[Congressional Record Volume 151, Number 74 (Tuesday, June 7, 2005)]
[Senate]
[Pages S6159-S6165]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CRAIG:
  S. 1182. A bill to amend title 38, United States Code, to improve 
health care for veterans, and for other purposes; to the Committee on 
Veterans' Affairs.
  Mr. CRAIG. Mr. President, I seek recognition today to introduce 
legislation that will expand the services available to our Nation's 
veterans and their dependents, and improve the ability of the 
Department of Veterans Affairs (VA) to provide health care services to 
this same group of deserving Americans. I take a few moments now to 
explain the provisions of this legislation.
  First, the bill would, in section 2, exempt veterans enrolled for VA 
care from all copayments for hospice care services provided by VA. Over 
the past several years, VA has greatly expanded its efforts to provide 
compassionate end-of-life care for our Nation's heroes. Last year, 
Congress made efforts to ensure that the surviving spouses and children 
would not receive bills for such services following the deaths of such 
veterans who were in the hospice program. Unfortunately, last year's 
legislation did not go far enough, and today some veterans' families 
are still paying for this care. This provision would end that practice 
in all hospice care settings.
  Section 3 of the bill would exempt former Prisoners of War from 
copayments that are applicable to care in a VA extended care facility. 
Congress has already exempted this deserving group of veterans from 
other VA medical copayments, and this provision would complete the 
range of services available to these veterans free of charge. In 
addition, this section bill would remove the requirement that VA 
maintain the exact number of nursing home care beds in VA facilities as 
it had during fiscal year 1998. Now before some suggest that I am 
advocating the reduction in services available to veterans, I'd like to 
explain how the current requirement came about and why I believe it 
should be reconsidered.
  The requirement that VA maintain a specified level of nursing home 
beds was inserted into the law in 1999 when Congress enacted 
legislation to expand options for non-institutional, long-term care 
services available to veterans. At that time, some felt that by growing 
the non-institutional care program, VA would seek simply to shut all of 
its institutional care capacity. So in a compromise, Congress decided 
that fiscal year 1998 would be the year against which changes in the 
institutional care program would be measured. And then it required that 
VA maintain all of the beds it had in 1998.
  Since 1998, VA has increased the number of veterans it treats by 
nearly 2 million. Yet, year after year, VA reports to Congress that it 
does not need to maintain the number of nursing home beds required by 
law. Does that mean VA is closing beds unnecessarily? No. It means VA 
has followed the progress of medicine and is offering tens-of-thousands 
of veterans non-institutional care services while keeping them at home 
rather than in VA nursing home beds. I do not believe that Congress 
should continue to mandate the maintenance of an arbitrarily-determined 
number of beds in a system that is trying to effectively use every 
dollar it can to provide real and needed services to our veterans. This 
provision reflects that belief.
  The fourth section of the legislation, if enacted, would ensure that 
veterans who seek emergency medical services at the nearby community 
medical facilities are treated no differently financially than if the 
care had been provided at a VA medical facility. This is an important 
issue in the provision of quality health care for our veterans. VA has 
some evidence that veterans who need emergency services are bypassing 
local medical facilities, and are attempting to ``make it'' to a VA 
facility even in the face of an emergency, because of concerns that 
VA's reimbursement policies for non-VA provided

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emergency care will result in the veteran paying more out-of-pocket 
costs. Clearly, that is not the kind of behavior Congress wants to 
encourage in our veterans. Nor is it good medicine. This provision 
would clarify once and for all that veterans will be treated equally 
regardless of where emergency care treatment is sought.

  Section 5 of the bill would authorize VA to provide or pay for up to 
the first fourteen days of care for a newborn child of an enrolled 
female veteran who delivers her baby under VA provided, or VA financed, 
care. As most of my colleagues know, VA provides what it calls a 
``comprehensive package of health benefits for eligible veterans.'' 
Unfortunately, for the increasing number of female veterans enrolling 
for VA care, the word ``comprehensive'' does not include coverage for a 
newborn's first few days of needed care. This type of arrangement is 
common in the private sector. In my judgment, this is an issue we must 
address to assure our female service members that, as more and more of 
them join the service and change the face of the American military, we 
will make certain that the face of VA changes right along with it.
  Section 6 would allow private health care providers to recoup costs 
for care provided to children afflicted with spina bifida of Vietnam 
veterans--children who are, by law, entitled to VA-provided care--when 
the costs are not fully covered by VA reimbursements. This so-called 
``balance billing'' authority would prohibit charging individual 
patients or veterans themselves. Only a beneficiary with private 
insurance could have his or her insurance cover charges not covered by 
VA. This provision is important because it will provide a financial 
incentive to many providers who, unfortunately in some cases today, are 
not willing to provide the very specialized services needed by these 
children because some costs are not reimbursed by VA at a sufficient 
rate.
  Section 7 of this bill would increase the authorized level of funding 
for the Homeless Grant and Per Diem Program at the Department of 
Veterans Affairs. I know all of my colleagues would agree that any man 
or woman who served this country in uniform should not be among the 
unfortunate Americans who find themselves on the street without 
shelter. VA has made tremendous strides in this area by providing grant 
programs, health care services, mental health treatment, and other 
assistance to those veterans who do find themselves on the street. This 
provision would ensure that good programs remain on track for the 
foreseeable future.
  The eighth section of this bill would authorize VA medical centers to 
employ Marriage and Family Therapists. I realize that to some of my 
colleagues this may sound as though VA is beginning to become a family 
health care system and not a veterans' health care system. I want to 
assure any who harbor such concerns that this is not the intention or 
the purpose of this proposed authority. Rather, this proposal seeks to 
recognize that for some veterans, the trauma and experiences of war may 
lead to troubles at home. Often in these situations, treatment as a 
family is more effective for the betterment of the veteran. Of course, 
preservation of the family is an extremely important byproduct of this 
treatment approach as well. I do not believe it is incompatible with 
the mission of treating our veterans to focus on their family well-
being when it is appropriate. The military is offering many of these 
services already to those who are returning from overseas. These 
programs are receiving good reviews from those in the mental health and 
counseling professions. It seems only logical that we extend successful 
ideas from the military experience to our veterans.
  Section 9 would provide pay equity for the national Director of VA's 
Nursing Service. Currently, this position is paid at a rate that is 
less than all of the other service chiefs at VA's Central Office. I 
believe correcting this inequity is not only a matter of fairness, but 
a long overdue recognition that VA's nursing service is just as 
important to the provision of health services for our veterans as the 
pharmacy service, the dental service, and other such services within 
VA.
  Section 10 of this bill would allow VA to conduct cost-comparison 
studies within its health care system. Mr. President, such studies are 
invaluable tools for government to measure whether its current 
workforce has identified the most efficient and effective means of 
delivering services to our veterans, and value to the taxpayers. In my 
opinion, any organization that fails to measure its performance against 
others in the same field will quickly cease to be an effective 
organization. VA is--and it must continue to be--an effective and 
efficient health care provider. This small change in the law will 
provide one additional tool to ensure that is the case far into the 
future.
  Section 11 of my legislation would focus on an area of great 
importance to many members of the Senate: The treatment of mental 
health issues for those returning from service in Operations Iraqi 
Freedom and Enduring Freedom. I know many of us have read reports that 
estimate that as many as 20 percent of those serving overseas will need 
some mental health care services to cope with the stress of serving in 
a war zone. First, I want to say to my colleagues that the Department 
of Veterans Affairs already has in place numerous programs and services 
to respond to the needs of those veterans seeking care for mental 
health issues. Still, as Chairman of the Veterans' Affairs Committee, I 
believe it is important that we assure our brave servicemen and women, 
and the American people, that we are not satisfied with merely 
maintaining VA's ability to provide mental health services. Rather, we 
must assure that VA continues to improve and expand the treatment 
options available.
  This section of the bill would authorize $95 million in both fiscal 
years 2006 and 2007 to improve and expand the mental health services 
available to our Nation's veterans. The Secretary of Veterans Affairs 
would be required to devote specific resources to certain 
important areas of treatment including, but not limited to $5 million 
to expand the number of clinical teams devoted to the treatment of 
Post-Traumatic Stress Disorder; $50 million to expand the services 
available to diagnose and treat veterans with substance abuse problems; 
$10 million to expand tele-health capabilities in areas of the country 
where access to basic mental health services is nearly impossible; $1 
million to improve educational programs available for primary care 
providers to learn more about diagnosing and treating veterans with 
mental illness; $20 million to expand the number of community-based 
outpatient clinics with mental health services; and $5 million to 
expand VA's Mental Health Intensive Case Management Teams.

  I want to make it clear to my colleagues that I am taking this 
approach because I am concerned about the availability of these 
services as much as anyone in the Senate. But, I am also concerned 
about recent moves to ``micro-manage'' the VA health care system by 
requiring, for example, that certain percentages of VA's budget be 
spent on one service or another, or that every VA facility have some 
certain clinical service available. These approaches, while well-
intentioned, run the risk of diverting important resources away from 
services that are extremely important to our veterans. My approach is 
to put Congress on record as expecting improvements and expansion in 
certain important programs, attaching a reasonable amount of money to 
those efforts, and then monitoring the progress closely from the 
Veterans' Committee.
  Section 12 addresses a point of legal contention that has restricted 
the sharing of medical information between the Department of Defense 
and VA. As a result, record transfers for patients who would be VA 
patients are not arriving in VA hands as quickly and as seamlessly as 
they should. This provision would make clear that DoD and VA may 
exchange health records information for the purpose of providing health 
care to beneficiaries of one system who seek to quickly move to the 
other for services.
  Section 13 of the bill would direct VA to expand the number VA 
employees dedicated to serving the Veterans Readjustment Counseling 
Service's Global War on Terrorism (GWOT) Outreach Program. The 
Committee on Veterans' Affairs held a hearing earlier this year at 
which two GWOT counselors testified on the numerous services their 
program provides to returning service

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members, specifically Guardsmen and Reservists coming back from Iraq 
and Afghanistan. In many cases, these GWOT counselors are the first VA 
officials to welcome home our troops at the airport, provide them with 
their first briefing on VA benefits and services, and steer those in 
need to counseling services and health care centers. This is a 
creative, vibrant program with only 50 employees that is just now 
beginning to reach its peak effect on returning combat veterans. I 
believe VA should expand its efforts in this area to ensure we are 
reaching everyone we can.
  Section 14 of this bill would require VA to expand the number of Vet 
Centers capable of providing tele-health services and counseling to 
veterans returning from combat. Currently there are 21 Vet Center 
facilities that maintain this capability. And while that is a laudable 
effort, I believe we can do better. Tele-medicine offers a tremendous 
opportunity to bring many health services, particularly mental health 
services, to veterans who reside in areas of the country where those 
services would not otherwise be available. Practitioners are showing 
great results with tele-health services for mental health treatment, 
and our veterans are getting the services they need, closer to home, in 
a more timely fashion. Expansion of such success only seems logical.
  Finally, section 15 of this bill would require the Secretary of 
Veterans Affairs to submit a report on all of the mental health data 
maintained by VA, including the actual geographic locations of 
collection and whether all of these points of data should continue to 
be collected.
  Over the next several weeks, the Committee on Veterans' Affairs will 
be taking testimony on this bill and other legislation introduced by 
Senators to improve the range of services and benefits available to our 
Nation's veterans. I look forward to working with my colleagues 
throughout the rest of this session of Congress on these and other 
important efforts.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1182

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

     SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38, UNITED STATES 
                   CODE.

       (a) Short Title.--This Act may be cited as the ``Veterans 
     Health Care Act of 2005''.
       (b) References.--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.

     SEC. 2. COPAYMENT EXEMPTION FOR HOSPICE CARE.

       Section 1710 is amended--
       (1) in subsection (f)(1), by inserting ``(other than 
     hospice care)'' after ``nursing home care''; and
       (2) in subsection (g)(1), by inserting ``(other than 
     hospice care)'' after ``medical services''.

     SEC. 3. NURSING HOME BED LEVELS; EXEMPTION FROM EXTENDED CARE 
                   SERVICES COPAYMENTS FOR FORMER POWS.

       Section 1710B is amended--
       (1) by striking subsection (b);
       (2) by redesignating subsections (c) through (e) as 
     subsections (b) through (d), respectively; and.
       (3) in subsection (b)(2), as redesignated--
       (A) by redesignating subparagraphs (B) and (C) as 
     subparagraphs (C) and (D), respectively; and
       (B) by inserting after subparagraph (A) the following:
       ``(B) to a veteran who is a former prisoner of war;''.

     SEC. 4. REIMBURSEMENT FOR CERTAIN VETERANS' OUTSTANDING 
                   EMERGENCY TREATMENT EXPENSES.

        (a) In General.--Subchapter III of chapter 17 is amended 
     by inserting after section 1725 the following:

     ``Sec. 1725A. Reimbursement for emergency treatment expenses 
       for which certain veterans remain personally liable

       ``(a)(1) Subject to subsection (c), the Secretary may 
     reimburse a veteran described in subsection (b) for expenses 
     resulting from emergency treatment furnished to the veteran 
     in a non-Department facility for which the veteran remains 
     personally liable.
       ``(2) In any case in which reimbursement is authorized 
     under subsection (a)(1), the Secretary, in the Secretary's 
     discretion, may, in lieu of reimbursing the veteran, make 
     payment--
       ``(A) to a hospital or other health care provider that 
     furnished the treatment; or
       ``(B) to the person or organization that paid for such 
     treatment on behalf of the veteran.
       ``(b) A veteran referred to in subsection (a) is an 
     individual who--
       ``(1) is enrolled in the health care system established 
     under section 1705(a) of this title;
       ``(2) received care under this chapter during the 24-month 
     period preceding the furnishing of such emergency treatment;
       ``(3) is entitled to care or services under a health-plan 
     contract that partially reimburses the cost of the veteran's 
     emergency treatment;
       ``(4) is financially liable to the provider of emergency 
     care treatment for costs not covered by the veteran's health-
     plan contract, including copayments and deductibles; and
       ``(5) is not eligible for reimbursement for medical care or 
     services under section 1725 or 1728 of this title.
       ``(c)(1) Any amount paid by the Secretary under subsection 
     (a) shall exclude the amount of any payment the veteran would 
     have been required to make to the United States under this 
     chapter if the veteran had received the emergency treatment 
     from the Department.
       ``(2) The Secretary may not provide reimbursement under 
     this section with respect to any item or service--
       ``(A) provided or for which payment has been made, or can 
     reasonably be expected to be made, under the veteran's 
     health-plan contract; or
       ``(B) for which payment has been made or can reasonably be 
     expected to be made by a third party.
       ``(3)(A) Payment by the Secretary under this section on 
     behalf of a veteran to a provider of emergency treatment 
     shall, unless rejected and refunded by the provider within 30 
     days of receipt, extinguish any liability on the part of the 
     veteran for that treatment.
       ``(B) The absence of a contract or agreement between the 
     Secretary and the provider, any provision of a contract or 
     agreement, or an assignment to the contrary shall not operate 
     to modify, limit, or negate the requirement under 
     subparagraph (A).
       ``(4) In accordance with regulations prescribed by the 
     Secretary, the Secretary shall--
       ``(A) establish criteria for determining the amount of 
     reimbursement (which may include a maximum amount) payable 
     under this section; and
       ``(B) delineate the circumstances under which such payment 
     may be made, including requirements for requesting 
     reimbursement.
       ``(d)(1) In accordance with regulations prescribed by the 
     Secretary, the United States shall have the independent right 
     to recover any amount paid under this section if, and to the 
     extent that, a third party subsequently makes a payment for 
     the same emergency treatment.
       ``(2) Any amount paid by the United States to the veteran, 
     the veteran's personal representative, successor, dependents, 
     or survivors, or to any other person or organization paying 
     for such treatment shall constitute a lien in favor of the 
     United States against any recovery the payee subsequently 
     receives from a third party for the same treatment.
       ``(3) Any amount paid by the United States to the provider 
     that furnished the veteran's emergency treatment shall 
     constitute a lien against any subsequent amount the provider 
     receives from a third party for the same emergency treatment 
     for which the United States made payment.
       ``(4) The veteran or the veteran's personal representative, 
     successor, dependents, or survivors shall--
       ``(A) ensure that the Secretary is promptly notified of any 
     payment received from any third party for emergency treatment 
     furnished to the veteran;
       ``(B) immediately forward all documents relating to a 
     payment described in subparagraph (A);
       ``(C) cooperate with the Secretary in an investigation of a 
     payment described in subparagraph (A); and
       ``(D) assist the Secretary in enforcing the United States 
     right to recover any payment made under subsection (c)(3).
       ``(e) The Secretary may waive recovery of a payment made to 
     a veteran under this section that is otherwise required under 
     subsection (d)(1) if the Secretary determines that such 
     waiver would be in the best interest of the United States, as 
     defined by regulations prescribed by the Secretary.
       ``(f) For purposes of this section--
       ``(1) the term `health-plan contract' includes--
       ``(A) an insurance policy or contract, medical or hospital 
     service agreement, membership or subscription contract, or 
     similar arrangement, under which health services for 
     individuals are provided or the expenses of such services are 
     paid;
       ``(B) an insurance program described in section 1811 of the 
     Social Security Act (42 U.S.C. 1395c) or established by 
     section 1831 of that Act (42 U.S.C. 1395j);
       ``(C) a State plan for medical assistance approved under 
     title XIX of such Act (42 U.S.C. 1396 et seq.); and
       ``(D) a workers' compensation law or plan described in 
     section 1729(A)(2)(B) of this title;
       ``(2) the term `third party' means--
       ``(A) a Federal entity;
       ``(B) a State or political subdivision of a State;
       ``(C) an employer or an employer's insurance carrier; and

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       ``(D) a person or entity obligated to provide, or pay the 
     expenses of, such emergency treatment; and
       ``(3) the term `emergency treatment' has the meaning given 
     such term in section 1725 of this title.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 is amended by inserting after the 
     item relating to section 1725 the following:

``Sec. 1725A. Reimbursement for emergency treatment expenses for which 
              certain veterans remain personally liable.''.

     SEC. 5. 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:

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

       ``The Secretary may furnish care to a newborn child of a 
     woman veteran, who is receiving maternity care furnished by 
     the Department, for not more than 14 days after the birth of 
     the child if the veteran delivered the child in a Department 
     facility or in another facility pursuant to a Department 
     contract for the delivery services.''.
       (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:

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

     SEC. 6. ENHANCEMENT OF PAYER PROVISIONS FOR HEALTH CARE 
                   FURNISHED TO CERTAIN CHILDREN OF VIETNAM 
                   VETERANS.

       (a) Health Care for Spina Bifida and Associated 
     Disabilities.--Section 1803 is amended--
       (1) by redesignating subsection (c) as subsection (d); and
       (2) by inserting after subsection (b) the following:
       ``(c)(1) If a payment made by the Secretary for health care 
     under this section is less than the amount billed for such 
     health care, the health care provider or agent of the health 
     care provider may, in accordance with paragraphs (2) through 
     (4), 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 would be eligible to receive payment for such health 
     care from such third party.
       ``(2) The health care provider or agent may not impose any 
     additional charge on the beneficiary who received the health 
     care, or the family of such beneficiary, for any service or 
     item for which the Secretary has made payment under this 
     section;
       ``(3) The total amount of payment a health care provider or 
     agent may receive for health care furnished under this 
     section may not exceed the amount billed to the Secretary.
       ``(4) The Secretary, upon request, shall disclose to such 
     third party information received for the purposes of carrying 
     out this section.''.
       (b) Health Care for Birth Defects and Associated 
     Disabilities.--Section 1813 is amended--
       (1) by redesignating subsection (c) as subsection (d); and
       (2) by inserting after subsection (b) the following:
       ``(c)(1) If payment made by the Secretary for health care 
     under this section is less than the amount billed for such 
     health care, the health care provider or agent of the health 
     care provider may, in accordance with paragraphs (2) through 
     (4), 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 would be eligible to receive payment for such health 
     care from such third party.
       ``(2) The health care provider or agent may not impose any 
     additional charge on the beneficiary who received health 
     care, or the family of such beneficiary, for any service or 
     item for which the Secretary has made payment under this 
     section;
       ``(3) The total amount of payment a health care provider or 
     agent may receive for health care furnished under this 
     section may not exceed the amount billed to the Secretary; 
     and
       ``(4) The Secretary, upon request, shall disclose to such 
     third party information received for the purposes of carrying 
     out this section.''.

     SEC. 7. IMPROVEMENTS TO HOMELESS PROVIDERS GRANT AND PER DIEM 
                   PROGRAM.

       (a) Permanent Authority.--Section 2011 (a) is amended--
       (1) in paragraph (1), by striking ``(1)''; and
       (2) by striking paragraph (2).
       (b) Authorization of Appropriations.--Section 2013 is 
     amended to read as follows:

     ``Sec. 2013. Authorization of appropriations

       ``There are authorized to be appropriated $130,000,000 for 
     fiscal year 2006 and each subsequent fiscal year to carry out 
     this subchapter.''.

     SEC. 8. MARRIAGE AND FAMILY THERAPISTS.

       (a) Qualifications.--Section 7402(b) is amended--
       (1) by redesignating paragraph (10) as paragraph (11); and
       (2) by inserting after paragraph (9) the following:
       ``(10) Marriage and family therapist.--To be eligible to be 
     appointed to a marriage and family therapist position, a 
     person must--
       ``(A) hold a master's degree in marriage and family 
     therapy, or a comparable degree in mental health, from a 
     college or university approved by the Secretary; and
       ``(B) be licensed or certified to independently practice 
     marriage and family therapy in a State, except that the 
     Secretary may waive the requirement of licensure or 
     certification for an individual marriage and family therapist 
     for a reasonable period of time recommended by the Under 
     Secretary for Health.''.
       (b) Report on Marriage and Family Therapy Workload.--
       (1) In general.--Not later than 90 days after the date of 
     enactment of this Act, the Under Secretary for Health, 
     Department 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 provisions of post-traumatic stress disorder treatment by 
     marriage and family therapists.
       (2) Contents.--The report submitted under paragraph (1) 
     shall include--
       (A) the actual and projected workloads in facilities of the 
     Veterans Readjustment Counseling Service and the Veterans 
     Health Administration for the provision of marriage and 
     family counseling for veterans diagnosed with, or otherwise 
     in need of treatment for, post-traumatic stress disorder;
       (B) the resources available and needed to support the 
     workload projections described in subparagraph (A);
       (C) an assessment by the Under Secretary for Health of the 
     effectiveness of treatment by marriage and family therapists; 
     and
       (D) recommendations, if any, for improvements in the 
     provision of such counseling treatment.

     SEC. 9. PAY COMPARABILITY FOR CHIEF NURSING OFFICER, OFFICE 
                   OF NURSING SERVICES.

       Section 7404 is amended--
       (1) in subsection (d), by striking ``subchapter III'' and 
     inserting ``paragraph (e), subchapter III,''; and
       (2) by adding at the end the following:
       ``(e) The position of Chief Nursing Officer, Office of 
     Nursing Services, shall be exempt from the provisions of 
     section 7451 of this title and shall be paid at a rate not to 
     exceed the maximum rate established for the Senior Executive 
     Service under section 5382 of title 5 United States Code, as 
     determined by the Secretary.''.

     SEC. 10. REPEAL OF COST COMPARISON STUDIES PROHIBITION.

       Section 8110(a) is amended--
       (1) by striking paragraph (5); and
       (2) by redesignating paragraph (6) as paragraph (5).

     SEC. 11. IMPROVEMENTS AND EXPANSION OF MENTAL HEALTH 
                   SERVICES.

       (a) In General.--The Secretary of Veterans affairs shall--
       (1) expand the number of clinical treatment teams 
     principally dedicated to the treatment of post-traumatic 
     stress disorder in medical facilities of the Department of 
     Veterans Affairs;
       (2) expand and improve the services available to diagnose 
     and treat substance abuse;
       (3) expand and improve tele-health initiatives to provide 
     better access to mental health services in areas of the 
     country in which the Secretary determines that a need for 
     such services exist due to the distance of such locations 
     from an appropriate facility of the Department of Veterans 
     Affairs;
       (4) improve education programs available to primary care 
     delivery professionals and dedicate such programs to 
     recognize, treat, and clinically manage veterans with mental 
     health care needs;
       (5) expand the delivery of mental health services in 
     community-based outpatient clinics of the Department of 
     Veterans Affairs in which such services are not available as 
     of the date of enactment of this Act; and
       (6) expand and improve the Mental Health Intensive Case 
     Management Teams for the treatment and clinical case 
     management of veterans with serious or chronic mental 
     illness.
       (b) Authorization of Appropriations.--There are authorized 
     to be appropriated in each of fiscal years 2006 and 2007, 
     $95,000,000 to improve and expand the treatment services and 
     options available to veterans in need of mental health 
     treatment from the Department of Veterans Affairs, of which--
       (1) $5,000,000 shall be allocated to carry out subsection 
     (a)(1);
       (2) $50,000,000 shall be allocated to carry out subsection 
     (a)(2);
       (3) $10,000,000 shall be allocated to carry out subsection 
     (a)(3);
       (4) $1,000,000 shall be allocated to carry out subsection 
     (a)(4);
       (5) $20,000,000 shall be allocated to carry out subsection 
     (a)(5); and
       (6) $5,000,000 shall be allocated to carry out subsection 
     (a)(6).

     SEC. 12. DATA SHARING IMPROVEMENTS.

       Notwithstanding any other provision of law, the Department 
     of Veterans Affairs and the Department of Defense may 
     exchange protected health information for--
       (1) patients receiving treatment from the Department of 
     Veterans Affairs; or
       (2) individuals who may receive treatment from the 
     Department of Veterans Affairs in the future, including all 
     current and former members of the Armed Services.

     SEC. 13. EXPANSION OF NATIONAL GUARD OUTREACH PROGRAM.

       (a) Requirement.--The Secretary of Veterans Affairs shall 
     expand the total number

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     of personal employed by the Department of Veterans Affairs as 
     part of the Readjustment Counseling Service's Global War on 
     Terrorism Outreach Program (referred to in this section as 
     the ``Program'').
       (b) Coordination.--In carrying out subsection (a), the 
     Secretary shall coordinate participation in the Program by 
     appropriate employees of the Veterans Benefits Administration 
     and the Veterans Health Administration.
       (c) Information and Assessments.--The Secretary shall 
     ensure that--
       (1) all appropriate health, education, and benefits 
     information is available to returning members of the National 
     Guard; and
       (2) proper assessments of the needs in each of these areas 
     is made by the Department of Veterans Affairs.
       (d) Collaboration.--The Secretary of Veterans Affairs shall 
     collaborate with appropriate State National Guard officials 
     and provide such officials with any assets or services of the 
     Department of Veterans Affairs that the Secretary determines 
     to be necessary to carry out the Global War on Terrorism 
     Outreach Program.

     SEC. 14. EXPANSION OF TELE-HEALTH SERVICES.

       (a) In General.--The Secretary shall increase the number of 
     Veterans Readjustment Counseling Service facilities capable 
     of providing health services and counseling through tele-
     health linkages with facilities of the Veterans Health 
     Administration.
       (b) Plan.--The Secretary shall submit to the Committee on 
     Veterans' Affairs of the Senate and the Committee on 
     Veterans' Affairs of the House of Representatives a plan to 
     implement the requirement under subsection (a), which shall 
     describe the facilities that will have such capabilities at 
     the end of each of fiscal years 2005, 2006, and 2007.

     SEC. 15. MENTAL HEALTH DATA SOURCES REPORT.

       (a) In General.--Not less than 180 days after the date of 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit a report to the Committee on Veterans' Affairs 
     of the Senate and the Committee on Veterans' Affairs of the 
     House of Representatives describing the mental health data 
     maintained by the Department of Veterans Affairs.
       (b) Contents.--The report submitted under subsection (a) 
     shall include--
       (1) a comprehensive list of the sources of all such data, 
     including the geographic locations of facilities of the 
     Department of Veterans Affairs maintaining such data;
       (2) an assessment of the limitations or advantages to 
     maintaining the current data configuration and locations; and
       (3) any recommendations, if any, for improving the 
     collection, use, and location of mental health data 
     maintained by the Department of Veterans Affairs.
                                 ______