[Congressional Record Volume 160, Number 32 (Wednesday, February 26, 2014)]
[Senate]
[Pages S1178-S1185]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           TEXT OF AMENDMENTS

  SA 2754. Mr. KAINE submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 33, after line 18, add the following:

     SEC. 207. COURSES UNDER EDUCATIONAL ASSISTANCE AUTHORITIES 
                   ADMINISTERED BY SECRETARY OF VETERANS AFFAIRS.

       (a) In General.--Section 3679 is amended by adding at the 
     end the following new subsection:
       ``(c) A course offered by an educational institution in a 
     State that is a required element of the curriculum to be 
     satisfied to obtain employment in an occupation or profession 
     requiring the approval or licensure of a board or agency of 
     that State may be treated as approved for purposes of this 
     chapter by an individual seeking to obtain employment in that 
     occupation or profession only if--
       ``(1) the successful completion of the curriculum fully 
     qualifies a student to--
       ``(A) take any examination required for entry into the 
     occupation or profession, including satisfying any State or 
     professionally mandated programmatic and specialized 
     accreditation requirements; and
       ``(B) be certified or licensed or meet any other 
     academically related pre-conditions that are required for 
     entry into the occupation or profession; and
       ``(2) in the case of State licensing or professionally 
     mandated requirements for entry into the occupation or 
     profession that require specialized accreditation, the 
     curriculum meets the requirement for specialized 
     accreditation through its accreditation or pre-accreditation 
     by an accrediting agency or association recognized by the 
     Secretary of Education or designated by that State as a 
     reliable authority as to the quality or training offered by 
     the institution in that program.''.
       (b) Effective Date.--The amendments made by this section 
     shall take effect on August 1, 2014, and shall apply with 
     respect to courses pursued on or after that date.

     SEC. 208. REVIVAL OF PROFESSIONAL CERTIFICATION AND LICENSURE 
                   ADVISORY COMMITTEE OF THE DEPARTMENT OF 
                   VETERANS AFFAIRS.

       (a) In General.--The Secretary of Veterans Affairs shall 
     reestablish the Professional Certification and Licensure 
     Advisory Committee of the Department of Veterans Affairs 
     provided for under section 3689(e) of title 38, United States 
     Code. The Committee shall be reestablished in accordance with 
     the provisions of such section 3689(e), as amended by 
     subsection (b), and shall carry out its duties in conformance 
     with, and subject to the requirements of such section, as so 
     amended.
       (b) Modification of Authorities and Requirements.--Section 
     3689(e) is amended--
       (1) in paragraph (2)--
       (A) by inserting ``(A)'' after ``(2)''; and
       (B) by adding at the end the following new subparagraph:
       ``(B) In addition to the duties under subparagraph (A), the 
     Committee shall--
       ``(i) develop, in coordination with other appropriate 
     agencies, guidance to be used by the Department or other 
     entities to perform periodic audits of licensure and 
     certification programs to ensure the highest quality 
     education is available to veterans and members of the Armed 
     Forces; and
       ``(ii) develop, in coordination with the Department of 
     Defense, appropriate certification agencies, and other 
     appropriate nonprofit organizations, a plan to improve 
     outreach to veterans and members of the Armed Forces on the 
     importance of licensing and certification, as well as 
     educational benefits available to them.'';
       (2) in paragraph (3)(B), by striking ``and the Secretary of 
     Defense'' and inserting ``the Secretary of Defense, and the 
     Secretary of Education'';
       (3) in paragraph (4), by striking subparagraph (B) and 
     inserting the following new subparagraph:
       ``(B) The Committee shall meet with such frequency as the 
     Committee determines appropriate.''; and
       (4) in paragraph (5), by striking ``December 31, 2006'' and 
     inserting ``December 31, 2019''.
       (c) Report.--Not later than 180 days after the date of the 
     reestablishment of the Professional Certification and 
     Licensure Advisory Committee of the Department of Veterans 
     Affairs pursuant to this section, the Committee shall submit 
     to Congress a report setting forth an assessment of the 
     feasibility and advisability of permitting members of the 
     Armed Forces to use educational assistance to which they are 
     entitled under chapters 30 and 33 of title 38, United States 
     Code, to obtain or pursue civilian employment certifications 
     or licenses without the use of such assistance for that 
     purpose being charged against the entitlement of such members 
     to such educational assistance.
                                 ______
                                 
  SA 2755. Mr. BOOZMAN (for himself and Mr. Begich) submitted an 
amendment intended to be proposed by him to the bill S. 1982, to 
improve the provision of medical services and benefits to veterans, and 
for other purposes; which was ordered to lie on the table; as follows:

       Beginning on page 233, strike line 20 and all that follows 
     through page 236, line 25, and insert the following:

     SEC. 504. ADVANCE APPROPRIATIONS FOR CERTAIN ACCOUNTS OF THE 
                   DEPARTMENT OF VETERANS AFFAIRS.

       (a) In General.--Section 117 is amended--
       (1) by striking ``medical care accounts of the Department'' 
     each place it appears and inserting ``covered accounts of the 
     Department'';
       (2) in subsection (c)--
       (A) by striking ``medical care accounts of the Veterans 
     Health Administration, Department of Veterans Affairs 
     account'' and inserting ``accounts of the Department of 
     Veterans Affairs account'';
       (B) in paragraph (1), by inserting ``Veterans Health 
     Administration,'' after ``(1)'';
       (C) in paragraph (2), by inserting ``Veterans Health 
     Administration,'' after ``(2)'';
       (D) in paragraph (3), by inserting ``Veterans Health 
     Administration,'' after ``(3)'';
       (E) by redesignating paragraphs (1) through (3) as 
     paragraphs (7) through (9), respectively;
       (F) by inserting before paragraph (7), as redesignated by 
     subparagraph (E), the following new paragraphs:
       ``(1) Veterans Benefits Administration, Compensation and 
     Pensions.
       ``(2) Veterans Benefits Administration, Readjustment 
     Benefits.
       ``(3) Veterans Benefits Administration, Veterans Insurance 
     and Indemnities.
       ``(4) Veterans Benefits Administration, Veterans Housing 
     Benefit Program Fund.
       ``(5) Veterans Benefits Administration, Vocational 
     Rehabilitation Loans Program Account.

[[Page S1179]]

       ``(6) Veterans Benefits Administration, Native American 
     Veteran Housing Loan Program Account.'';and
       (G) by adding at the end the following new paragraphs:
       ``(10) Veterans Health Administration, Medical and 
     Prosthetic Research.
       ``(11) National Cemetery Administration.
       ``(12) Departmental Administration, General Administration.
       ``(13) Departmental Administration, General Operating 
     Expenses, Veterans Benefits Administration.
       ``(14) Departmental Administration, Information Technology 
     Systems.
       ``(15) Departmental Administration, Office of Inspector 
     General.
       ``(16) Departmental Administration, Construction, Major 
     Projects.
       ``(17) Departmental Administration, Construction, Minor 
     Projects.
       ``(18) Departmental Administration, Grants for Construction 
     of State Extended Care Facilities.
       ``(19) Departmental Administration, Grants for Construction 
     of Veterans Cemeteries.'';
       (H) in the subsection heading, by striking ``Medical Care 
     Accounts'' and inserting ``Covered Accounts''; and
       (3) in the section heading, by striking ``CERTAIN MEDICAL 
     CARE ACCOUNTS'' and inserting ``CERTAIN ACCOUNTS''.
       (b) Effective Date.--The amendments made by subsection (a) 
     shall apply with respect to fiscal year 2016 and each 
     subsequent fiscal year.
       (c) Conforming Amendment.--Section 1105 of title 31, United 
     States Code, is amended by striking the first paragraph (37) 
     and inserting the following:
       ``(37) information on estimates of appropriations for the 
     fiscal year following the fiscal year for which the budget is 
     submitted for the following accounts of the Department of 
     Veterans Affairs:
       ``(A) Veterans Benefits Administration, Compensation and 
     Pensions.
       ``(B) Veterans Benefits Administration, Readjustment 
     Benefits.
       ``(C) Veterans Benefits Administration, Veterans Insurance 
     and Indemnities.
       ``(D) Veterans Benefits Administration, Veterans Housing 
     Benefit Program Fund.
       ``(E) Veterans Benefits Administration, Vocational 
     Rehabilitation Loans Program Account.
       ``(F) Veterans Benefits Administration, Native American 
     Veteran Housing Loan Program Account.
       ``(G) Veterans Health Administration, Medical Services.
       ``(H) Veterans Health Administration, Medical Support and 
     Compliance.
       ``(I) Veterans Health Administration, Medical Facilities.
       ``(J) Veterans Health Administration, Medical and 
     Prosthetic Research.
       ``(K) National Cemetery Administration.
       ``(L) Departmental Administration, General Administration.
       ``(M) Departmental Administration, General Operating 
     Expenses, Veterans Benefits Administration.
       ``(N) Departmental Administration, Information Technology 
     Systems.
       ``(O) Departmental Administration, Office of the Inspector 
     General.
       ``(P) Departmental Administration, Construction, Major 
     Projects.
       ``(Q) Departmental Administration, Construction, Minor 
     Projects.
       ``(R) Departmental Administration, Grants for Construction 
     of State Extended Care Facilities.
       ``(S) Departmental Administration, Grants for Construction 
     of Veterans Cemeteries.''.
       (d) Technical Correction.--Such section is further amended 
     by redesignating the second paragraph (37), as added by 
     section 11(a)(2) of the GPRA Modernization Act of 2010 
     (Public Law 111-352; 124 Stat. 3881), as paragraph (39).
                                 ______
                                 
  SA 2756. Mr. HELLER submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 291, after line 21, add the following:

                       Subtitle E--Other Matters

     SEC. 641. IMPROVEMENTS TO AUTHORITY FOR PERFORMANCE OF 
                   MEDICAL DISABILITIES EXAMINATIONS BY CONTRACT 
                   PHYSICIAN.

       (a) Extension of Temporary Authority.--Subsection (c) of 
     section 704 of the Veterans Benefits Act of 2003 (Public Law 
     108-183; 38 U.S.C. 5101 note) is amended by striking 
     ``December 31, 2014'' and inserting ``December 31, 2016''.
       (b) Licensure of Contract Physicians.--
       (1) Temporary authority.--Such section 704 is further 
     amended--
       (A) by redesignating subsection (d) as subsection (e); and
       (B) by inserting after subsection (c) the following new 
     subsection (d):
       ``(d) Licensure of Contract Physicians.--
       ``(1) In general.--Notwithstanding any law regarding the 
     licensure of physicians, a physician described in paragraph 
     (2) may conduct an examination pursuant to a contract entered 
     into under subsection (b) at any location in any State, the 
     District of Columbia, or a Commonwealth, territory, or 
     possession of the United States, so long as the examination 
     is within the scope of the authorized duties under such 
     contract.
       ``(2) Physician described.--A physician described in this 
     paragraph is a physician who--
       ``(A) has a current license to practice the health care 
     profession of the physician; and
       ``(B) is performing authorized duties for the Department of 
     Veterans Affairs pursuant to a contract entered into under 
     subsection (b).''.
       (2) Pilot program.--Section 504 of the Veterans' Benefits 
     Improvement Act of 1996 (Public Law 104-275; 38 U.S.C. 5101 
     note) is amended--
       (A) by redesignating subsections (c) and (d) as subsections 
     (d) and (e), respectively; and
       (B) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c) Licensure of Contract Physicians.--
       ``(1) In general.--Notwithstanding any law regarding the 
     licensure of physicians, a physician described in paragraph 
     (2) may conduct an examination pursuant to a contract entered 
     into under subsection (a) at any location in any State, the 
     District of Columbia, or a Commonwealth, territory, or 
     possession of the United States, so long as the examination 
     is within the scope of the authorized duties under such 
     contract.
       ``(2) Physician described.--A physician described in this 
     paragraph is a physician who--
       ``(A) has a current license to practice the health care 
     profession of the physician; and
       ``(B) is performing authorized duties for the Department of 
     Veterans Affairs pursuant to a contract entered into under 
     subsection (a).''.
       (c) Expansion of Pilot Program.--Subsection (b) of such 
     section 504 is amended to read as follows:
       ``(b) Locations.--
       ``(1) Number.--The Secretary may carry out the pilot 
     program under this section through not more than 15 regional 
     offices of the Department of Veterans Affairs.
       ``(2) Selection.--The Secretary shall select the regional 
     offices under paragraph (1) by analyzing appropriate data to 
     determine the regional offices that require support. Such 
     appropriate data shall include--
       ``(A) the number of backlogged claims;
       ``(B) the total pending case workload;
       ``(C) the length of time cases have been pending;
       ``(D) the accuracy of completed cases;
       ``(E) the overall timeliness of completed cases;
       ``(F) the availability and workload of the examination 
     units and physicians of the medical centers in the regional 
     office; and
       ``(G) any other data the Secretary determines appropriate.
       ``(3) Annual analysis.--The Secretary shall carry out the 
     data analysis of the regional offices under paragraph (2) 
     during each year in which the program under this section is 
     carried out to determine the regional offices selected under 
     paragraph (1) for such year.''.
                                 ______
                                 
  SA 2757. Mr. HELLER (for himself, Ms. Heitkamp, and Mr. Manchin) 
submitted an amendment intended to be proposed by him to the bill S. 
1982, to improve the provision of medical services and benefits to 
veterans, and for other purposes; which was ordered to lie on the 
table; as follows:

       At the end of title IX, add the following:

     SEC. 918. EXCLUSION FROM INCOME.

       Section 3(b)(4) of the United States Housing Act of 1937 
     (42 U.S.C. 1437a(b)(4)) is amended--
       (1) by striking ``and any amounts'' and inserting ``, any 
     amounts'';
       (2) by striking ``or any deferred'' and inserting ``, any 
     deferred''; and
       (3) by inserting after ``prospective monthly amounts'' the 
     following: ``, and any reimbursement related to aid and 
     attendance as detailed under section 1521 of title 38, United 
     States Code''.
                                 ______
                                 
  SA 2758. Mr. COBURN (for himself, Mr. McCain, and Mr. Burr) submitted 
an amendment intended to be proposed by him to the bill S. 1982, to 
improve the provision of medical services and benefits to veterans, and 
for other purposes; which was ordered to lie on the table; as follows:

       On page 76, between lines 8 and 9, insert the following:

     SEC. 330. PUBLICATION OF INFORMATION ON PROVISION OF HEALTH 
                   CARE BY DEPARTMENT OF VETERANS AFFAIRS.

       (a) Publication of Information.--
       (1) In general.--Not later than 180 days after the date of 
     the enactment of this Act, and every 180 days thereafter, the 
     Secretary of Veterans Affairs shall publish on an Internet 
     database of the Department of Veterans Affairs available to 
     the public information on the provision of health care by the 
     Department of Veterans Affairs.
       (2) Elements.--
       (A) In general.--Each publication required by paragraph (1) 
     shall include, with respect to each medical facility of the 
     Department during the 180-day period preceding such 
     publication, the following:
       (i) An assessment of the outcomes of each surgical 
     procedure with respect to each patient, including--

       (I) the quality of such procedure;
       (II) any complications that occurred during such procedure; 
     and
       (III) the safety of such patient in connection with such 
     procedure.

[[Page S1180]]

       (ii) The average length of stay for inpatient care.
       (iii) A description of any hospital-acquired condition 
     acquired by any patient.
       (iv) The rate of readmission of patients within 30 days of 
     release.
       (v) The rate of mortality of patients within 30 days of 
     release.
       (vi) The rate at which opiods are prescribed to each 
     patient.
       (vii) An assessment of the outcomes of mental health 
     treatment with respect to each patient, including--

       (I) the suicide rate; and
       (II) the safety of such patient in connection with such 
     mental health treatment.

       (viii) An assessment of the outcomes of nursing home 
     treatment, if any, with respect to each patient, including 
     the safety of such patient in connection with such nursing 
     home treatment.
       (ix) The average wait time for emergency room treatment.
       (x) A description of any scheduling backlog with respect to 
     patient appointments.
       (B) Additional elements.--The Secretary may include in each 
     publication required by paragraph (1) any additional 
     information on the safety of facilities of the Department, 
     health outcomes at such facilities, and quality of care at 
     such facilities as the Secretary considers appropriate.
       (3) Searchability.--The Secretary shall ensure that the 
     Internet database required by paragraph (1) is searchable by 
     State, city, and facility.
       (4) Personal information.--The Secretary shall ensure that 
     personal information connected to information published under 
     paragraph (1) is protected from disclosure as required by 
     applicable law.
       (b) Comptroller General Report.--Not later than 180 days 
     after the date of the enactment of this Act, the Comptroller 
     General of the United States shall submit to Congress a 
     report setting forth recommendations for additional elements 
     to be included with the information published under 
     subsection (a) to improve the evaluation and assessment of 
     the safety and health of individuals receiving care under the 
     laws administered by the Secretary and the quality of care 
     received by such individuals.
                                 ______
                                 
  SA 2759. Mr. COBURN (for himself, Mr. McCain, and Mr. Burr) submitted 
an amendment intended to be proposed by him to the bill S. 1982, to 
improve the provision of medical services and benefits to veterans, and 
for other purposes; which was ordered to lie on the table; as follows:

       On page 34, strike line 6 and all that follows through page 
     38, line 22.
                                 ______
                                 
  SA 2760. Mr. COBURN (for himself, Mr. McCain, and Mr. Burr) submitted 
an amendment intended to be proposed by him to the bill S. 1982, to 
improve the provision of medical services and benefits to veterans, and 
for other purposes; which was ordered to lie on the table; as follows:

       On page 76, between lines 8 and 9, insert the following:

     SEC. 330. PROGRAM TO ALLOW INDIVIDUALS ELIGIBLE FOR HEALTH 
                   CARE FROM DEPARTMENT OF VETERANS AFFAIRS TO 
                   RECEIVE SUCH CARE FROM NON-DEPARTMENT ENTITIES.

       (a) In General.--Chapter 17 is amended by inserting after 
     section 1703 the following new section:

     ``Sec. 1703A. Program to allow individuals eligible for 
       health care from Department to receive such care from non-
       Department entities

       ``(a) In General.--(1) Commencing not later than one year 
     after the date of the enactment of the Comprehensive Veterans 
     Health and Benefits and Military Retirement Pay Restoration 
     Act of 2014, the Secretary shall carry out a program to 
     provide health care and services to eligible individuals 
     described in subsection (b) through non-Department providers 
     and suppliers.
       ``(2) For purposes of this section:
       ``(A) The term `provider' means a provider of services, as 
     that term is defined in subsection (u) of section 1861 of the 
     Social Security Act (42 U.S.C. 1395x), participating in the 
     Medicare program under title XVIII of such Act.
       ``(B) The term `supplier' means a supplier, as that term is 
     defined in subsection (d) of such section, participating in 
     the Medicare program under title XVIII of such Act.
       ``(b) Eligible Individuals.--An eligible individual 
     described in this subsection is an individual who--
       ``(1) is a veteran, surviving spouse of a veteran, spouse 
     of a veteran, or a child of a veteran; and
       ``(2) is eligible for health care and services under the 
     laws administered by the Secretary.
       ``(c) Restriction on Certain Providers and Suppliers.--The 
     Secretary may restrict a provider or supplier from providing 
     care and services under the program if the Secretary 
     determines that veterans have received substandard care from 
     that provider or supplier.
       ``(d) Payments to Providers and Suppliers.--(1) Subject to 
     paragraph (2), payment rates to providers and suppliers for 
     the provision of care and services under the program shall 
     not exceed the payment rates under the fee-for-service 
     program under the Medicare program under title XVIII of the 
     Social Security Act (42 U.S.C. 1355 et seq.) for a comparable 
     item or service.
       ``(2) The Secretary shall ensure that the aggregate amount 
     paid to non-Department providers and suppliers for the 
     provision of care and services under the program does not 
     exceed the cost of providing such care and services through 
     the Department.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 17 is amended by inserting after the 
     item relating to section 1703 the following new item:

``1703A. Program to allow individuals eligible for health care from 
              Department to receive such care from non-Department 
              entities.''.
                                 ______
                                 
  SA 2761. Mr. COBURN submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 76, between lines 8 and 9, insert the following:

     SEC. 330. PILOT PROGRAM TO ALLOW INDIVIDUALS ELIGIBLE FOR 
                   HEALTH CARE FROM DEPARTMENT OF VETERANS AFFAIRS 
                   TO RECEIVE SUCH CARE FROM NON-DEPARTMENT 
                   ENTITIES.

       (a) In General.--Not later than one year after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall commence a pilot program to assess the feasibility and 
     advisability of providing health care and services to 
     eligible individuals described in subsection (b) through non-
     Department providers and at non-Department facilities.
       (b) Eligible Individuals.--Eligible individuals described 
     in this subsection are veterans, surviving spouses of 
     veterans, spouses of veterans, and children of veterans (as 
     those terms are defined in section 101 of title 38, United 
     States Code) who are eligible for health care and services 
     under the laws administered by the Secretary.
       (c) Providers and Facilities.--In carrying out the pilot 
     program under this section, the Secretary shall select such 
     non-Department providers and such non-Department facilities 
     as the Secretary considers appropriate to provide health care 
     and services as described in subsection (a).
       (d) Locations.--
       (1) In general.--Subject to paragraph (3), the Secretary 
     shall carry out the pilot program at not more than 40 
     locations selected by the Secretary for purposes of the pilot 
     program, which shall include at least one location within 
     each Veterans Integrated Service Network (VISN).
       (2) Priority.--In selecting locations under paragraph (1), 
     the Secretary shall give priority consideration to those 
     locations in which individuals seeking primary care 
     appointments at the nearest medical facility of the 
     Department of Veterans Affairs have the longest average wait 
     time.
       (3) Additional locations.--The Secretary may expand the 
     pilot program to include more than 40 locations as the 
     Secretary considers appropriate on the earlier of--
       (A) the date that the Secretary determines that the pilot 
     program--
       (i) is cost effective, feasible, and advisable; and
       (ii) has equal or better outcomes and satisfaction among 
     veterans as compared to health care and services received 
     through providers and facilities of the Department; or
       (B) three years after the date of the commencement of the 
     pilot program.
       (e) Payments to Providers and Facilities.--
       (1) Payment rates.--Subject to paragraph (2), in carrying 
     out the pilot program under this section, the Secretary shall 
     specify the rates by which non-Department providers and non-
     Department facilities are paid for the provision of care and 
     services under the pilot program.
       (2) Limitation.--The Secretary shall ensure that the 
     aggregate amount paid to non-Department providers and non-
     Department facilities for the provision of care and services 
     under the pilot program does not exceed the cost of providing 
     such care and services through providers and facilities of 
     the Department.
                                 ______
                                 
  SA 2762. Mr. COBURN (for himself, Mr. McCain, Mr. Burr, Mr. Lee, and 
Mr. Flake) submitted an amendment intended to be proposed by him to the 
bill S. 1982, to improve the provision of medical services and benefits 
to veterans, and for other purposes; which was ordered to lie on the 
table; as follows:

       On page 367, after line 14, insert the following:

     SEC. 817. LIMITATION ON IMPLEMENTATION OF NEW PROGRAMS AND 
                   EXPANSION OF EXISTING PROGRAMS.

       Notwithstanding any other provision of this Act, the 
     Secretary of Veterans Affairs may not implement any new 
     program or expand any existing program pursuant to any 
     provision of this Act until the Comptroller General of the 
     United States certifies to Congress that the Secretary is 
     meeting all strategic targets for every program measure 
     established in the report of the Department

[[Page S1181]]

     of Veterans Affairs entitled ``2013 Performance and 
     Accountability Report''.
                                 ______
                                 
  SA 2763. Ms. COLLINS submitted an amendment intended to be proposed 
by her to the bill S. 1982, to improve the provision of medical 
services and benefits to veterans, and for other purposes; which was 
ordered to lie on the table; as follows:

       On page 291, after line 21, add the following:

              Subtitle E--Other Claims Processing Matters

     SEC. 641. INSPECTOR GENERAL INVESTIGATION INTO WHETHER 
                   EMPLOYEES OF DEPARTMENT OF VETERANS AFFAIRS 
                   DESTROYED FILES TO MISREPRESENT BACKLOG OF 
                   CLAIMS.

       (a) In General.--Not later than 30 days after the date of 
     the enactment of this Act, the Inspector General of the 
     Department of Veterans Affairs shall commence an 
     investigation to assess whether employees of the Department 
     of Veterans Affairs have destroyed files in order to 
     misrepresent the backlog of claims filed with the Secretary 
     of Veterans Affairs for benefits under laws administered by 
     the Secretary.
       (b) Initial Report.--Not later than 90 days after the date 
     of the enactment of this Act, the Inspector General shall 
     submit to Congress a report on the findings of the Inspector 
     General with respect to the investigation carried out 
     pursuant to subsection (a).
                                 ______
                                 
  SA 2764. Ms. BALDWIN submitted an amendment intended to be proposed 
by her to the bill S. 1982, to improve the provision of medical 
services and benefits to veterans, and for other purposes; which was 
ordered to lie on the table; as follows:

       On page 131, after line 19, add the following:

     SEC. 365. AGREEMENTS WITH ORGANIZATIONS TO PROVIDE SERVICES 
                   TO VETERANS WHO ARE SURVIVORS OF MILITARY 
                   SEXUAL TRAUMA.

       (a) Memoranda of Understanding.--The Secretary of Veterans 
     Affairs may enter into a memorandum of understanding with an 
     organization described in subsection (b) to provide services 
     to veterans who are survivors of military sexual trauma.
       (b) Covered Organizations.--Organizations described in this 
     subsection are civilian organizations, including the 
     following:
       (1) Nonprofit, nongovernmental organizations.
       (2) Religious or community-based organizations.
       (3) Federally qualified health centers.
       (4) The Indian Health Service.
       (c) Purpose.--The purpose of a memoranda of understanding 
     entered into under subsection (a) shall be to facilitate 
     working and collegial relationships between the senior 
     leadership of the Department of Veterans Affairs and an 
     organization described in subsection (b) in order to assist 
     the Department in better addressing military sexual trauma in 
     one or more veteran communities.
       (d) Annual Reports.--
       (1) In general.--Not less frequently than once each year, 
     the Secretary shall submit to Congress a report on any 
     memoranda of understanding entered into under subsection (a).
       (2) In general.--Each report submitted under paragraph (1) 
     shall include the following:
       (A) How many memoranda have been entered into and are 
     currently in force.
       (B) The strategies in such memoranda.
       (C) The outcomes of the relationships sought through such 
     memoranda.
       (D) Such recommendations as the Secretary may have for 
     legislative or administrative action to facilitate a 
     relationship described in subsection (c) or otherwise better 
     address military sexual trauma in a veteran community.

     SEC. 366. REPORT ON FEASIBILITY AND ADVISABILITY OF 
                   SUPPORTING PARTNERSHIPS TO PROVIDE SERVICES TO 
                   VETERANS WHO ARE SURVIVORS OF MILITARY SEXUAL 
                   TRAUMA.

       (a) Report Required.--Not later than one year after the 
     date of the enactment of this Act, the Secretary of Veterans 
     Affairs shall submit to Congress a report on the feasibility 
     and advisability of supporting partnerships between local 
     medical facilities (as defined in section 8101 of title 38, 
     United States Code) with organizations described in 
     subsection (b) to provide services (including mental health 
     services and trauma-informed services) to veterans who are 
     survivors of military sexual trauma.
       (b) Covered Organizations.--Organizations described in this 
     subsection are civilian organizations, including the 
     following:
       (1) Nonprofit, nongovernmental organizations.
       (2) Religious or community-based organizations.
       (3) Federally qualified health centers.
       (4) The Indian Health Service.
       (c) Contents.--The report required by subsection (a) shall 
     include the following:
       (1) An assessment of the effect of the Patient-Center 
     Community Care program of the Department of Veterans Affairs 
     on the provision of specialty care for survivors of military 
     sexual trauma.
       (2) An assessment of the feasibility and advisability of 
     supporting partnerships as described in subsection (a) in not 
     fewer than three Veterans Integrated Service Networks.
       (3) Recommendations as to the kinds or types of 
     organizations to which medical facilities should partner as 
     described in subsection (a), including recommendations on the 
     following:
       (A) Nonprofit, nongovernmental organizations, the primary 
     purpose of which is to provide services to survivors of 
     military sexual trauma, sexual assault, domestic violence, 
     family violence, or stalking.
       (B) Religious or community-based organizations that 
     specialize in working with survivors described in 
     subparagraph (A).
                                 ______
                                 
  SA 2765. Ms. STABENOW submitted an amendment intended to be proposed 
by her to the bill S. 1982, to improve the provision of medical 
services and benefits to veterans, and for other purposes; which was 
ordered to lie on the table; as follows:

       On page 109, strike lines 18 through 22 and insert the 
     following:
       (2) The number of individuals participating in the pilot 
     program at each site, disaggregated by--
       (A) age;
       (B) sex;
       (C) disability rating;
       (D) any illness or condition co-occurring with the mental 
     health disorder for which the individual is receiving 
     treatment under the pilot program and with which the 
     individual has been previously diagnosed by the Department; 
     and
       (E) whether or not the individual is homeless.
       (3) A detailed assessment of the effectiveness of the pilot 
     program, including a survey of each veteran participating in 
     the pilot program, to determine the impact of the program 
     on--
       (A) the success of such veteran in obtaining and 
     maintaining gainful employment;
       (B) the success of such veteran in pursuing and completing 
     educational opportunities;
       (C) the interpersonal relationships of such veteran, 
     including relationships with family members; and
       (D) the success of such veteran in achieving stable 
     housing.
                                 ______
                                 
  SA 2766. Mr. REID proposed an amendment to amendment SA 2747 proposed 
by Mr. Sanders to the bill S. 1982, to improve the provision of medical 
services and benefits to veterans, and for other purposes; as follows:

       At the end, add the following:
       This Act shall become effective 1 day after enactment.
                                 ______
                                 
  SA 2767. Mr. REID proposed an amendment to the bill S. 1982, to 
improve the provision of medical services and benefits to veterans, and 
for other purposes; as follows:

       At the end, add the following:
       This Act shall become effective 3 days after enactment.
                                 ______
                                 
  SA 2768. Mr. REID proposed an amendment to amendment SA 2767 proposed 
by Mr. Reid to the bill S. 1982, to improve the provision of medical 
services and benefits to veterans, and for other purposes; as follows:

       In the amendment, strike ``3 days'' and insert ``4 days''.
                                 ______
                                 
  SA 2769. Mr. REID proposed an amendment to amendment SA 2768 proposed 
by Mr. Reid to the amendment SA 2767 proposed by Mr. Reid to the bill 
S. 1982, to improve the provision of medical services and benefits to 
veterans, and for other purposes; as follows:

       In the amendment, strike ``4 days'' and insert ``5 days''.
                                 ______
                                 
  SA 2770. Mr. LEE submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       Beginning on page 155, strike line 8 and all that follows 
     through page 157, line 17.
                                 ______
                                 
  SA 2771. Mr. LEE submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       Beginning on page 132, strike line 13 and all that follows 
     through the matter preceding line 1 on page 134.
                                 ______
                                 
  SA 2772. Mr. LEE submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 39, strike lines 18 through 25.
                                 ______
                                 
  SA 2773. Mr. LEE submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the

[[Page S1182]]

provision of medical services and benefits to veterans, and for other 
purposes; which was ordered to lie on the table; as follows:

       On page 122, after line 20, insert the following:

     SEC. 356. TERMINATION OF CERTAIN PROGRAMS RELATING TO DENTAL 
                   CARE.

       (a) Pilot Program on Expansion of Furnishing of Dental Care 
     to Veterans.--Notwithstanding subsection (b) of section 352, 
     the pilot program required by such section shall terminate 
     not later than three years after the date of the enactment of 
     this Act.
       (b) Program of Education to Promote Dental Health for 
     Veterans.--The program required by section 353 shall 
     terminate not later than three years after the date of the 
     enactment of this Act.
       (c) Pilot Program on Dental Insurance.--Notwithstanding 
     section 354(b), the dental insurance pilot program 
     established by section 17.169 of title 38, Code of Federal 
     Regulations, shall terminate not later than three years after 
     the date of the enactment of this Act.
                                 ______
                                 
  SA 2774. Mr. LEE submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       Beginning on page 53, strike line 13 and all that follows 
     through page 61, line 5.
                                 ______
                                 
  SA 2775. Mrs. SHAHEEN (for herself, Mr. Udall of Colorado, Mrs. 
Gillibrand, Mr. Blumenthal, and Ms. Baldwin) submitted an amendment 
intended to be proposed by her to the bill S. 1982, to improve the 
provision of medical services and benefits to veterans, and for other 
purposes; which was ordered to lie on the table; as follows:

       At the end, add the following:

     SEC. 918. DEFINITION OF SPOUSE FOR PURPOSES OF VETERAN 
                   BENEFITS TO REFLECT NEW STATE DEFINITIONS OF 
                   SPOUSE.

       (a) Spouse Defined.--Section 101 is amended--
       (1) in paragraph (3), by striking ``of the opposite sex''; 
     and
       (2) by striking paragraph (31) and inserting the following 
     new paragraph (31):
       ``(31)(A) An individual shall be considered a `spouse' if--
       ``(i) the marriage of the individual is valid in the State 
     in which the marriage was entered into; or
       ``(ii) in the case of a marriage entered into outside any 
     State--
       ``(I) if the marriage of the individual is valid in the 
     place in which the marriage was entered into; and
       ``(II)(aa) the marriage could have been entered into in a 
     State; or
       ``(bb) the marriage was valid in the place in which all 
     parties to the marriage resided at the time the marriage was 
     entered into.
       ``(B) In this paragraph, the term `State' has the meaning 
     given that term in paragraph (20), except that the term also 
     includes the Commonwealth of the Northern Mariana Islands.''.
       (b) Marriage Determination.--Section 103(c) is amended by 
     striking ``according to'' and all that follows through the 
     period at the end and inserting ``in accordance with section 
     101(31) of this title.''.
                                 ______
                                 
  SA 2776. Mr. UDALL of New Mexico (for himself and Mr. Heller) 
submitted an amendment intended to be proposed by him to the bill S. 
1982, to improve the provision of medical services and benefits to 
veterans, and for other purposes; which was ordered to lie on the 
table; as follows:

       On page 155, between lines 2 and 3, insert the following:

               Subtitle I--Health Care for Rural Veterans

     SEC. 391. PROVISION OF MENTAL HEALTH CARE TO CERTAIN VETERANS 
                   IN RURAL AND HIGHLY RURAL AREAS.

       (a) In General.--The Secretary of Veterans Affairs shall 
     provide mental health care to eligible veterans described in 
     subsection (c) for which a determination has been made under 
     subsection (d).
       (b) Use of Other Providers.--
       (1) In general.--The Secretary may provide mental health 
     care under this section by contracting with or providing 
     payments to mental health care providers that are not 
     otherwise affiliated with the Department of Veterans Affairs 
     and shall, to the extent feasible, use health care resources 
     pursuant to existing arrangements, contracts, or agreements 
     entered into under section 8153 of title 38, United States 
     Code.
       (2) Payments.--The Secretary may not provide payments 
     described in paragraph (1) that exceed the amount that the 
     Secretary would otherwise expend in providing similar mental 
     health care through the Department or under such existing 
     arrangements, contracts, or agreements.
       (c) Eligible Veterans.--An eligible veteran described in 
     this subsection is a veteran that--
       (1) has a mental health issue resulting from post-traumatic 
     stress disorder, traumatic brain injury, or any other health 
     condition that was incurred or aggravated in line of duty in 
     the active military, naval, or air service; and
       (2) lives in a rural area or highly rural area.
       (d) Determination.--The Secretary shall provide the care 
     required by subsection (a) to an eligible veteran if the 
     Secretary determines any of the following:
       (1)(A) A mental health care provider affiliated with the 
     Department is not available to provide mental health care 
     services to the eligible veteran at the medical facility of 
     the Department that is nearest to the residence of the 
     eligible veteran; and
       (B)(i) in-person and telehealth mental health care services 
     from the Department are not available to the eligible 
     veteran;
       (ii) the eligible veteran requests that a mental health 
     care provider affiliated with the Department provide mental 
     health care services to the eligible veteran in private and 
     the provider is unable or unwilling to do so; or
       (iii) travel by the eligible veteran to a regional medical 
     center of the Department is impractical or severely 
     detrimental to the health of the eligible veteran.
       (2) That--
       (A)(i) a mental health care provider affiliated with the 
     Department has recommended that a complementary and 
     alternative therapy approved by the Food and Drug 
     Administration be administered to the eligible veteran;
       (ii) the eligible veteran is a member of an Indian tribe or 
     a Native Hawaiian and requests a healing method that is a 
     cultural tradition of the eligible veteran; or
       (iii) a mental health care provider has recommended a 
     treatment for the eligible veteran that, based on the medical 
     knowledge of the health care provider, is safe and would 
     assist the eligible veteran in coping with post-traumatic 
     stress disorder, traumatic brain injury, or another mental 
     health issue; and
       (B)(i) the eligible veteran has not received the therapy, 
     healing method, or treatment described in subparagraph (A) 
     because of the inaccessibility or unavailability of such 
     treatment from a medical facility of the Department; and
       (ii) the eligible veteran, as a result of the mental health 
     condition of the eligible veteran--
       (I) cannot work or maintain employment;
       (II) is at increased risk of doing physical harm to the 
     eligible veteran or others; or
       (III) cannot adequately manage activities of daily life.
       (e) Indian Tribe Defined.--In this section, the term 
     ``Indian tribe'' has the meaning given that term in section 4 
     of the Indian Self-Determination and Education Assistance Act 
     (25 U.S.C. 450b).

     SEC. 392. GRANTS TO PROVIDE TRANSPORTATION TO COMMUNITY-BASED 
                   OUTPATIENT CLINICS FOR VETERANS IN RURAL AND 
                   HIGHLY RURAL AREAS.

       (a) Grants Authorized.--
       (1) In general.--The Secretary of Veterans Affairs may 
     award grants to eligible entities to provide transportation 
     to veterans in rural and highly rural areas who would 
     otherwise be eligible for reimbursement for or payment of 
     travel expenses by the Department of Veterans Affairs 
     pursuant to section 111 or section 111A of title 38, United 
     States Code.
       (2) Maximum amount.--The Secretary may not award a grant 
     under this section in an amount that exceeds $100,000.
       (3) No matching required.--The Secretary may not require 
     that an eligible entity provide a contribution of funds as a 
     condition of receiving the grant.
       (b) Eligible Entities.--The Secretary may award grants 
     under this section to any of the following entities:
       (1) State veterans agencies.
       (2) Veterans service organizations.
       (3) Tribal organizations.
       (c) Use of Grants.--Eligible entities in receipt of a grant 
     under this section may use the grant amount as follows:
       (1) To provide transportation to veterans in rural and 
     highly rural areas to and from medical centers of the 
     Department of Veterans Affairs, including transportation by 
     air or sea if necessary.
       (2) To otherwise assist veterans in rural and highly rural 
     areas with transportation in connection with the provision of 
     medical care to those veterans, including transportation by 
     air or sea if necessary.
       (d) Application.--
       (1) In general.--Each eligible entity seeking a grant under 
     this section shall submit an application to the Secretary at 
     such time, in such manner, and accompanied by such 
     information as the Secretary may require.
       (2) Contents.--Each application submitted pursuant to 
     paragraph (1) shall contain a proposal for the manner in 
     which the eligible entity seeks to provide the transportation 
     described in subsection (a).
       (e) Priority.--The Secretary shall give priority in the 
     awarding of grants under this section to applications 
     submitted under subsection (d) that contain proposals that 
     comply with section 504 of the Rehabilitation Act of 1973 (29 
     U.S.C. 794) and regulations issued by the Secretary of 
     Transportation under such section 504.
       (f) Definitions.--In this section:
       (1) Tribal organization.--The term ``tribal organization'' 
     has the meaning given that term in section 4 of the Indian 
     Self-Determination and Education Assistance Act (25 U.S.C. 
     450b).
       (2) Veterans service organization.--The term ``veterans 
     service organization'' means

[[Page S1183]]

     an organization recognized by the Secretary of Veterans 
     Affairs for the representation of veterans under section 5902 
     of title 38, United States Code.

     SEC. 393. PILOT PROGRAM ON HOUSING ALLOWANCES FOR HEALTH CARE 
                   PROVIDERS OF THE DEPARTMENT OF VETERANS AFFAIRS 
                   ACCEPTING ASSIGNMENT AT RURAL AND HIGHLY RURAL 
                   COMMUNITY-BASED OUTPATIENT CLINICS.

       (a) Pilot Program Authorized.--The Secretary of Veterans 
     Affairs may carry out a pilot program to assess the 
     feasability and advisability of providing a housing allowance 
     to health care providers of the Department of Veterans 
     Affairs who accept assignment at rural or highly rural 
     community-based outpatient clinics as a means of encouraging 
     such health care providers to accept assignment to such 
     Clinics.
       (b) Eligibility.--An individual is eligible for 
     participation in the pilot program if the individual--
       (1) is a health care provider;
       (2) is, or agrees to become, an employee of the Veterans 
     Health Administration on a full-time basis in a health care 
     position designated by the Secretary for purposes of the 
     pilot program; and
       (3) accepts an assignment in such position for a term of 
     not less than 36 months at a rural or highly rural community-
     based outpatient clinic selected by the Secretary for 
     purposes of the pilot program.
       (c) Conditions on Payment of Housing Allowance.--Except as 
     provided in subsection (d)(3), an individual may be provided 
     a housing allowance under the pilot program only while--
       (1) in good standing as a health care provider within the 
     Veterans Health Administration; and
       (2) assigned as a health care provider at a rural or highly 
     rural community-based outpatient clinic.
       (d) Amount of Housing Allowance.--
       (1) Monthly amount during initial term.--During the first 
     36 months of participation in the pilot program, the housing 
     allowance provided a health care provider participating in 
     the pilot program shall be provided on a monthly basis at a 
     rate that is equivalent to the monthly rate of basic 
     allowance for housing (BAH) payable under section 403 of 
     title 37, United States Code, to members of the uniformed 
     services whose grade, dependency status, and geographic 
     location most closely equals, as determined by the Secretary, 
     the grade of such provider under section 7404 of title 38, 
     United States Code, and the dependency status and geographic 
     location of such provider.
       (2) Monthly amount for certain providers for additional 
     term.--If upon completion of the first 36 months in the pilot 
     program a health care provider accepts continuing 
     participation in the pilot program at a rural or highly rural 
     community-based outpatient clinic for a term of not less than 
     12 additional months, the housing allowance provided the 
     health care provider under the pilot program shall be 
     provided on a monthly basis for such additional months at a 
     rate determined in accordance with paragraph (1).
       (3) Bonus amount.--
       (A) Completion of initial term.--Any health care provider 
     who successfully completes 36 months of participation in the 
     pilot program shall be paid upon completion of participation 
     in the pilot program an amount equal to three months of the 
     monthly rate of housing allowance provided the health care 
     provider under paragraph (1) during the last month before the 
     provider's completion of participation in the pilot program.
       (B) Completion of additional one-year term.--Any health 
     care provider who successfully completes 48 months of 
     participation in the pilot program shall be paid upon 
     completion of participation in the pilot program an amount 
     equal to 12 months of the monthly rate of housing allowance 
     provided the health care provider under paragraph (2) during 
     the last month before the provider's completion of 
     participation in the pilot program.
       (C) Completion of additional two-year term.--Any health 
     care provider who successfully completes 60 months of 
     participation in the pilot program shall be paid upon 
     completion of participation in the pilot program an amount 
     equal to 13 months of the monthly rate of housing allowance 
     provided the health care provider under paragraph (2) during 
     the last month before the provider's completion of 
     participation in the pilot program.
       (D) No requirement to remain on assignment.--An amount 
     payable under this paragraph shall be paid whether or not the 
     health care provider concerned remains in an assignment at a 
     rural or highly rural community-based outpatient clinic.
       (e) Nature of Allowance.--
       (1) Supplemental amount.--Any housing allowance provided 
     under the pilot program shall be in addition to any pay 
     (including basic pay, special pay, and retirement or other 
     bonus pay) payable to personnel of the Veterans Health 
     Administration personnel under chapter 74 of title 38, United 
     States Code, or any other provision of law.
       (2) Exemption from taxation.--For purposes of the Internal 
     Revenue Code of 1986, any housing allowance provided under 
     the pilot program shall not be included in gross income.
       (f) Annual Reports.--
       (1) In general.--Not later than one year after the date of 
     the enactment of this Act and not less frequently than once 
     each year thereafter while the pilot program is in effect, 
     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 pilot 
     program.
       (2) Elements.--Each report submitted under paragraph (1) 
     shall include the following:
       (A) A current description of the pilot program, including 
     the current number of participants in the pilot program and 
     the amounts of housing allowance being provided such 
     participants.
       (B) A current assessment of the value of the housing 
     allowance under the pilot program in encouraging health care 
     providers in accepting assignment to rural and highly rural 
     community-based outpatient clinics.
       (g) Funding.--Amounts for housing allowances under the 
     pilot program shall be derived from amounts available for the 
     Veterans Health Administration for Medical Services.
       (h) Sunset.--
       (1) In general.--No individual may commence participation 
     in the pilot program on or after the date that is five years 
     after the date of the enactment of this Act.
       (2) Continuation of on-going provision of allowance.--
     Nothing in paragraph (1) shall be construed to prohibit the 
     Secretary from providing housing allowances under the pilot 
     program to individuals who commence participation in the 
     pilot program before the date that is five years after the 
     date of the enactment of this Act.
       (i) Rural or Highly Rural Community-based Outpatient Clinic 
     Defined.--In this section, the term ``rural or highly rural 
     community-based outpatient clinic'' means a community-based 
     outpatient clinic of the Veterans Health Administration that 
     predominantly serves veterans who live in rural and highly 
     rural areas.

     SEC. 394. PROGRAM ON TRAINING HEALTH CARE PROFESSIONALS FOR 
                   ASSIGNMENT AT COMMUNITY-BASED OUTPATIENT 
                   CLINICS THAT PREDOMINANTLY SERVE VETERANS WHO 
                   LIVE IN RURAL AND HIGHLY RURAL AREAS.

       (a) Program Required.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     establish a program to train health care professionals for 
     assignment at community-based outpatient clinics that 
     predominantly serve veterans who live in rural and highly 
     rural areas.
       (2) Partnership with educational institutions.--
       (A) In general.--In carrying out the program, the Secretary 
     may enter into partnerships with educational institutions.
       (B) Consultation.--If the Secretary enters into a 
     partnership with an educational institution to carry out the 
     program, the Secretary shall consult with the head of such 
     educational institution with respect to the training and 
     curriculum provided under the program at such educational 
     institution.
       (b) Training.--The training provided to health care 
     professionals under the program shall include the following 
     courses:
       (1) Courses on general professional development of health 
     care professionals.
       (2) Courses on providing health care to rural populations 
     and specifically to rural veterans.
       (c) Curriculum.--The program shall include training with 
     respect to health issues that commonly afflict veterans as 
     specified by the Secretary.
       (d) Hiring Preference.--
       (1) In general.--Each health care professional that 
     completes the program and completes a three-year assignment 
     at a community-based outpatient clinic that predominantly 
     serves veterans who live in rural and highly rural areas 
     shall receive a preference in selection for employment in the 
     Veterans Health Administration at the end of such three-year 
     assignment.
       (2) Degree of preference.--
       (A) In general.--The preference received under paragraph 
     (1) shall be less than the preference given a veteran.
       (B) Veterans.--A veteran that receives a preference under 
     paragraph (1) shall receive a greater preference than an 
     individual that receives a preference under such paragraph 
     who is not a veteran.

     SEC. 395. ENCOURAGING AND FACILITATING TRANSITION OF MILITARY 
                   MEDICAL PROFESSIONALS INTO EMPLOYMENT WITH 
                   VETERANS HEALTH ADMINISTRATION.

       (a) Encouraging Employment With Veterans Health 
     Administration.--The Secretary of Veterans Affairs and the 
     Secretary of Defense shall jointly establish a program to 
     encourage an individual who serves in the Armed Forces with a 
     military occupational specialty relating to the provision of 
     health care to seek employment with the Veterans Health 
     Administration when the individual has been discharged or 
     released from service in the Armed Forces or is contemplating 
     separating from such service.
       (b) Matching of Military Occupational Specialties.--The 
     Secretary of Veterans Affairs and the Secretary of Defense 
     shall jointly identify military occupational specialties 
     relating to the provision of health care and match such 
     occupational specialties with occupations and positions of 
     employment within the Veterans Health Administration for 
     which experience in such military occupational specialty 
     qualifies one for employment in such occupation or position 
     of employment.
       (c) Facilitation of Transition to Employment With Veterans 
     Health Administration.--The Secretary of Veterans Affairs and

[[Page S1184]]

     the Secretary of Defense shall prescribe such regulations and 
     take such actions as may be necessary to facilitate the 
     transition of individuals with military occupational 
     specialties identified under subsection (b) into the 
     corresponding occupations and positions of employment with 
     the Veterans Health Administration under such subsection.

     SEC. 396. ASSESSMENT OF COMMUNITY-BASED OUTPATIENT CLINICS IN 
                   RURAL AND HIGHLY RURAL AREAS.

       (a) Assessment.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     conduct a periodic assessment of community-based outpatient 
     clinics in rural and highly rural areas to determine whether 
     expansion and improvement of community-based outpatient 
     clinics in those areas is feasible or advisable.
       (2) Elements.--Each periodic assessment required by 
     subsection (a) shall include the following with respect to 
     each community-based outpatient clinic assessed:
       (A) An assessment of whether the facility--
       (i) meets applicable building code requirements;
       (ii) meets applicable health care requirements related to 
     privacy;
       (iii) has the capacity to handle the number of patients 
     that seek care at the facility;
       (iv) has sufficient parking for patients that seek care at 
     the facility;
       (v) has adequate access to broadband technology to allow 
     the use or expansion of telehealth services at the facility; 
     and
       (vi) has the capacity to properly store and dispose of 
     medical and other hazardous waste.
       (B) A survey of health care providers who practice at the 
     facility with respect to--
       (i) strengths of the facility;
       (ii) weaknesses of the facility; and
       (iii) areas in which the facility may be improved.
       (b) Report.--Not later than one year after the date of the 
     enactment of this Act, and not less frequently than once each 
     year thereafter, the Secretary shall submit to the Committee 
     on Veterans' Affairs and the Committee on Appropriations of 
     the Senate and the Committee on Veterans' Affairs and the 
     Committee on Appropriations of the House of Representatives a 
     report on the findings of the Secretary with respect to the 
     most recently completed assessment conducted under subsection 
     (a), including such recommendations as the Secretary may have 
     for the expansion or improvement of community-based 
     outpatient clinics in rural and highly rural areas.

     SEC. 397. REPORT ON ESTABLISHMENT OF POLYTRAUMA 
                   REHABILITATION CENTERS OR POLYTRAUMA NETWORK 
                   SITES OF THE DEPARTMENT OF VETERANS AFFAIRS IN 
                   RURAL AREAS.

       (a) In General.--Not later than 180 days after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to Congress a report on the feasibility and 
     advisability of establishing a Polytrauma Rehabilitation 
     Center or Polytrauma Network Site in each area in which the 
     nearest Polytrauma Rehabilitation Center or Polytrauma 
     Network Site is more than 300 miles away.
       (b) Requirements.--
       (1) In general.--The report required by this section shall 
     include the following:
       (A) An assessment of the adequacy of existing Polytrauma 
     Rehabilitation Centers and Polytrauma Network Sites in 
     providing care to veterans that live more than 300 miles from 
     such facilities.
       (B) An assessment of the adequacy of existing Polytrauma 
     Rehabilitation Centers and Polytrauma Network Sites in 
     providing rehabilitation services pursuant to section 1710C 
     of title 38, United States Code.
       (C) An assessment of the feasibility and advisability of 
     establishing a Polytrauma Rehabilitation Center or Polytrauma 
     Network Site in each State in which there is a medical center 
     of the Department of Veterans Affairs.
       (D) An assessment of whether establishing new Polytrauma 
     Rehabilitation Centers and Polytrauma Network Sites would be 
     beneficial--
       (i) to the veteran population in general;
       (ii) to veterans who live--

       (I) more than 300 miles from the nearest Polytrauma 
     Rehabilitation Center or Polytrauma Network Site; or
       (II) in a State in which there is not a Polytrauma 
     Rehabilitation Center or Polytrauma Network Site; and

       (iii) to veterans who served in the active military, naval, 
     or air service on or after September 11, 2001.
       (2) Budget for additional facilities.--If the Secretary 
     determines that establishing additional Polytrauma 
     Rehabilitation Centers and Polytrauma Network Sites is 
     feasible and advisable, the Secretary shall include with the 
     report required by subsection (a) a budget and plan for the 
     establishment of those additional facilities.

     SEC. 398. REPORT ON EFFECTIVENESS OF COMPLEMENTARY AND 
                   ALTERNATIVE MEDICINE IN TREATING VETERANS WITH 
                   CERTAIN MENTAL ILLNESSES.

       Not later than one year after the date of the enactment of 
     this Act, the Secretary of Veterans Affairs shall submit to 
     the Committee on Veterans' Affairs of the Senate and the 
     Committee on Veterans' Affairs of the House of 
     Representatives a report on the effectiveness of 
     complementary and alternative medicine used by the Department 
     of Veterans Affairs in treating veterans with mental health 
     conditions resulting from post-traumatic stress disorder, 
     traumatic brain injury, or any other health condition that 
     was incurred or aggravated in line of duty in the active 
     military, naval, or air service.

     SEC. 399. DEFINITIONS.

       In this subtitle:
       (1) Active military, naval, or air service.--The term 
     ``active military, naval, or air service'' has the meaning 
     given that term in section 101 of title 38, United States 
     Code.
       (2) Highly rural area.--The term ``highly rural area'' 
     means an area located in a county that has less than seven 
     individuals residing in that county per square mile.
       (3) Rural area.--The term ``rural area'' means any area 
     that is not an urbanized area or a highly rural area.
       (4) Urbanized area.--The term ``urbanized area'' has the 
     meaning given that term by the Director of the Bureau of the 
     Census.
                                 ______
                                 
  SA 2777. Mr. UDALL of New Mexico submitted an amendment intended to 
be proposed by him to the bill S. 1982, to improve the provision of 
medical services and benefits to veterans, and for other purposes; 
which was ordered to lie on the table; as follows:

       On page 33, after line 18, add the following:

     SEC. 207. EXPANSION OF ELIGIBILITY FOR POST-9/11 EDUCATIONAL 
                   ASSISTANCE TO INCLUDE SERVICE ON ACTIVE DUTY IN 
                   ENTRY LEVEL AND SKILL TRAINING UNDER CERTAIN 
                   CIRCUMSTANCES.

       (a) For Individuals Who Serve Between 18 and 24 Months.--
     Section 3311(b)(5)(A) of title 38, United States Code, is 
     amended by striking ``excluding'' and inserting 
     ``including''.
       (b) For Individuals Who Served in Operation Enduring 
     Freedom, Operation Iraqi Freedom, or Certain Other 
     Contingency Operations.--Section 3311(b) of such title is 
     amended in paragraphs (6)(A) and (7)(A) by striking 
     ``excluding service on active duty in entry level and skill 
     training'' and inserting ``including service on active duty 
     in entry level and skill training for individuals who served 
     on active duty in the Armed Forces in Operation Enduring 
     Freedom, Operation Iraqi Freedom, Operation New Dawn, or any 
     other contingency operation (as that term is defined in 
     section 101 of title 10) and excluding service on active duty 
     in entry level and skill training for all other 
     individuals''.
                                 ______
                                 
  SA 2778. Mr. BOOKER submitted an amendment intended to be proposed by 
him to the bill S. 1982, to improve the provision of medical services 
and benefits to veterans, and for other purposes; which was ordered to 
lie on the table; as follows:

       On page 110, between lines 13 and 14, insert the following:

     SEC. 345. REPORTS ON IMPLEMENTATION OF PATIENT-CENTERED 
                   COMMUNITY CARE PROGRAM OF DEPARTMENT OF 
                   VETERANS AFFAIRS.

       (a) In General.--Not later than 450 days after the date of 
     the enactment of this Act, and not later than September 30 
     each year thereafter for two years, 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 program described in 
     subsection (b).
       (b) Program Described.--The program described in this 
     subsection is the program carried out by the Veterans Health 
     Administration that offers veterans access to non-Department 
     of Veterans Affairs inpatient specialty care, outpatient 
     specialty care, mental health care, limited emergency care, 
     and limited newborn care, commonly known as the ``Patient-
     Centered Community Care Program''.
       (c) Elements.--Each report submitted under subsection (a) 
     shall include the following:
       (1) A description of the specific factors used by the 
     Department to determine the use of the program described in 
     subsection (b) by facilities of the Department.
       (2) An analysis of the 10 health care services most 
     frequently provided through the program and any 
     recommendations by the Secretary to expand access to such 
     services at facilities of the Department.
       (3) An analysis of the quality of care provided through the 
     program, including feedback from health care providers.
       (4) An analysis of whether required medical documentation 
     from health care providers participating in the program is 
     provided to the Department in a timely and comprehensive 
     manner for inclusion in the electronic health records of 
     veterans.
       (5) An analysis of the timeliness of payments made by the 
     Department to health care providers for services provided 
     through the program.
       (6) A description of the specific factors used by the 
     Department in determining if a veteran is eligible for care 
     through non-Department providers, including such care that is 
     not provided through the program.
       (7) A description of the impact of the program on veterans 
     participating in the program, including--
       (A) the average increase or reduction in any travel 
     required by such veterans for care;
       (B) the average increase or reduction in wait-times by such 
     veterans for care; and
       (C) an analysis of the satisfaction of such veterans with 
     the program.
       (8) In response to information compiled or analyses 
     conducted under paragraphs (1)

[[Page S1185]]

     through (7), a description of any proposed mechanisms--
       (A) to reduce travel required by veterans to receive care;
       (B) to reduce wait-times for veterans receiving care; or
       (C) to increase the quality of care received by veterans.
       (d) Effective Date.--This section shall take effect on the 
     date that is one year after the date of the enactment of this 
     Act.
                                 ______
                                 
  SA 2779. Ms. COLLINS submitted an amendment intended to be proposed 
by her to the bill S. 1982, to improve the provision of medical 
services and benefits to veterans, and for other purposes; which was 
ordered to lie on the table; as follows:

       On page 291, after line 21, add the following:

              Subtitle E--Other Claims Processing Matters

     SEC. 641. INSPECTOR GENERAL INVESTIGATION INTO WHETHER 
                   EMPLOYEES OF DEPARTMENT OF VETERANS AFFAIRS 
                   DESTROYED FILES TO MISREPRESENT BACKLOG OF 
                   CLAIMS.

       (a) In General.--Not later than 30 days after the date of 
     the enactment of this Act, the Inspector General of the 
     Department of Veterans Affairs shall commence an 
     investigation to assess--
       (1) whether employees of the Department of Veterans Affairs 
     have destroyed files; and
       (2) whether the destruction of such files was carried out 
     in order to misrepresent the backlog of claims filed with the 
     Secretary of Veterans Affairs for benefits under laws 
     administered by the Secretary.
       (b) Initial Report.--Not later than 90 days after the date 
     of the enactment of this Act, the Inspector General shall 
     submit to Congress a report on the findings of the Inspector 
     General with respect to the investigation carried out 
     pursuant to subsection (a).

                          ____________________