[Congressional Record (Bound Edition), Volume 154 (2008), Part 15]
[House]
[Pages 21100-21119]
[From the U.S. Government Publishing Office, www.gpo.gov]




    VETERANS' MENTAL HEALTH AND OTHER CARE IMPROVEMENTS ACT OF 2008

  Mr. FILNER. Mr. Speaker, I move to suspend the rules and pass the 
Senate bill (S. 2162) to improve the treatment and services provided by 
the Department of Veterans Affairs to veterans with post-traumatic 
stress disorder and substance use disorders, and for other purposes, as 
amended.
  The Clerk read the title of the Senate bill.
  The text of the Senate bill is as follows:

                                S. 2162

       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 ``Veterans' 
     Mental Health and Other Care Improvements Act of 2008''.
       (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.

[[Page 21101]]

        TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

Sec. 101. Tribute to Justin Bailey.
Sec. 102. Findings on substance use disorders and mental health.
Sec. 103. Expansion of substance use disorder treatment services 
              provided by Department of Veterans Affairs.
Sec. 104. Care for veterans with mental health and substance use 
              disorders.
Sec. 105. Pilot program for Internet-based substance use disorder 
              treatment for veterans of Operation Iraqi Freedom and 
              Operation Enduring Freedom.
Sec. 106. Report on residential mental health care facilities of the 
              Veterans Health Administration.
Sec. 107. Pilot program on peer outreach and support for veterans and 
              use of community mental health centers and Indian Health 
              Service facilities.

                    TITLE II--MENTAL HEALTH RESEARCH

Sec. 201. Research program on comorbid post-traumatic stress disorder 
              and substance use disorders.
Sec. 202. Extension of authorization for Special Committee on Post-
              Traumatic Stress Disorder.

             TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

Sec. 301. Clarification of authority of Secretary of Veterans Affairs 
              to provide mental health services to families of 
              veterans.
Sec. 302. Pilot program on provision of readjustment and transition 
              assistance to veterans and their families in cooperation 
              with Vet Centers.

                     TITLE IV--HEALTH CARE MATTERS

Sec. 401. Veterans beneficiary travel program.
Sec. 402. Mandatory reimbursement of veterans receiving emergency 
              treatment in non-Department of Veterans Affairs 
              facilities until transfer to Department facilities.
Sec. 403. Pilot program of enhanced contract care authority for health 
              care needs of veterans in highly rural areas.
Sec. 404. Epilepsy centers of excellence.
Sec. 405. Establishment of qualifications for peer specialist 
              appointees.
Sec. 406. Establishment of consolidated patient accounting centers.
Sec. 407. Repeal of limitation on authority to conduct widespread HIV 
              testing program.
Sec. 408. Provision of comprehensive health care by Secretary of 
              Veterans Affairs to children of Vietnam veterans born 
              with Spina Bifida.
Sec. 409. Exemption from copayment requirement for veterans receiving 
              hospice care.

                           TITLE V--PAIN CARE

Sec. 501. Comprehensive policy on pain management.

                  TITLE VI--HOMELESS VETERANS MATTERS

Sec. 601. Increased authorization of appropriations for comprehensive 
              service programs.
Sec. 602. Expansion and extension of authority for program of referral 
              and counseling services for at-risk veterans 
              transitioning from certain institutions.
Sec. 603. Permanent authority for domiciliary services for homeless 
              veterans and enhancement of capacity of domiciliary care 
              programs for female veterans.
Sec. 604. Financial assistance for supportive services for very low-
              income veteran families in permanent housing.

TITLE VII--AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND MAJOR MEDICAL 
                            FACILITY LEASES

Sec. 701. Authorization for fiscal year 2009 major medical facility 
              projects.
Sec. 702. Modification of authorization amounts for certain major 
              medical facility construction projects previously 
              authorized.
Sec. 703. Authorization of fiscal year 2009 major medical facility 
              leases.
Sec. 704. Authorization of appropriations.
Sec. 705. Increase in threshold for major medical facility leases 
              requiring Congressional approval.
Sec. 706. Conveyance of certain non-Federal land by City of Aurora, 
              Colorado, to Secretary of Veterans Affairs for 
              construction of veterans medical facility.
Sec. 707. Report on facilities administration.
Sec. 708. Annual report on outpatient clinics.
Sec. 709. Name of Department of Veterans Affairs spinal cord injury 
              center, Tampa, Florida.

              TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

Sec. 801. Repeal of sunset on inclusion of noninstitutional extended 
              care services in definition of medical services.
Sec. 802. Extension of recovery audit authority.
Sec. 803. Permanent authority for provision of hospital care, medical 
              services, and nursing home care to veterans who 
              participated in certain chemical and biological testing 
              conducted by the Department of Defense.
Sec. 804. Extension of expiring collections authorities.
Sec. 805. Extension of nursing home care.
Sec. 806. Permanent authority to establish research corporations.
Sec. 807. Extension of requirement to submit annual report on the 
              Committee on Care of Severely Chronically Mentally Ill 
              Veterans.
Sec. 808. Permanent requirement for biannual report on Women's Advisory 
              Committee.
Sec. 809. Extension of pilot program on improvement of caregiver 
              assistance services.

                        TITLE IX--OTHER MATTERS

Sec. 901. Technical amendments.

     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--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

     SEC. 101. TRIBUTE TO JUSTIN BAILEY.

       This title is enacted in tribute to Justin Bailey, who, 
     after returning to the United States from service as a member 
     of the Armed Forces in Operation Iraqi Freedom, died in a 
     domiciliary facility of the Department of Veterans Affairs 
     while receiving care for post-traumatic stress disorder and a 
     substance use disorder.

     SEC. 102. FINDINGS ON SUBSTANCE USE DISORDERS AND MENTAL 
                   HEALTH.

       Congress makes the following findings:
       (1) More than 1,500,000 members of the Armed Forces have 
     been deployed in Operation Iraqi Freedom and Operation 
     Enduring Freedom. The 2005 Department of Defense Survey of 
     Health Related Behaviors Among Active Duty Personnel reports 
     that 23 percent of members of the Armed Forces on active duty 
     acknowledge a significant problem with alcohol use disorder, 
     with similar rates of acknowledged problems with alcohol use 
     disorder among members of the National Guard.
       (2) The effects of substance use disorder are wide ranging, 
     including significantly increased risk of suicide, 
     exacerbation of mental and physical health disorders, 
     breakdown of family support, and increased risk of 
     unemployment and homelessness.
       (3) While veterans suffering from mental health conditions, 
     chronic physical illness, and polytrauma may be at increased 
     risk for development of a substance use disorder, treatment 
     for these veterans is complicated by the need to address 
     adequately the physical and mental symptoms associated with 
     these conditions through appropriate medical intervention.
       (4) While the Veterans Health Administration has 
     dramatically increased health services for veterans from 1996 
     through 2006, the number of veterans receiving specialized 
     substance use disorder treatment services decreased 18 
     percent during that time. No comparable decrease in the 
     national rate of substance use disorder has been observed 
     during that time.
       (5) While some facilities of the Veterans Health 
     Administration provide exemplary substance use disorder 
     treatment services, the availability of such treatment 
     services throughout the health care system of the Veterans 
     Health Administration is inconsistent.
       (6) According to a 2006 report by the Government 
     Accountability Office, the Department of Veterans Affairs 
     significantly reduced its substance use disorder treatment 
     and rehabilitation services between 1996 and 2006, and the 
     Fiscal Year 2007 National Mental Health Program Monitoring 
     System report shows that little progress has been made in 
     restoring these services to their pre-1996 levels.

     SEC. 103. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT 
                   SERVICES PROVIDED BY DEPARTMENT OF VETERANS 
                   AFFAIRS.

       (a) In General.--The Secretary of Veterans Affairs shall 
     ensure the provision of such services and treatment to each 
     veteran enrolled in the health care system of the Department 
     of Veterans Affairs who is in need of services and treatments 
     for a substance use disorder as follows:
       (1) Screening for substance use disorder in all settings, 
     including primary care settings.
       (2) Short term motivational counseling services.
       (3) Marital and family counseling.
       (4) Intensive outpatient or residential care services.

[[Page 21102]]

       (5) Relapse prevention services.
       (6) Ongoing aftercare and outpatient counseling services.
       (7) Opiate substitution therapy services.
       (8) Pharmacological treatments aimed at reducing craving 
     for drugs and alcohol.
       (9) Detoxification and stabilization services.
       (10) Coordination with groups providing peer to peer 
     counseling.
       (11) Such other services as the Secretary considers 
     appropriate.
       (b) Provision of Services.--
       (1) Allocation of resources for provision of services.--The 
     Secretary shall ensure that amounts made available for care, 
     treatment, and services provided under this section are 
     allocated in such a manner that a full continuum of care, 
     treatment, and services described in subsection (a) is 
     available to veterans seeking such care, treatment, or 
     services, without regard to the location of the residence of 
     any such veterans.
       (2) Manner of provision.--The services and treatment 
     described in subsection (a) may be provided to a veteran 
     described in such subsection--
       (A) at Department of Veterans Affairs medical centers or 
     clinics;
       (B) by referral to other facilities of the Department that 
     are accessible to such veteran; or
       (C) by contract or fee-for-service payments with community-
     based organizations for the provision of such services and 
     treatments.
       (c) Alternatives in Case of Services Denied Due to Clinical 
     Necessity.--If the Secretary denies the provision to a 
     veteran of services or treatment for a substance use disorder 
     due to clinical necessity, the Secretary shall provide the 
     veteran such other services or treatment as are medically 
     appropriate.

     SEC. 104. CARE FOR VETERANS WITH MENTAL HEALTH AND SUBSTANCE 
                   USE DISORDERS.

       (a) In General.--If the Secretary of Veterans Affairs 
     provides a veteran inpatient or outpatient care for a 
     substance use disorder and a comorbid mental health disorder, 
     the Secretary shall ensure that treatment for such disorders 
     is provided concurrently--
       (1) through a service provided by a clinician or health 
     professional who has training and expertise in treatment of 
     substance use disorders and mental health disorders;
       (2) by separate substance use disorder and mental health 
     disorder treatment services when there is appropriate 
     coordination, collaboration, and care management between such 
     treatment services; or
       (3) by a team of clinicians with appropriate expertise.
       (b) Team of Clinicians With Appropriate Expertise 
     Defined.--In this section, the term ``team of clinicians with 
     appropriate expertise'' means a team consisting of the 
     following:
       (1) Clinicians and health professionals with expertise in 
     treatment of substance use disorders and mental health 
     disorders who act in coordination and collaboration with each 
     other.
       (2) Such other professionals as the Secretary considers 
     appropriate for the provision of treatment to veterans for 
     substance use and mental health disorders.

     SEC. 105. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE USE 
                   DISORDER TREATMENT FOR VETERANS OF OPERATION 
                   IRAQI FREEDOM AND OPERATION ENDURING FREEDOM.

       (a) Findings.--Congress makes the following findings:
       (1) Stigma associated with seeking treatment for mental 
     health disorders has been demonstrated to prevent some 
     veterans from seeking such treatment at a medical facility 
     operated by the Department of Defense or the Department of 
     Veterans Affairs.
       (2) There is a significant incidence among veterans of 
     post-deployment mental health problems, especially among 
     members of a reserve component who return as veterans to 
     civilian life.
       (3) Computer-based self-guided training has been 
     demonstrated to be an effective strategy for supplementing 
     the care of psychological conditions.
       (4) Younger veterans, especially those who served in 
     Operation Enduring Freedom or Operation Iraqi Freedom, are 
     comfortable with and proficient at computer-based technology.
       (5) Veterans living in rural areas may find access to 
     treatment for substance use disorder limited.
       (6) Self-assessment and treatment options for substance use 
     disorders through an Internet website may reduce stigma and 
     provides additional access for individuals seeking care and 
     treatment for such disorders.
       (b) In General.--Not later than October 1, 2009, the 
     Secretary of Veterans Affairs shall carry out a pilot program 
     to assess the feasibility and advisability of providing 
     veterans who seek treatment for substance use disorders 
     access to a computer-based self-assessment, education, and 
     specified treatment program through a secure Internet website 
     operated by the Secretary. Participation in the pilot program 
     shall be available on a voluntary basis for those veterans 
     who have served in Operation Enduring Freedom or Operation 
     Iraqi Freedom.
       (c) Elements of Pilot Program.--
       (1) In general.--In carrying out the pilot program under 
     this section, the Secretary shall ensure that--
       (A) access to the Internet website and the programs 
     available on the website by a veteran (or family member) does 
     not involuntarily generate an identifiable medical record of 
     that access by that veteran in any medical database 
     maintained by the Department of Veterans Affairs;
       (B) the Internet website is accessible from remote 
     locations, especially rural areas; and
       (C) the Internet website includes a self-assessment tool 
     for substance use disorders, self-guided treatment and 
     educational materials for such disorders, and appropriate 
     information and materials for family members of veterans.
       (2) Consideration of similar projects.--In designing the 
     pilot program under this section, the Secretary shall 
     consider similar pilot projects of the Department of Defense 
     for the early diagnosis and treatment of post-traumatic 
     stress disorder and other mental health conditions 
     established under section 741 of the John Warner National 
     Defense Authorization Act of Fiscal Year 2007 (Public Law 
     109-364; 120 Stat. 2304).
       (3) Location of pilot program.--The Secretary shall carry 
     out the pilot program through those medical centers of the 
     Department of Veterans Affairs that have established Centers 
     for Excellence for Substance Abuse Treatment and Education or 
     that have established a Substance Abuse Program Evaluation 
     and Research Center.
       (4) Contract authority.--The Secretary may enter into 
     contracts with qualified entities or organizations to carry 
     out the pilot program required under this section.
       (d) Duration of Pilot Program.--The pilot program required 
     by subsection (a) 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 six months after the completion 
     of the pilot program, the Secretary shall submit to Congress 
     a report on the pilot program, and shall include in that 
     report--an assessment of the feasibility and advisability of 
     continuing or expanding the pilot program, of any cost 
     savings or other benefits associated with the pilot program, 
     and any other recommendations.
       (f) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs 
     $1,500,000 for each of fiscal years 2010 and 2011 to carry 
     out the pilot program under this section.

     SEC. 106. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES 
                   OF THE VETERANS HEALTH ADMINISTRATION.

       (a) Review.--
       (1) In general.--Not later than six months after the date 
     of the enactment of this Act, the Secretary of Veterans 
     Affairs shall, acting through the Inspector General of the 
     Department of Veterans Affairs, complete a review of all 
     residential mental health care facilities, including 
     domiciliary facilities, of the Veterans Health 
     Administration.
       (2) Assessment.--As part of the review required by 
     paragraph (1), the Secretary, acting through the Inspector 
     General, shall assess the following:
       (A) The availability of care in residential mental health 
     care facilities in each Veterans Integrated Service Network 
     (VISN).
       (B) The supervision and support provided in the residential 
     mental health care facilities of the Veterans Health 
     Administration.
       (C) The ratio of staff members at each residential mental 
     health care facility to patients at such facility.
       (D) The appropriateness of rules and procedures for the 
     prescription and administration of medications to patients in 
     such residential mental health care facilities.
       (E) The protocols at each residential mental health care 
     facility for handling missed appointments.
       (3) Recommendations.--As part of the review required by 
     paragraph (1), the Secretary, acting through the Inspector 
     General, shall develop such recommendations as the Secretary 
     considers appropriate for improvements to residential mental 
     health care facilities of the Veterans Health Administration 
     and the care provided in such facilities.
       (b) Follow-up Review.--Not later than two years after the 
     date of the completion of the review required by subsection 
     (a), the Secretary of Veterans Affairs shall, acting through 
     the Inspector General of the Department of Veterans Affairs, 
     complete a follow-up review of the facilities reviewed under 
     subsection (a) to evaluate any improvements made or problems 
     remaining since the review under subsection (a) was 
     completed.
       (c) Report.--Not later than 90 days after the completion of 
     the review required by subsection (a), 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 findings of 
     the Secretary with respect to such review.

     SEC. 107. PILOT PROGRAM ON PEER OUTREACH AND SUPPORT FOR 
                   VETERANS AND USE OF COMMUNITY MENTAL HEALTH 
                   CENTERS AND INDIAN HEALTH SERVICE FACILITIES.

       (a) Pilot Program Required.--Commencing not later than 180 
     days after the date of the enactment of this Act, the 
     Secretary of Veterans Affairs shall carry out a pilot program 
     to assess the feasability and

[[Page 21103]]

     advisability of providing to veterans of Operation Iraqi 
     Freedom and Operation Enduring Freedom, and, in particular, 
     veterans who served in such operations as a member of the 
     National Guard or Reserve, the following:
       (1) Peer outreach services.
       (2) Peer support services provided by licensed providers of 
     peer support services or veterans who have personal 
     experience with mental illness.
       (3) Readjustment counseling services described in section 
     1712A of title 38, United States Code.
       (4) Other mental health services.
       (b) Provision of Certain Services.--In providing services 
     described in paragraphs (3) and (4) of subsection (a) under 
     the pilot program to veterans who reside in rural areas and 
     do not have adequate access through the Department of 
     Veterans Affairs to the services described in such 
     paragraphs, the Secretary shall, acting through the Office of 
     Mental Health Services and the Office of Rural Health, 
     provide such services as follows:
       (1) Through community mental health centers under contracts 
     or other agreements if entered into by the Secretary of 
     Veterans Affairs and the Secretary of Health and Human 
     Services for the provision of such services for purposes of 
     the pilot program.
       (2) Through the Indian Health Service, or an Indian tribe 
     or tribal organization that has entered into an agreement 
     with the Indian Health Service pursuant to the Indian Self-
     Determination and Education Assistance Act (25 U.S.C. 450 et 
     seq.), if a memorandum of understanding is entered into by 
     the Secretary of Veterans Affairs and the Secretary of Health 
     and Human Services for purposes of the pilot program.
       (3) Through other appropriate entities under contracts or 
     other agreements entered into by the Secretary of Veterans 
     Affairs for the provision of such services for purposes of 
     the pilot program.
       (c) Duration.--The pilot program shall be carried out 
     during the three-year period beginning on the date of the 
     commencement of the pilot program.
       (d) Program Locations.--
       (1) In general.--The pilot program shall be carried out 
     within areas selected by the Secretary for the purpose of the 
     pilot program in at least three Veterans Integrated Service 
     Networks (VISNs).
       (2) Rural geographic locations.--The locations selected 
     shall be in rural geographic locations that, as determined by 
     the Secretary, lack access to comprehensive mental health 
     services through the Department of Veterans Affairs.
       (3) Qualified providers.--In selecting locations for the 
     pilot program, the Secretary shall select locations in which 
     an adequate number of licensed mental health care providers 
     with credentials equivalent to those of Department mental 
     health care providers are available in Indian Health Service 
     facilities, community mental health centers, and other 
     entities for participation in the pilot program.
       (e) Participation in Program.--Each community mental health 
     center, facility of the Indian Health Service, or other 
     entity participating in the pilot program under subsection 
     (b) shall--
       (1) provide the services described in paragraphs (3) and 
     (4) of subsection (a) to eligible veterans, including, to the 
     extent practicable, telehealth services that link the center 
     or facility with Department of Veterans Affairs clinicians;
       (2) use the clinical practice guidelines of the Veterans 
     Health Administration or the Department of Defense in the 
     provision of such services; and
       (3) meet such other requirements as the Secretary shall 
     require.
       (f) Compliance With Department Protocols.--Each community 
     mental health center, facility of the Indian Health Service, 
     or other entity participating in the pilot program under 
     subsection (b) shall comply with--
       (1) applicable protocols of the Department before incurring 
     any liability on behalf of the Department for the provision 
     of services as part of the pilot program; and
       (2) access and quality standards of the Department relevant 
     to the provision of services as part of the pilot program.
       (g) Provision of Clinical Information.--Each community 
     mental health center, facility of the Indian Health Service, 
     or other entity participating in the pilot program under 
     subsection (b) shall, in a timely fashion, provide the 
     Secretary with such clinical information on each veteran for 
     whom such health center or facility provides mental health 
     services under the pilot program as the Secretary shall 
     require.
       (h) Training.--
       (1) Training of veterans.--As part of the pilot program, 
     the Secretary shall carry out a program of training for 
     veterans described in subsection (a) to provide the services 
     described in paragraphs (1) and (2) of such subsection.
       (2) Training of clinicians.--
       (A) In general.--The Secretary shall conduct a training 
     program for clinicians of community mental health centers, 
     Indian Health Service facilities, or other entities 
     participating in the pilot program under subsection (b) to 
     ensure that such clinicians can provide the services 
     described in paragraphs (3) and (4) of subsection (a) in a 
     manner that accounts for factors that are unique to the 
     experiences of veterans who served on active duty in 
     Operation Iraqi Freedom or Operation Enduring Freedom 
     (including their combat and military training experiences).
       (B) Participation in training.--Personnel of each community 
     mental health center, facility of the Indian Health Service, 
     or other entity participating in the pilot program under 
     subsection (b) shall participate in the training program 
     conducted pursuant to subparagraph (A).
       (i) Annual Reports.--Each community mental health center, 
     facility of the Indian Health Service, or other entity 
     participating in the pilot program under subsection (b) shall 
     submit to the Secretary on an annual basis a report 
     containing, with respect to the provision of services under 
     subsection (b) and for the last full calendar year ending 
     before the submission of such report--
       (1) the number of--
       (A) veterans served; and
       (B) courses of treatment provided; and
       (2) demographic information for such services, diagnoses, 
     and courses of treatment.
       (j) Program Evaluation.--
       (1) In general.--The Secretary shall, through Department of 
     Veterans Affairs Mental Health Services investigators and in 
     collaboration with relevant program offices of the 
     Department, design and implement a strategy for evaluating 
     the pilot program.
       (2) Elements.--The strategy implemented under paragraph (1) 
     shall assess the impact that contracting with community 
     mental health centers, the Indian Health Service, and other 
     entities participating in the pilot program under subsection 
     (b) has on the following:
       (A) Access to mental health care by veterans in need of 
     such care.
       (B) The use of telehealth services by veterans for mental 
     health care needs.
       (C) The quality of mental health care and substance use 
     disorder treatment services provided to veterans in need of 
     such care and services.
       (D) The coordination of mental health care and other 
     medical services provided to veterans.
       (k) Definitions.--In this section:
       (1) The term ``community mental health center'' has the 
     meaning given such term in section 410.2 of title 42, Code of 
     Federal Regulations (as in effect on the day before the date 
     of the enactment of this Act).
       (2) The term ``eligible veteran'' means a veteran in need 
     of mental health services who--
       (A) is enrolled in the Department of Veterans Affairs 
     health care system; and
       (B) has received a referral from a health professional of 
     the Veterans Health Administration to a community mental 
     health center, a facility of the Indian Health Service, or 
     other entity for purposes of the pilot program.
       (3) The term ``Indian Health Service'' means the 
     organization established by section 601(a) of the Indian 
     Health Care Improvement Act (25 U.S.C. 1661(a)).
       (l) Authorization of Appropriations.--There is authorized 
     to be appropriated such sums as may be necessary to carry out 
     the provisions of this section.

                    TITLE II--MENTAL HEALTH RESEARCH

     SEC. 201. RESEARCH PROGRAM ON COMORBID POST-TRAUMATIC STRESS 
                   DISORDER AND SUBSTANCE USE DISORDERS.

       (a) Program Required.--The Secretary of Veterans Affairs 
     shall, through the Office of Research and Development, carry 
     out a program of research into comorbid post-traumatic stress 
     disorder (PTSD) and substance use disorder.
       (b) Discharge Through National Center for Posttraumatic 
     Stress Disorder.--The research program required by subsection 
     (a) shall be carried out by the National Center for 
     Posttraumatic Stress Disorder. In carrying out the program, 
     the Center shall--
       (1) develop protocols and goals with respect to research 
     under the program; and
       (2) coordinate research, data collection, and data 
     dissemination under the program.
       (c) Research.--The program of research required by 
     subsection (a) shall address the following:
       (1) Comorbid post-traumatic stress disorder and substance 
     use disorder.
       (2) The systematic integration of treatment for post-
     traumatic stress disorder with treatment for substance use 
     disorder.
       (3) The development of protocols to evaluate care of 
     veterans with comorbid post-traumatic stress disorder and 
     substance use disorder.
       (d) Funding.--
       (1) Authorization of appropriations.--There is authorized 
     to be appropriated for the Department of Veterans Affairs for 
     each of fiscal years 2009 through 2012, $2,000,000 to carry 
     out this section.
       (2) Availability.--Amounts authorized to be appropriated by 
     paragraph (1) shall be made available to the National Center 
     on Posttraumatic Stress Disorder for the purpose specified in 
     that paragraph.
       (3) Supplement not supplant.--Any amount made available to 
     the National Center on Posttraumatic Stress Disorder for a 
     fiscal year under paragraph (2) is in addition to any other 
     amounts made available to the National Center on 
     Posttraumatic Stress

[[Page 21104]]

     Disorder for such year under any other provision of law.

     SEC. 202. EXTENSION OF AUTHORIZATION FOR SPECIAL COMMITTEE ON 
                   POST-TRAUMATIC STRESS DISORDER.

       Section 110(e)(2) of the Veterans' Health Care Act of 1984 
     (38 U.S.C. 1712A note; Public Law 98-528) is amended by 
     striking ``through 2008'' and inserting ``through 2012''.

             TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

     SEC. 301. CLARIFICATION OF AUTHORITY OF SECRETARY OF VETERANS 
                   AFFAIRS TO PROVIDE MENTAL HEALTH SERVICES TO 
                   FAMILIES OF VETERANS.

       (a) In General.--Chapter 17 is amended--
       (1) in section 1701(5)(B)--
       (A) by inserting ``marriage and family counseling,'' after 
     ``professional counseling,''; and
       (B) by striking ``as may be essential to'' and inserting 
     ``as the Secretary considers appropriate for''; and
       (2) in section 1782--
       (A) in subsection (a), by inserting ``marriage and family 
     counseling,'' after ``professional counseling,''; and
       (B) in subsection (b)--
       (i) by inserting ``marriage and family counseling,'' after 
     ``professional counseling,''; and
       (ii) by striking ``if--'' and all that follows and 
     inserting a period.
       (b) Location.--Paragraph (5) of section 1701 of title 38, 
     United States Code, shall not be construed to prevent the 
     Secretary of Veterans Affairs from providing services 
     described in subparagraph (B) of such paragraph to 
     individuals described in such subparagraph in centers under 
     section 1712A of such title (commonly referred to as ``Vet 
     Centers''), Department of Veterans Affairs medical centers, 
     community-based outpatient clinics, or in such other 
     facilities of the Department of Veterans Affairs as the 
     Secretary considers necessary.

     SEC. 302. PILOT PROGRAM ON PROVISION OF READJUSTMENT AND 
                   TRANSITION ASSISTANCE TO VETERANS AND THEIR 
                   FAMILIES IN COOPERATION WITH VET CENTERS.

       (a) Pilot Program.--The Secretary of Veterans Affairs shall 
     carry out, through a non-Department of Veterans Affairs 
     entity, a pilot program to assess the feasability and 
     advisability of providing readjustment and transition 
     assistance described in subsection (b) to veterans and their 
     families in cooperation with centers under section 1712A of 
     title 38, United States Code (commonly referred to as ``Vet 
     Centers'').
       (b) Readjustment and Transition Assistance.--Readjustment 
     and transition assistance described in this subsection is 
     assistance as follows:
       (1) Readjustment and transition assistance that is 
     preemptive, proactive, and principle-centered.
       (2) Assistance and training for veterans and their families 
     in coping with the challenges associated with making the 
     transition from military to civilian life.
       (c) Non-Department of Veterans Affairs Entity.--
       (1) In general.--The Secretary shall carry out the pilot 
     program through any for-profit or non-profit organization 
     selected by the Secretary for purposes of the pilot program 
     that has demonstrated expertise and experience in the 
     provision of assistance and training described in subsection 
     (b).
       (2) Contract or agreement.--The Secretary shall carry out 
     the pilot program through a non-Department entity described 
     in paragraph (1) pursuant to a contract or other agreement 
     entered into by the Secretary and the entity for purposes of 
     the pilot program.
       (d) Commencement of Pilot Program.--The pilot program shall 
     commence not later than 180 days after the date of the 
     enactment of this Act.
       (e) Duration of Pilot Program.--The pilot program shall be 
     carried out during the three-year period beginning on the 
     date of the commencement of the pilot program, and may be 
     carried out for additional one-year periods thereafter.
       (f) Location of Pilot Program.--
       (1) In general.--The Secretary shall provide assistance 
     under the pilot program in cooperation with 10 centers 
     described in subsection (a) designated by the Secretary for 
     purposes of the pilot program.
       (2) Designations.--In designating centers described in 
     subsection (a) for purposes of the pilot program, the 
     Secretary shall designate centers so as to provide a balanced 
     geographical representation of such centers throughout the 
     United States, including the District of Columbia, the 
     Commonwealth of Puerto Rico, tribal lands, and other 
     territories and possessions of the United States.
       (g) Participation of Centers.--A center described in 
     subsection (a) that is designated under subsection (f) for 
     participation in the pilot program shall participate in the 
     pilot program by promoting awareness of the assistance and 
     training available to veterans and their families through--
       (1) the facilities and other resources of such center;
       (2) the non-Department of Veterans Affairs entity selected 
     pursuant to subsection (c); and
       (3) other appropriate mechanisms.
       (h) Additional Support.--In carrying out the pilot program, 
     the Secretary may enter into contracts or other agreements, 
     in addition to the contract or agreement described in 
     subsection (c), with such other non-Department of Veterans 
     Affairs entities meeting the requirements of subsection (c) 
     as the Secretary considers appropriate for purposes of the 
     pilot program.
       (i) Report on Pilot Program.--
       (1) Report required.--Not later than three years after the 
     date of the enactment of this Act, the Secretary shall submit 
     to the congressional veterans affairs committees a report on 
     the pilot program.
       (2) Elements.--Each report under paragraph (1) shall 
     include the following:
       (A) A description of the activities under the pilot program 
     as of the date of such report, including the number of 
     veterans and families provided assistance under the pilot 
     program and the scope and nature of the assistance so 
     provided.
       (B) A current assessment of the effectiveness of the pilot 
     program.
       (C) Any recommendations that the Secretary considers 
     appropriate for the extension or expansion of the pilot 
     program.
       (3) Congressional veterans affairs committees defined.--In 
     this subsection, the term ``congressional veterans affairs 
     committees'' means--
       (A) the Committees on Veterans' Affairs and Appropriations 
     of the Senate; and
       (B) the Committees on Veterans' Affairs and Appropriations 
     of the House of Representatives.
       (j) Authorization of Appropriations.--
       (1) In general.--There is authorized to be appropriated for 
     the Department of Veterans Affairs for each of fiscal years 
     2009 through 2011 $1,000,000 to carry out this section.
       (2) Availability.--Amounts authorized to be appropriated by 
     paragraph (1) shall remain available until expended.

                     TITLE IV--HEALTH CARE MATTERS

     SEC. 401. VETERANS BENEFICIARY TRAVEL PROGRAM.

       (a) Repeal of Requirement To Adjust Amounts Deducted From 
     Payments or Allowances for Beneficiary Travel.--
       (1) In general.--Section 111(c) is amended--
       (A) by striking paragraph (5); and
       (B) in paragraph (2), by striking ``, except as provided in 
     paragraph (5) of this subsection,''.
       (2) Reinstatement of amount of deduction specified by 
     statute.--Notwithstanding any adjustment made by the 
     Secretary of Veterans Affairs under paragraph (5) of section 
     111(c) of title 38, United States Code, as such paragraph was 
     in effect before the date of the enactment of this Act, the 
     amount deducted under paragraph (1) of such section 111(c) on 
     or after such date shall be the amount specified in such 
     paragraph.
       (b) Determination of Mileage Reimbursement Rate.--Section 
     111(g) is amended--
       (1) by amending paragraph (1) to read as follows:
       ``(1) Subject to paragraph (3), in determining the amount 
     of allowances or reimbursement to be paid under this section, 
     the Secretary shall use 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) by striking paragraphs (3) and (4); and
       (3) by inserting after paragraph (2) the following new 
     paragraph (3):
       ``(3) Subject to the availability of appropriations, the 
     Secretary may modify the amount of allowances or 
     reimbursement to be paid under this section using a mileage 
     reimbursement rate in excess of that prescribed under 
     paragraph (1).''.
       (c) Report.--Not later than 14 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 a report containing an estimate of the 
     additional costs incurred by the Department of Veterans 
     Affairs because of this section, including--
       (1) any costs resulting from increased utilization of 
     healthcare services by veterans eligible for travel 
     allowances or reimbursements under section 111 of title 38, 
     United States Code; and
       (2) the additional costs that would be incurred by the 
     Department should the Secretary exercise the authority 
     described in subsection (g)(3) of such section.
       (d) Effective Date.--The amendments made by this section 
     shall apply with respect to travel expenses incurred after 
     the expiration of the 90-day period that begins on the date 
     of the enactment of this Act.

     SEC. 402. MANDATORY REIMBURSEMENT OF VETERANS RECEIVING 
                   EMERGENCY TREATMENT IN NON-DEPARTMENT OF 
                   VETERANS AFFAIRS FACILITIES UNTIL TRANSFER TO 
                   DEPARTMENT FACILITIES.

       (a) Certain Veterans Without Service-Connected 
     Disability.--Section 1725 is amended--
       (1) in subsection (a)(1), by striking ``may reimburse'' and 
     inserting ``shall reimburse''; and

[[Page 21105]]

       (2) in subsection (f)(1), by striking subparagraph (C) and 
     inserting the following new subparagraph (C):
       ``(C) until--
       ``(i) such time as the veteran can be transferred safely to 
     a Department facility or other Federal facility and such 
     facility is capable of accepting such transfer; or
       ``(ii) such time as a Department facility or other Federal 
     facility accepts such transfer if--

       ``(I) at the time the veteran could have been transferred 
     safely to a Department facility or other Federal facility, no 
     Department facility or other Federal facility agreed to 
     accept such transfer; and
       ``(II) the non-Department facility in which such medical 
     care or services was furnished made and documented reasonable 
     attempts to transfer the veteran to a Department facility or 
     other Federal facility.''.

       (b) Certain Veterans With Service-Connected Disability.--
     Section 1728 is amended--
       (1) by striking subsection (a) and inserting the following 
     new subsection (a):
       ``(a) The Secretary shall, under such regulations as the 
     Secretary prescribes, reimburse veterans eligible for 
     hospital care or medical services under this chapter for the 
     customary and usual charges of emergency treatment (including 
     travel and incidental expenses under the terms and conditions 
     set forth in section 111 of this title) for which such 
     veterans have made payment, from sources other than the 
     Department, where such emergency treatment was rendered to 
     such veterans in need thereof for any of the following:
       ``(1) An adjudicated service-connected disability.
       ``(2) A non-service-connected disability associated with 
     and held to be aggravating a service-connected disability.
       ``(3) Any disability of a veteran if the veteran has a 
     total disability permanent in nature from a service-connected 
     disability.
       ``(4) Any illness, injury, or dental condition of a veteran 
     who--
       ``(A) is a participant in a vocational rehabilitation 
     program (as defined in section 3101(9) of this title); and
       ``(B) is medically determined to have been in need of care 
     or treatment to make possible the veteran's entrance into a 
     course of training, or prevent interruption of a course of 
     training, or hasten the return to a course of training which 
     was interrupted because of such illness, injury, or dental 
     condition.'';
       (2) in subsection (b), by striking ``care or services'' 
     both places it appears and inserting ``emergency treatment''; 
     and
       (3) by adding at the end the following new subsection:
       ``(c) In this section, the term `emergency treatment' has 
     the meaning given such term in section 1725(f)(1) of this 
     title.''.

     SEC. 403. PILOT PROGRAM OF ENHANCED CONTRACT CARE AUTHORITY 
                   FOR HEALTH CARE NEEDS OF VETERANS IN HIGHLY 
                   RURAL AREAS.

       (a) Pilot Program Required.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     conduct a pilot program under which the Secretary provides 
     covered health services to covered veterans through 
     qualifying non-Department of Veterans Affairs health care 
     providers.
       (2) Commencement.--The Secretary shall commence the conduct 
     of the pilot program on the date that is 120 days after the 
     date of the enactment of this Act.
       (3) Termination.--A veteran may receive health services 
     under the pilot program only during the three-year period 
     beginning on the date of the commencement of the pilot 
     program under paragraph (2).
       (4) Program locations.--The pilot program shall be carried 
     out within areas selected by the Secretary for the purposes 
     of the pilot program in at least five Veterans Integrated 
     Service Networks (VISNs). Of the Veterans Integrated Service 
     Networks so selected--
       (A) not less than four such networks shall include at least 
     three highly rural counties, as determined by the Secretary 
     upon consideration of the most recent decennial census;
       (B) not less than one such network, not including a network 
     selected under subparagraph (A), shall include only one 
     highly rural county, as determined by the Secretary upon 
     consideration of the most recent decennial census;
       (C) all such networks shall include area within the borders 
     of at least four States; and
       (D) no such networks shall be participants in the 
     Healthcare Effectiveness through Resource Optimization pilot 
     program of the Department of Veterans Affairs.
       (b) Covered Veterans.--
       (1) In general.--For purposes of the pilot program under 
     this section, a covered veteran is any highly rural veteran 
     who 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.
       (2) Highly rural veterans.--For purposes of this 
     subsection, a highly rural veteran is any veteran who--
       (A) resides in a location that is--
       (i) more than 60 miles driving distance from the nearest 
     Department health care facility providing primary care 
     services, if the veteran is seeking such services;
       (ii) more than 120 miles driving distance from the nearest 
     Department health care facility providing acute hospital 
     care, if the veteran is seeking such care; or
       (iii) more than 240 miles driving distance from the nearest 
     Department health care facility providing tertiary care, if 
     the veteran is seeking such care; or
       (B) in the case of a veteran who resides in a location less 
     than the distance specified in clause (i), (ii), or (iii) of 
     subparagraph (A), as applicable, experiences such hardship or 
     other difficulties in travel to the nearest appropriate 
     Department health care facility that such travel is not in 
     the best interest of the veteran, as determined by the 
     Secretary pursuant to regulations prescribed for purposes of 
     this subsection.
       (c) Covered Health Services.--For purposes of the pilot 
     program under this section, a covered health service with 
     respect to a covered veteran is any hospital care, medical 
     service, rehabilitative service, or preventative health 
     service that is authorized to be provided by the Secretary to 
     the veteran under chapter 17 of title 38, United States Code, 
     or any other provision of law.
       (d) Qualifying Non-Department Health Care Providers.--For 
     purposes of the pilot program under this section, an entity 
     or individual is a qualifying non-Department health care 
     provider of a covered health service if the Secretary 
     determines that the entity or individual is qualified to 
     furnish such service to veterans under the pilot program.
       (e) Election.--A covered veteran seeking to be provided 
     covered health services under the pilot program under this 
     section shall submit to the Secretary an application therefor 
     in such form, and containing such information as the 
     Secretary shall specify for purposes of the pilot program.
       (f) Provision of Services Through Contract.--The Secretary 
     shall provide covered health services to veterans under the 
     pilot program under this section through contracts with 
     qualifying non-Department health care providers for the 
     provision of such services.
       (g) Exchange of Medical Information.--In conducting the 
     pilot program under this section, the Secretary shall develop 
     and utilize a functional capability to provide for the 
     exchange of appropriate medical information between the 
     Department and non-Department health care providers providing 
     health services under the pilot program.
       (h) Reports.--Not later than the 30 days after the end of 
     each year in which the pilot program under this section is 
     conducted, the Secretary shall submit to the Committee of 
     Veterans' Affairs of the Senate and the Committee on 
     Veterans' Affairs of the House of Representatives a report 
     which includes--
       (1) the assessment of the Secretary of the pilot program 
     during the preceding year, including its cost, volume, 
     quality, patient satisfaction, benefit to veterans, and such 
     other findings and conclusions with respect to pilot program 
     as the Secretary considers appropriate; and
       (2) such recommendations as the Secretary considers 
     appropriate regarding--
       (A) the continuation of the pilot program;
       (B) extension of the pilot program to other or all Veterans 
     Integrated Service Networks of the Department;
       (C) making the pilot program permanent.

     SEC. 404. EPILEPSY CENTERS OF EXCELLENCE.

       (a) In General.--Subchapter II of chapter 73 is amended by 
     adding at the end the following new section:

     ``Sec. 7330A. Epilepsy centers of excellence

       ``(a) Establishment of Centers.--(1) Not later than 120 
     days after the date of the enactment of the Veterans' Mental 
     Health and Other Care Improvements Act of 2008, the Secretary 
     shall designate at least four but not more than six 
     Department health care facilities as locations for epilepsy 
     centers of excellence for the Department.
       ``(2) Of the facilities designated under paragraph (1), not 
     less than two shall be centers designated under section 7327 
     of this title.
       ``(3) Of the facilities designated under paragraph (1), not 
     less than two shall be facilities that are not centers 
     designated under section 7327 of this title.
       ``(4) Subject to the availability of appropriations for 
     such purpose, the Secretary shall establish and operate an 
     epilepsy center of excellence at each location designated 
     under paragraph (1).
       ``(b) Designation of Facilities.--(1) In designating 
     locations for epilepsy centers of excellence under subsection 
     (a), the Secretary shall solicit proposals from Department 
     health care facilities seeking designation as a location for 
     an epilepsy center of excellence.
       ``(2) The Secretary may not designate a facility as a 
     location for an epilepsy center of excellence under 
     subsection (a) unless the peer review panel established under 
     subsection (c) has determined under that subsection that the 
     proposal submitted by such facility seeking designation as a 
     location for an epilepsy center of excellence is among those 
     proposals that meet the highest competitive standards of 
     scientific and clinical merit.
       ``(3) In choosing from among the facilities meeting the 
     requirements of paragraph (2),

[[Page 21106]]

     the Secretary shall also consider appropriate geographic 
     distribution when designating the epilepsy centers of 
     excellence under subsection (a).
       ``(c) Peer Review Panel.--(1) The Under Secretary for 
     Health shall establish a peer review panel to assess the 
     scientific and clinical merit of proposals that are submitted 
     to the Secretary for the designation of epilepsy centers of 
     excellence under this section.
       ``(2)(A) The membership of the peer review panel shall 
     consist of experts on epilepsy, including post-traumatic 
     epilepsy.
       ``(B) Members of the peer review panel shall serve for a 
     period of no longer than two years, except as specified in 
     subparagraph (C).
       ``(C) Of the members first appointed to the panel, one half 
     shall be appointed for a period of three years and one half 
     shall be appointed for a period of two years, as designated 
     by the Under Secretary at the time of appointment.
       ``(3) The peer review panel shall review each proposal 
     submitted to the panel by the Under Secretary for Health and 
     shall submit its views on the relative scientific and 
     clinical merit of each such proposal to the Under Secretary.
       ``(4) The peer review panel shall, in conjunction with the 
     national coordinator designated under subsection (e), conduct 
     regular evaluations of each epilepsy center of excellence 
     established and operated under subsection (a) to ensure 
     compliance with the requirements of this section.
       ``(5) The peer review panel shall not be subject to the 
     Federal Advisory Committee Act.
       ``(d) Epilepsy Center of Excellence Defined.--In this 
     section, the term `epilepsy center of excellence' means a 
     health care facility that has (or in the foreseeable future 
     can develop) the necessary capacity to function as a center 
     of excellence in research, education, and clinical care 
     activities in the diagnosis and treatment of epilepsy and has 
     (or may reasonably be anticipated to develop) each of the 
     following:
       ``(1) An affiliation with an accredited medical school that 
     provides education and training in neurology, including an 
     arrangement with such school under which medical residents 
     receive education and training in the diagnosis and treatment 
     of epilepsy (including neurosurgery).
       ``(2) The ability to attract the participation of 
     scientists who are capable of ingenuity and creativity in 
     health care research efforts.
       ``(3) An advisory committee composed of veterans and 
     appropriate health care and research representatives of the 
     facility and of the affiliated school or schools to advise 
     the directors of such facility and such center on policy 
     matters pertaining to the activities of the center during the 
     period of the operation of such center.
       ``(4) The capability to conduct effectively evaluations of 
     the activities of such center.
       ``(5) The capability to assist in the expansion of the 
     Department's use of information systems and databases to 
     improve the quality and delivery of care for veterans 
     enrolled within the Department's health care system.
       ``(6) The capability to assist in the expansion of the 
     Department telehealth program to develop, transmit, monitor, 
     and review neurological diagnostic tests.
       ``(7) The ability to perform epilepsy research, education, 
     and clinical care activities in collaboration with Department 
     medical facilities that have centers for research, education, 
     and clinical care activities on complex multi-trauma 
     associated with combat injuries established under section 
     7327 of this title.
       ``(e) National Coordinator for Epilepsy Programs.--(1) To 
     assist the Secretary and the Under Secretary for Health in 
     carrying out this section, the Secretary shall designate an 
     individual in the Veterans Health Administration to act as a 
     national coordinator for epilepsy programs of the Veterans 
     Health Administration.
       ``(2) The duties of the national coordinator for epilepsy 
     programs shall include the following:
       ``(A) To supervise the operation of the centers established 
     pursuant to this section.
       ``(B) To coordinate and support the national consortium of 
     providers with interest in treating epilepsy at Department 
     health care facilities lacking such centers in order to 
     ensure better access to state-of-the-art diagnosis, research, 
     clinical care, and education for traumatic brain injury and 
     epilepsy throughout the health care system of the Department.
       ``(C) To conduct, in conjunction with the peer review panel 
     established under subsection (c), regular evaluations of the 
     epilepsy centers of excellence to ensure compliance  with the 
     requirements of this section.
       ``(D) To coordinate (as part of an integrated national 
     system) education, clinical care, and research activities 
     within all facilities with an epilepsy center of excellence.
       ``(E) To develop jointly a national consortium of providers 
     with interest in treating epilepsy at Department health care 
     facilities lacking an epilepsy center of excellence in order 
     to ensure better access to state-of-the-art diagnosis, 
     research, clinical care, and education for traumatic brain 
     injury and epilepsy throughout the health care system of the 
     Department. Such consortium should include a designated 
     epilepsy referral clinic in each Veterans Integrated Service 
     Network.
       ``(3) In carrying out duties under this subsection, the 
     national coordinator for epilepsy programs shall report to 
     the official of the Veterans Health Administration 
     responsible for neurology.
       ``(f) Authorization of Appropriations.--(1) There are 
     authorized to be appropriated $6,000,000 for each of fiscal 
     years 2009 through 2013 for the support of the clinical care, 
     research, and education activities of the epilepsy centers of 
     excellence established and operated pursuant to subsection 
     (a)(2).
       ``(2) There are authorized to be appropriated for each 
     fiscal year after fiscal year 2013 such sums as may be 
     necessary for the support of the clinical care, research, and 
     education activities of the epilepsy centers of excellence 
     established and operated pursuant to subsection (a)(2).
       ``(3) The Secretary shall ensure that funds for such 
     centers are designated for the first three years of operation 
     as a special purpose program for which funds are not 
     allocated through the Veterans Equitable Resource Allocation 
     system.
       ``(4) In addition to amounts authorized to be appropriated 
     under paragraphs (1) and (2) for a fiscal year, the Under 
     Secretary for Health shall allocate to such centers from 
     other funds appropriated generally for the Department medical 
     services account and medical and prosthetics research 
     account, as appropriate, such amounts as the Under Secretary 
     for Health determines appropriate.
       ``(5) In addition to amounts authorized to be appropriated 
     under paragraphs (1) and (2) for a fiscal year, there are 
     authorized to be appropriated such sums as may be necessary 
     to fund the national coordinator established by subsection 
     (e).''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of chapter 73 is amended by inserting after the 
     item relating to section 7330 the following new item:

``7330A. Epilepsy centers of excellence.''.

     SEC. 405. ESTABLISHMENT OF QUALIFICATIONS FOR PEER SPECIALIST 
                   APPOINTEES.

       (a) In General.--Section 7402(b) is amended--
       (1) by redesignating the paragraph (11) relating to other 
     health care positions as paragraph (14); and
       (2) by inserting after paragraph (12) the following new 
     paragraph (13):
       ``(13) Peer Specialist.--To be eligible to be appointed to 
     a peer specialist position, a person must--
       ``(A) be a veteran who has recovered or is recovering from 
     a mental health condition; and
       ``(B) be certified by--
       ``(i) a not-for-profit entity engaged in peer specialist 
     training as having met such criteria as the Secretary shall 
     establish for a peer specialist position; or
       ``(ii) a State as having satisfied relevant State 
     requirements for a peer specialist position.''.
       (b) Peer Specialist Training.--Section 7402 is amended by 
     adding at the end the following new subsection:
       ``(g) The Secretary may enter into contracts with not-for-
     profit entities to provide--
       ``(1) peer specialist training to veterans; and
       ``(2) certification for veterans under subsection 
     (b)(13)(B)(i).''.

     SEC. 406. ESTABLISHMENT OF CONSOLIDATED PATIENT ACCOUNTING 
                   CENTERS.

       (a) Establishment of Centers.--Chapter 17 is amended by 
     inserting after section 1729A the following new section:

     ``Sec. 1729B. Consolidated patient accounting centers

       ``(a) In General.--Not later than five years after the date 
     of the enactment of this section, the Secretary of Veterans 
     Affairs shall establish not more than seven consolidated 
     patient accounting centers for conducting industry-modeled 
     regionalized billing and collection activities of the 
     Department.
       ``(b) Functions.--The centers shall carry out the following 
     functions:
       ``(1) Reengineer and integrate all business processes of 
     the revenue cycle of the Department.
       ``(2) Standardize and coordinate all activities of the 
     Department related to the revenue cycle for all health care 
     services furnished to veterans for non-service-connected 
     medical conditions.
       ``(3) Apply commercial industry standards for measures of 
     access, timeliness, and performance metrics with respect to 
     revenue enhancement of the Department.
       ``(4) Apply other requirements with respect to such revenue 
     cycle improvement as the Secretary may specify.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by inserting after the 
     item relating to section 1729A the following:

``1729B. Consolidated patient accounting centers.''.

     SEC. 407. REPEAL OF LIMITATION ON AUTHORITY TO CONDUCT 
                   WIDESPREAD HIV TESTING PROGRAM.

       Section 124 of the Veterans' Benefits and Services Act of 
     1988 (title I of Public Law 100-322, as amended; 38 U.S.C. 
     7333 note) is repealed.

[[Page 21107]]



     SEC. 408. PROVISION OF COMPREHENSIVE HEALTH CARE BY SECRETARY 
                   OF VETERANS AFFAIRS TO CHILDREN OF VIETNAM 
                   VETERANS BORN WITH SPINA BIFIDA.

       (a) Provision of Comprehensive Health Care.--Section 
     1803(a) is amended by striking ``such health care as the 
     Secretary determines is needed by the child for the spina 
     bifida or any disability that is associated with such 
     condition'' and inserting ``health care under this section''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply with respect to care furnished after the date of 
     the enactment of this Act.

     SEC. 409. EXEMPTION FROM COPAYMENT REQUIREMENT FOR VETERANS 
                   RECEIVING HOSPICE CARE.

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

                           TITLE V--PAIN CARE

     SEC. 501. COMPREHENSIVE POLICY ON PAIN MANAGEMENT.

       (a) Comprehensive Policy Required.--Not later than October 
     1, 2009, the Secretary of Veterans Affairs shall develop and 
     implement a comprehensive policy on the management of pain 
     experienced by veterans enrolled for health care services 
     provided by the Department of Veterans Affairs.
       (b) Scope of Policy.--The policy required by subsection (a) 
     shall cover each of the following:
       (1) The Department-wide management of acute and chronic 
     pain experienced by veterans.
       (2) The standard of care for pain management to be used 
     throughout the Department.
       (3) The consistent application of pain assessments to be 
     used throughout the Department.
       (4) The assurance of prompt and appropriate pain care 
     treatment and management by the Department, system-wide, when 
     medically necessary.
       (5) Department programs of research related to acute and 
     chronic pain suffered by veterans, including pain 
     attributable to central and peripheral nervous system damage 
     characteristic of injuries incurred in modern warfare.
       (6) Department programs of pain care education and training 
     for health care personnel of the Department.
       (7) Department programs of patient education for veterans 
     suffering from acute or chronic pain and their families.
       (c) Updates.--The Secretary shall revise the policy 
     required by subsection (a) on a periodic basis in accordance 
     with experience and evolving best practice guidelines.
       (d) Consultation.--The Secretary shall develop the policy 
     required by subsection (a), and revise such policy under 
     subsection (c), in consultation with veterans service 
     organizations and organizations with expertise in the 
     assessment, diagnosis, treatment, and management of pain.
       (e) Annual Report.--
       (1) In general.--Not later than 180 days after the date of 
     the completion and initial implementation of the policy 
     required by subsection (a) and on October 1 of every fiscal 
     year thereafter through fiscal year 2018, 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 policy 
     required by subsection (a).
       (2) Contents.--The report required by paragraph (1) shall 
     include the following:
       (A) A description of the policy developed and implemented 
     under subsection (a) and any revisions to such policy under 
     subsection (c).
       (B) A description of the performance measures used to 
     determine the effectiveness of such policy in improving pain 
     care for veterans system-wide.
       (C) An assessment of the adequacy of Department pain 
     management services based on a survey of patients managed in 
     Department clinics.
       (D) An assessment of the research projects of the 
     Department relevant to the treatment of the types of acute 
     and chronic pain suffered by veterans.
       (E) An assessment of the training provided to Department 
     health care personnel with respect to the diagnosis, 
     treatment, and management of acute and chronic pain.
       (F) An assessment of the patient pain care education 
     programs of the Department.
       (f) Veterans Service Organization Defined.--In this 
     section, the term ``veterans service organization'' means any 
     organization recognized by the Secretary for the 
     representation of veterans under section 5902 of title 38, 
     United States Code.

                  TITLE VI--HOMELESS VETERANS MATTERS

     SEC. 601. INCREASED AUTHORIZATION OF APPROPRIATIONS FOR 
                   COMPREHENSIVE SERVICE PROGRAMS.

       Section 2013 is amended by striking ``$130,000,000'' and 
     inserting ``$150,000,000''.

     SEC. 602. EXPANSION AND EXTENSION OF AUTHORITY FOR PROGRAM OF 
                   REFERRAL AND COUNSELING SERVICES FOR AT-RISK 
                   VETERANS TRANSITIONING FROM CERTAIN 
                   INSTITUTIONS.

       (a) Program Authority.--Subsection (a) of section 2023 is 
     amended by striking ``a demonstration program for the purpose 
     of determining the costs and benefits of providing'' and 
     inserting ``a program of''.
       (b) Scope of Program.--Subsection (b) of such section is 
     amended--
       (1) by striking ``Demonstration'' in the subsection 
     heading;
       (2) by striking ``demonstration''; and
       (3) by striking ``in at least six locations'' and inserting 
     ``in at least 12 locations''.
       (c) Extension of Authority.--Subsection (d) of such section 
     is amended by striking ``shall cease'' and all that follows 
     and inserting ``shall cease on September 30, 2012.''.
       (d) Conforming Amendments.--
       (1) Subsection (c)(1) of such section is amended by 
     striking ``demonstration''.
       (2) The heading of such section is amended to read as 
     follows:

     ``Sec. 2023. Referral and counseling services: veterans at 
       risk of homelessness who are transitioning from certain 
       institutions''.

       (3) Section 2022(f)(2)(C) of such title is amended by 
     striking ``demonstration''.
       (e) Clerical Amendment.--The table of sections at the 
     beginning of chapter 20 is amended by striking the item 
     relating to section 2023 and inserting the following:

``2023. Referral and counseling services: veterans at risk of 
              homelessness who are transitioning from certain 
              institutions.''.

     SEC. 603. PERMANENT AUTHORITY FOR DOMICILIARY SERVICES FOR 
                   HOMELESS VETERANS AND ENHANCEMENT OF CAPACITY 
                   OF DOMICILIARY CARE PROGRAMS FOR FEMALE 
                   VETERANS.

       Subsection (b) of section 2043 is amended to read as 
     follows:
       ``(b) Enhancement of Capacity of Domiciliary Care Programs 
     for Female Veterans.--The Secretary shall take appropriate 
     actions to ensure that the domiciliary care programs of the 
     Department are adequate, with respect to capacity and with 
     respect to safety, to meet the needs of veterans who are 
     women.''.

     SEC. 604. FINANCIAL ASSISTANCE FOR SUPPORTIVE SERVICES FOR 
                   VERY LOW-INCOME VETERAN FAMILIES IN PERMANENT 
                   HOUSING.

       (a) Purpose.--The purpose of this section is to facilitate 
     the provision of supportive services for very low-income 
     veteran families in permanent housing.
       (b) Financial Assistance.--
       (1) In general.--Subchapter V of chapter 20 is amended by 
     adding at the end the following new section:

     ``Sec. 2044. Financial assistance for supportive services for 
       very low-income veteran families in permanent housing

       ``(a) Distribution of Financial Assistance.--(1) The 
     Secretary shall provide financial assistance to eligible 
     entities approved under this section to provide and 
     coordinate the provision of supportive services described in 
     subsection (b) for very low-income veteran families occupying 
     permanent housing.
       ``(2) Financial assistance under this section shall consist 
     of grants for each such family for which an approved eligible 
     entity is providing or coordinating the provision of 
     supportive services.
       ``(3)(A) The Secretary shall provide such grants to each 
     eligible entity that is providing or coordinating the 
     provision of supportive services.
       ``(B) The Secretary is authorized to establish intervals of 
     payment for the administration of such grants and establish a 
     maximum amount to be awarded, in accordance with the services 
     being provided and their duration.
       ``(4) In providing financial assistance under paragraph 
     (1), the Secretary shall give preference to entities 
     providing or coordinating the provision of supportive 
     services for very low-income veteran families who are 
     transitioning from homelessness to permanent housing.
       ``(5) The Secretary shall ensure that, to the extent 
     practicable, financial assistance under this subsection is 
     equitably distributed across geographic regions, including 
     rural communities and tribal lands.
       ``(6) Each entity receiving financial assistance under this 
     section to provide supportive services to a very low-income 
     veteran family shall notify that family that such services 
     are being paid for, in whole or in part, by the Department.
       ``(7) The Secretary may require entities receiving 
     financial assistance under this section to submit a report to 
     the Secretary that describes the projects carried out with 
     such financial assistance.
       ``(b) Supportive Services.--The supportive services 
     referred to in subsection (a) are the following:
       ``(1) Services provided by an eligible entity or a 
     subcontractor of an eligible entity that address the needs of 
     very low-income veteran families occupying permanent housing, 
     including--
       ``(A) outreach services;

[[Page 21108]]

       ``(B) case management services;
       ``(C) assistance in obtaining any benefits from the 
     Department which the veteran may be eligible to receive, 
     including, but not limited to, vocational and rehabilitation 
     counseling, employment and training service, educational 
     assistance, and health care services; and
       ``(D) assistance in obtaining and coordinating the 
     provision of other public benefits provided in federal, 
     State, or local agencies, or any organization defined in 
     subsection (f), including--
       ``(i) health care services (including obtaining health 
     insurance);
       ``(ii) daily living services;
       ``(iii) personal financial planning;
       ``(iv) transportation services;
       ``(v) income support services;
       ``(vi) fiduciary and representative payee services;
       ``(vii) legal services to assist the veteran family with 
     issues that interfere with the family's ability to obtain or 
     retain housing or supportive services;
       ``(viii) child care;
       ``(ix) housing counseling; and
       ``(x) other services necessary for maintaining independent 
     living.
       ``(2) Services described in paragraph (1) that are 
     delivered to very low-income veteran families who are 
     homeless and who are scheduled to become residents of 
     permanent housing within 90 days pending the location or 
     development of housing suitable for permanent housing.
       ``(3) Services described in paragraph (1) for very low-
     income veteran families who have voluntarily chosen to seek 
     other housing after a period of tenancy in permanent housing, 
     that are provided, for a period of 90 days after such 
     families exit permanent housing or until such families 
     commence receipt of other housing services adequate to meet 
     their current needs, but only to the extent that services 
     under this paragraph are designed to support such families in 
     their choice to transition into housing that is responsive to 
     their individual needs and preferences.
       ``(c) Application for Financial Assistance.--(1) An 
     eligible entity seeking financial assistance under subsection 
     (a) shall submit to the Secretary an application therefor in 
     such form, in such manner, and containing such commitments 
     and information as the Secretary determines to be necessary 
     to carry out this section.
       ``(2) Each application submitted by an eligible entity 
     under paragraph (1) shall contain--
       ``(A) a description of the supportive services proposed to 
     be provided by the eligible entity and the identified needs 
     for those services;
       ``(B) a description of the types of very low-income veteran 
     families proposed to be provided such services;
       ``(C) an estimate of the number of very low-income veteran 
     families proposed to be provided such services;
       ``(D) evidence of the experience of the eligible entity in 
     providing supportive services to very low-income veteran 
     families; and
       ``(E) a description of the managerial capacity of the 
     eligible entity--
       ``(i) to coordinate the provision of supportive services 
     with the provision of permanent housing by the eligible 
     entity or by other organizations;
       ``(ii) to assess continuously the needs of very low-income 
     veteran families for supportive services;
       ``(iii) to coordinate the provision of supportive services 
     with the services of the Department;
       ``(iv) to tailor supportive services to the needs of very 
     low-income veteran families; and
       ``(v) to seek continuously new sources of assistance to 
     ensure the long-term provision of supportive services to very 
     low-income veteran families.
       ``(3) The Secretary shall establish criteria for the 
     selection of eligible entities to be provided financial 
     assistance under this section.
       ``(d) Technical Assistance.--(1) The Secretary shall 
     provide training and technical assistance to participating 
     eligible entities regarding the planning, development, and 
     provision of supportive services to very low-income veteran 
     families occupying permanent housing, through the Technical 
     Assistance grants program in section 2064 of this title.
       ``(2) The Secretary may provide the training described in 
     paragraph (1) directly or through grants or contracts with 
     appropriate public or nonprofit private entities.
       ``(e) Funding.--(1) From amounts appropriated to the 
     Department for Medical Services, there shall be available to 
     carry out subsection (a), (b), and (c) amounts as follows:
       ``(A) $15,000,000 for fiscal year 2009.
       ``(B) $20,000,000 for fiscal year 2010.
       ``(C) $25,000,000 for fiscal year 2011.
       ``(2) Not more than $750,000 may be available under 
     paragraph (1) in any fiscal year to provide technical 
     assistance under subsection (d).
       ``(3) There is authorized to be appropriated $1,000,000 for 
     each of the fiscal year 2009 through 2011 to carry out the 
     provisions of subsection (d).
       ``(f) Definitions.--In this section:
       ``(1) The term `consumer cooperative' has the meaning given 
     such term in section 202 of the Housing Act of 1959 (12 
     U.S.C. 1701q).
       ``(2) The term `eligible entity' means--
       ``(A) a private nonprofit organization; or
       ``(B) a consumer cooperative.
       ``(3) The term `homeless' has the meaning given that term 
     in section 103 of the McKinney-Vento Homeless Assistance Act 
     (42 U.S.C. 11302).
       ``(4) The term `permanent housing' means community-based 
     housing without a designated length of stay.
       ``(5) The term `private nonprofit organization' means any 
     of the following:
       ``(A) Any incorporated private institution or foundation--
       ``(i) no part of the net earnings of which inures to the 
     benefit of any member, founder, contributor, or individual;
       ``(ii) which has a governing board that is responsible for 
     the operation of the supportive services provided under this 
     section; and
       ``(iii) which is approved by the Secretary as to financial 
     responsibility.
       ``(B) A for-profit limited partnership, the sole general 
     partner of which is an organization meeting the requirements 
     of clauses (i), (ii), and (iii) of subparagraph (A).
       ``(C) A corporation wholly owned and controlled by an 
     organization meeting the requirements of clauses (i), (ii), 
     and (iii) of subparagraph (A).
       ``(D) A tribally designated housing entity (as defined in 
     section 4 of the Native American Housing Assistance and Self-
     Determination Act of 1996 (25 U.S.C. 4103)).
       ``(6)(A) Subject to subparagraphs (B) and (C), the term 
     `very low-income veteran family' means a veteran family whose 
     income does not exceed 50 percent of the median income for an 
     area specified by the Secretary for purposes of this section, 
     as determined by the Secretary in accordance with this 
     paragraph.
       ``(B) The Secretary shall make appropriate adjustments to 
     the income requirement under subparagraph (A) based on family 
     size.
       ``(C) The Secretary may establish an income ceiling higher 
     or lower than 50 percent of the median income for an area if 
     the Secretary determines that such variations are necessary 
     because the area has unusually high or low construction 
     costs, fair market rents (as determined under section 8 of 
     the United States Housing Act of 1937 (42 U.S.C. 1437f)), or 
     family incomes.
       ``(7) The term `veteran family' includes a veteran who is a 
     single person and a family in which the head of household or 
     the spouse of the head of household is a veteran.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 20 is amended by inserting after the 
     item relating to section 2043 the following new item:

``2044. Financial assistance for supportive services for very low-
              income veteran families in permanent housing.''.
       (c) Study of Effectiveness of Permanent Housing Program.--
       (1) In general.--For fiscal years 2009 and 2010, the 
     Secretary shall conduct a study of the effectiveness of the 
     permanent housing program under section 2044 of title 38, 
     United States Code, as added by subsection (b), in meeting 
     the needs of very low-income veteran families, as that term 
     is defined in that section.
       (2) Comparison.--In the study required by paragraph (1), 
     the Secretary shall compare the results of the program 
     referred to in that subsection with other programs of the 
     Department of Veterans Affairs dedicated to the delivery of 
     housing and services to veterans.
       (3) Criteria.--In making the comparison required in 
     paragraph (2), the Secretary shall examine the following:
       (A) The satisfaction of veterans targeted by the programs 
     described in paragraph (2).
       (B) The health status of such veterans.
       (C) The housing provided such veterans under such programs.
       (D) The degree to which such veterans are encouraged to 
     productive activity by such programs.
       (4) Report.--Not later than March 31, 2011, 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 results of the study required 
     by paragraph (1).

TITLE VII--AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND MAJOR MEDICAL 
                            FACILITY LEASES

     SEC. 701. AUTHORIZATION FOR FISCAL YEAR 2009 MAJOR MEDICAL 
                   FACILITY PROJECTS.

       The Secretary of Veterans Affairs may carry out the 
     following major medical facility projects in fiscal year 2009 
     in the amount specified for each project:
       (1) Seismic corrections, Building 2, at the Department of 
     Veterans Affairs Palo Alto Health Care System, Palo Alto 
     Division Palo Alto, California, in an amount not to exceed 
     $54,000,000.
       (2) Construction of a polytrauma healthcare and 
     rehabilitation center at the Department of Veterans Affairs 
     Medical Center, San Antonio, Texas, in an amount not to 
     exceed $66,000,000.

[[Page 21109]]

       (3) Seismic corrections, Building 1, at the Department of 
     Veterans Affairs Medical Center, San Juan, Puerto Rico, in an 
     amount not to exceed $225,900,000.

     SEC. 702. MODIFICATION OF AUTHORIZATION AMOUNTS FOR CERTAIN 
                   MAJOR MEDICAL FACILITY CONSTRUCTION PROJECTS 
                   PREVIOUSLY AUTHORIZED.

       (a) Modification of Major Medical Facility 
     Authorizations.--Section 801(a) of the Veterans Benefits, 
     Health Care, and Information Technology Act of 2006 (Public 
     Law 109-461) is amended--
       (1) in paragraph (1)--
       (A) by striking ``$300,000,000'' and inserting 
     ``$625,000,000''; and
       (B) by striking the second sentence; and
       (2) in paragraph (3), by striking ``$98,000,000'' and 
     inserting ``$568,400,000''.
       (b) Modification of Authorization for Certain Major Medical 
     Facility Construction Projects Previously Authorized in 
     Connection With Capital Asset Realignment Initiative.--
       (1) Correction of patient privacy deficiencies at the 
     department of veterans affairs medical center, gainesville, 
     florida.--Paragraph (5) of section 802 of the Veterans 
     Benefits, Health Care, and Information Technology Act of 2006 
     (Public Law 109-461) is amended by striking ``$85,200,000'' 
     and inserting ``$136,700,000''.
       (2) Construction of a new medical center facility at the 
     department of veterans affairs medical center, las vegas, 
     nevada.--Paragraph (7) of such section is amended by striking 
     ``$406,000,000'' and inserting ``$600,400,000''.
       (3) Construction of a new outpatient clinic, lee county, 
     florida.--Paragraph (8) of such section is amended--
       (A) by striking ``ambulatory'' and all that follows through 
     ``purchase,'' and inserting ``outpatient clinic in''; and
       (B) by striking ``$65,100,000'' and inserting 
     ``$131,800,000''.
       (4) Construction of a new medical center facility, orlando, 
     florida.--Paragraph (11) of such section is amended by 
     striking ``$377,700,000'' and inserting ``$656,800,000''.
       (5) Consolidation of campuses at the university drive and 
     h. john heinz iii divisions, pittsburgh, pennsylvania.--
     Paragraph (12) of such section is amended by striking 
     ``$189,205,000'' and inserting ``$295,600,000''.

     SEC. 703. AUTHORIZATION OF FISCAL YEAR 2009 MAJOR MEDICAL 
                   FACILITY LEASES.

       The Secretary of Veterans Affairs may carry out the 
     following major medical facility leases in fiscal year 2009 
     at the locations specified, and in an amount for each lease 
     not to exceed the amount shown for such location:
       (1) For an outpatient clinic, Brandon, Florida, $4,326,000.
       (2) For an outpatient clinic, Colorado Springs, Colorado, 
     $10,300,000.
       (3) For an outpatient clinic, Eugene, Oregon, $5,826,000.
       (4) For the expansion of an outpatient clinic, Green Bay, 
     Wisconsin, $5,891,000.
       (5) For an outpatient clinic, Greenville, South Carolina, 
     $3,731,000.
       (6) For an outpatient clinic, Mansfield, Ohio, $2,212,000.
       (7) For an outpatient clinic, Mayaguez, Puerto Rico, 
     $6,276,000.
       (8) For an outpatient clinic, Mesa, Arizona, $5,106,000.
       (9) For interim research space, Palo Alto, California, 
     $8,636,000.
       (10) For the expansion of an outpatient clinic, Savannah, 
     Georgia, $3,168,000.
       (11) For an outpatient clinic, Sun City, Arizona, 
     $2,295,000.
       (12) For a primary care annex, Tampa, Florida, $8,652,000.
       (13) For an outpatient clinic, Peoria, Illinois, 
     $3,600,000.

     SEC. 704. AUTHORIZATION OF APPROPRIATIONS.

       (a) Authorization of Appropriations for Fiscal Year 2009 
     Major Medical Facility Projects.--There is authorized to be 
     appropriated for the Secretary of Veterans Affairs for fiscal 
     year 2009 for the Construction, Major Projects, account--
       (1) $345,900,000 for the projects authorized in section 
     701; and
       (2) $1,493,495,000 for the increased amounts authorized for 
     projects whose authorizations are modified by section 702.
       (b) Authorization For Appropriations For Fiscal Year 2009 
     Major Medical Facility Leases.--There is authorized to be 
     appropriated for the Secretary of Veterans Affairs for fiscal 
     year 2009 for the Medical Facilities account, $70,019,000, 
     for the leases authorized in section 703.

     SEC. 705. INCREASE IN THRESHOLD FOR MAJOR MEDICAL FACILITY 
                   LEASES REQUIRING CONGRESSIONAL APPROVAL.

       Section 8104(a)(3)(B) is amended by striking ``$600,000'' 
     and inserting ``$1,000,000''.

     SEC. 706. CONVEYANCE OF CERTAIN NON-FEDERAL LAND BY CITY OF 
                   AURORA, COLORADO, TO SECRETARY OF VETERANS 
                   AFFAIRS FOR CONSTRUCTION OF VETERANS MEDICAL 
                   FACILITY.

       Section 410 of title IV of division I of the Consolidated 
     Appropriations Act, 2008 (Public Law 110-161; 121 Stat. 2276) 
     is amended to read as follows:

     ``SEC. 410. CONVEYANCE OF CERTAIN NON-FEDERAL LAND.

       ``(a) Definitions.--In this section:
       ``(1) City.--The term `City' means the City of Aurora, 
     Colorado.
       ``(2) Deed.--The term `deed' means the quitclaim deed--
       ``(A) conveyed to the City by the Secretary (acting through 
     the Director of the National Park Service); and
       ``(B) dated May 24, 1999.
       ``(3) Non-federal land.--The term `non-Federal land' 
     means--
       ``(A) parcel I of the former United States Army Garrison 
     Fitzsimons, Adams County, Colorado, as more specifically 
     described in the deed; and
       ``(B) the parcel of land described in the deed.
       ``(4) Secretary.--The term `Secretary' means the Secretary 
     of the Interior.
       ``(b) Duty of Secretary.--To allow the City to convey by 
     donation to the United States the non-Federal land to be used 
     by the Secretary of Veterans Affairs for the construction of 
     a veterans medical facility, not later than 60 days after the 
     date of enactment of this section, the Secretary shall 
     execute each instrument that is necessary to release all 
     rights, conditions, and restrictions retained by the United 
     States in and to the non-Federal land conveyed in the 
     deed.''.

     SEC. 707. REPORT ON FACILITIES ADMINISTRATION.

       Not later than 60 days 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 progress of the Secretary in 
     complying with section 312A of title 38, United States Code.

     SEC. 708. ANNUAL REPORT ON OUTPATIENT CLINICS.

       (a) Annual Report Required.--Subchapter I of chapter 81 is 
     amended by adding at the end the following new section:

     ``Sec. 8119. Annual report on outpatient clinics

       ``(a) Annual Report Required.--The Secretary shall submit 
     to the committees an annual report on community-based 
     outpatient clinics and other outpatient clinics of the 
     Department. The report shall be submitted each year not later 
     than the date on which the budget for the next fiscal year is 
     submitted to the Congress under section 1105 of title 31.
       ``(b) Contents of Report.--Each report required under 
     subsection (a) shall include the following:
       ``(1) A list of each community-based outpatient clinic and 
     other outpatient clinic of the Department, and for each such 
     clinic, the type of clinic, location, size, number of health 
     professionals employed by the clinic, workload, whether the 
     clinic is leased or constructed and operated by the 
     Secretary, and the annual cost of operating the clinic.
       ``(2) A list of community-based outpatient clinics and 
     other outpatient clinics that the Secretary opened during the 
     fiscal year preceding the fiscal year during which the report 
     is submitted and a list of clinics the Secretary proposes 
     opening during the fiscal year during which the report is 
     submitted and the subsequent fiscal year, together with the 
     cost of activating each such clinic and the information 
     required to be provided under paragraph (1) for each such 
     clinic and proposed clinic.
       ``(3) A list of proposed community-based outpatient clinics 
     and other outpatient clinics that are, as of the date of the 
     submission of the report, under review by the National Review 
     Panel and a list of possible locations for future clinics 
     identified in the Department's strategic planning process, 
     including any identified locations in rural and underserved 
     areas.
       ``(4) A prioritized list of sites of care identified by the 
     Secretary that the Secretary could establish without carrying 
     out construction or entering into a lease, including--
       ``(A) any such sites that could be expanded by hiring 
     additional staff or allocating staff to Federal facilities or 
     facilities operating in collaboration with the Federal 
     Government; and
       ``(B) any sites established, or able to be established, 
     under sections 8111 and 8153 of this title.''.
       (b) Deadline for First Annual Report.--The Secretary of 
     Veterans Affairs shall submit the first report required under 
     section 8119(a) of title 38, United States Code, as added by 
     subsection (a), by not later than 90 days after the date of 
     the enactment of this Act.
       (c) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by adding at the end of 
     the items relating to subchapter I the following new item:

``8119. Annual report on outpatient clinics.''.

     SEC. 709. NAME OF DEPARTMENT OF VETERANS AFFAIRS SPINAL CORD 
                   INJURY CENTER, TAMPA, FLORIDA.

       The spinal cord injury center located at the James A. Haley 
     Department of Veterans Affairs Medical Center in Tampa, 
     Florida, shall after the date of the enactment of this Act be 
     known and designated as the ``Michael Bilirakis Department of 
     Veterans Affairs Spinal Cord Injury Center''. Any reference 
     to such center in any law, regulation,

[[Page 21110]]

     map, document, record, or other paper of the United States 
     shall be considered to be a reference to the ``Michael 
     Bilirakis Department of Veterans Affairs Spinal Cord Injury 
     Center''.

              TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

     SEC. 801. REPEAL OF SUNSET ON INCLUSION OF NONINSTITUTIONAL 
                   EXTENDED CARE SERVICES IN DEFINITION OF MEDICAL 
                   SERVICES.

       Section 1701 is amended--
       (1) by striking paragraph (10); and
       (2) in paragraph (6)--
       (A) by redesignating subparagraphs (E) and (F) as 
     subparagraphs (F) and (G), respectively; and
       (B) by inserting after subparagraph (D) the following new 
     subparagraph (E):
       ``(E) Noninstitutional extended care services, including 
     alternatives to institutional extended care that the 
     Secretary may furnish directly, by contract, or through 
     provision of case management by another provider or payer.''.

     SEC. 802. EXTENSION OF RECOVERY AUDIT AUTHORITY.

       Section 1703(d)(4) is amended by striking ``September 30, 
     2008'' and inserting ``September 30, 2013''.

     SEC. 803. PERMANENT AUTHORITY FOR PROVISION OF HOSPITAL CARE, 
                   MEDICAL SERVICES, AND NURSING HOME CARE TO 
                   VETERANS WHO PARTICIPATED IN CERTAIN CHEMICAL 
                   AND BIOLOGICAL TESTING CONDUCTED BY THE 
                   DEPARTMENT OF DEFENSE.

       (a) Permanent Authority.--Subsection (e)(3) of section 1710 
     is amended--
       (1) in subparagraph (B), by inserting ``and'' after the 
     semicolon;
       (2) in subparagraph (C), by striking ``; and'' and 
     inserting a period; and
       (3) by striking subparagraph (D).
       (b) Conforming Amendment.--Subsection (e)(1)(E) of such 
     section is amended by striking ``paragraphs (2) and (3)'' and 
     inserting ``paragraph (2)''.

     SEC. 804. EXTENSION OF EXPIRING COLLECTIONS AUTHORITIES.

       (a) Health Care Copayments.--Section 1710(f)(2)(B) is 
     amended by striking ``September 30, 2008'' and inserting 
     ``September 30, 2010''.
       (b) Medical Care Cost Recovery.--Section 1729(a)(2)(E) is 
     amended by striking ``October 1, 2008'' and inserting 
     ``October 1, 2010''.

     SEC. 805. EXTENSION OF NURSING HOME CARE.

       Section 1710A(d) is amended by striking ``December 31, 
     2008'' and inserting ``December 31, 2013''.

     SEC. 806. PERMANENT AUTHORITY TO ESTABLISH RESEARCH 
                   CORPORATIONS.

       (a) Repeal.--Chapter 73 is amended by striking section 
     7368.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter is amended by striking the item 
     relating to section 7368.

     SEC. 807. EXTENSION OF REQUIREMENT TO SUBMIT ANNUAL REPORT ON 
                   THE COMMITTEE ON CARE OF SEVERELY CHRONICALLY 
                   MENTALLY ILL VETERANS.

       Section 7321(d)(2) is amended by striking ``through 2008'' 
     and inserting ``through 2012''.

     SEC. 808. PERMANENT REQUIREMENT FOR BIANNUAL REPORT ON 
                   WOMEN'S ADVISORY COMMITTEE.

       Section 542(c)(1) is amended by striking ``through 2008''.

     SEC. 809. EXTENSION OF PILOT PROGRAM ON IMPROVEMENT OF 
                   CAREGIVER ASSISTANCE SERVICES.

       Section 214 of the Veterans Benefits, Health Care, and 
     Information Technology Act of 2006 (Public Law 109-461; 38 
     U.S.C. 1710B note) is amended--
       (1) in subsection (b), by striking ``two-year period'' and 
     inserting ``three-year period''; and
       (2) in subsection (d), by striking ``fiscal years 2007 and 
     2008'' and inserting ``fiscal years 2007 through 2009''.

                        TITLE IX--OTHER MATTERS

     SEC. 901. TECHNICAL AMENDMENTS.

       (a) Title 38.--Title 38, United States Code, is amended--
       (1) in section 1712A--
       (A) by striking subsection (g);
       (B) by redesignating subsections (d) through (i) as 
     subsections (c) through (f), respectively; and
       (C) in subsection (f), as so redesignated, by striking 
     ``(including a Resource Center designated under subsection 
     (h)(3)(A) of this section)'';
       (2) in section 2065(b)(3)(C), by striking ``)'';
       (3) in the table of sections at the beginning of chapter 
     36, by striking the item relating to section 3684A and 
     inserting the following new item:

``3684A. Procedures relating to computer matching program.'';
       (4) in section 4110(c)(1), by striking ``15'' and inserting 
     ``16'';
       (5) in the table of sections at the beginning of chapter 
     51, by striking the item relating to section 5121 and 
     inserting the following new item:

``5121. Payment of certain accrued benefits upon death of a 
              beneficiary.'';
       (6) in section 7458(b)(2), by striking ``pro rated'' and 
     inserting ``pro-rated'';
       (7) in section 8117(a)(1), by striking ``such such'' and 
     inserting ``such''; and
       (8) in each of sections 1708(d), 7314(f), 7320(j)(2), 
     7325(i)(2), and 7328(i)(2), by striking ``medical care 
     account'' and inserting ``medical services account''.
       (b) Veterans Benefits, Health Care, and Information 
     Technology Act of 2006.--Section 807(e) of the Veterans 
     Benefits, Health Care, and Information Technology Act of 2006 
     (Public Law 109-461) is amended by striking ``Medical Care'' 
     each place it appears and inserting ``Medical Facilities''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Filner) and the gentleman from Indiana (Mr. Buyer) each 
will control 20 minutes.
  The Chair recognizes the gentleman from California.
  Mr. FILNER. Mr. Speaker, I yield myself such time as I may consume.
  We are considering two bills. This first one, S. 2162, as amended, 
the Veterans' Mental Health and Other Care Improvements Act of 2008, 
and the next one is going to be about the Veterans' Benefits 
Improvement Act of 2008. These are two bills which passed the Senate, 
and is an omnibus bill that includes legislation from the Senate and 
from the House.
  Many of our Members have legislation in this bill. And they are two 
bills that are really going to be great for veterans, greatly enhance 
the benefit in both the health field and on the benefit field.
  As we have discussed these bills, we have learned much about the 
needs of our Nation's veterans, and this bill goes a long way to 
address them. Rates for post traumatic stress disorder, for example, 
amongst Operation Enduring Freedom and Operation Iraqi Freedom veterans 
has been estimated to be higher than 30 percent. Additionally, as we 
have tragically learned, suicide is on the rise. The Army reports, in 
fact, rates as high as they were during the Vietnam War. And the rate 
of homelessness among this cohort is also tragically growing. We must 
act now to address these issues before it's too late.
  We know from past wars that some veterans will struggle with 
substance abuse, homelessness, and PTSD. And we can see the same 
patterns emerging as a result of the stress of repeated deployments to 
OEF and OIF.
  This bill expands and improves the health care services available to 
veterans fighting substance use disorders and requires that all VA 
medical centers provide veterans access to the full continuum of care 
for substance use disorders.
  I would like to recognize both the leadership of the chairman of the 
Subcommittee on Health, Mr. Michaud, and Ms. Berkley for their strong 
advocacy for veterans who suffer with substance use disorder and for 
their contributions to this very important provision in the bill.
  As a way to honor the memory of Justin Bailey, a brave veteran that 
we lost to the horrors of war, this bill would ensure that the VA 
conduct more research about the often tragic relationship between PTSD 
and substance use disorders. The bill allows community mental health 
centers in rural areas to work with the VA to provide peer outreach and 
support services as well as readjustment and mental health services.
  We now know that PTSD not only affects the veteran, but also has a 
profound effect on their family. Thanks to the leadership of Mr. Hare 
from Illinois, this bill makes necessary changes to the law to allow 
the VA to provide needed counseling to families of veterans.
  In addition to addressing the mental health challenges facing our 
veterans, many also experience homelessness. While the VA continues to 
be the largest provider of direct services to homeless veterans, we 
must ensure that it remains postured to assist the growing number of 
homeless veterans and veterans at risk for homelessness. To this end, 
the bill increases the authorization for homeless programs to $150 
million.
  It also expands and extends a valuable joint VA and Department of 
Labor program of referral and counseling services, ensures that the VA 
domiciliary program is capable of meeting the needs of the growing 
female population, and provides necessary support to low-income veteran 
families that have made the transition to permanent housing. I want to 
thank Mr. Murphy

[[Page 21111]]

and Ms. Herseth Sandlin for their focus on this issue and ensuring that 
these provisions are in the bill.
  Aside from mental health and homelessness, many veterans struggle to 
cope with chronic and acute pain. This pain lingers long after the 
physical wounds of war have healed and affects the quality of life of 
many veterans. Thanks to Mr. Walz of Minnesota's leadership, this bill 
would require the VA to develop and implement a system-wide policy on 
pain management.
  S. 2162 also improves the health care for certain groups of 
especially vulnerable populations within the VA. It establishes 
Epilepsy Centers of Excellence to care for the 89,000 veterans with 
epilepsy, provides comprehensive health care to children of Vietnam 
veterans born with spina bifida, and updates VA policies regarding HIV 
testing. This would not have been possible without the hard work of Mr. 
Perlmutter of Colorado, Mr. Ellsworth of Indiana, and Mr. Doyle of 
Pennsylvania.
  Next, this bill would reduce the financial burden placed on our 
veterans. It requires the VA to reimburse veterans for the cost of 
emergency treatment received in non-VA facilities, prohibits the 
collection of copayments for all hospice care furnished by the VA, and 
increases the beneficiary travel mileage reimbursement rate to the 
current government employee rate. I want to thank Mr. Space of Ohio for 
his contribution on the emergency treatment provision. And I would like 
to thank Mr. Miller from Florida for his work on prohibiting copayments 
for hospice care.
  Another challenge facing the VA is rural health. Today, nearly 39 
percent of veterans enrolled in the VA health care system live in rural 
areas. Despite the expansion of community-based outpatient clinics and 
vet centers, many rural veterans still have problems of access. Thanks 
to Mr. Moran of Kansas' leadership, this bill requires the VA to 
conduct a 3-year pilot program in five Veterans Integrated Service 
Networks to allow highly rural veterans to seek covered health services 
from non-VA health care providers.
  The VA is currently authorized to collect third-party payments from 
veterans' insurance companies, but due to ineffective procedures, over 
$1 billion go uncollected annually. This legislation would require the 
VA to establish no more than seven other Consolidated Patient Account 
Centers to enable it to improve its billing performance. And I want to 
recognize and thank my ranking member, Mr. Buyer of Indiana, for his 
contributions to this issue.
  The bill also gives the VA the legal authorities it needs to move 
forward in major facility construction projects and leases so that it 
can continue to provide world-class health care to veterans in world-
class facilities.
  The bill also extends or makes permanent a number of important 
expiring authorities.
  Finally, the bill would name the VA Spinal Cord Injury Center in 
Tampa, Florida, after our former colleague, Michael Bilirakis. It was 
through former Congressman Bilirakis' efforts that this center came 
into being. He served in the Air Force in the 1950s and served in 
Congress for 24 years. It is fitting that we recognize his efforts in 
naming the center after him.
  I want to recognize and thank Mr. Miller of Florida for his 
leadership on this issue, and also the younger Mr. Bilirakis from 
Florida for carrying on his father's tradition.
  Mr. Speaker, both Republican and Democratic Members of this committee 
made major contributions to this bill. And I want to thank the staff 
from both sides of the aisle for putting together such a comprehensive 
package. It takes care of the men and women who have given so much to 
defend this Nation, provides our veterans with the quality health care 
programs and services they need and they so richly deserve.
  I hope my colleagues will support S. 2162, as amended.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BUYER. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise in support of S. 2162, the Veterans' Mental 
Health and Other Care Improvements Act of 2008, as amended. I would 
like to say up front how very pleased I am with the overall bill, as 
well as S. 3023, as amended, the Veterans' Benefits Improvement Act, 
which will follow this bill.
  Before us, this bill incorporates almost 50 veterans' health care 
provisions that have passed either the House or the Senate this 
Congress in 15 bills listed in the joint explanatory statement 
accompanying this legislation.
  I would like to thank Chairman Filner and our esteemed colleagues in 
the Senate, Chairman Akaka and Ranking Member Richard Burr, for their 
bipartisan efforts to bring the compromise to the floor here tonight.
  I would also like to commend Health Subcommittee Chairman Mike 
Michaud and Ranking Member Jeff Miller for their leadership and spirit 
of cooperation that enabled us to reach this compromise agreement with 
the Senate.
  This comprehensive bill includes an array of substantive initiatives, 
and I would like to highlight just a few of them.
  The chairman just mentioned the construction bill. And in particular, 
I'm very pleased that we have the $66 million to fund for the fifth 
polytrauma center. And at these polytrauma centers, very dedicated 
individuals do amazing work to help save America's most precious 
assets. And so funding for the fifth polytrauma center is extremely 
important.
  I am also pleased that we have not only the facilities in Palo Alto, 
but also in Puerto Rico with regard to seismic corrections. We have 
increases in previous authorizations, not only in New Orleans, but also 
in Denver. And I'm most hopeful that the initiatives in Denver can be 
worked out satisfactorily that also please the Secretary of the VA. We 
also have increases with Orlando. So these three ongoing projects, New 
Orleans, Denver and Orlando, are extremely important to me.
  I also recognize and I want to thank the chairman. At the last 
moment--out-of-scope revisions are always difficult for us, and the VA 
brought us one of the out-of-scope provisions that dealt with the 
outpatient clinic in Peoria. And I want to thank the chairman for 
taking this up, and I also want to thank the Senate for accepting this, 
because that facility in Peoria, there were some miscalculations. And 
had we not acted, the VA could have proceeded, but in the end it would 
have cost us more money.

                              {time}  1945

  Acting and taking care of this outpatient clinic in Peoria was the 
right thing to do. I want to thank the chairman for taking up this out-
of-scope provision and also for the leadership of Ray LaHood of 
Illinois.
  I also want to comment on the VA substance-use disorder and mental 
health programs. A full continuum of care for substance-use disorder 
will go a long way I believe to help at-risk veterans obtain care and 
overcome the stigma that may prevent them from seeking the services 
that they in fact need.
  In order to ensure that VA implements a patient-centered pain care 
strategy that is effective and consistent system-wide, the bill will 
require the VA to develop and implement a comprehensive pain management 
policy.
  The bill will also establish a pilot program to allow veterans in 
certain highly rural areas to obtain care from their local community 
providers. This provision originated from legislation introduced by my 
good friend and long-time member of the VA Committee, Jerry Moran of 
Kansas. Jerry Moran is a real champion of rural veterans, and I applaud 
him for his hard work and dedication to this cause. This is a cause 
that has lasted now for several Congresses.
  I am pleased that this bill also includes a measure I introduced, 
H.R. 6366, to help the VA secure collections from third-party insurance 
companies. This is an issue that I have been working on now for the 
last four sessions of Congress. Specifically, it would require the VA 
to establish seven Consolidated

[[Page 21112]]

Patient Accounting Centers, or CPACs, modeled after the successful Mid-
Atlantic CPAC over the next 5 years. I would like to thank Chairman 
Filner for working with me in a bipartisan fashion to make sure that 
this was included in the bill, and I also want to applaud the 
leadership of Mike Michaud and Mr. Miller.
  This measure comes from a bill I introduced to help the VA better 
manage third-party collections and provide additional fiscal 
responsibility for the department. The Consolidated Patient Accounting 
Center was established as a demonstration project back in 2005. It 
proved to be very successful in enhancing revenue by more than $12.5 
million in fiscal year 2007 in the demonstration project alone and more 
than $22 million over and above the goal as of August for fiscal year 
2008.
  Building on this success would enable the VA to secure hundreds of 
millions of dollars that currently go uncollected. What we did is we 
did a pilot. We found how successful that pilot project was over and 
above the projected revenue that we would get. And so we looked at this 
and said, well, this is something that needs to be rolled out across 
the country, and when we do this, we in fact are going to be receiving 
hundreds of millions of dollars. Those dollars then can be poured back 
in to further improve veterans' health care.
  I want to thank subcommittee Chairman Mike Michaud and Ranking Member 
Jeff Miller for having joined me as cosponsors on this initiative along 
with the leadership of Chairman Filner.
  Also, Mr. Speaker, there are a number of other important provisions 
in this bill that are omitted from my remarks simply because of the 
result of the constraints on time. But I would like to conclude by 
mentioning a notable provision that would designate the spinal cord 
injury center at the VA Medical Center in Tampa, Florida, as the 
Michael Bilirakis Department of Veterans Affairs Spinal Cord Injury 
Center that the chairman spoke of. All of us have a great deal of 
respect for Michael Bilirakis, and I am very, very pleased that my good 
friend and this great public servant is going to be recognized.
  Mr. Speaker, I would like to acknowledge at this time the hard work 
of the staff of both sides of the aisle here in the House Committee on 
Veterans' Affairs for their work on this legislation, in particular not 
only the individuals of the House majority health subcommittee but also 
that in the House and the Senate.
  With that, I want to reserve my time.
  Mr. FILNER. Mr. Speaker, I would like to yield 4 minutes to an 
incredibly active and important new Member from New York, John Hall, 
who chairs our Subcommittee on Disability Assistance and Memorial 
Affairs. I thank you for all your efforts on behalf of our veterans.
  Mr. HALL of New York. Thank you, Mr. Chairman.
  I rise today in strong support of this bill, the Veterans' Mental 
Health and Other Care Improvements Act. I am so pleased that the needs 
of our returning soldiers are finally being recognized and that 
Congress is finally taking action.
  While this is no panacea and much still needs to be done to fully 
care for our soldiers, namely to make wartime service in the theater of 
combat a presumption for post traumatic stress disorder which I have 
submitted that concept in independent legislation, I am glad to see 
that mental health is beginning to gain the recognition and the 
treatment it deserves.
  There is no greater time for this recognition than right now. The 
Rand Corporation did studies showing that approximately 20 to 30 
percent of our military servicemembers returning from Iraq and 
Afghanistan are showing symptoms of PTSD or depression. Longer and more 
frequent deployments are placing increased stresses on our military 
families and are taking a very real toll. Substance abuse and suicides 
are up, and coupled with our current financial hardships, our returning 
brave men and women and their families are facing incredibly difficult 
times.
  I am very grateful for all the work of the members of the Senate and 
House Veterans' Affairs Committees and for the leadership of Chairman 
Filner and Ranking Member Buyer for pushing through this legislation.
  Just to name a few of the provisions of the bill, it will utilize the 
Internet to provide education, outreach and treatment for substance 
abuse, PTSD or other ailments soldiers are facing; a review and update 
of all the VA's mental health facilities by the Inspector General; an 
additional pilot program providing peer outreach, peer support, 
readjustment and mental health services to veterans through contracts 
with community mental health centers; it increases funds for mental 
health research; and it provides marriage and family counseling within 
authorized mental health services and also bolsters family outreach 
programs.
  I strongly encourage my colleagues to support this bill and provide 
the returning men and women of our Armed Forces who have sacrificed so 
much for our Nation with the treatment and the respect that they 
deserve.
  Mr. BUYER. Mr. Speaker, I would like to yield to the gentleman from 
Kansas who actually represents 69 counties in the State of Kansas, 
which is about the size of the State of Indiana. But before he gets too 
excited, you could probably take five Kansases and put it in the State 
of Alaska. I bring that to your attention, Mr. Speaker, because this 
gentleman is a champion of rural America.
  With that, I yield as much time as the gentleman from Kansas (Mr. 
Moran) may consume.
  Mr. MORAN of Kansas. I thank the gentleman from Indiana for yielding 
me the time, and I am very grateful for the efforts that he and our 
chairman, the gentleman from California (Mr. Filner) have made on this 
entire legislation. But I'm here tonight to express my gratitude for 
the inclusion of provisions that for a long time have been a high 
priority for me as a Member of Congress from a very rural part of 
America. I have always thought that our veterans should not be 
discriminated against based upon where they live. And while we've made 
progress in regard to caring for all our veterans, we've made progress 
in regard to caring for our rural veterans, we still have a lot of 
effort that needs to be made. This bill tonight takes one additional 
step that I think is very important.
  The Department of Veterans Affairs, through our encouragement, has 
increased the number of outpatient clinics in this country so that 
those who live long distances from a VA hospital can access routine 
health care closer to home. We also have significantly increased the 
mileage reimbursement rate for veterans who live long distances. That 
is a major undertaking on our part, particularly with the ever rising 
cost of gasoline. And so we are making some steps that I think benefit 
rural veterans.
  But still, despite that effort, many veterans, including many who 
live in my congressional district in the State of Kansas, drive up to 5 
hours to access a VA outpatient clinic or a VA hospital. And so what a 
portion of this bill does tonight, the part I want to commend and bring 
forth for the Members of the House of Representatives to know and to 
understand, is this bill requires the Department of Veterans Affairs to 
create a 3-year pilot project that gives our highly rural veterans 
living in rural regions of this country the choice to receive health 
care at home. What this says is that the veteran can have the 
opportunity to see his or her hometown physician, be admitted to his or 
her hometown hospital, and that the Department of Veterans Affairs must 
enter into a contract to provide those services.
  So while I am very appreciative of the outpatient clinics and I 
appreciate the service and care that our VA hospitals provide, we have 
the opportunity for our veterans, particularly those who are aging, and 
many of our rural veterans are older every day, many of them are World 
War II veterans in their eighties and nineties, and a trip that is 
miles away and hours from home requires a significant undertaking. This 
allows those who are that distance, and that distance being about

[[Page 21113]]

60 miles from a VA clinic, 120 miles from a VA hospital or 240 miles 
from a specialized care facility, to have those services provided at 
home.
  It's also a good thing for the rural health care provider. I always 
describe it this way: Our hospitals, the infrastructure that surrounds 
the delivery of health care in rural America, is a lot like schools. We 
need every student we can get in a rural school to keep the school 
going, just as our hospitals and physicians need every patient that 
they can get in order to keep the hospital alive and well.
  So I'm here to commend my colleagues for their support of this 
legislation. I am very grateful to Delores Dunn, the staff director of 
the subcommittee, who has shepherded this effort on my behalf but 
really on behalf of veterans across rural America, and I commend our 
chairman and ranking member for their strong efforts on behalf of rural 
American veterans.
  Mr. BUYER. Reclaiming my time, I want to thank the gentleman for his 
leadership. He went through several Congresses with this. This is a 
testimonial really to your persistence and your dedication to the 
issue. I want to thank you. You never gave up on it. I want to thank 
you for your leadership.
  With that, I reserve my time.
  Mr. FILNER. Mr. Speaker, I would recognize another great and new 
member of our committee, the gentleman from Illinois (Mr. Hare), also 
for 4 minutes.
  Mr. HARE. Mr. Speaker, I rise in strong support of S. 2162, the 
Veterans' Mental Health and Other Care Improvement Acts of 2008. I want 
to commend Chairman Akaka, Chairman Filner, Ranking Member Buyer and 
all the members of the Senate and House Veterans' Affairs Committee for 
their leadership and hard work on this bill.
  S. 2162 is a bill that improves a variety of health care services 
provided by the Department of Veterans Affairs. First, it improves the 
treatment and services provided by the VA to veterans suffering from 
post traumatic stress disorder. Second, it provides more treatment for 
veterans battling substance-use disorders, and it directs the VA to 
develop and implement a comprehensive policy on the management of pain 
care.
  The bill also authorizes medical facility projects and major medical 
facility leases which are crucial to the improvement of health care for 
our veterans. And it takes on the unacceptable plight of homelessness, 
which thousands of our veterans face each and every night.
  S. 2162 also improves access to health care for veterans living in 
rural areas. It allows highly rural veterans to get services closer to 
home, and it provides a fair reimbursement rate to those who have to 
drive considerable distances. We have been working on this issue 
tirelessly throughout the 110th Congress. As someone who represents a 
district in Illinois that is very rural, I appreciate the progress that 
has been made on this issue. I want to commend my friend, Congressman 
Moran from Kansas, for his hard work and dedication on this issue.
  Finally, S. 2162 expands mental health care for the families of our 
heroes. The psychological toll that war brings also extends to the 
brave family members of our servicemembers. That is why I am encouraged 
to see that a bill I introduced, the Mental Health For Heroes' Family 
Act of 2008, has been included in S. 2162. Specifically, my bill 
removes the requirement that counseling must be initiated during the 
veteran's hospitalization, and is essential to permit the discharge for 
the veteran from the hospital. It also directs the Secretary of the 
Veterans Administration to carry out a 3-year pilot program to assess 
the feasibility and advisability of providing readjustment and 
transition assistance to veterans and their families.
  Mr. Speaker, I again thank Chairman Akaka, Chairman Filner and 
Ranking Member Buyer for their leadership on this bill and I want to 
commend both the Senate and House Veterans' Affairs Committee staff for 
their tireless work on this bill. I urge all of my colleagues to 
support this incredibly important piece of legislation.
  Mr. BUYER. The first thing I would like to do, Mr. Speaker, is I want 
to thank Mr. Hare for his leadership in mental health. You're a great 
addition to the committee, and I want to thank the gentleman.
  With that I reserve my time.
  Mr. FILNER. Mr. Speaker, I would like to recognize for 5 minutes the 
dynamic gentlelady from Florida who has served with me and fought with 
me for 16 years on this committee, Ms. Brown.

                              {time}  2000

  Ms. CORRINE BROWN of Florida. Mr. Speaker, first of all, let me thank 
Mr. Filner for his leadership on this committee. I am so proud that I 
am a part of this committee. Under his leadership, we passed the 
largest VA budget in the history of the United States. Our committee 
doesn't just ``talk the talk.'' We are ``walking the walk'' for the 
veterans. Thank you, and thanks to all of the members of the committee.
  I rise in support of S. 2162, the Veterans' Mental Health and Other 
Care Improvements Act of 2008. This bill includes many important issues 
of concern for veterans: mental health care, assistance for families, 
health care, pain care, provisions helping homeless vets, and 
construction of badly needed medical facilities.
  This last item is very important to Florida. My State has the largest 
and fastest growing elderly veterans population in the country. 
Everyone enjoys the warm weather, and veterans are no different. It is 
high time we build the facilities that will take care of those heroes 
and sheroes.
  The bill increases the authorization for the construction of a new VA 
medical facility in Orlando for close to $700 million. We have waited 
over 25 years for this facility. Let me repeat that. We have waited 
over 25 years for this facility, and to have construction delayed 
because of lack of money due to increased energy costs or inflation 
would be criminal.
  Also this bill increases the authorization by $51.5 million to fund 
patient privacy at the Gainesville Medical Center. We need to make sure 
our veterans are treated with respect.
  Earlier this year, this Congress passed the Military Construction and 
Veterans Affairs Appropriations bill under the leadership of Chairman 
Chet Edwards. I appreciate his including funds for the projects in this 
bill, allowing for the continued development of these medical centers.
  I urge the passage of this bill and continued support for our 
Nation's veterans.
  May God bless America, and I thank all the veterans for their 
service.
  Mr. FILNER. Mr. Speaker, I yield such time as he may consume to the 
gentleman from Texas (Mr. Rodriguez), another Member who has served on 
our committee for almost a decade.
  Mr. RODRIGUEZ. Madam Speaker, let me take this opportunity once again 
to thank Chairman Filner and the ranking member for this opportunity.
  Let me just say that the 110th Congress will be seen as the Congress 
that has done the most for veterans in the history of this House in 
terms of the funding of over $13 billion from the 2007-2008 budget, in 
addition to the supplementals. This will be the largest amount of 
resources for the VA since its inception in any one session. So the 
110th Congress is going to be seen as one of those Congresses that 
provided the resources, but also provided the programs that were needed 
and the accountability that needs to occur in order to make it happen. 
The result of that is because of the leadership in the form of 
Congressman Bob Filner, and I want to once again personally thank him 
for his leadership.
  Let me just say this particular bill has language that begins to make 
services permanent for those soldiers that participated in what was 
referred to as Project 112, or Project SHAD, which were the studies 
during the Cold War that this country did on our soldiers from the use 
of nerve gas to other items to see how our soldiers reacted. Now we 
know these soldiers are in need of services, and this language extends 
that opportunity for thousands of these soldiers to get those services 
that they

[[Page 21114]]

are entitled to. So I want to thank the leadership for that. I know it 
was a struggle with the Department of Defense in just identifying these 
projects.
  Secondly, I also want to signify that we have four major polytrauma 
centers throughout this country. The fifth one is going to be built in 
San Antonio. This particular center allows an opportunity for those 
soldiers that are out there that come back as veterans that have a 
multitude of problems, and this will allow the opportunity for 
returning servicemembers to be able to get the help they are entitled 
to and the construction of this facility, referred to as the fifth 
polytrauma center.
  In closing, let me also just say that I have one of the largest 
districts in the Nation. My district runs in a straight line 650 miles 
and 785 miles along the border, over 20 large counties. Some of the 
counties are larger than some of the States in the country. I have an 
area where not a single clinic exists in the Rural Health Initiatives 
that are out there to provide access for these soldiers and veterans.
  It is also important and essential, as indicated earlier, the fact 
that we have raised the amount of resources for reimbursement rates per 
mile for gasoline, and we know we might have to come back and revisit 
this because of the cost of gasoline.
  So, once again I thank the chairman and the ranking member for 
allowing us to pass these pieces of legislation.
  Mr. BUYER. Madam Speaker, I yield myself such time as I may consume.
  I would like to comment on a provision from the ranking member in the 
Senate, Richard Burr, the provision to require the VA to provide 
financial assistance grants to very low income veterans families 
residing in permanent housing for supportive services, including 
outreach, case management, assistance in obtaining VA benefits and 
assistance in obtaining other forms of public benefits.
  As we transition veterans from homelessness into permanent housing, 
these are provisions that in the last Congress Senator Burr was working 
very hard on, but did not come out as a result of the conference. He 
hung in there and we were able to get this done, and I want to thank 
Chairman Filner, who also accepted these provisions, and I want to 
extend my appreciation.
  I also want to extend appreciation to the leadership and to some 
Members who worked very hard on Orlando in making sure that that 
becomes a reality. These are Members that seem to never leave me alone. 
In particular, Tom Feeney, Cliff Stearns, Corrine Brown, Ginny Brown-
Waite and Ric Keller, working very hard to make sure that Orlando 
becomes a reality.
  The last thing I would like to thank Chairman Filner for was 
accepting the provisions along with Chairman Michaud, and that was 
Ranking Member Jeff Miller of the Health Subcommittee sought to 
eliminate all copayments for hospice care. Those of us that have had to 
deal with a loved one that goes through hospice care understand how 
difficult and challenging that moment is in all of our lives. So for us 
to waive those copayments during that time period I think was the right 
thing to do, and I want to thank the gentleman for his leadership on 
that.
  With that, I encourage all Members to support this legislation.
  Madam Speaker, I yield back my time.


                             General Leave

  Mr. FILNER. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material on S. 2162, as amended.
  The SPEAKER pro tempore (Ms. Kaptur). Is there objection to the 
request of the gentleman from California?
  There was no objection.
  Mr. FILNER. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I want to say to Congressman Buyer, the ranking 
member, and really all the Members on both the Republican and Democrat 
side of this committee, we have had some ups and downs in this year, 
but these two bills that we are doing today are great bills. I think 
we, and I say ``we'' meaning all of us, have a great deal to be proud 
of. We are going to touch millions of veterans with these bills, 
millions, and their families, and we are doing it on behalf of people 
that we know deserve no less.
  We have traveled around the country. We have met thousands of 
veterans in different States. I think both of us get more and more 
impressed with both the newer veterans and the older veterans and what 
they have accomplished and how they have carried out their lives. So we 
are very proud to have worked together to produce these bills.

          Joint Explanatory Statement For S. 2162, as Amended

    Veterans' Mental Health and Other Care Improvements Act of 2008

       The ``Veterans' Mental Health and Other Care Improvements 
     Act of 2008'' reflects a compromise agreement that the Senate 
     and House of Representatives' Committees on Veterans' Affairs 
     reached on certain provisions of a number of bills considered 
     by the House and Senate during the 110th Congress, including: 
     S. 2162, to improve the treatment and services provided by 
     the Department of Veterans Affairs to veterans with post-
     traumatic stress disorder and substance use disorders, and 
     for other purposes, passed by the Senate on June 3, 2008 
     [hereinafter, ``Senate Bill'']; H.R. 5554, to expand and 
     improve health care services available to veterans from the 
     Department of Veterans Affairs for substance use disorders, 
     and for other purposes, passed by the House on May 20, 2008 
     [hereinafter, ``House Bill'']; S. 1233, to provide and 
     enhance intervention, rehabilitative treatment, and services 
     to veterans with traumatic brain injury, and for other 
     purposes, placed on the Senate calendar on August 29, 2007.
       H.R. 1527, to conduct a pilot program to permit certain 
     highly rural veterans enrolled in the health system of the 
     Department of Veterans Affairs to receive covered health 
     services through providers other than those of the 
     Department, passed by the House on September 10, 2008; H.R. 
     2623, to prohibit the collection of copayments for all 
     hospice care furnished by the Department of Veterans Affairs, 
     passed by the House on July 30, 2007; H.R. 2818, to provide 
     for the establishment of epilepsy centers of excellence in 
     the Veterans Health Administration of the Department of 
     Veterans Affairs, passed by the House on June 24, 2008; H.R. 
     2874, to make certain improvements in the provision of health 
     care to veterans, and for other purposes, passed by the House 
     on July 30, 2007; S. 2969, to enhance the capacity of the 
     Department of Veterans Affairs to recruit and retain nurses 
     and other critical health care professionals, and for other 
     purposes, placed on the Senate calendar on September 18, 
     2008.
       H.R. 3819, to reimburse veterans receiving emergency 
     treatment in non-Department of Veterans Affairs facilities 
     for such treatment until such veterans are transferred to 
     Department facilities, and for other purposes, passed by the 
     House on May 21, 2008; H.R. 4264, to name the Department of 
     Veterans Affairs spinal cord injury center in Tampa, Florida, 
     as the ``Michael Bilirakis Department of Veterans Affairs 
     Spinal Cord Injury Center, passed by the House on June 26, 
     2008; H.R. 5729, to provide comprehensive health care to 
     children of Vietnam veterans born with Spina Bifida, and for 
     other purposes, passed by the House on May 20, 2008; H.R. 
     6445, to prohibit the Secretary of Veterans Affairs from 
     collecting certain copayments from veterans who are 
     catastrophically disabled, and for other purposes, passed by 
     the House on July 30, 2008; H.R. 6832, to authorize major 
     medical facility projects and major medical facility leases 
     for the Department of Veterans Affairs for fiscal year 2009, 
     to extend certain authorities of the Secretary of Veterans 
     Affairs, and for other purposes, passed by the House on 
     September 11, 2008; S. 2969, to enhance the capacity of the 
     Department of Veterans Affairs to recruit and retain nurses 
     and other critical health care professionals and for other 
     purposes, which was placed on the Senate legislative calendar 
     on September 18, 2008.
       The House and Senate Committees on Veterans' Affairs have 
     prepared the following explanation of the compromise bill, S. 
     2162 (hereinafter referred to as the ``Compromise 
     Agreement''). Differences between the provisions contained in 
     the Compromise Agreement and the related provisions in the 
     bills listed above are noted in this document, except for 
     clerical corrections and conforming changes made necessary by 
     the Compromise Agreement, and minor drafting, technical, and 
     clarifying changes.

        Title I--Substance Use Disorders and Mental Health Care

     Tribute to Justin Bailey (sec. 101)

       The Senate bill contained a provision (sec. 306) to specify 
     that this title is enacted in tribute to Justin Bailey, who, 
     after returning to the United States from service as member 
     of the Armed Forces in Operation Iraqi Freedom, died in a 
     domiciliary facility

[[Page 21115]]

     of the Department of Veterans Affairs while receiving care 
     for post-traumatic stress disorder and a substance use 
     disorder.
       Section 6 of the House bill contained the identical 
     provision.
       The Compromise Agreement contains this provision.

     Findings on Substance Use Disorders and Mental Health (sec. 
         102)

       The Senate bill contained a provision (sec. 301) that would 
     express the sense of the Congress that:
       (1) More than 1,500,000 members of the Armed Forces have 
     been deployed in Operation Iraqi Freedom and Operation 
     Enduring Freedom. The 2005 Department of Defense Survey of 
     Health Related Behaviors Among Active Duty Personnel reports 
     that 23 percent of members of the Armed Forces on active duty 
     acknowledge a significant problem with alcohol use, with 
     similar rates of acknowledged problems with alcohol use among 
     members of the National Guard.
       (2) The effects of substance abuse are wide ranging, 
     including significantly increased risk of suicide, 
     exacerbation of mental and physical health disorders, 
     breakdown of family support, and increased risk of 
     unemployment and homelessness.
       (3) While veterans suffering from mental health conditions, 
     chronic physical illness, and poly trauma may be at increased 
     risk for development of a substance use disorder, treatment 
     for these veterans is complicated by the need to address 
     adequately the physical and mental symptoms associated with 
     these conditions through appropriate medical intervention.
       (4) While the Veterans Health Administration has 
     dramatically increased health services for veterans from 1996 
     through 2006, the number of veterans receiving specialized 
     substance abuse treatment services decreased 18 percent 
     during that time. No comparable decrease in the national rate 
     of substance abuse has been observed during that time.
       (5) While some facilities of the Veterans Health 
     Administration provide exemplary substance use disorder 
     treatment services, the availability of such treatment 
     services throughout the health care system of the Veterans 
     Health Administration is inconsistent.
       (6) According to the Government Accountability Office, the 
     Department of Veterans Affairs significantly reduced its 
     substance use disorder treatment and rehabilitation services 
     between 1996 and 2006, and has made little progress since in 
     restoring these services to their pre-1996 levels.
       The House bill contained no similar provision.
       The Compromise Agreement contains the Senate provision but 
     modifies finding (6) to include the year of the Government 
     Accountability report and cites the National Mental Health 
     Program Monitoring System report.

     Expansion of Substance Use Disorder Treatment Services 
         Provided by the Department of Veterans Affairs (sec. 103)

       The Senate bill contained a provision (sec. 302) that would 
     require that the Secretary of Veterans Affairs ensure the 
     provision of services and treatment to each veteran enrolled 
     in the health care system of the Department who is in need of 
     services and treatments for a substance use disorder, and the 
     bill included a specific list of services. The Senate bill 
     would also authorize that the services and treatments may be 
     provided to a veteran: (1) at Department of Veterans Affairs 
     medical centers or clinics; (2) by referral to other 
     facilities of the Department that are accessible to such 
     veteran; or (3) by contract or fee- for-service payments with 
     community-based organizations for the provision of such 
     services and treatments.
       The House bill contained a similar provision (sec. 2) that 
     would require the Secretary to provide a full continuum of 
     care for substance use disorders to veterans in need of such 
     care and included a specific list of services, including 
     three services not included in the Senate bill: marital and 
     family counseling, screening for substance use disorders, and 
     coordination with groups providing peer to peer counseling. 
     The House bill (sec. 3) would also require the Secretary to 
     ensure that the amounts made available for care, treatment, 
     and services are allocated evenly throughout the system, 
     including an annual reporting requirement.
       The Compromise Agreement includes the listing of substance 
     use disorder services included in both the Senate and House 
     bills, and follows the Senate bill with respect to the 
     locations of where services would be provided. The Compromise 
     Agreement follows the House bill with respect to ensuring the 
     equitable distribution of resources for substance abuse 
     services but does not include the annual reporting 
     requirement.

     Care for Veterans with Mental Health and Substance Use 
         Disorders (sec. 104)

       The Senate bill contained a provision (sec. 303) that would 
     ensure that if the Secretary of Veterans Affairs provides a 
     veteran inpatient or outpatient care for a substance use 
     disorder and a comorbid mental health disorder, that the 
     treatment for such disorders be provided concurrently: (1) 
     through a service provided by a clinician or health 
     professional who has training and expertise in treatment of 
     substance use disorders and mental health disorders; (2) by 
     separate substance use disorder and mental health disorder 
     treatment services when there is appropriate coordination, 
     collaboration, and care management between such treatment 
     services; or (3) by a team of clinicians with appropriate 
     expertise.
       The House bill contained no similar provision.
       The Compromise Agreement contains the Senate provision.

     Pilot Program for Internet-based Substance Use Disorder 
         Treatment for Veterans of Operation Iraqi Freedom and 
         Operation Enduring Freedom (sec. 105)

       The House bill contained a provision (sec. 4) that would 
     express the sense of the Congress that:
       (1) Stigma associated with seeking treatment for mental 
     health disorders has been demonstrated to prevent some 
     veterans from seeking such treatment at a medical facility 
     operated by the Department of Defense or the Department of 
     Veterans Affairs.
       (2) There is a significant incidence among veterans of 
     post-deployment mental health problems, especially among 
     members of a reserve component who return as veterans to 
     civilian life.
       (3) Computer-based self-guided training has been 
     demonstrated to be an effective strategy for supplementing 
     the care of psychological conditions.
       (4) Younger veterans, especially those who served in 
     Operation Enduring Freedom or Operation Iraqi Freedom, are 
     comfortable with and proficient at computer-based technology.
       (5) Veterans living in rural areas find access to treatment 
     for substance use disorder limited.
       (6) Self-assessment and treatment options for substance use 
     disorders through an Internet website may reduce stigma and 
     provides additional access for individuals seeking care and 
     treatment for such disorders.
       This provision would also require the Secretary of Veterans 
     Affairs to carry out a pilot program to test the feasibility 
     and advisability of providing veterans who seek treatment for 
     substance use disorders access to a computer-based self-
     assessment, education, and specified treatment program 
     through a secure Internet website operated by the Secretary.
       The Senate bill contained no similar provision.
       The Compromise Agreement contains the House provision.

     Report on Residential Mental Health Care Facilities of the 
         Veterans Health Administration (sec. 106)

       The Senate bill contained a provision (sec. 305) that would 
     require the Secretary of Veterans Affairs, acting through the 
     Office of Mental Health Services of the Department of 
     Veterans Affairs, not later than six months after the date of 
     the enactment of this Act, conduct a review of all 
     residential mental health care facilities, including 
     domiciliary facilities, of the Veterans Health 
     Administration; and not later than two years after the date 
     of the completion of the first review conduct a follow-up 
     review of such facilities to evaluate any improvements made 
     or problems remaining since the first review was completed. 
     Not later than 90 days after the completion of the first 
     review, the Secretary would be required to 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 review.
       The House bill (sec. 5) contained a similar provision, 
     except there was no provision for a two-year follow-up 
     review, and the six-month review would be carried out by the 
     Office of the Medical Inspector.
       The Compromise Agreement includes the Senate provision 
     which specifies the two-year follow-up review, but would have 
     the Inspector General carry out the reviews.

     Pilot Program on Peer Outreach and Support for Veterans and 
         Use of Community Mental Health Centers and Indian Health 
         Service Facilities (sec. 107)

       The Senate bill contained a provision (sec. 401) that would 
     require the Secretary of Veterans Affairs to carry out a 
     pilot program to assess the feasibility and advisability of 
     providing the following to veterans of OIF/OEF in at least 
     two Veterans Integrated Service Networks: 1) peer outreach 
     services; 2) peer support services provided by licensed 
     providers of peer support services or veterans who have 
     personal experience with mental illness; 3) readjustment 
     counseling services; and other mental health services. 
     Services would be provided through community mental health 
     centers or other entities under contracts or other agreements 
     and through the Indian Health Service pursuant to a 
     memorandum of understanding entered into by the Secretary of 
     Veterans Affairs and the Secretary of Health and Human 
     Services.
       Section 6 of H.R. 2874 required the Secretary to carry out 
     a program to provide peer outreach services, peer support 
     services, and readjustment and mental health services to 
     covered veterans. This provision was not a pilot program and 
     did not provide for the means to collaborate with the Indian 
     Health Service.

[[Page 21116]]

       The Compromise Agreement contains the Senate provision with 
     an amendment that would authorize at least three pilot sites.

                    Title II--Mental Health Research

     Research Program on Comorbid Post-traumatic Stress Disorder 
         and Substance Use Disorders (sec. 201)

       The Senate bill contained a provision (sec. 501) that would 
     require the Secretary of Veterans Affairs to carry out a 
     program of research into comorbid post-traumatic stress 
     disorder (PTSD) and substance use disorder. This research 
     program shall be carried out by the National Center for 
     Posttraumatic Stress Disorder. In carrying out the program, 
     the Center shall: 1) develop protocols and goals with respect 
     to research under the program; and 2) coordinate research, 
     data collection, and data dissemination under the program.
       The House bill contained no similar provision.
       The Compromise Agreement contains the Senate provision.

     Extension of Authorization for Special Committee on Post-
         Traumatic Stress Disorder (sec. 202)

       The Senate bill contained a provision (sec. 502) that would 
     modify section 110(e)(2) of the Veterans' Health Care Act of 
     1984, P.L. 98-528, to extend the reporting requirement for 
     the Special Committee on Post-Traumatic Stress Disorder. 
     Currently, the reporting requirement is set to expire in 
     2008; this provision would extend it through 2012.
       Section 209 of H.R. 6832 contained an identical provision.
       The Compromise Agreement contains the provision.

             Title III--Assistance for Families of Veterans

     Clarification of Authority of Secretary of Veterans Affairs 
         to Provide Mental Health Services to Families of Veterans 
         (sec. 301)

       The Senate bill contained a provision (sec. 601) that would 
     amend section 1701(5)(B) of title 38, United States Code, to 
     clarify the authority of the Secretary of Veterans Affairs to 
     provide mental health services to families of veterans.
       Section 3 of H.R. 6445 contained a provision that would 
     modify section 1782(b) of title 38 so as to eliminate the 
     requirement that family support services be initiated during 
     the veteran's hospitalization and deemed essential to permit 
     the veteran's discharge.
       The Compromise Agreement follows the House bill with 
     respect to the provision eliminating the need for services to 
     be initiated during a veteran's hospitalization and essential 
     to the veteran's discharge, but follows the Senate bill with 
     respect to the provision to clarify the authority of the 
     Secretary of Veterans Affairs to provide mental health 
     services to families.

     Pilot Program on Provision of Readjustment and Transition 
         Assistance to Veterans and Their Families in Cooperation 
         with Vet Centers (sec. 302)

       The Senate bill contained a provision (sec. 402) that would 
     establish a pilot program to assess the feasibility and 
     advisability of providing additional readjustment and 
     transition assistance to veterans and their families in 
     cooperation with Readjustment Counseling Centers. The pilot 
     would be similar to family assistance programs previously 
     conducted at ten Army facilities around the country.
       The House bill contained no similar provision.
       The Compromise Agreement contains the Senate provision with 
     an amendment to begin the pilot program no later than 180 
     days after the enactment of the Act.

                     Title IV--Health Care Matters

     Veterans Beneficiary Travel Program (sec. 401)

       The Senate bill contained a provision (sec. 101) that would 
     direct the Secretary to reimburse qualifying veterans at the 
     rate authorized for Government employees under section 
     5707(b) of title 5. The Senate provision would also strike a 
     provision that allows the Secretary to raise or lower the 
     deductible for reimbursements in proportion to a change in 
     the mileage rate. Finally, the Senate provision would 
     reinstate the amount of the deductible for the beneficiary 
     travel reimbursement program to the amount in effect prior to 
     the Secretary's February 1, 2008, decision on beneficiary 
     travel.
       The House bill contained no similar provision.
       The Compromise Agreement contains the Senate provision.

     Mandatory Reimbursement of Veterans Receiving Emergency 
         Treatment in Non-Department of Veterans Affairs 
         Facilities until Transfer to Department Facilities (sec. 
         402)

       The Senate bill contained a provision that would amend 
     section 1725 of title 38 in subsections (a)(1) and (f)(1). 
     Subsection (a)(1) would be amended by replacing `may 
     reimburse' with `shall reimburse.' This change would make 
     reimbursement for emergency care received at non-VA 
     facilities mandatory for eligible veterans, rather than at 
     the discretion of the Secretary. Subsection (f)(1) would be 
     amended to provide greater specificity regarding the 
     termination of VA's obligation to reimburse. The Senate bill 
     would also amend section 1728 of title 38 so as to make that 
     section, which relates to reimbursement for the emergency 
     treatment of service-connected conditions, consistent with 
     section 1725, as amended. Thus, reimbursement would also be 
     made mandatory under Section 1728. The existing criteria, 
     defining veteran eligibility for reimbursement for emergency 
     care services, would be carried over in the revised statutory 
     language. In addition, the Senate bill would further amend 
     section 1728 so as to strike the phrase `care and services' 
     in current subsection (b) of section 1728, and replace that 
     phrase with `emergency treatment.' This proposed change is 
     designed to promote consistency between sections 1725 and 
     1728.
       H.R. 3819 contained similar provisions.
       The Compromise Agreement contains these provisions.

     Pilot Program of Enhanced Contract Care Authority for Health 
         Care Needs of Veterans in Highly Rural Areas (sec. 403)

       H.R. 1527 (sec. 2) would require the Secretary to conduct a 
     pilot program which permits highly rural veterans who are 
     enrolled in the system of patient enrollment established 
     under section 1705(a) of title 38, and who reside in Veterans 
     Integrated Service Networks (VISNs) 1, 15, 18, and 19, to 
     elect to receive covered health services for which such 
     veterans are eligible, through a non-Department health care 
     provider.
       The Senate bill contained no similar provision.
       The Compromise Agreement follows the House bill, with an 
     amendment that specifies that the pilot program will be 
     carried out in 5 VISNs, four of which shall include at least 
     three highly rural counties (as determined by the Secretary 
     based upon the most recent census data), and one of which 
     shall include one highly rural county. All VISNs selected 
     must include an area within the borders of at least four 
     states, and not be already participating in Project HERO. 
     Eligibility for participation in the pilot program would be 
     limited to those veterans already enrolled in the VA health 
     care system at the time of commencement of the program, as 
     well as OIF/OEF veterans who are eligible for VA health care 
     under section 1710(e)(3)(C) of title 38.

     Epilepsy Centers of Excellence (sec. 404)

       The Senate bill contained a provision (sec. 103) that would 
     require that the Secretary, upon the recommendation of the 
     Under Secretary for Health, designate not less than six 
     Department health care facilities as locations for epilepsy 
     centers of excellence.
       H.R. 2818 (sec. 2) would require the Secretary to designate 
     an epilepsy center of excellence at each of the 5 centers 
     designated under section 7327 of title 38 (Centers for 
     research, education, and clinical activities on complex 
     multi-trauma associated with combat injuries).
       The Compromise Agreement specifies that the Secretary shall 
     designate at least four but not more than six Department 
     health care facilities as locations for epilepsy centers of 
     excellence. Not less than two of these centers shall be 
     collocated with centers designated under 7327 of title 38.

     Establishment of Qualifications for Peer Specialist 
         Appointees (sec. 405)

       The Senate bill contained a provision (sec. 104) that would 
     amend section 7402(b) of title 38 so as to define 
     qualifications for peer specialist positions employed by the 
     Veterans Health Administration. Specifically, in order to be 
     eligible to be appointed to a peer specialist position, a 
     person must be a veteran who has recovered or is recovering 
     from a mental health condition; and be certified by a not-
     for-profit entity engaged in peer specialist training by 
     having met such criteria as the Secretary shall establish for 
     a peer specialist position; or a State by having satisfied 
     relevant State requirements for a peer specialist position. 
     The Senate bill would also amend section 7402 of title 38 so 
     as to add a new subsection providing authority for the 
     Secretary to enter into contracts with not-for-profit 
     entities to provide peer specialist training to veterans and 
     certification for veterans.
       The House bill contained no similar provision.
       The Compromise Agreement contains the Senate provision.

     Establishment of Consolidated Patient Accounting Centers 
         (sec. 406)

       Section 5 of H.R. 6445 contained a provision that would 
     amend chapter 17 of title 38 to insert a new section 
     mandating that not later than 5 years after the date of 
     enactment of this bill, the Secretary of Veterans Affairs 
     shall establish not more than seven consolidated patient 
     accounting centers for conducting industry-modeled 
     regionalized billing and collection activities of the 
     Department.
       The Senate bill contained no comparable provision.
       The Compromise Agreement contains the House provision.


[[Page 21117]]


     Repeal of Limitation on Authority to Conduct Widespread HIV 
         Testing Program (sec. 407)
       Section 217 of S. 2969 would repeal section 124 of Public 
     Law 100-322, which permits VA to test a patient for HIV 
     infection only if the veteran receives pre-test counseling 
     and provides written informed consent for such testing. 
     Eliminating this section from the law would bring VA's 
     statutory HIV testing requirements in line with current 
     guidelines issued by the Centers for Disease Control and 
     Prevention.
       Section 6 of H.R. 6445 contained an identical provision.
       The Compromise Agreement contains the provision.

     Provision of Comprehensive Health Care by Secretary of 
         Veterans Affairs to Children of Vietnam Veterans Born 
         with Spina Bifida (sec. 408)

       H.R. 5729 would amend section 1803(a) of title 38 so as to 
     expand the existing VA Spina Bifida Health Care Program and 
     provide a comprehensive health benefit to beneficiaries.
       The Senate bill contained no comparable provision.
       The Compromise Agreement contains the House provision.

     Exemption from Copayment Requirement for Veterans Receiving 
         Hospice Care (sec. 409)

       Section 309 of S. 1233 would amend section 1710 of title 38 
     so as to exempt hospice care provided in all settings from 
     the copayment requirement for VA long-term care. Under 
     current law, only hospice care provided in a VA nursing home 
     is exempted from copayment.
       H.R. 2623 contained a similar provision.
       The Compromise Agreement contains the provision.

                           Title V--Pain Care

     Comprehensive Policy on Pain Management (sec. 501)

       The Senate bill contained a provision (sec. 201) that would 
     require the Secretary of Veterans Affairs to develop and 
     implement a comprehensive policy on the management of pain 
     experienced by veterans enrolled for VA health care services 
     no later than October 1, 2008.
       The policy would be required to cover the following: the 
     Department-wide management of acute and chronic pain 
     experienced by veterans; the standard of care for pain 
     management to be used throughout the Department; the 
     consistent application of pain assessments to be used 
     throughout the Department; the assurance of prompt and 
     appropriate pain care treatment and management by the 
     Department, system-wide, when medically necessary; Department 
     programs of research related to acute and chronic pain 
     suffered by veterans, including pain attributable to central 
     and peripheral nervous system damage characteristic of 
     injuries incurred in modern warfare; Department programs of 
     pain care education and training for health care personnel of 
     the Department; and Department programs of patient education 
     for veterans suffering from acute or chronic pain and their 
     families.
       Section 4 of H.R. 6445 contained identical provisions.
       The Compromise Agreement contains the provisions, but would 
     require the Secretary of Veterans Affairs to develop and 
     implement a comprehensive policy on pain management no later 
     than October 1, 2009.

                  Title VI--Homeless Veterans Matters

     Increase in Authorization of Appropriations for the Homeless 
         Grant and Per Diem Program (sec. 601)

       Section 506 of S. 2969 would amend section 2013 of title 
     38, to increase the authorization of appropriations for the 
     Homeless Grant and Per Diem Program from $130 million to $200 
     million.
       The House bill contained no comparable provision.
       The Compromise Agreement contains the Senate provision but 
     changes the authorization amount to $150 million.

     Expansion and Extension of Authority for Program of Referral 
         and Counseling Services for At-risk Veterans 
         Transitioning from Certain Institutions (sec. 602)

       Section 403 of S. 1233 would amend section 2023 of title 38 
     so as to extend and expand the authority for a program to aid 
     incarcerated veterans in their transition back to civilian 
     life. The program would be extended until September 30, 2011, 
     and would be expanded from six to twelve sites.
       Section 7 of H.R. 2874 contained identical provisions.
       The Compromise Agreement contains the provision, but would 
     extend the program until September 30, 2012.

     Permanent Authority for Domiciliary Services for Homeless 
         Veterans and Enhancement of Capacity of Domiciliary Care 
         Programs for Female Veterans (sec. 603)

       Section 405 of S. 1233 would amend section 2043 of title 38 
     to make permanent an existing authority to expand domiciliary 
     care for homeless women veterans.
       Section 8 of H.R. 2874 contained identical provisions.
       The Compromise Agreement contains the provisions.

     Financial Assistance for Supportive Services for Very-low 
         Income Veteran Families in Permanent Housing (sec. 604)

       Section 406 of S. 1233 would amend title 38 so as to add a 
     new section 2044, relating to supportive services for very 
     low-income veterans and their families occupying permanent 
     housing. Proposed new section 2044 would direct VA to provide 
     grants to eligible entities to provide and coordinate the 
     provision of a comprehensive range of supportive services for 
     very low-income veteran families occupying permanent housing, 
     including those transitioning from homelessness to such 
     housing.
       Those families may be occupying permanent housing, moving 
     into permanent housing within 90 days, or moving from one 
     permanent residence to another to better suit their needs. 
     Entities eligible to receive grants under this provision are 
     public or private non-profit organizations which have 
     demonstrated the capacity and experience necessary to deliver 
     the services outlined in the proposed new section. Under the 
     provisions of the proposed new section 2044, grants would be 
     provided for a wide range of services, so as to give families 
     a broad set of tools to maintain a permanent residence. To 
     this end, providers could receive grants to furnish outreach, 
     case management, assistance in obtaining and coordinating VA 
     benefits, and assistance in obtaining and coordinating other 
     public benefits provided by federal, state, or local agencies 
     or organizations.
       Section 9 of H.R. 2874 contained similar provisions but 
     provided a more expansive list of supportive services, and 
     authorized for appropriations a different funding level.
       The Compromise Agreement contains the Senate provision.

Title VII--Authorization of Medical Facility Projects and Major Medical 
                            Facility Leases

     Authorization for Fiscal Year 2009 Major Medical Facility 
         Projects (sec. 701)

       Section 701 of S. 2969 would authorize:
       $54,000,000 to construct a facility to replace a 
     seismically unsafe acute psychiatric inpatient building in 
     Palo Alto, California.
       $131,800,000 for an outpatient clinic in Lee County, 
     Florida.
       $225,900,000 to make seismic corrections at a VA Medical 
     Center in San Juan, Puerto Rico.
       $66,000,000 to construct a state-of-the-art polytrauma 
     health care and rehabilitation center in San Antonio, Texas.
       Section 101 of H.R. 6832 contained the same provisions, 
     except for Lee County, Florida. Instead, H.R. 6832 authorizes 
     the Lee County project under a different section.
       The Compromise Agreement contains the House provision.

     Modification of Authorization Amounts for Certain Major 
         Medical Facility Construction Projects Previously 
         Authorized (sec. 702)

       Section 702 of S. 2969 would modify previous authorizations 
     by providing $625,000,000 for restoration, new construction, 
     or replacement of the medical care facility for the VA 
     Medical Center at New Orleans, Louisiana.
       Section 102 of H.R. 6832 contained the same provisions and 
     the following additional provisions:
       $769,200,000 for the replacement of the VA Medical Center 
     at Denver, Colorado.
       $131,800,000 for an outpatient clinic in Lee County, 
     Florida.
       $136,700,000 to correct patient privacy deficiencies at the 
     VA Medical Center in Gainesville, Florida.
       $600,400,000 to build a new VA Medical Center in Las Vegas, 
     Nevada.
       $656,800,000 to build a new medical center in Orlando, 
     Florida.
       $295,600,000 to consolidate the campuses at the University 
     Drive and H. John Heinz III Divisions in Pittsburgh, 
     Pennsylvania.
       The Compromise Agreement contains the House provision with 
     an amendment to provide $568,000,000 for the replacement of 
     the VA Medical Center at Denver, Colorado.

     Authorization of Fiscal Year 2009 Major Medical Facility 
         Leases (sec. 703)

       Section 703 of S. 2969 would authorize fiscal year 2009 
     major medical facility leases as follows:
       $4,326,000 for an outpatient clinic in Brandon, Florida.
       $10,300,000 for a community-based outpatient clinic in 
     Colorado Springs, Colorado.
       $5,826,000 for an outpatient clinic in Eugene, Oregon.
       $5,891,000 to expand an outpatient clinic in Green Bay, 
     Wisconsin.
       $3,731,000 for an outpatient clinic in Greenville, South 
     Carolina.
       $2,212,000 for a community-based outpatient clinic in 
     Mansfield, Ohio.
       $6,276,000 for a satellite outpatient clinic in Mayaguez, 
     Puerto Rico.
       $5,106,000 for a community-based outpatient clinic in 
     Southeast Phoenix, Mesa, Arizona.
       $8,636,000 for interim research space in Palo Alto, 
     California.

[[Page 21118]]

       $3,168,000 to expand a community-based outpatient clinic in 
     Savannah, Georgia.
       $2,295,000 for a community-based outpatient clinic in 
     Northwest Phoenix, Sun City, Arizona.
       $8,652,000 for a primary care annex in Tampa, Florida.
       Section 102 of H.R. 6832 included the same provisions, 
     except that it provided $3,995,000 for Colorado Springs.
       The Compromise Agreement includes the Senate provisions.

     Authorization of Appropriations (sec. 704)

       Section 704 of S. 2969 would authorize for appropriations:
       $477,700,000 for the aforementioned list of major medical 
     facility projects authorized for fiscal year 2009.
       $625,000,000 for the aforementioned list of major medical 
     facility construction projects previously authorized.
       $66,419,000 for the aforementioned list of major facility 
     leases authorized for fiscal year 2009.
       S. 2969 also identified funding sources which may be used 
     to carry out major medical facility projects authorized for 
     fiscal year 2009 and for those projects previously 
     authorized.
       Section 105 of H.R. 6832 would authorize for 
     appropriations:
       $345,900,000 for the aforementioned list of major medical 
     facility projects authorized for fiscal year 2009.
       $1,694,295,000 for the aforementioned list of major medical 
     facility construction projects previously authorized.
       $54,475,000 for the aforementioned list of major facility 
     leases authorized for fiscal year 2009.
       The Compromise Agreement includes the House provision, with 
     amendments to provide $1,493,495,000 for major facility 
     construction projects previously authorized and $70,019,000 
     for major facility leases authorized for fiscal year 2009. 
     The Agreement also includes the provision in S. 2969 on 
     allowable funding sources to carry out major medical facility 
     projects.

     Increase in Threshold for Major Medical Facility Leases 
         Requiring Congressional Approval (sec. 705)

       Section 705 of S. 2969 would increase the threshold for 
     major medical facility leases requiring Congressional 
     approval from $600,000 to $1,000,000.
       H.R. 6832 contained no comparable provision.
       The Compromise Agreement contains the Senate provision.

     Conveyance of Certain Non-Federal Land by City of Aurora, 
         Colorado, to Secretary of Veterans Affairs for 
         Construction of Veterans Medical Facility (sec. 706)

       Section 706 of S. 2969 would allow the city of Aurora to 
     donate non-Federal land for use by the Secretary of Veterans 
     Affairs no later than 60 days after the enactment of this 
     section.
       H.R. 6832 contained no comparable provision.
       The Compromise Agreement contains the Senate provision.

     Report on facilities administration (sec. 707)

       Section 106 of H.R. 6832 would require the Secretary of 
     Veterans Affairs to submit a report on facilities 
     administration no later than 60 days after the date of the 
     enactment of this section.
       S. 2969 contained no comparable provision
       The Compromise Agreement includes the House provision.

     Annual report on outpatient clinics (sec. 708)

       Section 107 of H.R. 6832 would require an annual report on 
     outpatient clinics no later than the date on which the budget 
     for the next fiscal year is submitted to the Congress under 
     section 1105 of title 31.
       S. 2969 contained no comparable provision.
       The Compromise Agreement includes the House provision.

     Name of Department of Veterans Affairs Spinal Cord Injury 
         Center, Tampa, Florida (sec. 709)

       H.R. 4264 would name the VA spinal cord injury center in 
     Tampa Florida, ``Michael Bilirakis Department of Veterans 
     Affairs Spinal Cord Injury Center.''
       S. 2969 contained no comparable provision.
       The Compromise Agreement includes the House provision.

              Title VIII--Extension of Certain Authorities

     Repeal of Sunset on Inclusion of Non-institutional Extended 
         Care Services in Definition of Medical Services (sec. 
         801)

       Section 201 of S. 2969 would amend section 1701 of title 38 
     to repeal the December 31, 2008, sunset on the inclusion of 
     non-institutional extended care services in the definition of 
     medical services.
       Sec. 201 of H.R. 6832 contained an identical provision.
       The Compromise Agreement contains the provision.

     Extension of Recovery Audit Authority (sec. 802)

       Section 202 of S. 2969 would amend section 1703(d)(4) of 
     title 38 to extend the recovery audit authority for fee-basis 
     contracts and other medical services contracts in non-VA 
     facilities from September 30, 2008, to September 30, 2013.
       Sec. 202 of H.R. 6832 contained an identical provision.
       The Compromise Agreement contains the provision.

     Permanent Authority for Provision of Hospital Care, Medical 
         Services, and Nursing Home Care to Veterans who 
         Participated in Certain Chemical and Biological Testing 
         Conducted by the Department of Defense (sec. 803)

       Section 203 of S. 2969 would amend subsection (e)(3) of 
     section 1710 of title 38 to provide permanent authority for 
     the provision of hospital care, medical services, and nursing 
     home care to veterans who participated in certain chemical 
     and biological testing conducted by the Department of 
     Defense.
       Section 203 of H.R. 6832 contained an identical provision.
       The Compromise Agreement contains the provision.

     Extension of Expiring Collections Authorities (sec. 804)

       S. 2969 contained no comparable provision.
       Section 204 of H.R. 6832 would extend the expiring 
     collections authorities for the following: a) amend section 
     1710(f)(2)(B) of title 38 to extend health care copayments 
     from September 30, 2008, under current law, to September 30, 
     2010; and b) amend section 1729 (a)(2)(E) of title 38 to 
     extend the medical care cost recovery from October 1, 2008, 
     to October 1, 2010.
       The Compromise Agreement contains the House provision.

     Extension of Nursing Home Care (sec. 805)

       Section 202 of S. 2969 would amend 1710A(d) of title 38 to 
     provide nursing home care to veterans with service-connected 
     disability, which expires on December 31, 2008, to December 
     31, 2013.
       Section 205 of H.R. 6832 contained an identical provision.
       The Compromise Agreement contains the provision.

     Permanent Authority to Establish Research Corporations (sec. 
         806)

       Section 607 of S. 2969 would strike section 7368 of title 
     38 to provide permanent authority to establish research 
     corporations
       Section 207 of H.R. 6832 contained an identical provision.
       The Compromise Agreement contains the provision.

     Extension of Requirement to Submit Annual Report on the 
         Committee on Care of Severely Chronically Mentally Ill 
         Veterans (sec. 807)

       Section 210 of H.R. 6832 would amend section 7321(d)(2) of 
     title 38 to extend the requirement to submit an annual report 
     on the committee on care of severely chronically mentally ill 
     veterans through 2012.
       S. 2969 contained no comparable provision.
       The Compromise Agreement contains the House provision.

     Permanent Requirement for Biannual Report on Women's Advisory 
         Committee (sec. 808)

       Section 211 of H.R. 6832 would amend section 542(c)(1) of 
     title 38 to provide for a permanent requirement for a 
     biannual report by the women's advisory committee on the 
     needs of women veterans including compensation, health care, 
     rehabilitation, outreach, and other benefits and programs 
     administered by the VA.
       S. 2969 contained no comparable provision.
       The Compromise Agreement contains the House provision.

     Extension of Pilot Program on Improvement of Caregiver 
         Assistance Services (sec. 809)

       Section 222 of S. 2969 would extend the pilot program on 
     improvement of caregiver assistance services for a three-year 
     period through fiscal year 2009.
       H.R. 6832 contained no comparable provision.
       The Compromise Agreement includes the Senate provision.

                        Title IX--Other Matters

     Technical Amendments (sec. 901)

       Section 303 of H.R. 6832 would provide for technical 
     amendments for the following sections of title 38: 1712A; 
     2065(b)(3)(C); 4110(c)(1); 7458(b)(2); 8117(a)(1); 1708(d); 
     7314(f); 7320(j)(2); 7325(i)(2); and 7328(i)(2). It also 
     would provide for technical amendments to the table of 
     sections at the beginning of chapter 36 and chapter 51, as 
     well as amend section 807(e) of the Veterans Benefits, Health 
     Care, and Information Technology Act of 2006 (Public Law 109-
     461) to replace the phrase `Medical Care' with `Medical 
     Facilities.'
       S. 2969 contained no comparable provision.
       The Compromise Agreement contains the House provision.
  Ms. BERKLEY. Madam Speaker, I am grateful for the opportunity to be 
part of this important legislation which expands mental health services 
for PTSD and substance use

[[Page 21119]]

disorders, among other initiatives, for the brave men and women who 
have selflessly served our nation.
  Nationally, one in five veterans returning from Iraq and Afghanistan 
suffers from PTSD. Twenty-three percent of members of the Armed Forces 
on active duty acknowledge a significant problem with alcohol use. It 
is vital that our veterans receive the help they need to deal with 
these conditions.
  The effects of substance abuse are wide ranging, including 
significantly increased risk of suicide, exacerbation of mental and 
physical health disorders, breakdown of family support, and increased 
risk of unemployment and homelessness. Veterans suffering from mental 
health issues are at an increased risk for developing a substance abuse 
disorder.
  A constituent of mine, Lance Corporal Justin Bailey, was a 1998 
graduate of Las Vegas High School. Upon returning from a tour of duty 
in Iraq, he was diagnosed with PTSD, and was discharged from the 
Marines in 2004. He developed a substance abuse disorder and checked 
himself into a VA facility in West Los Angeles. After being given 5 
medications on a self-medication policy, Justin overdosed and died on 
January 26, 2007.
  Justin's parents were treated with indifference and apathy at the 
West LA facility. They were even handed Justin's belongings in a trash 
bag. Last August, 8 months after Justin's death, the Baileys returned 
to Los Angeles to meet with the Chief of Staff at the West LA VA 
Hospital. They came away from the meeting feeling the Chief of Staff 
had been completely unprepared and seemed out of touch with the needs 
of veterans. He even went so far as to state his staff does not know 
how to treat veterans of Iraq and Afghanistan because they are young 
and the staff is not tough enough on the younger veterans--giving them 
anything they ask for.
  I introduced the House companion bill to S. 2162--the Mental Health 
Improvements Act, H.R. 4053--because it is imperative that we provide 
adequate mental health services for those who have sacrificed for this 
great nation and those who continue to serve. I am so thankful that the 
House is considering S. 2162 today.
  Passage of this bill will help to ensure that we have the mental 
health resources and substance abuse treatment programs needed to care 
for our veterans.
  The assessments of residential mental health facilities required by 
the bill will help tell us how well the VA is performing and what we 
can do to improve these services, including expanding availability at 
VA hospitals.
  The availability of treatment for PTSD, including substance use 
disorder counseling, literally saves lives--so this must remain a top 
priority. A review of the services provided to our veterans is needed 
to ensure that what happened to Justin does not happen to anyone else.
  I am grateful that this bill also contains the final authorization 
for the new Las Vegas VA Medical Complex that is so desperately needed 
in Southern Nevada. The complex will feature a 90-bed inpatient 
hospital, 120-bed nursing home for veterans, and an outpatient clinic. 
The complex will be over 900,000 square feet and is scheduled to open 
by mid-2011.
  I want to thank both the Chairmen and Ranking Members of the House 
and Senate Veterans' Affairs Committees for working together to come to 
a compromise on a bill that contains many vital initiatives for our 
veterans. I whole-heartedly support S. 2162 and I urge my colleagues to 
do the same.
  Mr. FILNER. Madam Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Filner) that the House suspend the rules 
and pass the Senate bill, S. 2162, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the Senate bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________