.</DELETED>
<DELETED> (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''.</DELETED>
<DELETED> (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).</DELETED>
<DELETED> (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''.</DELETED>
<DELETED>SEC. 603. MODIFICATION OF REQUIREMENTS FOR BOARDS OF DIRECTORS
OF CORPORATIONS.</DELETED>
<DELETED> (a) Requirements for Department Board Members.--Paragraph
(1) of section 7363(a) is amended to read as follows:</DELETED>
<DELETED> ``(1) with respect to the Department medical
center--</DELETED>
<DELETED> ``(A)(i) the director (or directors of
each Department medical center, in the case of a multi-
medical center research corporation);</DELETED>
<DELETED> ``(ii) the chief of staff; and</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(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''.</DELETED>
<DELETED> (b) Requirements for Non-department Board Members.--
Paragraph (2) of such section is amended--</DELETED>
<DELETED> (1) by inserting ``not less than two'' before
``members''; and</DELETED>
<DELETED> (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.''.</DELETED>
<DELETED> (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''.</DELETED>
<DELETED>SEC. 604. CLARIFICATION OF POWERS OF CORPORATIONS.</DELETED>
<DELETED> (a) In General.--Section 7364 is amended to read as
follows:</DELETED>
<DELETED>``Sec. 7364. General powers</DELETED>
<DELETED> ``(a) In General.--(1) A corporation established under
this subchapter may, solely to carry out the purposes of this
subchapter--</DELETED>
<DELETED> ``(A) accept, administer, retain, and spend funds
derived from gifts, contributions, grants, fees,
reimbursements, and bequests from individuals and public and
private entities;</DELETED>
<DELETED> ``(B) enter into contracts and agreements with
individuals and public and private entities;</DELETED>
<DELETED> ``(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;</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(E) employ such employees as the corporation
considers necessary for such purposes and fix the compensation
of such employees.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (b) Conforming Amendment.--Section 7362(a), as amended by
section 602(a)(1) of this Act, is further amended by striking the last
sentence.</DELETED>
<DELETED>SEC. 605. REDESIGNATION OF SECTION 7364A OF TITLE 38, UNITED
STATES CODE.</DELETED>
<DELETED> (a) Redesignation.--Section 7364A is redesignated as
section 7365.</DELETED>
<DELETED> (b) Clerical Amendments.--The table of sections at the
beginning of chapter 73 is amended--</DELETED>
<DELETED> (1) by striking the item relating to section
7364A; and</DELETED>
<DELETED> (2) by striking the item relating to section 7365
and inserting the following new item:</DELETED>
<DELETED>``7365. Coverage of employees under certain Federal tort
claims laws.''.
<DELETED>SEC. 606. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF
CORPORATIONS.</DELETED>
<DELETED> (a) Additional Information in Annual Reports.--Subsection
(b) of section 7366 is amended to read as follows:</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(2)(A) A corporation with revenues in excess of $300,000
for any year shall obtain an audit of the corporation for that
year.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(C) Any audit under this paragraph shall be performed by
an independent auditor.</DELETED>
<DELETED> ``(3) The corporation shall include in each report to the
Secretary under paragraph (1) the following:</DELETED>
<DELETED> ``(A) The most recent audit of the corporation
under paragraph (2).</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED> (b) Confirmation of Application of Conflict of Interest
Regulations to Appropriate Corporation Positions.--Subsection (c) of
such section is amended--</DELETED>
<DELETED> (1) by striking ``laws and'' each place it
appears;</DELETED>
<DELETED> (2) in paragraph (1)--</DELETED>
<DELETED> (A) by inserting ``each officer and''
after ``under this subchapter,''; and</DELETED>
<DELETED> (B) by striking ``, and each employee of
the Department'' and all that follows through ``during
any year''; and</DELETED>
<DELETED> (3) in paragraph (2)--</DELETED>
<DELETED> (A) by inserting ``, officer,'' after
``verifying that each director''; and</DELETED>
<DELETED> (B) by striking ``in the same manner'' and
all that follows before the period at the
end.</DELETED>
<DELETED> (c) Establishment of Appropriate Payee Reporting
Threshold.--Subsection (d)(3)(C) of such section is amended by striking
``$35,000'' and inserting ``$50,000''.</DELETED>
<DELETED>TITLE VII--MISCELLANEOUS PROVISIONS</DELETED>
<DELETED>SEC. 701. EXPANSION OF AUTHORITY FOR DEPARTMENT OF VETERANS
AFFAIRS POLICE OFFICERS.</DELETED>
<DELETED> Section 902 is amended--</DELETED>
<DELETED> (1) in subsection (a)--</DELETED>
<DELETED> (A) by amending paragraph (1) to read as
follows:</DELETED>
<DELETED> ``(1) Employees of the Department who are
Department police officers shall, with respect to acts
occurring on Department property--</DELETED>
<DELETED> ``(A) enforce Federal laws;</DELETED>
<DELETED> ``(B) enforce the rules prescribed under
section 901 of this title;</DELETED>
<DELETED> ``(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;</DELETED>
<DELETED> ``(D) carry the appropriate Department-
issued weapons, including firearms, while off
Department property in an official capacity or while in
an official travel status;</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(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.'';</DELETED>
<DELETED> (B) by striking paragraph (2) and
redesignating paragraph (3) as paragraph (2);
and</DELETED>
<DELETED> (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</DELETED>
<DELETED> (2) by amending subsection (c) to read as
follows:</DELETED>
<DELETED> ``(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.''.</DELETED>
<DELETED>SEC. 702. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS AFFAIRS
POLICE OFFICERS.</DELETED>
<DELETED> Section 903 is amended--</DELETED>
<DELETED> (1) by amending subsection (b) to read as
follows:</DELETED>
<DELETED> ``(b)(1) The amount of the allowance that the Secretary
may pay under this section is the lesser of--</DELETED>
<DELETED> ``(A) the amount currently allowed as prescribed
by the Office of Personnel Management; or</DELETED>
<DELETED> ``(B) estimated costs or actual costs as
determined by periodic surveys conducted by the
Department.</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> (2) by striking subsection (c) and inserting the
following new subsection (c):</DELETED>
<DELETED> ``(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.''.</DELETED>
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Veterans Health
Care Authorization 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--DEPARTMENT PERSONNEL MATTERS
Sec. 101. Enhancement of authorities for retention of medical
professionals.
Sec. 102. Limitations on overtime duty, weekend duty, and alternative
work schedules for nurses.
Sec. 103. Improvements to certain educational assistance programs.
Sec. 104. Standards for appointment and practice of physicians in
Department of Veterans Affairs medical
facilities.
TITLE II--HEALTH CARE MATTERS
Sec. 201. Repeal of certain annual reporting requirements.
Sec. 202. Modifications to annual Gulf War research report.
Sec. 203. Payment for care furnished to CHAMPVA beneficiaries.
Sec. 204. Disclosures from certain medical records.
Sec. 205. Disclosure to Secretary of health-plan contract information
and social security number of certain
veterans receiving care.
Sec. 206. Enhancement of quality management.
Sec. 207. Reports on improvements to Department health care quality
management.
Sec. 208. 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. 209. Specialized residential care and rehabilitation for certain
veterans.
Sec. 210. Expanded study on the health impact of Project Shipboard
Hazard and Defense.
Sec. 211. Use of non-Department facilities for rehabilitation of
individuals with traumatic brain injury.
Sec. 212. Inclusion of federally recognized tribal organizations in
certain programs for State veterans homes.
Sec. 213. Pilot program on provision of dental insurance plans to
veterans and survivors and dependents of
veterans.
TITLE III--WOMEN VETERANS HEALTH CARE MATTERS
Sec. 301. Report on barriers to receipt of health care for women
veterans.
Sec. 302. Plan to improve provision of health care services to women
veterans.
Sec. 303. Independent study on health consequences of women veterans of
military service in Operation Iraqi Freedom
and Operation Enduring Freedom.
Sec. 304. Training and certification for mental health care providers
on care for veterans suffering from sexual
trauma.
Sec. 305. Pilot program on counseling in retreat settings for women
veterans newly separated from service in
the Armed Forces.
Sec. 306. Report on full-time women veterans program managers at
medical centers.
Sec. 307. Service on certain advisory committees of women recently
separated from service in the Armed Forces.
Sec. 308. Pilot program on subsidies for child care for certain
veterans receiving health care.
Sec. 309. Care for newborn children of women veterans receiving
maternity 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.
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--HOMELESS VETERANS MATTERS
Sec. 501. Pilot program on financial support for entities that
coordinate the provision of supportive
services to formerly homeless veterans
residing on certain military property.
Sec. 502. Pilot program on financial support of entities that
coordinate the provision of supportive
services to formerly homeless veterans
residing in permanent housing.
Sec. 503. Pilot program on financial support of entities that provide
outreach to inform certain veterans about
pension benefits.
Sec. 504. Assessment of pilot programs.
TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS
Sec. 601. General authorities on establishment of corporations.
Sec. 602. Clarification of purposes of corporations.
Sec. 603. Modification of requirements for boards of directors of
corporations.
Sec. 604. Clarification of powers of corporations.
Sec. 605. Redesignation of section 7364A of title 38, United States
Code.
Sec. 606. Improved accountability and oversight of corporations.
TITLE VII--OTHER MATTERS
Sec. 701. Expansion of authority for Department of Veterans Affairs
police officers.
Sec. 702. 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 or repeal to
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--DEPARTMENT PERSONNEL MATTERS
SEC. 101. 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. 102. 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. 103. 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. 104. 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 II--HEALTH CARE MATTERS
SEC. 201. 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. 202. 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. 203. 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. 204. 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. 205. 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. 206. 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. 207. 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 104 and 206 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 104 and 206 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. 208. 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. 209. 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. 210. 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. 211. 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. 212. 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. 213. 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.
TITLE III--WOMEN VETERANS HEALTH CARE MATTERS
SEC. 301. 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. 302. 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. 303. 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. 304. 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. 305. 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. 306. 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. 307. 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. 308. 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. 309. 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 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--HOMELESS VETERANS MATTERS
SEC. 501. 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. 502. 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. 503. 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. 504. 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 VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS
SEC. 601. 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. 602. 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. 603. 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. 604. 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
602(a)(1) of this Act, is further amended by striking the last
sentence.
SEC. 605. 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. 606. 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 VII--OTHER MATTERS
SEC. 701. 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. 702. 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. 128
111th CONGRESS
1st Session
S. 252
[Report No. 111-60]
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to enhance the capacity of the
Department of Veterans Affairs to recruit and retain nurses and other
critical health-care professionals, to improve the provision of health
care to veterans, and for other purposes.
_______________________________________________________________________
July 24, 2009
Reported with an amendment