[Congressional Record Volume 155, Number 172 (Thursday, November 19, 2009)]
[Senate]
[Pages S11552-S11573]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




 CAREGIVERS AND VETERANS OMNIBUS HEALTH SERVICES ACT OF 2009--Continued


                           Amendment No. 2785

  The PRESIDING OFFICER. There will now be 2 minutes of debate equally 
divided on the amendment offered by the Senator from Oklahoma, Mr. 
Coburn.
  The Senator from Oklahoma is recognized.
  Mr. COBURN. This is a straightforward amendment. You get to decide 
whether you want to continue to send money to an organization that is 
bankrupt, fraudulent; has peacekeeping troops that rape men, women, and 
children; has absolutely no transparency in spite of our law that 
demands it, or to pay for the courage and the support of people who do 
deserve it.
  We always find a reason not to make the hard choice. I suspect we 
will find a good reason not to make the hard choice this time. But for 
$3.7 billion to help the people who help us and quit sending money that 
goes down the tube--half of everything we send to the United Nations 
gets wasted or defrauded--it is time for us to make the hard choice. 
That is what the amendment is about. There are a lot of reasons you can 
find to vote against it. It will take real courage to vote for it.
  The PRESIDING OFFICER. The Senator from Hawaii is recognized.
  Mr. AKAKA. Mr. President, I urge our colleagues to reject the pending 
amendment. For one thing, it appears that the amendment could end up 
denying caregiver assistance to many OEF/OIF veterans by significantly 
narrowing the eligibility criteria for caregiver assistance. While the 
amendment seeks to ``pay for'' the costs associated with this bill, I 
understand from CBO, however, that this amendment does not even 
accomplish what I believe the amendment's author intends.
  Every major veterans group supports the underlying bill because of 
what it means for all veterans--for women veterans, for homeless 
veterans, and for veterans of every era.
  I urge a ``no'' vote on the amendment, followed by a vote to pass S. 
1963.
  The PRESIDING OFFICER. All time has expired.
  The question is on agreeing to the amendment.
  Mr. LeMIEUX. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second? There is a 
sufficient second.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from Montana (Mr. Baucus) and 
the Senator from West Virginia (Mr. Byrd) are necessarily absent.
  The PRESIDING OFFICER (Ms. Klobuchar). Are there any other Senators 
in the Chamber desiring to vote?
  The result was announced--yeas 32, nays 66, as follows:

                      [Rollcall Vote No. 351 Leg.]

                                YEAS--32

     Alexander
     Barrasso
     Bayh
     Bennett
     Brownback
     Bunning
     Burr
     Chambliss
     Coburn
     Cornyn
     Crapo
     DeMint
     Ensign
     Enzi
     Graham
     Hatch
     Hutchison
     Inhofe
     Isakson
     Johanns
     Kyl
     LeMieux
     McCain
     McConnell
     Murkowski
     Risch
     Roberts
     Sessions
     Shelby
     Thune
     Vitter
     Wicker

                                NAYS--66

     Akaka
     Begich
     Bennet
     Bingaman
     Bond
     Boxer
     Brown
     Burris
     Cantwell
     Cardin
     Carper
     Casey
     Cochran
     Collins
     Conrad
     Corker
     Dodd
     Dorgan
     Durbin
     Feingold
     Feinstein
     Franken
     Gillibrand
     Grassley
     Gregg
     Hagan
     Harkin
     Inouye
     Johnson
     Kaufman
     Kerry
     Kirk
     Klobuchar
     Kohl
     Landrieu
     Lautenberg
     Leahy
     Levin
     Lieberman
     Lincoln
     Lugar
     McCaskill
     Menendez
     Merkley
     Mikulski
     Murray
     Nelson (NE)
     Nelson (FL)
     Pryor
     Reed
     Reid
     Rockefeller
     Sanders
     Schumer
     Shaheen
     Snowe
     Specter
     Stabenow
     Tester
     Udall (CO)
     Udall (NM)
     Voinovich
     Warner
     Webb
     Whitehouse
     Wyden

[[Page S11553]]



                             NOT VOTING--2

     Baucus
     Byrd
       
  The amendment (No. 2785) was rejected.
  Mrs. MURRAY. Madam President, I move to reconsider the vote.
  Mr. DURBIN. I move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The question is on the engrossment and third 
reading of the bill.
  The bill was ordered to be engrossed for a third reading and was read 
the third time.
  Mrs. MURRAY. I ask for the yeas and nays.
  The PRESIDING OFFICER. Is there a sufficient second?
  There appears to be a sufficient second.
  The question is on passage of the bill.
  The clerk will call the roll.
  The assistant legislative clerk called the roll.
  Mr. DURBIN. I announce that the Senator from Montana (Mr. Baucus) and 
the Senator from West Virginia (Mr. Byrd) are necessarily absent.
  The PRESIDING OFFICER. Are there any other Senators in the Chamber 
desiring to vote?
  The result was announced--yeas 98, nays 0, as follows:

                      [Rollcall Vote No. 352 Leg.]

                                YEAS--98

     Akaka
     Alexander
     Barrasso
     Bayh
     Begich
     Bennet
     Bennett
     Bingaman
     Bond
     Boxer
     Brown
     Brownback
     Bunning
     Burr
     Burris
     Cantwell
     Cardin
     Carper
     Casey
     Chambliss
     Coburn
     Cochran
     Collins
     Conrad
     Corker
     Cornyn
     Crapo
     DeMint
     Dodd
     Dorgan
     Durbin
     Ensign
     Enzi
     Feingold
     Feinstein
     Franken
     Gillibrand
     Graham
     Grassley
     Gregg
     Hagan
     Harkin
     Hatch
     Hutchison
     Inhofe
     Inouye
     Isakson
     Johanns
     Johnson
     Kaufman
     Kerry
     Kirk
     Klobuchar
     Kohl
     Kyl
     Landrieu
     Lautenberg
     Leahy
     LeMieux
     Levin
     Lieberman
     Lincoln
     Lugar
     McCain
     McCaskill
     McConnell
     Menendez
     Merkley
     Mikulski
     Murkowski
     Murray
     Nelson (NE)
     Nelson (FL)
     Pryor
     Reed
     Reid
     Risch
     Roberts
     Rockefeller
     Sanders
     Schumer
     Sessions
     Shaheen
     Shelby
     Snowe
     Specter
     Stabenow
     Tester
     Thune
     Udall (CO)
     Udall (NM)
     Vitter
     Voinovich
     Warner
     Webb
     Whitehouse
     Wicker
     Wyden

                             NOT VOTING--2

     Baucus
     Byrd
       
  The bill (S. 1963) was passed, as follows:

                                S. 1963

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

     SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

       (a) Short Title.--This Act may be cited as the ``Caregivers 
     and Veterans Omnibus Health Services Act of 2009''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

                       TITLE I--CAREGIVER SUPPORT

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

              TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

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

                  TITLE III--RURAL HEALTH IMPROVEMENTS

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

                  TITLE IV--MENTAL HEALTH CARE MATTERS

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

                   TITLE V--OTHER HEALTH CARE MATTERS

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

[[Page S11554]]

                 TITLE VI--DEPARTMENT PERSONNEL MATTERS

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

                  TITLE VII--HOMELESS VETERANS MATTERS

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

       TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

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

               TITLE IX--CONSTRUCTION AND NAMING MATTERS

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

                         TITLE X--OTHER MATTERS

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

     SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.

       Except as otherwise expressly provided, whenever in this 
     Act an amendment or repeal is expressed in terms of an 
     amendment to, or repeal of, a section or other provision, the 
     reference shall be considered to be made to a section or 
     other provision of title 38, United States Code.

                       TITLE I--CAREGIVER SUPPORT

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

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

     SEC. 102. FAMILY CAREGIVER ASSISTANCE.

       (a) Requirement.--
       (1) In general.--Subchapter II of chapter 17 is amended by 
     inserting after section 1717 the following new section:

     ``Sec. 1717A. Family caregiver assistance

       ``(a) In General.--(1) As part of home health services 
     provided under section 1717 of this title, the Secretary 
     shall, upon the joint application of an eligible veteran and 
     a family member of such veteran (or other individual 
     designated by such veteran), furnish to such family member 
     (or designee) family caregiver assistance in accordance with 
     this section. The purpose of providing family caregiver 
     assistance under this section is--
       ``(A) to reduce the number of veterans who are receiving 
     institutional care, or who are in need of institutional care, 
     whose personal care service needs could be substantially 
     satisfied with the provision of such services by a family 
     member (or designee); and
       ``(B) to provide eligible veterans with additional options 
     so that they can choose the setting for the receipt of 
     personal care services that best suits their needs.
       ``(2) The Secretary shall only furnish family caregiver 
     assistance under this section to a family member of an 
     eligible veteran (or other individual designated by such 
     veteran) if the Secretary determines it is in the best 
     interest of the eligible veteran to do so.
       ``(b) Eligible Veterans.--For purposes of this section, an 
     eligible veteran is a veteran (or member of the Armed Forces 
     undergoing medical discharge from the Armed Forces)--
       ``(1) who has a serious injury (including traumatic brain 
     injury, psychological trauma, or other mental disorder) 
     incurred or aggravated in the line of duty in the active 
     military, naval, or air service on or after September 11, 
     2001; and
       ``(2) whom the Secretary determines, in consultation with 
     the Secretary of Defense as necessary, is in need of personal 
     care services because of--
       ``(A) an inability to perform one or more independent 
     activities of daily living;
       ``(B) a need for supervision or protection based on 
     symptoms or residuals of neurological or other impairment or 
     injury; or
       ``(C) such other matters as the Secretary shall establish 
     in consultation with the Secretary of Defense as appropriate.
       ``(c) Evaluation of Eligible Veterans and Family 
     Caregivers.--(1) The Secretary shall evaluate each eligible 
     veteran who makes a joint application under subsection 
     (a)(1)--
       ``(A) to identify the personal care services required by 
     such veteran; and
       ``(B) to determine whether such requirements could be 
     significantly or substantially satisfied with the provision 
     of personal care services from a family member (or other 
     individual designated by the veteran).
       ``(2) The Secretary shall evaluate each family member of an 
     eligible veteran (or other individual designated by the 
     veteran) who makes a joint application under subsection 
     (a)(1) to determine--
       ``(A) the basic amount of instruction, preparation, and 
     training such family member (or designee) requires, if any, 
     to provide the personal care services required by such 
     veteran; and
       ``(B) the amount of additional instruction, preparation, 
     and training such family member (or designee) requires, if 
     any, to be the primary personal care attendant designated for 
     such veteran under subsection (e).
       ``(3) An evaluation carried out under paragraph (1) may be 
     carried out--
       ``(A) at a Department facility;
       ``(B) at a non-Department facility determined appropriate 
     by the Secretary for purposes of such evaluation; and
       ``(C) at such other locations as the Secretary considers 
     appropriate.
       ``(d) Training and Approval.--(1) Except as provided in 
     subsection (a)(2), the Secretary shall provide each family 
     member of an eligible veteran (or other individual designated 
     by the veteran) who makes a joint application under 
     subsection (a)(1) the basic instruction, preparation, and 
     training determined to be required by such family member (or 
     designee) under subsection (c)(2)(A).
       ``(2) The Secretary may provide to a family member of an 
     eligible veteran (or other individual designated by the 
     veteran) the additional instruction, preparation, and 
     training determined to be required by such family member (or 
     designee) under subsection (c)(2)(B) if such family member 
     (or designee)--
       ``(A) is approved as a personal care attendant for the 
     veteran under paragraph (3); and
       ``(B) requests, with concurrence of the veteran, such 
     additional instruction, preparation, and training.
       ``(3) Upon the successful completion by a family member of 
     an eligible veteran (or other individual designated by the 
     veteran)

[[Page S11555]]

     of basic instruction, preparation, and training provided 
     under paragraph (1), the Secretary shall approve the family 
     member as a personal care attendant for the veteran.
       ``(4) If the Secretary determines that a primary personal 
     care attendant designated under subsection (e) requires 
     additional training to maintain such designation, the 
     Secretary shall make such training available to the primary 
     personal care attendant.
       ``(5) The Secretary shall, subject to regulations the 
     Secretary shall prescribe, provide for necessary travel, 
     lodging, and per diem expenses incurred by a family member of 
     an eligible veteran (or other individual designated by the 
     veteran) in undergoing training under this subsection.
       ``(6) If the participation of a family member of an 
     eligible veteran (or other individual designated by the 
     veteran) in training under this subsection would interfere 
     with the provision of personal care services to the veteran, 
     the Secretary shall, subject to regulations as the Secretary 
     shall prescribe and in consultation with the veteran, provide 
     respite care to the veteran during the provision of such 
     training to the family member so that such family caregiver 
     (or designee) can participate in such training without 
     interfering with the provision of such services.
       ``(e) Designation of Primary Personal Care Attendant.--(1) 
     For each eligible veteran with at least one family member (or 
     other individual designated by the veteran) who is described 
     by subparagraphs (A) through (E) of paragraph (2), the 
     Secretary shall designate one family member of such veteran 
     (or other individual designated by the veteran) as the 
     primary personal care attendant for such veteran to be the 
     primary provider of personal care services for such veteran.
       ``(2) A primary personal care attendant designated for an 
     eligible veteran under paragraph (1) shall be selected from 
     among family members of such veteran (or other individuals 
     designated by such veteran) who--
       ``(A) are approved under subsection (d)(3) as a personal 
     care attendant for such veteran;
       ``(B) complete all additional instruction, preparation, and 
     training, if any, provided under subsection (d)(2);
       ``(C) elect to provide the personal care services to such 
     veteran that the Secretary determines such veteran requires 
     under subsection (c)(1);
       ``(D) has the consent of such veteran to be the primary 
     provider of such services for such veteran; and
       ``(E) the Secretary considers competent to be the primary 
     provider of such services for such veteran.
       ``(3)(A) An eligible veteran receiving personal care 
     services from a family member (or other individual designated 
     by the veteran) designated as the primary personal care 
     attendant for the veteran under paragraph (1) may revoke 
     consent with respect to such family member (or designee) 
     under paragraph (2)(D).
       ``(B) An eligible veteran may revoke the designation of a 
     primary personal care attendant under subparagraph (A) at any 
     time, except that such revocation may not occur more 
     frequently than once every six months unless the Secretary 
     determines it is in the best interest of the eligible veteran 
     to permit such revocation to occur more frequently.
       ``(4) If an individual designated as the primary personal 
     care attendant of an eligible veteran under paragraph (1) 
     subsequently fails to meet the requirements set forth in 
     paragraph (2), the Secretary--
       ``(A) shall immediately revoke the individual's designation 
     under paragraph (1); and
       ``(B) may designate, in consultation with the eligible 
     veteran or the eligible veteran's surrogate appointed under 
     subsection (g), a new primary personal care attendant for the 
     veteran under such paragraph.
       ``(5) The Secretary shall take such actions as may be 
     necessary to ensure that the revocation of a designation 
     under paragraph (1) does not interfere with the provision of 
     personal care services required by a veteran.
       ``(f) Ongoing Family Caregiver Assistance.--(1) Except as 
     provided in subsection (a)(2) and subject to the provisions 
     of this subsection, the Secretary shall provide ongoing 
     family caregiver assistance to family members of eligible 
     veterans (or other individuals designated by such veterans) 
     as follows:
       ``(A) To each family member of an eligible veteran (or 
     designee) who is approved under subsection (d)(3) as a 
     personal care attendant for the veteran the following:
       ``(i) Direct technical support consisting of information 
     and assistance to timely address routine, emergency, and 
     specialized caregiving needs.
       ``(ii) Counseling.
       ``(iii) Access to an interactive Internet website on 
     caregiver services that addresses all aspects of the 
     provision of personal care services under this section.
       ``(B) To each family member of an eligible veteran (or 
     designee) who is designated as the primary personal care 
     attendant for the veteran under subsection (e) the following:
       ``(i) The ongoing family caregiver assistance described in 
     subparagraph (A).
       ``(ii) Mental health services.
       ``(iii) Respite care of not less than 30 days annually, 
     including 24-hour per day care of the veteran commensurate 
     with the care provided by the family caregiver to permit 
     extended respite.
       ``(iv) Medical care under section 1781 of this title if 
     such family member (or designee) is not entitled to care or 
     services under a health-plan contract (as defined in section 
     1725(f) of this title).
       ``(v) A monthly personal caregiver stipend.
       ``(2)(A) The Secretary shall provide respite care under 
     paragraph (1)(B)(iii), at the election of the Secretary--
       ``(i) through facilities of the Department that are 
     appropriate for the veteran; or
       ``(ii) through contracts under section 1720B(c) of this 
     title.
       ``(B) If the primary personal care attendant of an eligible 
     veteran designated under subsection (e)(1) determines in 
     consultation with the veteran or the veteran's surrogate 
     appointed under subsection (g), and the Secretary concurs, 
     that the needs of the veteran cannot be accommodated through 
     the facilities and contracts described in subparagraph (A), 
     the Secretary shall, in consultation with the primary 
     personal care attendant and the veteran (or the veteran's 
     surrogate), provide respite care through other facilities or 
     arrangements that are medically and age appropriate.
       ``(3) If the Secretary determines that the Department lacks 
     the capacity to furnish medical care under clause (iv) of 
     paragraph (1)(B), the Secretary may contract, in accordance 
     with such regulations as the Secretary shall prescribe, for 
     such insurance, medical services, or health plans as the 
     Secretary considers appropriate to furnish such medical care.
       ``(4)(A) The Secretary shall provide monthly personal 
     caregiver stipends under paragraph (1)(B)(v) in accordance 
     with a schedule established by the Secretary that specifies 
     stipends provided based upon the amount and degree of 
     personal care services provided.
       ``(B) The Secretary shall ensure, to the extent 
     practicable, that the schedule required by subparagraph (A) 
     specifies that the amount of the personal caregiver stipend 
     provided to a primary personal care attendant designated 
     under subsection (e)(1) for the provision of personal care 
     services to an eligible veteran is not less than the amount a 
     commercial home health care entity would pay an individual in 
     the geographic area of the veteran to provide equivalent 
     personal care services to the veteran.
       ``(C) If personal care services are not available from a 
     commercial provider in the geographic area of an eligible 
     veteran, the Secretary may establish the schedule required by 
     subparagraph (A) with respect to the veteran by considering 
     the costs of commercial providers of personal care services 
     in geographic areas other than the geographic area of the 
     veteran with similar costs of living.
       ``(5) Provision of ongoing family caregiver assistance 
     under this subsection for provision of personal care services 
     to an eligible veteran shall terminate if the veteran no 
     longer requires the personal care services.
       ``(g) Surrogates.--If an eligible veteran lacks the 
     capacity to submit an application, provide consent, make a 
     request, or concur with a request under this section, the 
     Secretary may, in accordance with regulations and policies of 
     the Department regarding the appointment of guardians or the 
     use of powers of attorney, appoint a surrogate for the 
     veteran who may submit applications, provide consent, make 
     requests, or concur with requests on behalf of the veteran 
     under this section.
       ``(h) Oversight.--(1) The Secretary shall enter into 
     contracts with appropriate entities to provide oversight of 
     the provision of personal care services under this section by 
     primary personal care attendants designated under subsection 
     (e)(1).
       ``(2) The Secretary shall ensure that each eligible veteran 
     receiving personal care services under this section from a 
     primary personal care attendant designated under subsection 
     (e)(1) is visited in the veteran's home by an entity 
     providing oversight under paragraph (1) at such frequency as 
     the Secretary shall determine under paragraph (3).
       ``(3)(A) Except as provided in subparagraph (B), the 
     Secretary shall determine the manner of oversight provided 
     under paragraph (1) and the frequency of visits under 
     paragraph (2) for an eligible veteran as the Secretary 
     considers commensurate with the needs of such veteran.
       ``(B) The frequency of visits under paragraph (2) for an 
     eligible veteran shall be not less frequent than once every 
     six months.
       ``(4)(A) An entity visiting an eligible veteran under 
     paragraph (2) shall submit to the Secretary the findings of 
     the entity with respect to each visit, including whether the 
     veteran is receiving the care the veteran requires.
       ``(B) If an entity finds under subparagraph (A) that an 
     eligible veteran is not receiving the care the veteran 
     requires, the entity shall submit to the Secretary a 
     recommendation on the corrective actions that should be taken 
     to ensure that the veteran receives the care the veteran 
     requires, including, if the entity considers appropriate, a 
     recommendation for revocation of a caregiver's approval under 
     subsection (d)(3) or revocation of the designation of an 
     individual under subsection (e)(1).
       ``(5) After receiving findings and recommendations, if any, 
     under paragraph (4) with respect to an eligible veteran, the 
     Secretary may take such actions as the Secretary considers 
     appropriate to ensure that the veteran receives the care the 
     veteran requires, including the following:
       ``(A) Revocation of a caregiver's approval under subsection 
     (d)(3).
       ``(B) Revocation of the designation of an individual under 
     subsection (e)(1).
       ``(6) If the Secretary terminates the provision of ongoing 
     family caregiver assistance

[[Page S11556]]

     under subsection (f) to a family member of an eligible 
     veteran (or other individual designated by the veteran) 
     because of findings of an entity submitted to the Secretary 
     under paragraph (4), the Secretary may not provide 
     compensation to such entity for the provision of personal 
     care services to such veteran, unless the Secretary 
     determines it would be in the best interest of such veteran 
     to provide compensation to such entity to provide such 
     services.
       ``(i) Outreach.--The Secretary shall carry out a program of 
     outreach to inform eligible veterans and their family members 
     of the availability and nature of family caregiver assistance 
     under this section.
       ``(j) Construction.--(1) A decision by the Secretary under 
     this section affecting the furnishing of family caregiver 
     assistance shall be considered a medical determination.
       ``(2) Nothing in this section shall be construed to create 
     an employment relationship between the Secretary and an 
     individual in receipt of family caregiver assistance under 
     this section.
       ``(3) Nothing in this section shall be construed to create 
     any entitlement to any services or stipends provided under 
     this section.
       ``(k) Definitions.--In this section:
       ``(1) The term `family caregiver assistance' includes the 
     instruction, preparation, training, and approval provided 
     under subsection (d) and the ongoing family caregiver 
     assistance provided under subsection (f).
       ``(2) The term `family member' shall have such meaning as 
     the Secretary shall determine by policy or regulation.
       ``(3) The term `personal care services', with respect to a 
     veteran, includes the following:
       ``(A) Supervision of the veteran.
       ``(B) Protection of the veteran.
       ``(C) Services to assist the veteran with one or more 
     independent activities of daily living.
       ``(D) Such other services as the Secretary considers 
     appropriate.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 17 is amended by inserting after the 
     item related to section 1717 the following new item:

``1717A. Family caregiver assistance.''.

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

     SEC. 103. LODGING AND SUBSISTENCE FOR ATTENDANTS.

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

     SEC. 104. SURVEY OF INFORMAL CAREGIVERS.

       (a) In General.--The Secretary of Veterans Affairs shall, 
     in collaboration with the Secretary of Defense, conduct a 
     national survey of family caregivers of seriously disabled 
     veterans and members of the Armed Forces to better understand 
     the size and characteristics of the population of such 
     caregivers and the types of care they provide such veterans 
     and members.
       (b) Report.--Not later than 540 days after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall, in collaboration with the Secretary of Defense,

[[Page S11557]]

     submit to Congress a report containing the findings of the 
     Secretary with respect to the survey conducted under 
     subsection (a). Results of the survey shall be disaggregated 
     by the following:
       (1) Veterans and members of the Armed Forces.
       (2) Veterans and members of the Armed Forces who served in 
     Operation Iraqi Freedom or Operation Enduring Freedom.
       (3) Veterans and members of the Armed Forces who live in 
     rural areas.

              TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

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

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

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

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

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

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

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

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

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

       (a) Pilot Program Required.--
       (1) In general.--Commencing not later than 180 days after 
     the date of the enactment of this Act, the Secretary of 
     Veterans Affairs shall carry out, through the Readjustment 
     Counseling Service of the Veterans Health Administration, a 
     pilot program to evaluate the feasibility and advisability of 
     providing reintegration and readjustment services described 
     in subsection (b) in group retreat settings to women veterans 
     who are recently separated from service in the Armed Forces 
     after a prolonged deployment.
       (2) Participation at election of veteran.--The 
     participation of a veteran in the pilot program under this 
     section shall be at the election of the veteran.
       (b) Covered Services.--The services provided to a woman 
     veteran under the pilot program shall include the following:
       (1) Information on reintegration into the veteran's family, 
     employment, and community.
       (2) Financial counseling.
       (3) Occupational counseling.
       (4) Information and counseling on stress reduction.
       (5) Information and counseling on conflict resolution.
       (6) Such other information and counseling as the Secretary 
     considers appropriate to assist a woman veteran under the 
     pilot program in reintegration into the veteran's family and 
     community.
       (c) Locations.--The Secretary shall carry out the pilot 
     program at not fewer than five locations selected by the 
     Secretary for purposes of the pilot program.

[[Page S11558]]

       (d) Duration.--The pilot program shall be carried out 
     during the two-year period beginning on the date of the 
     commencement of the pilot program.
       (e) Report.--Not later than 180 days after the completion 
     of the pilot program, the Secretary shall submit to Congress 
     a report on the pilot program. The report shall contain the 
     findings and conclusions of the Secretary as a result of the 
     pilot program, and shall include such recommendations for the 
     continuation or expansion of the pilot program as the 
     Secretary considers appropriate.
       (f) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs for 
     each of fiscal years 2010 and 2011, $2,000,000 to carry out 
     the pilot program.

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

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

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

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

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

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

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

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

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

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

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

                  TITLE III--RURAL HEALTH IMPROVEMENTS

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

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

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

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

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

``Sec.
``7501. Establishment of scholarship program; purpose.
``7502. Application and acceptance.
``7503. Amount of assistance; duration.
``7504. Agreement.
``7505. Repayment for failure to satisfy requirements of agreement.

     ``Sec. 7501. Establishment of scholarship program; purpose

       ``(a) Establishment.--Subject to the availability of 
     appropriations, the Secretary shall establish and carry out a 
     scholarship program to provide financial assistance in 
     accordance with this chapter to an individual--
       ``(1) who is accepted for enrollment or currently enrolled 
     in a program of study leading to a degree or certificate in 
     visual impairment or orientation and mobility, or a dual 
     degree or certification in both such areas, at an accredited 
     (as determined by the Secretary) educational institution that 
     is in a State; and
       ``(2) who enters into an agreement with the Secretary as 
     described in section 7504 of this chapter.
       ``(b) Purpose.--The purpose of the scholarship program 
     established under this chapter is to increase the supply of 
     qualified blind rehabilitation specialists for the Department 
     and the Nation.
       ``(c) Outreach.--The Secretary shall publicize the 
     scholarship program established

[[Page S11559]]

     under this chapter to educational institutions throughout the 
     United States, with an emphasis on disseminating information 
     to such institutions with high numbers of Hispanic students 
     and to Historically Black Colleges and Universities.

     ``Sec. 7502. Application and acceptance

       ``(a) Application.--(1) To apply and participate in the 
     scholarship program under this chapter, an individual shall 
     submit to the Secretary an application for such participation 
     together with an agreement described in section 7504 of this 
     chapter under which the participant agrees to serve a period 
     of obligated service in the Department as provided in the 
     agreement in return for payment of educational assistance as 
     provided in the agreement.
       ``(2) In distributing application forms and agreement forms 
     to individuals desiring to participate in the scholarship 
     program, the Secretary shall include with such forms the 
     following:
       ``(A) A fair summary of the rights and liabilities of an 
     individual whose application is approved (and whose agreement 
     is accepted) by the Secretary.
       ``(B) A full description of the terms and conditions that 
     apply to participation in the scholarship program and service 
     in the Department.
       ``(b) Approval.--(1) Upon the Secretary's approval of an 
     individual's participation in the scholarship program, the 
     Secretary shall, in writing, promptly notify the individual 
     of that acceptance.
       ``(2) An individual becomes a participant in the 
     scholarship program upon such approval by the Secretary.

     ``Sec. 7503. Amount of assistance; duration

       ``(a) Amount of Assistance.--The amount of the financial 
     assistance provided for an individual under this chapter 
     shall be the amount determined by the Secretary as being 
     necessary to pay the tuition and fees of the individual. In 
     the case of an individual enrolled in a program of study 
     leading to a dual degree or certification in both the areas 
     of study described in section 7501(a)(1) of this chapter, the 
     tuition and fees shall not exceed the amounts necessary for 
     the minimum number of credit hours to achieve such dual 
     certification or degree.
       ``(b) Relationship to Other Assistance.--Financial 
     assistance may be provided to an individual under this 
     chapter to supplement other educational assistance to the 
     extent that the total amount of educational assistance 
     received by the individual during an academic year does not 
     exceed the total tuition and fees for such academic year.
       ``(c) Maximum Amount of Assistance.--(1) In no case may the 
     total amount of assistance provided under this chapter for an 
     academic year to an individual who is a full-time student 
     exceed $15,000.
       ``(2) In the case of an individual who is a part-time 
     student, the total amount of assistance provided under this 
     chapter shall bear the same ratio to the amount that would be 
     paid under paragraph (1) if the participant were a full-time 
     student in the program of study being pursued by the 
     individual as the coursework carried by the individual to 
     full-time coursework in that program of study.
       ``(3) In no case may the total amount of assistance 
     provided to an individual under this chapter exceed $45,000.
       ``(d) Maximum Duration of Assistance.--The Secretary may 
     provide financial assistance to an individual under this 
     chapter for not more than six years.

     ``Sec. 7504. Agreement

       ``An agreement between the Secretary and a participant in 
     the scholarship program under this chapter shall be in 
     writing, shall be signed by the participant, and shall 
     include--
       ``(1) the Secretary's agreement to provide the participant 
     with financial assistance as authorized under this chapter;
       ``(2) the participant's agreement--
       ``(A) to accept such financial assistance;
       ``(B) to maintain enrollment and attendance in the program 
     of study described in section 7501(a)(1) of this chapter;
       ``(C) while enrolled in such program, to maintain an 
     acceptable level of academic standing (as determined by the 
     educational institution offering such program under 
     regulations prescribed by the Secretary); and
       ``(D) after completion of the program, to serve as a full-
     time employee in the Department for a period of three years, 
     to be served within the first six years after the participant 
     has completed such program and received a degree or 
     certificate described in section 7501(a)(1) of this chapter; 
     and
       ``(3) any other terms and conditions that the Secretary 
     determines appropriate for carrying out this chapter.

     ``Sec. 7505. Repayment for failure to satisfy requirements of 
       agreement

       ``(a) In General.--An individual who receives educational 
     assistance under this chapter shall repay to the Secretary an 
     amount equal to the unearned portion of such assistance if 
     the individual fails to satisfy the requirements of the 
     agreement entered into under section 7504 of this chapter, 
     except in circumstances authorized by the Secretary.
       ``(b) Amount of Repayment.--The Secretary shall establish, 
     by regulations, procedures for determining the amount of the 
     repayment required under this subsection and the 
     circumstances under which an exception to the required 
     repayment may be granted.
       ``(c) Waiver or Suspension of Compliance.--The Secretary 
     shall prescribe regulations providing for the waiver or 
     suspension of any obligation of an individual for service or 
     payment under this chapter (or an agreement under this 
     chapter) whenever noncompliance by the individual is due to 
     circumstances beyond the control of the individual or 
     whenever the Secretary determines that the waiver or 
     suspension of compliance is in the best interest of the 
     United States.
       ``(d) Obligation as Debt to United States.--An obligation 
     to repay the Secretary under this section is, for all 
     purposes, a debt owed the United States. A discharge in 
     bankruptcy under title 11 does not discharge a person from 
     such debt if the discharge order is entered less than five 
     years after the date of the termination of the agreement or 
     contract on which the debt is based.''.
       (b) Clerical Amendments.--The tables of chapters at the 
     beginning of title 38, and of part V of title 38, are each 
     amended by inserting after the item relating to chapter 74 
     the following new item:

``75. Visual Impairment and Orientation and Mobility Professionals 
    Education Assistance Program...........................7501.''.....

       (c) Effective Date.--The Secretary of Veterans Affairs 
     shall implement chapter 75 of title 38, United States Code, 
     as added by subsection (a), not later than six months after 
     the date of the enactment of this Act.

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

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

     SEC. 304. TELECONSULTATION AND TELEMEDICINE.

       (a) Teleconsultation and Teleretinal Imaging.--
       (1) In general.--Subchapter I of chapter 17 is amended by 
     adding at the end the following new section:

     ``Sec. 1709. Teleconsultation and teleretinal imaging

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

``1709. Teleconsultation and teleretinal imaging.''.

       (b) Training in Telemedicine.--The Secretary of Veterans 
     Affairs shall require each Department of Veterans Affairs 
     facility that is involved in the training of medical 
     residents to work with each university concerned to develop 
     an elective rotation in telemedicine for such residents.
       (c) Enhancement of VERA.--
       (1) Incentives for provision of teleconsultation, 
     teleretinal imaging, telemedicine, and telehealth services.--
     The Secretary of Veterans Affairs shall modify the Veterans 
     Equitable Resource Allocation system to provide Veterans 
     Integrated Services Networks with incentives to utilize 
     teleconsultation, teleretinal imaging, telemedicine, and 
     telehealth coordination services.
       (2) Inclusion of telemedicine visits in workload 
     reporting.--The Secretary shall modify the Veterans Equitable 
     Resource Allocation system to require the inclusion of all 
     telemedicine visits in the calculation of facility workload.

[[Page S11560]]

       (d) Definitions.--In this section:
       (1) The terms ``teleconsultation'' and ``teleretinal 
     imaging'' have the meanings given such terms in section 1709 
     of title 38, United States Code, as added by subsection (a).
       (2) The term ``telemedicine'' means the use by a health 
     care provider of telecommunications to assist in the 
     diagnosis or treatment of a patient's medical condition.
       (3) The term ``telehealth'' means the use of 
     telecommunications to collect patient data remotely and send 
     data to a monitoring station for interpretation.

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

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

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

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

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

       (a) Indian Health Coordinators.--
       (1) In general.--Subchapter II of chapter 73 is amended by 
     adding at the end the following new section:

     ``Sec. 7330B. Indian Veterans Health Care Coordinators

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

``7330B. Indian Veterans Health Coordinators.''.

       (b) Integration of Electronic Health Records With Indian 
     Health Service.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     and the Secretary of Health

[[Page S11561]]

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

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

       (a) Enhancement of Allowance Based Upon Mileage Traveled.--
     Section 111 is amended--
       (1) in subsection (a), by striking ``traveled,'' and 
     inserting ``(at a rate of 41.5 cents per mile),''; and
       (2) by amending subsection (g) to read as follows:
       ``(g)(1) Beginning one year after the date of the enactment 
     of the Caregivers and Veterans Omnibus Health Services Act of 
     2009, the Secretary may adjust the mileage rate described in 
     subsection (a) to be equal to the mileage reimbursement rate 
     for the use of privately owned vehicles by Government 
     employees on official business (when a Government vehicle is 
     available), as prescribed by the Administrator of General 
     Services under section 5707(b) of title 5.
       ``(2) If an adjustment in the mileage rate under paragraph 
     (1) results in a lower mileage rate than the mileage rate 
     otherwise specified in subsection (a), the Secretary shall, 
     not later than 60 days before the date of the implementation 
     of the mileage rate as so adjusted, submit to Congress a 
     written report setting forth the adjustment in the mileage 
     rate under this subsection, together with a justification for 
     the decision to make the adjustment in the mileage rate under 
     this subsection.''.
       (b) Coverage of Cost of Transportation by Air.--Subsection 
     (a) of section 111, as amended by subsection (a)(1), is 
     further amended by inserting after the first sentence the 
     following new sentence: ``Actual necessary expense of travel 
     includes the reasonable costs of airfare if travel by air is 
     the only practical way to reach a Department facility.''.
       (c) Elimination of Limitation Based on Maximum Annual Rate 
     of Pension.--Subsection (b)(1)(D)(i) of such section is 
     amended by inserting ``who is not traveling by air and'' 
     before ``whose annual''.
       (d) Determination of Practicality.--Subsection (b) of such 
     section is amended by adding at the end the following new 
     paragraph:
       ``(4) In determining for purposes of subsection (a) whether 
     travel by air is the only practical way for a veteran to 
     reach a Department facility, the Secretary shall consider the 
     medical condition of the veteran and any other impediments to 
     the use of ground transportation by the veteran.''.
       (e) No Expansion of Eligibility for Beneficiary Travel.--
     The amendments made by subsections (b) and (d) of this 
     section may not be construed as expanding or otherwise 
     modifying eligibility for payments or allowances for 
     beneficiary travel under section 111 of title 38, United 
     States Code, as in effect on the day before the date of the 
     enactment of this Act.
       (f) Clarification of Relation to Public Transportation in 
     Veterans Health Administration Handbook.--Not later than 30 
     days after the date of the enactment of this Act, the 
     Secretary of Veterans Affairs shall revise the Veterans 
     Health Administration Handbook to clarify that an allowance 
     for travel based on mileage paid under section 111(a) of 
     title 38, United States Code, may exceed the cost of such 
     travel by public transportation regardless of medical 
     necessity.

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

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

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

       (a) In General.--Subchapter I of chapter 17 is amended by 
     inserting after section 1703 the following new section:

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

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

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

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

       (a) Volunteer Counselors.--
       (1) In general.--Subsection (c) of section 1712A is 
     amended--
       (A) by striking ``The Under Secretary'' and inserting ``(1) 
     The Under Secretary'';
       (B) in paragraph (1), as designated by paragraph (1), by 
     striking ``, and, in carrying'' and all that follows through 
     ``screening activities''; and
       (C) by adding at the end the following new paragraphs:
       ``(2) In carrying out this section, the Under Secretary may 
     utilize the services of the following:

[[Page S11562]]

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

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

       (a) In General.--Subchapter II of chapter 73, as amended by 
     section 307 of this Act, is further amended by adding at the 
     end the following new section:

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

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

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

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

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

[[Page S11563]]

       (i) Collections From Third Parties.--In carrying out the 
     pilot program for the purpose described in subsection (a)(2), 
     the Secretary shall implement a variety and range of 
     requirements and mechanisms for the collection from third-
     party payors of amounts to reimburse the Department for 
     health care services provided to nonveterans under the pilot 
     program by eligible physicians discharging inpatient 
     responsibilities under the pilot program.
       (j) Inpatient Responsibilities Defined.--In this section, 
     the term ``inpatient responsibilities'' means on-call 
     responsibilities customarily required of a physician by a 
     community hospital as a condition of granting privileges to 
     the physician to practice in the hospital.
       (k) Report.--Not later than one year after the date of the 
     enactment of this Act and annually thereafter, the Secretary 
     shall submit to Congress a report on the pilot program, 
     including the following:
       (1) The findings of the Secretary with respect to the pilot 
     program.
       (2) The number of veterans and nonveterans provided 
     inpatient care by physicians participating in the pilot 
     program.
       (3) The amounts collected and payable under subsection (i).
       (l) Health Professional Shortage Area Defined.--In this 
     section, the term ``health professional shortage area'' has 
     the meaning given the term in section 332(a) of the Public 
     Health Service Act (42 U.S.C. 254e(a)).

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

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

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

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

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

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

                  TITLE IV--MENTAL HEALTH CARE MATTERS

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

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

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

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

     SEC. 403. STUDY ON SUICIDES AMONG VETERANS.

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

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

       (a) Transfer of Funds.--Not later than September 30, 2010, 
     the Secretary of Veterans Affairs shall transfer $5,000,000 
     from accounts of the Veterans Health Administration to the 
     Secretary of Health and Human Services for the Graduate 
     Psychology Education program established under section 
     755(b)(1)(J) of the Public Health Service Act (42 U.S.C. 
     294e(b)(1)(J)).
       (b) Use of Funds Transferred.--Funds transferred under 
     subsection (a) shall be used

[[Page S11564]]

     to award grants to support the training of psychologists in 
     the treatment of veterans with post traumatic stress 
     disorder, traumatic brain injury, and other combat-related 
     disorders.
       (c) Preference for Department of Veterans Affairs Health 
     Care Facilities.--In the awarding of grants under subsection 
     (b), the Graduate Psychology Education program shall give 
     preference to health care facilities of the Department of 
     Veterans Affairs and graduate programs of education that are 
     affiliated with such facilities.

                   TITLE V--OTHER HEALTH CARE MATTERS

     SEC. 501. REPEAL OF CERTAIN ANNUAL REPORTING REQUIREMENTS.

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

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

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

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

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

     SEC. 504. DISCLOSURES FROM CERTAIN MEDICAL RECORDS.

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

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

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

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

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

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

     SEC. 506. ENHANCEMENT OF QUALITY MANAGEMENT.

       (a) Enhancement of Quality Management Through Quality 
     Management Officers.--
       (1) In general.--Subchapter II of chapter 73 is amended by 
     inserting after section 7311 the following new section:

     ``Sec. 7311A. Quality management officers

       ``(a) National Quality Management Officer.--(1) The Under 
     Secretary for Health shall designate an official of the 
     Veterans Health Administration to act as the principal 
     quality management officer for the quality-assurance program 
     required by section 7311 of this title. The official so 
     designated may be known as the `National Quality Management 
     Officer of the Veterans Health Administration' (in this 
     section referred to as the `National Quality Management 
     Officer').
       ``(2) The National Quality Management Officer shall report 
     directly to the Under Secretary for Health in the discharge 
     of responsibilities and duties of the Officer under this 
     section.
       ``(3) The National Quality Management Officer shall be the 
     official within the Veterans Health Administration who is 
     principally responsible for the quality-assurance program 
     referred to in paragraph (1). In carrying out that 
     responsibility, the Officer shall be responsible for the 
     following:
       ``(A) Establishing and enforcing the requirements of the 
     program referred to in paragraph (1).
       ``(B) Developing an aggregate quality metric from existing 
     data sources, such as the Inpatient Evaluation Center of the 
     Department, the National Surgical Quality Improvement 
     Program, and the External Peer Review Program of the Veterans 
     Health Administration, that could be used to assess reliably 
     the quality of care provided at individual Department medical 
     centers and associated community based outpatient clinics.
       ``(C) Ensuring that existing measures of quality, including 
     measures from the Inpatient Evaluation Center, the National 
     Surgical Quality Improvement Program, System-Wide Ongoing 
     Assessment and Review reports of the Department, and Combined 
     Assessment Program reviews of the Office of Inspector General 
     of the Department, are monitored routinely and analyzed in a 
     manner that ensures the timely detection of quality of care 
     issues.
       ``(D) Encouraging research and development in the area of 
     quality metrics for the purposes of improving how the 
     Department measures quality in individual facilities.
       ``(E) Carrying out such other responsibilities and duties 
     relating to quality management in the Veterans Health 
     Administration as the Under Secretary for Health shall 
     specify.
       ``(4) The requirements under paragraph (3) shall include 
     requirements regarding the following:
       ``(A) A confidential system for the submittal of reports by 
     Veterans Health Administration personnel regarding quality 
     management at Department facilities.
       ``(B) Mechanisms for the peer review of the actions of 
     individuals appointed in the Veterans Health Administration 
     in the position of physician.
       ``(b) Quality Management Officers for VISNs.--(1) The 
     Regional Director of each Veterans Integrated Services 
     Network (VISN) shall appoint an official of the Network to 
     act as the quality management officer of the Network.
       ``(2) The quality management officer for a Veterans 
     Integrated Services Network shall report to the Regional 
     Director of the Veterans Integrated Services Network, and to 
     the National Quality Management Officer, regarding the 
     discharge of the responsibilities and duties of the officer 
     under this section.
       ``(3) The quality management officer for a Veterans 
     Integrated Services Network shall--
       ``(A) direct the quality management office in the Network; 
     and
       ``(B) coordinate, monitor, and oversee the quality 
     management programs and activities of the Administration 
     medical facilities in the Network in order to ensure the 
     thorough and uniform discharge of quality management 
     requirements under such programs and activities throughout 
     such facilities.
       ``(c) Quality Management Officers for Medical Facilities.--
     (1) The director of each Veterans Health Administration 
     medical facility shall appoint a quality management officer 
     for that facility.
       ``(2) The quality management officer for a facility shall 
     report directly to the director of the facility, and to the 
     quality management officer of the Veterans Integrated

[[Page S11565]]

     Services Network in which the facility is located, regarding 
     the discharge of the responsibilities and duties of the 
     quality management officer under this section.
       ``(3) The quality management officer for a facility shall 
     be responsible for designing, disseminating, and implementing 
     quality management programs and activities for the facility 
     that meet the requirements established by the National 
     Quality Management Officer under subsection (a).
       ``(d) Authorization of Appropriations.--(1) Except as 
     provided in paragraph (2), there are authorized to be 
     appropriated such sums as may be necessary to carry out this 
     section.
       ``(2) There are authorized to be appropriated to carry out 
     the provisions of subparagraphs (B), (C), and (D) of 
     subsection (a)(3), $25,000,000 for the two-year period of 
     fiscal years beginning after the date of the enactment of 
     this section.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 73 is amended by inserting after the 
     item relating to section 7311 the following new item:

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

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

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

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

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

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

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

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

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

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

       Section 1710E is amended--
       (1) by redesignating subsection (b) as subsection (c);
       (2) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b) Covered Individuals.--The care and services provided 
     under subsection (a) shall be made available to an 
     individual--
       ``(1) who is described in section 1710C(a) of this title; 
     and
       ``(2)(A) to whom the Secretary is unable to provide such 
     treatment or services at the frequency or for the duration 
     prescribed in such plan; or
       ``(B) for whom the Secretary determines that it is optimal 
     with respect to the recovery and rehabilitation for such 
     individual.''; and

[[Page S11566]]

       (3) by adding at the end the following new subsection:
       ``(d) Standards.--The Secretary may not provide treatment 
     or services as described in subsection (a) at a non-
     Department facility under such subsection unless such 
     facility maintains standards for the provision of such 
     treatment or services established by an independent, peer-
     reviewed organization that accredits specialized 
     rehabilitation programs for adults with traumatic brain 
     injury.''.

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

       (a) Treatment of Tribal Organization Health Facilities as 
     State Homes.--Section 8138 is amended--
       (1) by redesignating subsection (e) as subsection (f); and
       (2) by inserting after subsection (d) the following new 
     subsection (e):
       ``(e)(1) A health facility (or certain beds in a health 
     facility) of a tribal organization is treatable as a State 
     home under subsection (a) in accordance with the provisions 
     of that subsection.
       ``(2) Except as provided in paragraph (3), the provisions 
     of this section shall apply to a health facility (or certain 
     beds in such facility) treated as a State home under 
     subsection (a) by reason of this subsection to the same 
     extent as health facilities (or beds) treated as a State home 
     under subsection (a).
       ``(3) Subsection (f) shall not apply to the treatment of 
     health facilities (or certain beds in such facilities) of 
     tribal organizations as a State home under subsection (a).''.
       (b) State Home Facilities for Domiciliary, Nursing, and 
     Other Care.--
       (1) In general.--Chapter 81 is further amended--
       (A) in section 8131, by adding at the end the following new 
     paragraph:
       ``(5) The term `tribal organization' has the meaning given 
     such term in section 3765 of this title.'';
       (B) in section 8132, by inserting ``and tribal 
     organizations'' after ``the several States''; and
       (C) by inserting after section 8133 the following new 
     section:

     ``Sec. 8133A. Tribal organizations

       ``(a) Authority To Award Grants.--The Secretary may award a 
     grant to a tribal organization under this subchapter in order 
     to carry out the purposes of this subchapter.
       ``(b) Manner and Condition of Grant Awards.--(1) Grants to 
     tribal organizations under this section shall be awarded in 
     the same manner, and under the same conditions, as grants 
     awarded to the several States under the provisions of this 
     subchapter, subject to such exceptions as the Secretary shall 
     prescribe for purposes of this subchapter to take into 
     account the unique circumstances of tribal organizations.
       ``(2) For purposes of according priority under subsection 
     (c)(2) of section 8135 of this title to an application 
     submitted under subsection (a) of such section, an 
     application submitted under such subsection (a) by a tribal 
     organization of a State that has previously applied for award 
     of a grant under this subchapter for construction or 
     acquisition of a State nursing home shall be considered under 
     subparagraph (C) of such subsection (c)(2) an application 
     from a tribal organization that has previously applied for 
     such a grant.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 81 is amended by inserting after the 
     item relating to section 8133 the following new item:

``8133A. Tribal organizations.''.

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

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

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

       (a) Expansion of Eligibility.--Subsection (b)(3)(C) of 
     section 1725 is amended by striking ``, in whole or in 
     part,''.
       (b) Limitations on Reimbursement.--Section 1725 is further 
     amended--
       (1) in subsection (c), by adding at the end the following 
     new paragraph:
       ``(4)(A) If the veteran has contractual or legal recourse 
     against a third party that would, in part, extinguish the 
     veteran's liability to the provider of the emergency 
     treatment and payment for the treatment may be made both 
     under subsection (a) and by the third party, the amount 
     payable for such treatment under such subsection shall be the 
     amount by which the costs for the emergency treatment exceed 
     the amount payable or paid by the third party, except that 
     the amount payable may not exceed the maximum amount payable 
     established under paragraph (1)(A).
       ``(B) In any case in which a third party is financially 
     responsible for part of the veteran's emergency treatment 
     expenses, the Secretary shall be the secondary payer.
       ``(C) A payment in the amount payable under subparagraph 
     (A) shall be considered payment in full and shall extinguish 
     the veteran's liability to the provider.
       ``(D) The Secretary may not reimburse a veteran under this 
     section for any copayment or similar payment that the veteran 
     owes the third party or for which the veteran is responsible 
     under a health-plan contract.''; and
       (2) in subsection (f)(3)--
       (A) in subparagraph (A), by inserting before the period at 
     the end the following: ``, including the Secretary of Health 
     and Human Services with respect to the Medicare program under 
     title XVIII of the Social Security Act (42 U.S.C. 1395 et 
     seq.) and the Medicaid program under title XIX of such Act 
     (42 U.S.C. 1396 et seq.)''; and

[[Page S11567]]

       (B) in subparagraph (B), by inserting before the period at 
     the end the following: ``, including a State Medicaid agency 
     with respect to payments made under a State plan for medical 
     assistance approved under title XIX of such Act (42 U.S.C. 
     1396 et seq.)''.
       (c) Effective Date.--
       (1) In general.--The amendments made by subsections (a) and 
     (b) shall take effect on the date of the enactment of this 
     Act, and shall apply with respect to emergency treatment 
     furnished on or after that date.
       (2) Reimbursement for treatment before effective date.--The 
     Secretary of Veterans Affairs may provide reimbursement under 
     section 1725 of title 38, United States Code, as amended by 
     this subsection, for emergency treatment furnished before the 
     date of the enactment of this Act if the Secretary determines 
     that, under the circumstances applicable with respect to the 
     veteran, it is appropriate to do so.

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

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

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

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

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

                 TITLE VI--DEPARTMENT PERSONNEL MATTERS

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

       (a) Secretarial Authority To Extend Title 38 Status to 
     Additional Positions.--
       (1) In general.--Paragraph (3) of section 7401 is amended 
     by striking ``and blind rehabilitation outpatient 
     specialists.'' and inserting the following: ``blind 
     rehabilitation outpatient specialists, and such other classes 
     of health care occupations as the Secretary considers 
     necessary for the recruitment and retention needs of the 
     Department subject to the following requirements:
       ``(A) Such other classes of health care occupations--
       ``(i) are not occupations relating to administrative, 
     clerical, or physical plant maintenance and protective 
     services;
       ``(ii) that would otherwise receive basic pay in accordance 
     with the General Schedule under section 5332 of title 5;
       ``(iii) provide, as determined by the Secretary, direct 
     patient care services or services incident to direct patient 
     services; and
       ``(iv) would not otherwise be available to provide medical 
     care or treatment for veterans.
       ``(B) Not later than 45 days before the Secretary appoints 
     any personnel for a class of health care occupations that is 
     not specifically listed in this paragraph, the Secretary 
     shall submit to the Committee on Veterans' Affairs of the 
     Senate, the Committee on Veterans' Affairs of the House of 
     Representatives, and the Office of Management and Budget 
     notice of such appointment.
       ``(C) Before submitting notice under subparagraph (B), the 
     Secretary shall solicit comments from any labor organization 
     representing employees in such class and include such 
     comments in such notice.''.
       (2) Appointment of nurse assistants.--Such paragraph is 
     further amended by inserting ``nurse assistants,'' after 
     ``licensed practical or vocational nurses,''.
       (b) Probationary Periods for Registered Nurses.--Section 
     7403(b) is amended--
       (1) in paragraph (1), by striking ``Appointments'' and 
     inserting ``Except as otherwise provided in this subsection, 
     appointments'';
       (2) by redesignating paragraph (2) as paragraph (4); and
       (3) by inserting after paragraph (1) the following new 
     paragraphs:
       ``(2) With respect to the appointment of a registered nurse 
     under this chapter, paragraph (1) shall apply with respect to 
     such appointment regardless of whether such appointment is on 
     a full-time basis or a part-time basis.
       ``(3) An appointment described in subsection (a) on a part-
     time basis of a person who has previously served on a full-
     time basis for the probationary period for the position 
     concerned shall be without a probationary period.''.
       (c) Prohibition on Temporary Part-time Registered Nurse 
     Appointments in Excess of Two Years.--Section 7405 is amended 
     by adding at the end the following new subsection:
       ``(g)(1) Except as provided in paragraph (3), employment of 
     a registered nurse on a temporary part-time basis under 
     subsection (a)(1) shall be for a probationary period of two 
     years.
       ``(2) Except as provided in paragraph (3), upon completion 
     by a registered nurse of the probationary period described in 
     paragraph (1)--
       ``(A) the employment of such nurse shall--
       ``(i) no longer be considered temporary; and
       ``(ii) be considered an appointment described in section 
     7403(a) of this title; and
       ``(B) the nurse shall be considered to have served the 
     probationary period required by section 7403(b).
       ``(3) This subsection shall not apply to appointments made 
     on a term limited basis of less than or equal to three years 
     of--
       ``(A) nurses with a part-time appointment resulting from an 
     academic affiliation or teaching position in a nursing 
     academy of the Department;
       ``(B) nurses appointed as a result of a specific research 
     proposal or grant; or
       ``(C) nurses who are not citizens of the United States and 
     appointed under section 7407(a) of this title.''.
       (d) Waiver of Offset From Pay for Certain Reemployed 
     Annuitants.--
       (1) In general.--Section 7405, as amended by subsection 
     (c), is further amended by adding at the end the following 
     new subsection:
       ``(h)(1) The Secretary may waive the application of 
     sections 8344 and 8468 of title 5 (relating to annuities and 
     pay on reemployment) or any other similar provision of law 
     under a Government retirement system on a case-by-case basis 
     for an annuitant reemployed on a temporary basis under the 
     authority of subsection (a) in a position described under 
     paragraph (1) of that subsection.
       ``(2) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall not be considered an employee for purposes of 
     any Government retirement system.
       ``(3) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall be subject to the provisions of chapter 71 of 
     title 5 (including all labor authority and labor 
     representative collective bargaining agreements) applicable 
     to the position to which appointed.
       ``(4) In this subsection:
       ``(A) The term `annuitant' means an annuitant under a 
     Government retirement system.
       ``(B) The term `employee' has the meaning under section 
     2105 of title 5.
       ``(C) The term `Government retirement system' means a 
     retirement system established by law for employees of the 
     Government of the United States.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall take effect on the date that is 180 days after the date 
     of the enactment of this Act, and shall apply to pay periods 
     beginning on or after such effective date.
       (e) Rate of Basic Pay for Appointees to the Office of the 
     Under Secretary for Health Set to Rate of Basic Pay for 
     Senior Executive Service Positions.--
       (1) In general.--Section 7404(a) is amended--
       (A) by striking ``The annual'' and inserting ``(1) The 
     annual'';
       (B) by striking ``The pay'' and inserting the following:
       ``(2) The pay'';
       (C) by striking ``under the preceding sentence'' and 
     inserting ``under paragraph (1)''; and
       (D) by adding at the end the following new paragraph:
       ``(3)(A) The rate of basic pay for a position to which an 
     Executive order applies under paragraph (1) and is not 
     described by paragraph (2) shall be set in accordance with 
     section 5382 of title 5 as if such position were a Senior 
     Executive Service position (as such term is defined in 
     section 3132(a) of title 5).
       ``(B) A rate of basic pay for a position may not be set 
     under subparagraph (A) in excess of--
       ``(i) in the case the position is not described in clause 
     (ii), the rate of basic pay payable for level III of the 
     Executive Schedule; or
       ``(ii) in the case that the position is covered by a 
     performance appraisal system that meets the certification 
     criteria established by regulation under section 5307(d) of 
     title 5, the rate of basic pay payable for level II of the 
     Executive Schedule.
       ``(C) Notwithstanding the provisions of subsection (d) of 
     section 5307 of title 5, the Secretary may make any 
     certification under that subsection instead of the Office of 
     Personnel Management and without concurrence of the Office of 
     Management and Budget.''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall take effect on the first day of the first pay period 
     beginning after the day that is 180 days after the date of 
     the enactment of this Act.
       (f) Special Incentive Pay for Department Pharmacist 
     Executives.--Section 7410 is amended--
       (1) by striking ``The Secretary may'' and inserting the 
     following:
       ``(a) In General.--The Secretary may''; and
       (2) by adding at the end the following new subsection:
       ``(b) Special Incentive Pay for Department Pharmacist 
     Executives.--(1) In order to recruit and retain highly 
     qualified Department pharmacist executives, the Secretary may 
     authorize the Under Secretary for Health to pay special 
     incentive pay of not more than $40,000 per year to an 
     individual of the Veterans Health Administration who is a 
     pharmacist executive.
       ``(2) In determining whether and how much special pay to 
     provide to such individual, the Under Secretary shall 
     consider the following:
       ``(A) The grade and step of the position of the individual.
       ``(B) The scope and complexity of the position of the 
     individual.

[[Page S11568]]

       ``(C) The personal qualifications of the individual.
       ``(D) The characteristics of the labor market concerned.
       ``(E) Such other factors as the Secretary considers 
     appropriate.
       ``(3) Special incentive pay under paragraph (1) for an 
     individual is in addition to all other pay (including basic 
     pay) and allowances to which the individual is entitled.
       ``(4) Except as provided in paragraph (5), special 
     incentive pay under paragraph (1) for an individual shall be 
     considered basic pay for all purposes, including retirement 
     benefits under chapters 83 and 84 of title 5, and other 
     benefits.
       ``(5) Special incentive pay under paragraph (1) for an 
     individual shall not be considered basic pay for purposes of 
     adverse actions under subchapter V of this chapter.
       ``(6) Special incentive pay under paragraph (1) may not be 
     awarded to an individual in an amount that would result in an 
     aggregate amount of pay (including bonuses and awards) 
     received by such individual in a year under this title that 
     is greater than the annual pay of the President.''.
       (g) Pay for Physicians and Dentists.--
       (1) Non-foreign cost of living adjustment allowance.--
     Section 7431(b) is amended by adding at the end the following 
     new paragraph:
       ``(5) The non-foreign cost of living adjustment allowance 
     authorized under section 5941 of title 5 for physicians and 
     dentists whose pay is set under this section shall be 
     determined as a percentage of base pay only.''.
       (2) Market pay determinations for physicians and dentists 
     in administrative or executive leadership positions.--Section 
     7431(c)(4)(B)(i) is amended by adding at the end the 
     following: ``The Secretary may exempt physicians and dentists 
     occupying administrative or executive leadership positions 
     from the requirements of the previous sentence.''.
       (3) Exception to prohibition on reduction of market pay.--
     Section 7431(c)(7) is amended by striking ``concerned.'' and 
     inserting ``concerned, unless there is a change in board 
     certification or reduction of privileges.''.
       (h) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) 
     is amended by striking ``level V'' and inserting ``level 
     IV''.
       (i) Exemption for Certified Registered Nurse Anesthetists 
     From Limitation on Authorized Competitive Pay.--Section 
     7451(c)(2) is further amended by adding at the end the 
     following new sentence: ``The maximum rate of basic pay for a 
     grade for the position of certified registered nurse 
     anesthetist pursuant to an adjustment under subsection (d) 
     may exceed the maximum rate otherwise provided in the 
     preceding sentence.''.
       (j) Increased Limitation on Special Pay for Nurse 
     Executives.--Section 7452(g)(2) is amended by striking 
     ``$25,000'' and inserting ``$100,000''.
       (k) Locality Pay Scale Computations.--
       (1) Education, training, and support for facility directors 
     in wage surveys.--Section 7451(d)(3) is amended by adding at 
     the end the following new subparagraph:
       ``(F) The Under Secretary for Health shall provide 
     appropriate education, training, and support to directors of 
     Department health care facilities in the conduct and use of 
     surveys, including the use of third-party surveys, under this 
     paragraph.''.
       (2) Information on methodology used in wage surveys.--
     Section 7451(e)(4) is amended--
       (A) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (B) by inserting after subparagraph (C) the following new 
     subparagraph (D):
       ``(D) In any case in which the director conducts such a 
     wage survey during the period covered by the report and makes 
     adjustment in rates of basic pay applicable to one or more 
     covered positions at the facility, information on the 
     methodology used in making such adjustment or adjustments.''.
       (3) Disclosure of information to persons in covered 
     positions.--Section 7451(e), as amended by paragraph (2) of 
     this subsection, is further amended by adding at the end the 
     following new paragraph:
       ``(6)(A) Upon the request of an individual described in 
     subparagraph (B) for a report provided under paragraph (4) 
     with respect to a Department health-care facility, the Under 
     Secretary for Health or the director of such facility shall 
     provide to the individual the most current report for such 
     facility provided under such paragraph.
       ``(B) An individual described in this subparagraph is--
       ``(i) an individual in a covered position at a Department 
     health-care facility; or
       ``(ii) a representative of the labor organization 
     representing that individual who is designated by that 
     individual to make the request.''.
       (l) Eligibility of Part-Time Nurses for Additional Nurse 
     Pay.--
       (1) In general.--Section 7453 is amended--
       (A) in subsection (a), by striking ``a nurse'' and 
     inserting ``a full-time nurse or part-time nurse'';
       (B) in subsection (b)--
       (i) in the first sentence--

       (I) by striking ``on a tour of duty'';
       (II) by striking ``service on such tour'' and inserting 
     ``such service''; and
       (III) by striking ``of such tour'' and inserting ``of such 
     service''; and

       (ii) in the second sentence, by striking ``of such tour'' 
     and inserting ``of such service'';
       (C) in subsection (c)--
       (i) by striking ``on a tour of duty''; and
       (ii) by striking ``service on such tour'' and inserting 
     ``such service''; and
       (D) in subsection (e)--
       (i) in paragraph (1), by striking ``eight hours in a day'' 
     and inserting ``eight consecutive hours''; and
       (ii) in paragraph (5)(A), by striking ``tour of duty'' and 
     inserting ``period of service''.
       (2) Exclusion of application of additional nurse pay 
     provisions to certain additional employees.--Paragraph (3) of 
     section 7454(b) is amended to read as follows:
       ``(3) Employees appointed under section 7408 of this title 
     performing service on a tour of duty, any part of which is 
     within the period commencing at midnight Friday and ending at 
     midnight Sunday, shall receive additional pay in addition to 
     the rate of basic pay provided such employees for each hour 
     of service on such tour at a rate equal to 25 percent of such 
     employee's hourly rate of basic pay.''.
       (m) Enhanced Authority To Increase Rates of Basic Pay To 
     Obtain or Retain Services of Certain Persons.--Section 
     7455(c) is amended to read as follows:
       ``(c)(1) Subject to paragraph (2), the amount of any 
     increase under subsection (a) in the minimum rate for any 
     grade may not (except in the case of nurse anesthetists, 
     licensed practical nurses, licensed vocational nurses, 
     nursing positions otherwise covered by title 5, pharmacists, 
     and licensed physical therapists) exceed the maximum rate of 
     basic pay (excluding any locality-based comparability payment 
     under section 5304 of title 5 or similar provision of law) 
     for the grade or level by more than 30 percent.
       ``(2) No rate may be established under this section in 
     excess of the rate of basic pay payable for level IV of the 
     Executive Schedule.''.

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

       (a) Overtime Duty.--
       (1) In general.--Subchapter IV of chapter 74 is amended by 
     adding at the end the following new section:

     ``Sec. 7459. Nursing staff: special rules for overtime duty

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

``7459. Nursing staff: special rules for overtime duty.''.
       (b) Weekend Duty.--Section 7456 is amended--
       (1) by striking subsection (c); and
       (2) by redesignating subsection (d) as subsection (c).
       (c) Alternate Work Schedules.--
       (1) In general.--Section 7456A(b)(1)(A) is amended by 
     striking ``three regularly scheduled'' and all that follows 
     through the period at the end and inserting ``six regularly 
     scheduled 12-hour tours of duty within a 14-day period shall 
     be considered for all purposes to have worked a full 80-hour 
     pay period.''.
       (2) Conforming amendments.--Section 7456A(b) is amended--

[[Page S11569]]

       (A) in the subsection heading, by striking ``36/40'' and 
     inserting ``72/80'';
       (B) in paragraph (2)--
       (i) in subparagraph (A), by striking ``40-hour basic work 
     week'' and inserting ``80-hour pay period'';
       (ii) in subparagraph (B), by striking ``regularly scheduled 
     36-hour tour of duty within the work week'' and inserting 
     ``scheduled 72-hour tour of duty within the bi-weekly pay 
     period'';
       (iii) in subparagraph (C)--

       (I) in clause (i), by striking ``regularly scheduled 36-
     hour tour of duty within an administrative work week'' and 
     inserting ``scheduled 72-hour tour of duty within an 
     administrative pay period'';
       (II) in clause (ii), by striking ``regularly''; and
       (III) in clause (iii), by striking ``regularly scheduled 
     36-hour tour of duty work week'' and inserting ``scheduled 
     72-hour tour of duty pay period''; and

       (iv) in subparagraph (D), by striking ``regularly''; and
       (C) in paragraph (3), by striking ``regularly''.

     SEC. 603. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE 
                   PROGRAMS.

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

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

       (a) Standards.--
       (1) In general.--Subchapter I of chapter 74 is amended by 
     inserting after section 7402 the following new section:

     ``Sec. 7402A. Appointment and practice of physicians: 
       standards

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

[[Page S11570]]

       ``(g) Encouraging Hiring of Physicians With Board 
     Certification.--(1) The Secretary shall, for each performance 
     contract with a Director of a Veterans Integrated Services 
     Network (VISN), include in such contract a provision that 
     encourages such director to hire physicians who are board 
     eligible or board certified in the specialty in which the 
     physicians will practice.
       ``(2) The Secretary may determine the nature and manner of 
     the provision described in paragraph (1).''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 74 is amended by inserting after the 
     item relating to section 7402 the following new item:

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

                  TITLE VII--HOMELESS VETERANS MATTERS

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

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

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

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

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

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

     SEC. 704. ASSESSMENT OF PILOT PROGRAMS.

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

       TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

     SEC. 801. GENERAL AUTHORITIES ON ESTABLISHMENT OF 
                   CORPORATIONS.

       (a) Authorization of Multi-medical Center Research 
     Corporations.--
       (1) In general.--Section 7361 is amended--
       (A) by redesignating subsection (b) as subsection (e); and
       (B) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b)(1) Subject to paragraph (2), a corporation 
     established under this subchapter may facilitate the conduct 
     of research, education, or both at more than one medical 
     center. Such a corporation shall be known as a `multi-medical 
     center research corporation'.
       ``(2) The board of directors of a multi-medical center 
     research corporation under this subsection shall include the 
     official at each Department medical center concerned who is, 
     or who carries out the responsibilities of, the medical 
     center director of such center as specified in section 
     7363(a)(1)(A)(i) of this title.
       ``(3) In facilitating the conduct of research, education, 
     or both at more than one Department medical center under this 
     subchapter, a multi-medical center research corporation may 
     administer receipts and expenditures relating to such 
     research, education, or both, as applicable, performed at the 
     Department medical centers concerned.''.
       (2) Expansion of existing corporations to multi-medical 
     center research corporations.--Such section is further 
     amended by adding at the end the following new subsection:
       ``(f) A corporation established under this subchapter may 
     act as a multi-medical center research corporation under this 
     subchapter in accordance with subsection (b) if--
       ``(1) the board of directors of the corporation approves a 
     resolution permitting facilitation by the corporation of the 
     conduct of

[[Page S11571]]

     research, education, or both at the other Department medical 
     center or medical centers concerned; and
       ``(2) the Secretary approves the resolution of the 
     corporation under paragraph (1).''.
       (b) Restatement and Modification of Authorities on 
     Applicability of State Law.--
       (1) In general.--Section 7361, as amended by subsection (a) 
     of this section, is further amended by inserting after 
     subsection (b) the following new subsection (c):
       ``(c) Any corporation established under this subchapter 
     shall be established in accordance with the nonprofit 
     corporation laws of the State in which the applicable 
     Department medical center is located and shall, to the extent 
     not inconsistent with any Federal law, be subject to the laws 
     of such State. In the case of any multi-medical center 
     research corporation that facilitates the conduct of 
     research, education, or both at Department medical centers 
     located in different States, the corporation shall be 
     established in accordance with the nonprofit corporation laws 
     of the State in which one of such Department medical centers 
     is located.''.
       (2) Conforming amendment.--Section 7365 is repealed.
       (c) Clarification of Status of Corporations.--Section 7361, 
     as amended by this section, is further amended--
       (1) in subsection (a), by striking the second sentence; and
       (2) by inserting after subsection (c) the following new 
     subsection (d):
       ``(d)(1) Except as otherwise provided in this subchapter or 
     under regulations prescribed by the Secretary, any 
     corporation established under this subchapter, and its 
     officers, directors, and employees, shall be required to 
     comply only with those Federal laws, regulations, and 
     executive orders and directives that apply generally to 
     private nonprofit corporations.
       ``(2) A corporation under this subchapter is not--
       ``(A) owned or controlled by the United States; or
       ``(B) an agency or instrumentality of the United States.''.
       (d) Reinstatement of Requirement for 501(c)(3) Status of 
     Corporations.--Subsection (e) of section 7361, as 
     redesignated by subsection (a)(1) of this section, is further 
     amended by inserting ``section 501(c)(3) of'' after ``exempt 
     from taxation under''.

     SEC. 802. CLARIFICATION OF PURPOSES OF CORPORATIONS.

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

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

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

     SEC. 804. CLARIFICATION OF POWERS OF CORPORATIONS.

       (a) In General.--Section 7364 is amended to read as 
     follows:

     ``Sec. 7364. General powers

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

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

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

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

     SEC. 806. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF 
                   CORPORATIONS.

       (a) Additional Information in Annual Reports.--Subsection 
     (b) of section 7366 is amended to read as follows:
       ``(b)(1) Each corporation shall submit to the Secretary 
     each year a report providing a detailed statement of the 
     operations, activities, and accomplishments of the 
     corporation during that year.
       ``(2)(A) A corporation with revenues in excess of $300,000 
     for any year shall obtain an audit of the corporation for 
     that year.
       ``(B) A corporation with annual revenues between $10,000 
     and $300,000 shall obtain an audit of the corporation at 
     least once every three years.

[[Page S11572]]

       ``(C) Any audit under this paragraph shall be performed by 
     an independent auditor.
       ``(3) The corporation shall include in each report to the 
     Secretary under paragraph (1) the following:
       ``(A) The most recent audit of the corporation under 
     paragraph (2).
       ``(B) The most recent Internal Revenue Service Form 990 
     `Return of Organization Exempt from Income Tax' or equivalent 
     and the applicable schedules under such form.''.
       (b) Confirmation of Application of Conflict of Interest 
     Regulations to Appropriate Corporation Positions.--Subsection 
     (c) of such section is amended--
       (1) by striking ``laws and'' each place it appears;
       (2) in paragraph (1)--
       (A) by inserting ``each officer and'' after ``under this 
     subchapter,''; and
       (B) by striking ``, and each employee of the Department'' 
     and all that follows through ``during any year''; and
       (3) in paragraph (2)--
       (A) by inserting ``, officer,'' after ``verifying that each 
     director''; and
       (B) by striking ``in the same manner'' and all that follows 
     before the period at the end.
       (c) Establishment of Appropriate Payee Reporting 
     Threshold.--Subsection (d)(3)(C) of such section is amended 
     by striking ``$35,000'' and inserting ``$50,000''.

               TITLE IX--CONSTRUCTION AND NAMING MATTERS

     SEC. 901. AUTHORIZATION OF MEDICAL FACILITY PROJECTS.

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

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

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

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

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

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

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

                         TITLE X--OTHER MATTERS

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

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

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

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

  Mrs. MURRAY. Madam President, I move to reconsider the vote and I 
move to lay that motion on the table.
  The motion to lay on the table was agreed to.
  The PRESIDING OFFICER. The Senator from Washington is recognized.

[[Page S11573]]



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