[Congressional Record (Bound Edition), Volume 155 (2009), Part 1]
[Senate]
[Pages 1093-1123]
[From the U.S. Government Publishing Office, www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mr. AKAKA (for himself, Mr. Durbin, and Mrs. Murray):
  S. 252. a bill to amend title 38, United States Code, to enhance the 
capacity of the Department of Veterans Affairs to recruit and retain 
nurses and other critical health-care professionals, to improve the 
provision of health care veterans, and for other purposes; to the 
Committee on Veterans' Affairs.
  Mr. AKAKA. Mr. President, today I am introducing legislation which is 
drawn in large measure from S. 2969, the proposed Veterans' Health Care 
Authorization Act, as reported by the Committee on Veterans' Affairs 
last Congress.
  VA faces a looming shortage of health care personnel. Without 
concerted and timely action, this situation will only worsen in the 
years ahead. This is especially true as more Iraq and Afghanistan 
veterans return home injured and in need of new and specialized care. 
In order to avert this problem, VA must be able to offer competitive 
salaries, work schedules, and benefits. The provisions in the bill I am 
introducing will allow VA to recruit and retain nurses, home health 
aides, and specialty care providers.
  This bill also contains measures that would improve the efficiency of 
health care delivery to veterans, including a number of pilot programs 
designed to help VA find new and innovative ways to deliver better, 
faster, and more comprehensive treatment.
  Women make up an ever growing percentage of the Armed Forces. As 
such, they are also making up an ever growing percentage of the veteran 
population. While there have been efforts over the years to address the 
unique needs of women veterans, there is much more that VA might do. To 
that end, there are provisions in this bill to address current 
shortcomings and help VA better respond to the increased demand for 
care from women veterans. I particularly thank Senator Murray for her 
leadership on this issue.
  One of the most troubling and difficult challenges of warfare, which 
can be seen particularly in the current conflicts in Iraq and 
Afghanistan, is diagnosing and treating those who suffer from the 
invisible wounds of war. The lack of understanding of these injuries, 
the stigma associated with them, and many other factors make effective 
treatment difficult. Last Congress, legislation I authored, the 
Veterans Mental Health and Other Care Improvements Act, was enacted as 
Public Law

[[Page 1094]]

110-387. This Congress, I seek to improve upon those advances, and to 
continue to provide accessible, cutting-edge care for those afflicted 
with invisible wounds. This bill would expand eligibility and authority 
for the Vet Centers to provide needed services, and would commission a 
comprehensive study on suicides among veterans so that we can improve 
efforts to prevent such tragedies.
  This bill will also provide support for homeless veterans through a 
proposed series of innovative pilot programs. These programs are 
designed to significantly improve VA outreach to these veterans, in 
order to help them access the benefits and services provided by VA.
  I look forward to working with all of our colleagues to bring this 
legislation to the full Senate for consideration early in this Session. 
Mr. President, I ask unanimous consent that the text of this bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 252

       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 
     Health Care Authorization Act of 2009''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

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

                 TITLE I--DEPARTMENT PERSONNEL MATTERS

Sec. 101. Enhancement of authorities for retention of medical 
              professionals.
Sec. 102. Limitations on overtime duty, weekend duty, and alternative 
              work schedules for nurses.
Sec. 103. Improvements to certain educational assistance programs.
Sec. 104. Standards for appointment and practice of physicians in 
              Department of Veterans Affairs medical facilities.

                     TITLE II--HEALTH CARE MATTERS

Sec. 201. Repeal of certain annual reporting requirements.
Sec. 202. Modifications to annual Gulf War research report.
Sec. 203. Payment for care furnished to CHAMPVA beneficiaries.
Sec. 204. Payor provisions for care furnished to certain children of 
              Vietnam veterans.
Sec. 205. Disclosures from certain medical records.
Sec. 206. Disclosure to Secretary of health-plan contract information 
              and social security number of certain veterans receiving 
              care.
Sec. 207. Enhancement of quality management.
Sec. 208. Reports on improvements to Department health care quality 
              management.
Sec. 209. Pilot program on training and certification for family 
              caregiver personal care attendants for veterans and 
              members of the Armed Forces with traumatic brain injury.
Sec. 210. Pilot program on provision of respite care to members of the 
              Armed Forces and veterans with traumatic brain injury by 
              students in graduate programs of education related to 
              mental health or rehabilitation.
Sec. 211. Pilot program on use of community-based organizations and 
              local and State government entities to ensure that 
              veterans receive care and benefits for which they are 
              eligible.
Sec. 212. Specialized residential care and rehabilitation for certain 
              veterans.
Sec. 213. Authority to disclose medical records to third party for 
              collection of charges for provision of certain care.
Sec. 214. Expanded study on the health impact of Project Shipboard 
              Hazard and Defense.
Sec. 215. Use of non-Department facilities for rehabilitation of 
              individuals with traumatic brain injury.
Sec. 216. Inclusion of federally recognized tribal organizations in 
              certain programs for State veterans homes.
Sec. 217. Pilot program on provision of dental insurance plans to 
              veterans and survivors and dependents of veterans.

                 TITLE III--WOMEN VETERANS HEALTH CARE

Sec. 301. Report on barriers to receipt of health care for women 
              veterans.
Sec. 302. Plan to improve provision of health care services to women 
              veterans.
Sec. 303. Independent study on health consequences of women veterans of 
              military service in Operation Iraqi Freedom and Operation 
              Enduring Freedom.
Sec. 304. Training and certification for mental health care providers 
              on care for veterans suffering from sexual trauma.
Sec. 305. Pilot program on counseling in retreat settings for women 
              veterans newly separated from service in the Armed 
              Forces.
Sec. 306. Report on full-time women veterans program managers at 
              medical centers.
Sec. 307. Service on certain advisory committees of women recently 
              separated from service in the Armed Forces.
Sec. 308. Pilot program on subsidies for child care for certain 
              veterans receiving health care.
Sec. 309. Care for newborn children of women veterans receiving 
              maternity care.

                      TITLE IV--MENTAL HEALTH CARE

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

                       TITLE V--HOMELESS VETERANS

Sec. 501. Pilot program on financial support for entities that 
              coordinate the provision of supportive services to 
              formerly homeless veterans residing on certain military 
              property.
Sec. 502. Pilot program on financial support of entities that 
              coordinate the provision of supportive services to 
              formerly homeless veterans residing in permanent housing.
Sec. 503. Pilot program on financial support of entities that provide 
              outreach to inform certain veterans about pension 
              benefits.
Sec. 504. Pilot program on financial support of entities that provide 
              transportation assistance, child care assistance, and 
              clothing assistance to veterans entitled to a 
              rehabilitation program.
Sec. 505. Assessment of pilot programs.

        TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

Sec. 601. General authorities on establishment of corporations.
Sec. 602. Clarification of purposes of corporations.
Sec. 603. Modification of requirements for boards of directors of 
              corporations.
Sec. 604. Clarification of powers of corporations.
Sec. 605. Redesignation of section 7364A of title 38, United States 
              Code.
Sec. 606. Improved accountability and oversight of corporations.

                  TITLE VII--MISCELLANEOUS PROVISIONS

Sec. 701. Expansion of authority for Department of Veterans Affairs 
              police officers.
Sec. 702. Uniform allowance for Department of Veterans Affairs police 
              officers.

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

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

                 TITLE I--DEPARTMENT PERSONNEL MATTERS

     SEC. 101. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL 
                   PROFESSIONALS.

       (a) Secretarial Authority To Extend Title 38 Status to 
     Additional Positions.--
       (1) In general.--Paragraph (3) of section 7401 is amended 
     by striking ``and blind rehabilitation outpatient 
     specialists.'' and inserting the following: ``blind 
     rehabilitation outpatient specialists, and such other classes 
     of health care occupations as the Secretary considers 
     necessary for the recruitment and retention needs of the 
     Department subject to the following requirements:

[[Page 1095]]

       ``(A) Not later than 45 days before the Secretary appoints 
     any personnel for a class of health care occupations that is 
     not specifically listed in this paragraph, the Secretary 
     shall submit to the Committee on Veterans' Affairs of the 
     Senate, the Committee on Veterans' Affairs of the House of 
     Representatives, and the Office of Management and Budget 
     notice of such appointment.
       ``(B) Before submitting notice under subparagraph (A), the 
     Secretary shall solicit comments from any labor organization 
     representing employees in such class and include such 
     comments in such notice.''.
       (2) Appointment of nurse assistants.--Such paragraph is 
     further amended by inserting ``nurse assistants,'' after 
     ``licensed practical or vocational nurses,''.
       (b) Probationary Periods for Registered Nurses.--Section 
     7403(b) is amended--
       (1) in paragraph (1), by striking ``Appointments'' and 
     inserting ``Except as otherwise provided in this subsection, 
     appointments'';
       (2) by redesignating paragraph (2) as paragraph (4); and
       (3) by inserting after paragraph (1) the following new 
     paragraphs:
       ``(2) An appointment of a registered nurse under this 
     chapter, whether on a full-time basis or a part-time basis, 
     shall be for a probationary period ending upon the completion 
     by the person so appointed of a number of hours of work 
     pursuant to such appointment that the Secretary considers 
     appropriate for such appointment but not more than 4,180 
     hours.
       ``(3) An appointment described in subsection (a) on a part-
     time basis of a person who has previously served on a full-
     time basis for the probationary period for the position 
     concerned shall be without a probationary period.''.
       (c) Prohibition on Temporary Part-Time Registered Nurse 
     Appointments in Excess of 4,180 Hours.--Section 7405 is 
     amended by adding at the end the following new subsection:
       ``(g)(1) Employment of a registered nurse on a temporary 
     part-time basis under subsection (a)(1) shall be for a 
     probationary period ending upon the completion by the person 
     so employed of a number of hours of work pursuant to such 
     employment that the Secretary considers appropriate for such 
     employment but not more than 4,180 hours.
       ``(2) Upon completion by a registered nurse of the 
     probationary period described in paragraph (1)--
       ``(A) the employment of such nurse shall--
       ``(i) no longer be considered temporary; and
       ``(ii) be considered an appointment described in section 
     7403(a) of this title; and
       ``(B) the nurse shall be considered to have served the 
     probationary period required by section 7403(b).''.
       (d) Waiver of Offset From Pay for Certain Reemployed 
     Annuitants.--
       (1) In general.--Section 7405, as amended by subsection 
     (c), is further amended by adding at the end the following 
     new subsection:
       ``(h)(1) The Secretary may waive the application of 
     sections 8344 and 8468 of title 5 (relating to annuities and 
     pay on reemployment) or any other similar provision of law 
     under a Government retirement system on a case-by-case basis 
     for an annuitant reemployed on a temporary basis under the 
     authority of subsection (a) in a position described under 
     paragraph (1) of that subsection.
       ``(2) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall not be considered an employee for purposes of 
     any Government retirement system.
       ``(3) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall be subject to the provisions of chapter 71 of 
     title 5 (including all labor authority and labor 
     representative collective bargaining agreements) applicable 
     to the position to which appointed.
       ``(4) In this subsection:
       ``(A) The term `annuitant' means an annuitant under a 
     Government retirement system.
       ``(B) The term `employee' has the meaning under section 
     2105 of title 5.
       ``(C) The term `Government retirement system' means a 
     retirement system established by law for employees of the 
     Government of the United States.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall take effect on the date that is six months after the 
     date of the enactment of this Act, and shall apply to pay 
     periods beginning on or after such effective date.
       (e) Rate of Basic Pay for Appointees to the Office of the 
     Under Secretary for Health Set to Rate of Basic Pay for 
     Senior Executive Service Positions.--
       (1) In general.--Section 7404(a) is amended--
       (A) by striking ``The annual'' and inserting ``(1) The 
     annual'';
       (B) by striking ``The pay'' and inserting the following:
       ``(2) The pay'';
       (C) by striking ``under the preceding sentence'' and 
     inserting ``under paragraph (1)''; and
       (D) by adding at the end the following new paragraph:
       ``(3) The rate of basic pay for a position to which an 
     Executive order applies under paragraph (1) and is not 
     described by paragraph (2) shall be set in accordance with 
     section 5382 of title 5 as if such position were a Senior 
     Executive Service position (as such term is defined in 
     section 3132(a) of title 5).''.
       (2) Effective date.--The amendments made by paragraph (1) 
     shall take effect on the first day of the first pay period 
     beginning after the day that is 180 days after the date of 
     the enactment of this Act.
       (f) Comparability Pay Program for Appointees to the Office 
     of the Under Secretary for Health.--Section 7410 is amended--
       (1) by striking ``The Secretary may'' and inserting ``(a) 
     In General.--The Secretary may''; and
       (2) by adding at the end the following new subsection:
       ``(b) Comparability Pay for Appointees to the Office of the 
     Under Secretary for Health.--(1) The Secretary may authorize 
     the Under Secretary for Health to provide comparability pay 
     of not more than $100,000 per year to individuals of the 
     Veterans Health Administration appointed under section 7306 
     of this title who are not physicians or dentists and to 
     individuals who are appointed to Senior Executive Service 
     positions (as such term is defined in section 3132(a) of 
     title 5) to achieve annual pay levels for such individuals 
     that are comparable with annual pay levels of individuals 
     with similar positions in the private sector.
       ``(2) Comparability pay under paragraph (1) for an 
     individual is in addition to all other pay, awards, and 
     performance bonuses paid to such individual under this title.
       ``(3) Except as provided in paragraph (4), comparability 
     pay under paragraph (1) for an individual shall be considered 
     basic pay for all purposes, including retirement benefits 
     under chapters 83 and 84 of title 5, and other benefits.
       ``(4) Comparability pay under paragraph (1) for an 
     individual shall not be considered basic pay for purposes of 
     adverse actions under subchapter V of this chapter.
       ``(5) Comparability pay under paragraph (1) may not be 
     awarded to an individual in an amount that would result in an 
     aggregate amount of pay (including bonuses and awards) 
     received by such individual in a year under this title that 
     is greater than the annual pay of the President.''.
       (g) Special Incentive Pay for Department Pharmacist 
     Executives.--Section 7410, as amended by subsection (f) of 
     this section, is further amended by adding at the end the 
     following new subsection:
       ``(c) Special Incentive Pay for Department Pharmacist 
     Executives.--(1) In order to recruit and retain highly 
     qualified Department pharmacist executives, the Secretary may 
     authorize the Under Secretary for Health to pay special 
     incentive pay of not more than $40,000 per year to an 
     individual of the Veterans Health Administration who is a 
     pharmacist executive.
       ``(2) In determining whether and how much special pay to 
     provide to such individual, the Under Secretary shall 
     consider the following:
       ``(A) The grade and step of the position of the individual.
       ``(B) The scope and complexity of the position of the 
     individual.
       ``(C) The personal qualifications of the individual.
       ``(D) The characteristics of the labor market concerned.
       ``(E) Such other factors as the Secretary considers 
     appropriate.
       ``(3) Special incentive pay under paragraph (1) for an 
     individual is in addition to all other pay (including basic 
     pay) and allowances to which the individual is entitled.
       ``(4) Except as provided in paragraph (5), special 
     incentive pay under paragraph (1) for an individual shall be 
     considered basic pay for all purposes, including retirement 
     benefits under chapters 83 and 84 of title 5, and other 
     benefits.
       ``(5) Special incentive pay under paragraph (1) for an 
     individual shall not be considered basic pay for purposes of 
     adverse actions under subchapter V of this chapter.
       ``(6) Special incentive pay under paragraph (1) may not be 
     awarded to an individual in an amount that would result in an 
     aggregate amount of pay (including bonuses and awards) 
     received by such individual in a year under this title that 
     is greater than the annual pay of the President.''.
       (h) Pay for Physicians and Dentists.--
       (1) Non-foreign cost of living adjustment allowance.--
     Section 7431(b) is amended by adding at the end the following 
     new paragraph:
       ``(5) The non-foreign cost of living adjustment allowance 
     authorized under section 5941 of title 5 for physicians and 
     dentists whose pay is set under this section shall be 
     determined as a percentage of base pay only.''.
       (2) Market pay determinations for physicians and dentists 
     in administrative or executive leadership positions.--Section 
     7431(c)(4)(B)(i) is amended by adding at the end the 
     following: ``The Secretary may exempt physicians and dentists 
     occupying administrative or executive leadership positions 
     from the requirements of the previous sentence.''.
       (3) Exception to prohibition on reduction of market pay.--
     Section 7431(c)(7) is amended by striking ``concerned.'' and 
     inserting ``concerned, unless there is a change in board 
     certification or reduction of privileges.''.

[[Page 1096]]

       (i) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) 
     is amended by striking ``level V'' and inserting ``level 
     IV''.
       (j) Exemption for Certified Registered Nurse Anesthetists 
     From Limitation on Authorized Competitive Pay.--Section 
     7451(c)(2) is further amended by adding at the end the 
     following new sentence: ``The maximum rate of basic pay for a 
     grade for the position of certified registered nurse 
     anesthetist pursuant to an adjustment under subsection (d) 
     may exceed the maximum rate otherwise provided in the 
     preceding sentence.''.
       (k) Locality Pay Scale Computations.--
       (1) Education, training, and support for facility directors 
     in wage surveys.--Section 7451(d)(3) is amended by adding at 
     the end the following new subparagraph:
       ``(F) The Under Secretary for Health shall provide 
     appropriate education, training, and support to directors of 
     Department health care facilities in the conduct and use of 
     surveys, including the use of third-party surveys, under this 
     paragraph.''.
       (2) Information on methodology used in wage surveys.--
     Section 7451(e)(4) is amended--
       (A) by redesignating subparagraph (D) as subparagraph (E); 
     and
       (B) by inserting after subparagraph (C) the following new 
     subparagraph (D):
       ``(D) In any case in which the director conducts such a 
     wage survey during the period covered by the report and makes 
     adjustment in rates of basic pay applicable to one or more 
     covered positions at the facility, information on the 
     methodology used in making such adjustment or adjustments.''.
       (3) Disclosure of information to persons in covered 
     positions.--Section 7451(e), as amended by paragraph (2) of 
     this subsection, is further amended by adding at the end the 
     following new paragraph:
       ``(6)(A) Upon the request of an individual described in 
     subparagraph (B) for a report provided under paragraph (4) 
     with respect to a Department health-care facility, the Under 
     Secretary for Health or the director of such facility shall 
     provide to the individual the most current report for such 
     facility provided under such paragraph.
       ``(B) An individual described in this subparagraph is--
       ``(i) an individual in a covered position at a Department 
     health-care facility; or
       ``(ii) a representative of the labor organization 
     representing that individual who is designated by that 
     individual to make the request.''.
       (l) Increased Limitation on Special Pay for Nurse 
     Executives.--Section 7452(g)(2) is amended by striking 
     ``$25,000'' and inserting ``$100,000''.
       (m) Eligibility of Part-Time Nurses for Additional Nurse 
     Pay.--
       (1) In general.--Section 7453 is amended--
       (A) in subsection (a), by striking ``a nurse'' and 
     inserting ``a full-time nurse or part-time nurse'';
       (B) in subsection (b)--
       (i) in the first sentence--

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

       (ii) in the second sentence, by striking ``of such tour'' 
     and inserting ``of such service'';
       (C) in subsection (c)--
       (i) by striking ``on a tour of duty''; and
       (ii) by striking ``service on such tour'' and inserting 
     ``such service''; and
       (D) in subsection (e)--
       (i) in paragraph (1), by striking ``eight hours in a day'' 
     and inserting ``eight consecutive hours''; and
       (ii) in paragraph (5)(A), by striking ``tour of duty'' and 
     inserting ``period of service''.
       (2) Exclusion of application of additional nurse pay 
     provisions to certain additional employees.--Paragraph (3) of 
     section 7454(b) is amended to read as follows:
       ``(3) Employees appointed under section 7408 of this title 
     performing service on a tour of duty, any part of which is 
     within the period commencing at midnight Friday and ending at 
     midnight Sunday, shall receive additional pay in addition to 
     the rate of basic pay provided such employees for each hour 
     of service on such tour at a rate equal to 25 percent of such 
     employee's hourly rate of basic pay.''.
       (n) Exemption of Additional Nurse Positions From Limitation 
     on Increase in Rates of Basic Pay.--Section 7455(c)(1) is 
     amended by inserting after ``nurse anesthetists,'' the 
     following: ``licensed practical nurses, licensed vocational 
     nurses, and nursing positions otherwise covered by title 
     5,''.

     SEC. 102. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND 
                   ALTERNATIVE WORK SCHEDULES FOR NURSES.

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

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

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

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

       (b) Weekend Duty.--Section 7456 is amended--
       (1) by striking subsection (c); and
       (2) by redesignating subsection (d) as subsection (c).
       (c) Alternate Work Schedules.--
       (1) In general.--Section 7456A(b)(1)(A) is amended by 
     striking ``three regularly scheduled'' and all that follows 
     through the period at the end and inserting ``six regularly 
     scheduled 12-hour periods of service within a pay period 
     shall be considered for all purposes to have worked a full 
     80-hour pay period.''.
       (2) Conforming amendments.--Section 7456A(b) is amended--
       (A) in the subsection heading, by striking ``36/40'' and 
     inserting ``72/80'';
       (B) in paragraph (2)--
       (i) in subparagraph (A), by striking ``40-hour basic work 
     week'' and inserting ``80-hour pay period'';
       (ii) in subparagraph (B), by striking ``regularly scheduled 
     36-hour tour of duty within the work week'' and inserting 
     ``scheduled 72-hour period of service within the bi-weekly 
     pay period'';
       (iii) in subparagraph (C)--

       (I) in clause (i), by striking ``regularly scheduled 36-
     hour tour of duty within an administrative work week'' and 
     inserting ``scheduled 72-hour period of service within an 
     administrative pay period'';
       (II) in clause (ii), by striking ``regularly scheduled 12-
     hour tour of duty'' and inserting ``scheduled 12-hour period 
     of service''; and
       (III) in clause (iii), by striking ``regularly scheduled 
     36-hour tour of duty work week'' and inserting ``scheduled 
     72-hour period of service pay period''; and

       (iv) in subparagraph (D), by striking ``regularly scheduled 
     12-hour tour of duty'' and inserting ``scheduled 12-hour 
     period of service''; and
       (C) in paragraph (3), by striking ``regularly scheduled 12-
     hour tour of duty'' and inserting ``scheduled 12-hour period 
     of service''.

     SEC. 103. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE 
                   PROGRAMS.

       (a) Reinstatement of Health Professionals Educational 
     Assistance Scholarship Program.--
       (1) In general.--Section 7618 is amended by striking 
     ``December 31, 1998'' and inserting ``December 31, 2014''.
       (2) Expansion of eligibility requirements.--Section 
     7612(b)(2) is amended by striking ``(under section'' and all 
     that follows through ``or vocational nurse.'' and inserting 
     the following: ``as an appointee under paragraph (1) or (3) 
     of section 7401 of this title.''.
       (b) Improvements to Education Debt Reduction Program.--
       (1) Inclusion of employee retention as purpose of 
     program.--Section 7681(a)(2) is amended by inserting ``and 
     retention'' after ``recruitment'' the first time it appears.
       (2) Eligibility.--Section 7682 is amended--

[[Page 1097]]

       (A) in subsection (a)(1), by striking ``a recently 
     appointed'' and inserting ``an''; and
       (B) by striking subsection (c).
       (3) Maximum amounts of assistance.--Section 7683(d)(1) is 
     amended--
       (A) by striking ``$44,000'' and inserting ``$60,000''; and
       (B) by striking ``$10,000'' and inserting ``$12,000''.
       (c) Loan Repayment Program for Clinical Researchers From 
     Disadvantaged Backgrounds.--
       (1) In general.--The Secretary of Veterans Affairs may, in 
     consultation with the Secretary of Health and Human Services, 
     utilize the authorities available in section 487E of the 
     Public Health Service Act (42 U.S.C. 288-5) for the repayment 
     of the principal and interest of educational loans of 
     appropriately qualified health professionals who are from 
     disadvantaged backgrounds in order to secure clinical 
     research by such professionals for the Veterans Health 
     Administration.
       (2) Limitations.--The exercise by the Secretary of Veterans 
     Affairs of the authorities referred to in paragraph (1) shall 
     be subject to the conditions and limitations specified in 
     paragraphs (2) and (3) of section 487E(a) of the Public 
     Health Service Act (42 U.S.C. 288-5(a)(2) and (3)).
       (3) Funding.--Amounts for the repayment of principal and 
     interest of educational loans under this subsection shall be 
     derived from amounts available to the Secretary of Veterans 
     Affairs for the Veterans Health Administration for Medical 
     Services.

     SEC. 104. STANDARDS FOR APPOINTMENT AND PRACTICE OF 
                   PHYSICIANS IN DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL FACILITIES.

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

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

       ``(a) In General.--The Secretary shall, acting through the 
     Under Secretary for Health, prescribe standards to be met by 
     individuals in order to qualify for appointment in the 
     Veterans Health Administration in the position of physician 
     and to practice as a physician in medical facilities of the 
     Administration. The standards shall incorporate the 
     requirements of this section.
       ``(b) Disclosure of Certain Information Before 
     Appointment.--Each individual seeking appointment in the 
     Veterans Health Administration in the position of physician 
     shall do the following:
       ``(1) Provide the Secretary a full and complete explanation 
     of the following:
       ``(A) Each lawsuit, civil action, or other claim (whether 
     open or closed) brought against the individual for medical 
     malpractice or negligence (other than a lawsuit, action, or 
     claim closed without any judgment against or payment by or on 
     behalf of the individual).
       ``(B) Each payment made by or on behalf of the individual 
     to settle any lawsuit, action, or claim covered by 
     subparagraph (A).
       ``(C) Each investigation or disciplinary action taken 
     against the individual relating to the individual's 
     performance as a physician.
       ``(2) Submit a written request and authorization to the 
     State licensing board of each State in which the individual 
     holds or has held a license to practice medicine to disclose 
     to the Secretary any information in the records of such State 
     on the following:
       ``(A) Each lawsuit, civil action, or other claim brought 
     against the individual for medical malpractice or negligence 
     covered by paragraph (1)(A) that occurred in such State.
       ``(B) Each payment made by or on behalf of the individual 
     to settle any lawsuit, action, or claim covered by 
     subparagraph (A).
       ``(C) Each medical malpractice judgment against the 
     individual by the courts or administrative agencies or bodies 
     of such State.
       ``(D) Each disciplinary action taken or under consideration 
     against the individual by an administrative agency or body of 
     such State.
       ``(E) Any change in the status of the license to practice 
     medicine issued the individual by such State, including any 
     voluntary or nondisciplinary surrendering of such license by 
     the individual.
       ``(F) Any open investigation of the individual by an 
     administrative agency or body of such State, or any 
     outstanding allegation against the individual before such an 
     administrative agency or body.
       ``(G) Any written notification by the State to the 
     individual of potential termination of a license for cause or 
     otherwise.
       ``(c) Disclosure of Certain Information Following 
     Appointment.--(1) Each individual appointed in the Veterans 
     Health Administration in the position of physician after the 
     date of the enactment of this section shall, as a condition 
     of service under the appointment, disclose to the Secretary, 
     not later than 30 days after the occurrence of such event, 
     the following:
       ``(A) A judgment against the individual for medical 
     malpractice or negligence.
       ``(B) A payment made by or on behalf of the individual to 
     settle any lawsuit, action, or claim disclosed under 
     paragraph (1) or (2) of subsection (b).
       ``(C) Any disposition of or material change in a matter 
     disclosed under paragraph (1) or (2) of subsection (b).
       ``(2) Each individual appointed in the Veterans Health 
     Administration in the position of physician as of the date of 
     the enactment of this section shall do the following:
       ``(A) Not later than the end of the 60-day period beginning 
     on the date of the enactment of this section and as a 
     condition of service under the appointment after the end of 
     that period, submit the request and authorization described 
     in subsection (b)(2).
       ``(B) Agree, as a condition of service under the 
     appointment, to disclose to the Secretary, not later than 30 
     days after the occurrence of such event, the following:
       ``(i) A judgment against the individual for medical 
     malpractice or negligence.
       ``(ii) A payment made by or on behalf of the individual to 
     settle any lawsuit, action, or claim disclosed pursuant to 
     subparagraph (A) or under this subparagraph.
       ``(iii) Any disposition of or material change in a matter 
     disclosed pursuant to subparagraph (A) or under this 
     subparagraph.
       ``(3) Each individual appointed in the Veterans Health 
     Administration in the position of physician shall, as part of 
     the biennial review of the performance of the physician under 
     the appointment, submit the request and authorization 
     described in subsection (b)(2). The requirement of this 
     paragraph is in addition to the requirements of paragraph (1) 
     or (2), as applicable.
       ``(d) Investigation of Disclosed Matters.--(1) The Director 
     of the Veterans Integrated Services Network (VISN) in which 
     an individual is seeking appointment in the Veterans Health 
     Administration in the position of physician shall perform an 
     investigation (in such manner as the standards required by 
     this section shall specify) of each matter disclosed under 
     subsection (b) with respect to the individual.
       ``(2) The Director of the Veterans Integrated Services 
     Network in which an individual is appointed in the Veterans 
     Health Administration in the position of physician shall 
     perform an investigation (in a manner so specified) of each 
     matter disclosed under subsection (c) with respect to the 
     individual.
       ``(3) The results of each investigation performed under 
     this subsection shall be fully documented.
       ``(e) Approval of Appointments by Directors of VISNs.--(1) 
     An individual may not be appointed in the Veterans Health 
     Administration in the position of physician without the 
     approval of the Director of the Veterans Integrated Services 
     Network in which the individual will first serve under the 
     appointment.
       ``(2) In approving the appointment under this subsection of 
     an individual for whom any matters have been disclosed under 
     subsection (b), a Director shall--
       ``(A) certify in writing the completion of the performance 
     of the investigation under subsection (d)(1) of each such 
     matter, including the results of such investigation; and
       ``(B) provide a written justification why any matters 
     raised in the course of such investigation do not disqualify 
     the individual from appointment.
       ``(f) Enrollment of Physicians With Practice Privileges in 
     Proactive Disclosure Service.--Each medical facility of the 
     Department at which physicians are extended the privileges of 
     practice shall enroll each physician extended such privileges 
     in the Proactive Disclosure Service of the National 
     Practitioner Data Bank.
       ``(g) Encouraging Hiring of Physicians With Board 
     Certification.--(1) The Secretary shall, for each performance 
     contract with a Director of a Veterans Integrated Services 
     Network (VISN), include in such contract a provision that 
     encourages such director to hire physicians who are board 
     eligible or board certified in the specialty in which the 
     physicians will practice.
       ``(2) The Secretary may determine the nature and manner of 
     the provision described in paragraph (1).''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 74 is amended by inserting after the 
     item relating to section 7402 the following new item:

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

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

[[Page 1098]]



                     TITLE II--HEALTH CARE MATTERS

     SEC. 201. REPEAL OF CERTAIN ANNUAL REPORTING REQUIREMENTS.

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

     SEC. 202. MODIFICATIONS TO ANNUAL GULF WAR RESEARCH REPORT.

       Section 707(c)(1) of the Persian Gulf War Veterans' Health 
     Status Act (title VII of Public Law 102-585; 38 U.S.C. 527 
     note) is amended by striking ``Not later than March 1 of each 
     year'' and inserting ``Not later than July 1, 2008, and July 
     1 of each of the five following years''.

     SEC. 203. PAYMENT FOR CARE FURNISHED TO CHAMPVA 
                   BENEFICIARIES.

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

     SEC. 204. PAYOR PROVISIONS FOR CARE FURNISHED TO CERTAIN 
                   CHILDREN OF VIETNAM VETERANS.

       (a) Children of Vietnam Veterans Born With Spina Bifida.--
     Section 1803 is amended--
       (1) by redesignating subsection (c) as subsection (d); and
       (2) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c) Where payment by the Secretary under this section is 
     less than the amount of the charges billed, the health care 
     provider or agent of the health care provider may seek 
     payment for the difference between the amount billed and the 
     amount paid by the Secretary from a responsible third party 
     to the extent that the provider or agent thereof would be 
     eligible to receive payment for such care or services from 
     such third party, but--
       ``(1) the health care provider or agent for the health care 
     provider may not impose any additional charge on the 
     beneficiary who received the medical care, or the family of 
     such beneficiary, for any service or item for which the 
     Secretary has made payment under this section;
       ``(2) the total amount of payment a provider or agent of 
     the provider may receive for care and services furnished 
     under this section may not exceed the amount billed to the 
     Secretary; and
       ``(3) the Secretary, upon request, shall disclose to such 
     third party information received for the purposes of carrying 
     out this section.''.
       (b) Children of Women Vietnam Veterans Born With Birth 
     Defects.--Section 1813 is amended--
       (1) by redesignating subsection (c) as subsection (d); and
       (2) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c) Seeking Payment From Third Parties.--Where payment by 
     the Secretary under this section is less than the amount of 
     the charges billed, the health care provider or agent of the 
     health care provider may seek payment for the difference 
     between the amount billed and the amount paid by the 
     Secretary from a responsible third party to the extent that 
     the health care provider or agent thereof would be eligible 
     to receive payment for such care or services from such third 
     party, but--
       ``(1) the health care provider or agent for the health care 
     provider may not impose any additional charge on the 
     beneficiary who received medical care, or the family of such 
     beneficiary, for any service or item for which the Secretary 
     has made payment under this section;
       ``(2) the total amount of payment a provider or agent of 
     the provider may receive for care and services furnished 
     under this section may not exceed the amount billed to the 
     Secretary; and
       ``(3) the Secretary, upon request, shall disclose to such 
     third party information received for the purposes of carrying 
     out this section.''.

     SEC. 205. DISCLOSURES FROM CERTAIN MEDICAL RECORDS.

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

     SEC. 206. DISCLOSURE TO SECRETARY OF HEALTH-PLAN CONTRACT 
                   INFORMATION AND SOCIAL SECURITY NUMBER OF 
                   CERTAIN VETERANS RECEIVING CARE.

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

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

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

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

     SEC. 207. ENHANCEMENT OF QUALITY MANAGEMENT.

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

     ``Sec. 7311A. Quality management officers

       ``(a) National Quality Management Officer.--(1) The Under 
     Secretary for Health shall designate an official of the 
     Veterans Health Administration to act as the principal 
     quality management officer for the quality-assurance program 
     required by section 7311 of this title. The official so 
     designated may be known as the `National Quality Management 
     Officer of the Veterans Health Administration' (in this 
     section referred to as the `National Quality Management 
     Officer').
       ``(2) The National Quality Management Officer shall report 
     directly to the Under Secretary for Health in the discharge 
     of responsibilities and duties of the Officer under this 
     section.
       ``(3) The National Quality Management Officer shall be the 
     official within the Veterans Health Administration who is 
     principally responsible for the quality-assurance program 
     referred to in paragraph (1). In carrying out that 
     responsibility, the Officer shall be responsible for the 
     following:
       ``(A) Establishing and enforcing the requirements of the 
     program referred to in paragraph (1).
       ``(B) Developing an aggregate quality metric from existing 
     data sources, such as the Inpatient Evaluation Center of the 
     Department, the National Surgical Quality Improvement Program 
     of the American College of Surgeons, and the External Peer 
     Review

[[Page 1099]]

     Program of the Veterans Health Administration, that could be 
     used to assess reliably the quality of care provided at 
     individual Department medical centers and associated 
     community based outpatient clinics.
       ``(C) Ensuring that existing measures of quality, including 
     measures from the Inpatient Evaluation Center, the National 
     Surgical Quality Improvement Program, System-Wide Ongoing 
     Assessment and Review reports of the Department, and Combined 
     Assessment Program reviews of the Office of Inspector General 
     of the Department, are monitored routinely and analyzed in a 
     manner that ensures the timely detection of quality of care 
     issues.
       ``(D) Encouraging research and development in the area of 
     quality metrics for the purposes of improving how the 
     Department measures quality in individual facilities.
       ``(E) Carrying out such other responsibilities and duties 
     relating to quality management in the Veterans Health 
     Administration as the Under Secretary for Health shall 
     specify.
       ``(4) The requirements under paragraph (3) shall include 
     requirements regarding the following:
       ``(A) A confidential system for the submittal of reports by 
     Veterans Health Administration personnel regarding quality 
     management at Department facilities.
       ``(B) Mechanisms for the peer review of the actions of 
     individuals appointed in the Veterans Health Administration 
     in the position of physician.
       ``(b) Quality Management Officers for VISNs.--(1) The 
     Regional Director of each Veterans Integrated Services 
     Network (VISN) shall appoint an official of the Network to 
     act as the quality management officer of the Network.
       ``(2) The quality management officer for a Veterans 
     Integrated Services Network shall report to the Regional 
     Director of the Veterans Integrated Services Network, and to 
     the National Quality Management Officer, regarding the 
     discharge of the responsibilities and duties of the officer 
     under this section.
       ``(3) The quality management officer for a Veterans 
     Integrated Services Network shall--
       ``(A) direct the quality management office in the Network; 
     and
       ``(B) coordinate, monitor, and oversee the quality 
     management programs and activities of the Administration 
     medical facilities in the Network in order to ensure the 
     thorough and uniform discharge of quality management 
     requirements under such programs and activities throughout 
     such facilities.
       ``(c) Quality Management Officers for Medical Facilities.--
     (1) The director of each Veterans Health Administration 
     medical facility shall appoint a quality management officer 
     for that facility.
       ``(2) The quality management officer for a facility shall 
     report directly to the director of the facility, and to the 
     quality management officer of the Veterans Integrated 
     Services Network in which the facility is located, regarding 
     the discharge of the responsibilities and duties of the 
     quality management officer under this section.
       ``(3) The quality management officer for a facility shall 
     be responsible for designing, disseminating, and implementing 
     quality management programs and activities for the facility 
     that meet the requirements established by the National 
     Quality Management Officer under subsection (a).
       ``(d) Authorization of Appropriations.--(1) Except as 
     provided in paragraph (2), there are authorized to be 
     appropriated such sums as may be necessary to carry out this 
     section.
       ``(2) There are authorized to be appropriated to carry out 
     the provisions of subparagraphs (B), (C), and (D) of 
     subsection (a)(3), $25,000,000 for the two-year period of 
     fiscal years beginning after the date of the enactment of 
     this section.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 73 is amended by inserting after the 
     item relating to section 7311 the following new item:

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

     SEC. 208. REPORTS ON IMPROVEMENTS TO DEPARTMENT HEALTH CARE 
                   QUALITY MANAGEMENT.

       (a) Report.--Not later than December 15, 2009, and each 
     year thereafter through 2012, the Secretary of Veterans 
     Affairs shall submit to the congressional veterans affairs 
     committees a report on the implementation of sections 104 and 
     207 of this Act and the amendments made by such sections 
     during the preceding fiscal year. Each report shall include, 
     for the fiscal year covered by such report, the following:
       (1) A comprehensive description of the implementation of 
     sections 104 and 207 of this Act and the amendments made by 
     such sections.
       (2) Such recommendations as the Secretary considers 
     appropriate for legislative or administrative action to 
     improve the authorities and requirements in such sections and 
     the amendments made by such sections or to otherwise improve 
     the quality of health care and the quality of the physicians 
     in the Veterans Health Administration.
       (b) Congressional Veterans Affairs Committees Defined.--In 
     this section, the term ``congressional veterans affairs 
     committees'' means--
       (1) the Committees on Veterans' Affairs and Appropriations 
     of the Senate; and
       (2) the Committees on Veterans' Affairs and Appropriations 
     of the House of Representatives.

     SEC. 209. PILOT PROGRAM ON TRAINING AND CERTIFICATION FOR 
                   FAMILY CAREGIVER PERSONAL CARE ATTENDANTS FOR 
                   VETERANS AND MEMBERS OF THE ARMED FORCES WITH 
                   TRAUMATIC BRAIN INJURY.

       (a) Pilot Program Authorized.--The Secretary of Veterans 
     Affairs shall, in collaboration with the Secretary of 
     Defense, carry out a pilot program to assess the feasibility 
     and advisability of providing training and certification for 
     family caregivers of veterans and members of the Armed Forces 
     with traumatic brain injury as personal care attendants of 
     such veterans and members.
       (b) Duration of Program.--The pilot program required by 
     subsection (a) shall be carried out during the three-year 
     period beginning on the date of the commencement of the pilot 
     program.
       (c) Locations.--
       (1) In general.--The pilot program under this section shall 
     be carried out--
       (A) in three medical facilities of the Department of 
     Veterans Affairs; and
       (B) if determined appropriate by the Secretary of Veterans 
     Affairs and the Secretary of Defense, one medical facility of 
     the Department of Defense.
       (2) Emphasis on polytrauma centers.--In selecting the 
     locations of the pilot program at facilities of the 
     Department of Veterans Affairs, the Secretary of Veterans 
     Affairs shall give special emphasis to the polytrauma centers 
     of the Department of Veterans Affairs designated as Tier I 
     polytrauma centers.
       (d) Training Curricula.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     develop curricula for the training of personal care 
     attendants under the pilot program under this section. Such 
     curricula shall incorporate--
       (A) applicable standards and protocols utilized by 
     certification programs of national brain injury care 
     specialist organizations; and
       (B) best practices recognized by caregiving organizations.
       (2) Use of existing curricula.--In developing the curricula 
     required by paragraph (1), the Secretary of Veterans Affairs 
     shall, to the extent practicable, utilize and expand upon 
     training curricula developed pursuant to section 744(b) of 
     the John Warner National Defense Authorization Act for Fiscal 
     Year 2007 (Public Law 109-364; 120 Stat. 2308).
       (e) Participation in Programs.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     determine the eligibility of a family member of a veteran or 
     member of the Armed Forces for participation in the pilot 
     program under this section.
       (2) Basis for determination.--A determination made under 
     paragraph (1) shall be based on the needs of the veteran or 
     member of the Armed Forces concerned, as determined by the 
     physician of such veteran or member.
       (f) Eligibility for Compensation.--A family caregiver of a 
     veteran or member of the Armed Forces who receives 
     certification as a personal care attendant under the pilot 
     program under this section shall be eligible for

[[Page 1100]]

     compensation from the Department of Veterans Affairs for care 
     provided to such veteran or member.
       (g) Costs of Training.--
       (1) Training of families of veterans.--Any costs of 
     training provided under the pilot program under this section 
     for family members of veterans shall be borne by the 
     Secretary of Veterans Affairs.
       (2) Training of families of members of the armed forces.--
     The Secretary of Defense shall reimburse the Secretary of 
     Veterans Affairs for any costs of training provided under the 
     pilot program for family members of members of the Armed 
     Forces.
       (h) Assessment of Family Caregiver Needs.--
       (1) In general.--The Secretary of Veterans Affairs may 
     provide to a family caregiver who receives training under the 
     pilot program under this section--
       (A) an assessment of their needs with respect to their role 
     as a family caregiver; and
       (B) a referral to services and support that--
       (i) are relevant to any needs identified in such 
     assessment; and
       (ii) are provided in the community where the family 
     caregiver resides, including such services and support 
     provided by community-based organizations, publicly-funded 
     programs, and the Department of Veterans Affairs.
       (2) Use of existing tools.--In developing and administering 
     an assessment under paragraph (1), the Secretary shall, to 
     the extent practicable, use and expand upon caregiver 
     assessment tools already developed and in use by the 
     Department.
       (i) Report.--Not later than 2 years after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to Congress a report on the pilot program 
     carried out under this section, including the recommendations 
     of the Secretary with respect to expansion or modification of 
     the pilot program.
       (j) Construction.--Nothing in this section shall be 
     construed--
       (1) to establish a mandate or right for a family caregiver 
     to be trained and certified under this section; and
       (2) to prohibit the Secretary from considering or adopting 
     the preference of a veteran or member of the Armed Forces for 
     services provided by a personal care attendant who is not a 
     family caregiver.
       (k) Family Caregiver Defined.--In this section, with 
     respect to member of the Armed Forces or a veteran with 
     traumatic brain injury, the term ``family caregiver'' means a 
     family member of such member or veteran, or such other 
     individual of similar affinity to such member or veteran as 
     the Secretary proscribes, who is providing care to such 
     member or veteran for such traumatic brain injury.

     SEC. 210. PILOT PROGRAM ON PROVISION OF RESPITE CARE TO 
                   MEMBERS OF THE ARMED FORCES AND VETERANS WITH 
                   TRAUMATIC BRAIN INJURY BY STUDENTS IN GRADUATE 
                   PROGRAMS OF EDUCATION RELATED TO MENTAL HEALTH 
                   OR REHABILITATION.

       (a) Pilot Program Authorized.--The Secretary of Veterans 
     Affairs shall, in collaboration with the Secretary of 
     Defense, carry out a pilot program to assess the feasibility 
     and advisability of providing respite care to members of the 
     Armed Forces and veterans described in subsection (c) through 
     students enrolled in graduate programs of education described 
     in subsection (d)(1) to provide--
       (1) relief to the family caregivers of such members and 
     veterans from the responsibilities associated with providing 
     care to such members and veterans; and
       (2) socialization and cognitive skill development to such 
     members and veterans.
       (b) Duration of Program.--The pilot program required by 
     subsection (a) shall be carried out during the three-year 
     period beginning on the date of the commencement of the pilot 
     program.
       (c) Covered Members and Veterans.--The members of the Armed 
     Forces and veterans described in this subsection are the 
     individuals as follows:
       (1) Members of the Armed Forces who have been diagnosed 
     with traumatic brain injury, including limitations of 
     ambulatory mobility, cognition, and verbal abilities.
       (2) Veterans who have been so diagnosed.
       (d) Program Locations.--
       (1) In general.--The pilot program shall be carried out at 
     not more than 10 locations selected by the Secretary of 
     Veterans Affairs for purposes of the pilot program. Each 
     location so selected shall be a medical facility of the 
     Department of Veterans Affairs that is in close proximity to, 
     or that has a relationship, affiliation, or established 
     partnership with, an institution of higher education that has 
     a graduate program in an appropriate mental health or 
     rehabilitation related field, such as social work, nursing, 
     psychology, occupational therapy, physical therapy, or 
     interdisciplinary training programs.
       (2) Considerations.--In selecting medical facilities of the 
     Department for the pilot program, the Secretary shall give 
     special consideration to the following:
       (A) The polytrauma centers of the Department designated as 
     Tier I polytrauma centers.
       (B) Facilities of the Department in regions with a high 
     concentration of veterans with traumatic brain injury.
       (e) Scope of Assistance.--
       (1) Use of graduate students.--In carrying out the pilot 
     program, the Secretary shall--
       (A) recruit students enrolled in a graduate program of 
     education selected by the Secretary under subsection (d)(1) 
     to provide respite care to the members of the Armed Forces 
     and veterans described in subsection (c);
       (B) train such students to provide respite care to such 
     members and veterans; and
       (C) match such students with such members and veterans in 
     the student's local area for the provision of individualized 
     respite care to such members and veterans.
       (2) Determinations in conjunction with heads of graduate 
     programs of education.--The Secretary shall determine, in 
     collaboration with the head of the graduate program of 
     education chosen to participate in the pilot program under 
     subsection (d)(1), the following:
       (A) The amount of training that a student shall complete 
     before providing respite care under the pilot program.
       (B) The number of hours of respite care to be provided by 
     the students who participate in the pilot program.
       (C) The requirements for successful participation by a 
     student in the pilot program.
       (f) Training Standards and Best Practices.--In providing 
     training under subsection (e)(1)(B), the Secretary shall 
     use--
       (1) applicable standards and protocols used by 
     certification programs of national brain injury care 
     specialist organizations in the provision of respite care 
     training; and
       (2) best practices recognized by caregiving organizations.
       (g) Definitions.--In this section:
       (1) Family caregiver.--With respect to member of the Armed 
     Forces or a veteran with traumatic brain injury, the term 
     ``family caregiver'' means a relative, partner, or friend of 
     such member or veteran who is providing care to such member 
     or veteran for such traumatic brain injury.
       (2) Respite care.--The term ``respite care'' means the 
     temporary provision of care to an individual to provide 
     relief to the regular caregiver of the individual from the 
     ongoing responsibility of providing care to such individual.

     SEC. 211. PILOT PROGRAM ON USE OF COMMUNITY-BASED 
                   ORGANIZATIONS AND LOCAL AND STATE GOVERNMENT 
                   ENTITIES TO ENSURE THAT VETERANS RECEIVE CARE 
                   AND BENEFITS FOR WHICH THEY ARE ELIGIBLE.

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

[[Page 1101]]

     providers of services for veterans to reduce duplication of 
     services and to increase the effect of such services.
       (f) Use of Grant Funds.--The Secretary shall prescribe 
     appropriate uses of grant funds received under the pilot 
     program.
       (g) Report on Program.--
       (1) In general.--Not later than 180 days after the 
     completion of the pilot program, the Secretary shall submit 
     to Congress a report on the pilot program.
       (2) Elements.--The report required by paragraph (1) shall 
     include the following:
       (A) The findings and conclusions of the Secretary with 
     respect to the pilot program.
       (B) An assessment of the benefits to veterans of the pilot 
     program.
       (C) The recommendations of the Secretary as to the 
     advisability of continuing the pilot program.

     SEC. 212. SPECIALIZED RESIDENTIAL CARE AND REHABILITATION FOR 
                   CERTAIN VETERANS.

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

     SEC. 213. AUTHORITY TO DISCLOSE MEDICAL RECORDS TO THIRD 
                   PARTY FOR COLLECTION OF CHARGES FOR PROVISION 
                   OF CERTAIN CARE.

       (a) Limited Exception to Confidentiality of Medical 
     Records.--Section 5701 is amended by adding at the end the 
     following new subsection:
       ``(l) Under regulations that the Secretary shall prescribe, 
     the Secretary may disclose the name or address, or both, of 
     any individual who is a present or former member of the Armed 
     Forces, or who is a dependent of a present or former member 
     of the Armed Forces, to a third party, as defined in section 
     1729(i)(3)(D) of this title, in order to enable the Secretary 
     to collect reasonable charges under section 1729(a)(2)(E) of 
     this title for care or services provided for a non-service-
     connected disability.''.
       (b) Disclosures From Certain Medical Records.--Section 
     7332(b)(2), as amended by section 205 of this Act, is further 
     amended by adding at the end the following new subparagraph:
       ``(G) To a third party, as defined in section 1729(i)(3)(D) 
     of this title, to collect reasonable charges under section 
     1729(a)(2)(E) of this title for care or services provided for 
     a non-service-connected disability.''.

     SEC. 214. EXPANDED STUDY ON THE HEALTH IMPACT OF PROJECT 
                   SHIPBOARD HAZARD AND DEFENSE.

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

     SEC. 215. USE OF NON-DEPARTMENT FACILITIES FOR REHABILITATION 
                   OF INDIVIDUALS WITH TRAUMATIC BRAIN INJURY.

       Section 1710E is amended--
       (1) by redesignating subsection (b) as subsection (c);
       (2) by inserting after subsection (a) the following new 
     subsection (b):
       ``(b) Covered Individuals.--The care and services provided 
     under subsection (a) shall be made available to an 
     individual--
       ``(1) who is described in section 1710C(a) of this title; 
     and
       ``(2)(A) to whom the Secretary is unable to provide such 
     treatment or services at the frequency or for the duration 
     prescribed in such plan; or
       ``(B) for whom the Secretary determines that it is optimal 
     with respect to the recovery and rehabilitation for such 
     individual.''; and
       (3) by adding at the end the following new subsection:
       ``(d) Standards.--The Secretary may not provide treatment 
     or services as described in subsection (a) at a non-
     Department facility under such subsection unless such 
     facility maintains standards for the provision of such 
     treatment or services established by an independent, peer-
     reviewed organization that accredits specialized 
     rehabilitation programs for adults with traumatic brain 
     injury.''.

     SEC. 216. INCLUSION OF FEDERALLY RECOGNIZED TRIBAL 
                   ORGANIZATIONS IN CERTAIN PROGRAMS FOR STATE 
                   VETERANS HOMES.

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

     ``Sec. 8133A. Tribal organizations

       ``(a) Authority to Award Grants.--The Secretary may award a 
     grant to a tribal organization under this subchapter in order 
     to carry out the purposes of this subchapter.
       ``(b) Manner and Condition of Grant Awards.--(1) Grants to 
     tribal organizations under this section shall be awarded in 
     the same manner, and under the same conditions, as grants 
     awarded to the several States under the provisions of this 
     subchapter, subject to such exceptions as the Secretary shall 
     prescribe for purposes of this subchapter to take into 
     account the unique circumstances of tribal organizations.
       ``(2) For purposes of according priority under subsection 
     (c)(2) of section 8135 of this title to an application 
     submitted under subsection (a) of such section, an 
     application submitted under such subsection (a) by a tribal 
     organization of a State that has previously applied for award 
     of a grant under this subchapter for construction or 
     acquisition of a State nursing home shall be considered under 
     subparagraph (C) of such subsection (c)(2) an application 
     from a tribal organization that has not previously applied 
     for such a grant.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 81 is amended by inserting after the 
     item relating to section 8133 the following new item:

``8133A. Tribal organizations.''.

     SEC. 217. PILOT PROGRAM ON PROVISION OF DENTAL INSURANCE 
                   PLANS TO VETERANS AND SURVIVORS AND DEPENDENTS 
                   OF VETERANS.

       (a) Pilot Program Required.--The Secretary of Veterans 
     Affairs shall carry out a pilot program to assess the 
     feasibility and advisability of providing a dental insurance 
     plan to veterans and survivors and dependents of veterans 
     described in subsection (b).
       (b) Covered Veterans and Survivors and Dependents.--The 
     veterans and survivors and dependents of veterans described 
     in this subsection are as follows:
       (1) Any veteran who is enrolled in the system of annual 
     patient enrollment under section 1705 of this title.
       (2) Any survivor or dependent of a veteran who is eligible 
     for medical care under section 1781 of this title.
       (c) Duration of Program.--The pilot program shall be 
     carried out during the three-year period beginning on the 
     date of the enactment of this Act.
       (d) Pilot Program Locations.--The pilot program shall be 
     carried out in not less than two and not more than four 
     Veterans Integrated Services Networks (VISNs) selected by the 
     Secretary of Veterans Affairs for purposes of the pilot 
     program.
       (e) Administration.--The Secretary of Veterans Affairs 
     shall contract with a dental insurer to administer the dental 
     plan provided under the pilot program.
       (f) Benefits.--The dental insurance plan under the pilot 
     program shall provide such benefits for dental care and 
     treatment as the Secretary considers appropriate for the 
     dental insurance plan, including diagnostic services, 
     preventative services, endodontics and other restorative 
     services, surgical services, and emergency services.
       (g) Enrollment.--
       (1) Voluntary.--Enrollment in the dental insurance plan 
     under this section shall be voluntary.
       (2) Minimum period.--Enrollment in the dental insurance 
     plan shall be for such minimum period as the Secretary shall 
     prescribe for purposes of this section.
       (h) Premiums.--
       (1) In general.--Premiums for coverage under the dental 
     insurance plan under the pilot program shall be in such 
     amount or amounts as the Secretary of Veterans Affairs shall 
     prescribe to cover all costs associated with the pilot 
     program.

[[Page 1102]]

       (2) Annual adjustment.--The Secretary shall adjust the 
     premiums payable under the pilot program for coverage under 
     the dental insurance plan on an annual basis. Each individual 
     covered by the dental insurance plan at the time of such an 
     adjustment shall be notified of the amount and effective date 
     of such adjustment.
       (3) Responsibility for payment.--Each individual covered by 
     the dental insurance plan shall pay the entire premium for 
     coverage under the dental insurance plan, in addition to the 
     full cost of any copayments.
       (i) Voluntary Disenrollment.--
       (1) In general.--With respect to enrollment in the dental 
     insurance plan under the pilot program, the Secretary shall--
       (A) permit the voluntary disenrollment of an individual in 
     the dental insurance plan if the disenrollment occurs during 
     the 30-day period beginning on the date of the enrollment of 
     the individual in the dental insurance plan; and
       (B) permit the voluntary disenrollment of an individual in 
     the dental insurance plan for such circumstances as the 
     Secretary shall prescribe for purposes of this subsection, 
     but only to the extent such disenrollment does not jeopardize 
     the fiscal integrity of the dental insurance plan.
       (2) Allowable circumstances.--The circumstances prescribed 
     under paragraph (1)(B) shall include the following:
       (A) If an individual enrolled in the dental insurance plan 
     relocates to a location outside the jurisdiction of the 
     dental insurance plan that prevents utilization of the 
     benefits under the dental insurance plan.
       (B) If an individual enrolled in the dental insurance plan 
     is prevented by a serious medical condition from being able 
     to obtain benefits under the dental insurance plan.
       (C) Such other circumstances as the Secretary shall 
     prescribe for purposes of this subsection.
       (3) Establishment of procedures.--The Secretary shall 
     establish procedures for determinations on the permissibility 
     of voluntary disenrollments under paragraph (1)(B). Such 
     procedures shall ensure timely determinations on the 
     permissibility of such disenrollments.
       (j) Relationship to Dental Care Provided by Secretary.--
     Nothing in this section shall affect the responsibility of 
     the Secretary to provide dental care under section 1712 of 
     title 38, United States Code, and the participation of an 
     individual in the dental insurance plan under the pilot 
     program shall not affect the individual's entitlement to 
     outpatient dental services and treatment, and related dental 
     appliances, under that section.
       (k) Regulations.--The dental insurance plan under the pilot 
     program shall be administered under such regulations as the 
     Secretary shall prescribe.

                 TITLE III--WOMEN VETERANS HEALTH CARE

     SEC. 301. REPORT ON BARRIERS TO RECEIPT OF HEALTH CARE FOR 
                   WOMEN VETERANS.

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

     SEC. 302. PLAN TO IMPROVE PROVISION OF HEALTH CARE SERVICES 
                   TO WOMEN VETERANS.

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

     SEC. 303. INDEPENDENT STUDY ON HEALTH CONSEQUENCES OF WOMEN 
                   VETERANS OF MILITARY SERVICE IN OPERATION IRAQI 
                   FREEDOM AND OPERATION ENDURING FREEDOM.

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

     SEC. 304. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE 
                   PROVIDERS ON CARE FOR VETERANS SUFFERING FROM 
                   SEXUAL TRAUMA.

       (a) Program Required.--Section 1720D is amended--
       (1) by redesignating subsection (d) as subsection (f); and
       (2) by inserting after subsection (c) the following new 
     subsections:
       ``(d)(1) The Secretary shall implement a program for 
     education, training, certification, and continuing medical 
     education for mental health professionals to specialize in 
     the provision of counseling and care to veterans eligible for 
     services under subsection (a). In carrying out the program, 
     the Secretary shall ensure that all such mental health 
     professionals have been trained in a consistent manner and 
     that such training includes principles of evidence-based 
     treatment and care for sexual trauma.
       ``(2) The Secretary shall determine the minimum 
     qualifications necessary for mental health professionals 
     certified by the program under paragraph (1) to provide 
     evidence-based treatment and therapy to veterans eligible for 
     services under subsection (a) in facilities of the 
     Department.
       ``(e) The Secretary shall submit to Congress each year a 
     report on the counseling, care, and services provided to 
     veterans under this section. Each report shall include data 
     for the preceding year with respect to the following:
       ``(1) The number of mental health professionals and primary 
     care providers who have been certified under the program 
     under subsection (d), and the amount and nature of continuing 
     medical education provided under such program to 
     professionals and providers who have been so certified.
       ``(2) The number of women veterans who received counseling, 
     care, and services under subsection (a) from professionals 
     and providers who have been trained or certified under the 
     program under subsection (d).

[[Page 1103]]

       ``(3) The number of training, certification, and continuing 
     medical education programs operating under subsection (d).
       ``(4) The number of trained full-time equivalent employees 
     required in each facility of the Department to meet the needs 
     of veterans requiring treatment and care for sexual trauma.
       ``(5) Such other information as the Secretary considers 
     appropriate.''.
       (b) Standards for Personnel Providing Treatment for Sexual 
     Trauma.--The Secretary of Veterans Affairs shall establish 
     education, training, certification, and staffing standards 
     for Department of Veterans Affairs health-care facilities for 
     full-time equivalent employees who are trained to provide 
     treatment and care to veterans for sexual trauma.

     SEC. 305. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR 
                   WOMEN VETERANS NEWLY SEPARATED FROM SERVICE IN 
                   THE ARMED FORCES.

       (a) Pilot Program Required.--
       (1) In general.--Commencing not later than 180 days after 
     the date of the enactment of this Act, the Secretary of 
     Veterans Affairs shall carry out, through the Readjustment 
     Counseling Service of the Veterans Health Administration, a 
     pilot program to evaluate the feasibility and advisability of 
     providing reintegration and readjustment services described 
     in subsection (b) in group retreat settings to women veterans 
     who are recently separated from service in the Armed Forces 
     after a prolonged deployment.
       (2) Participation at election of veteran.--The 
     participation of a veteran in the pilot program under this 
     section shall be at the election of the veteran.
       (b) Covered Services.--The services provided to a woman 
     veteran under the pilot program shall include the following:
       (1) Information on reintegration into the veteran's family, 
     employment, and community.
       (2) Financial counseling.
       (3) Occupational counseling.
       (4) Information and counseling on stress reduction.
       (5) Information and counseling on conflict resolution.
       (6) Such other information and counseling as the Secretary 
     considers appropriate to assist a woman veteran under the 
     pilot program in reintegration into the veteran's family and 
     community.
       (c) Locations.--The Secretary shall carry out the pilot 
     program at not fewer than five locations selected by the 
     Secretary for purposes of the pilot program.
       (d) Duration.--The pilot program shall be carried out 
     during the two-year period beginning on the date of the 
     commencement of the pilot program.
       (e) Report.--Not later than 180 days after the completion 
     of the pilot program, the Secretary shall submit to Congress 
     a report on the pilot program. The report shall contain the 
     findings and conclusions of the Secretary as a result of the 
     pilot program, and shall include such recommendations for the 
     continuation or expansion of the pilot program as the 
     Secretary considers appropriate.
       (f) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs for 
     each of fiscal years 2010 and 2011, $2,000,000 to carry out 
     the pilot program.

     SEC. 306. REPORT ON FULL-TIME WOMEN VETERANS PROGRAM MANAGERS 
                   AT MEDICAL CENTERS.

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

     SEC. 307. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN 
                   RECENTLY SEPARATED FROM SERVICE IN THE ARMED 
                   FORCES.

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

     SEC. 308. PILOT PROGRAM ON SUBSIDIES FOR CHILD CARE FOR 
                   CERTAIN VETERANS RECEIVING HEALTH CARE.

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

     SEC. 309. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS 
                   RECEIVING MATERNITY CARE.

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

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

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

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

                      TITLE IV--MENTAL HEALTH CARE

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

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

[[Page 1104]]

     to such regulations as the Secretary of Defense and the 
     Secretary of Veterans Affairs shall jointly prescribe for 
     purposes of this section.
       (d) Subject to Availability of Appropriations.--The 
     provision of counseling and services under subsection (a) 
     shall be subject to the availability of appropriations for 
     such purpose.

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

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

     SEC. 403. STUDY ON SUICIDES AMONG VETERANS.

       (a) Study Required.--The Secretary of Veterans Affairs 
     shall conduct a study to determine the number of veterans who 
     died by suicide between January 1, 1997, and the date of the 
     enactment of this Act.
       (b) Coordination.--In carrying out the study under 
     subsection (b) the Secretary of Veterans Affairs shall 
     coordinate with--
       (1) the Secretary of Defense;
       (2) Veterans Service Organizations;
       (3) the Centers for Disease Control and Prevention; and
       (4) State public health offices and veterans agencies.
       (c) Report to Congress.--The Secretary of Veterans Affairs 
     shall submit to the Committee on Veterans' Affairs of the 
     Senate and the Committee on Veterans' Affairs of the House of 
     Representatives a report on the study required under 
     subsection (b) and the findings of the Secretary.
       (d) Authorization of Appropriations.--There are authorized 
     to be appropriated such sums as may be necessary to carry out 
     this section.

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

       (a) Transfer of Funds.--Not later than September 30, 2010, 
     the Secretary of Veterans Affairs shall transfer $5,000,000 
     from accounts of the Veterans Health Administration to the 
     Secretary of Health and Human Services for the Graduate 
     Psychology Education program established under section 
     755(b)(1)(J) of the Public Health Service Act (42 U.S.C. 
     294e(b)(1)(J)).
       (b) Use of Funds Transferred.--Funds transferred under 
     subsection (a) shall be used to award grants to support the 
     training of psychologists in the treatment of veterans with 
     post traumatic stress disorder, traumatic brain injury, and 
     other combat-related disorders.
       (c) Preference for Department of Veterans Affairs Health 
     Care Facilities.--In the awarding of grants under subsection 
     (b), the Graduate Psychology Education program shall give 
     preference to health care facilities of the Department of 
     Veterans Affairs and graduate programs of education that are 
     affiliated with such facilities.

                       TITLE V--HOMELESS VETERANS

     SEC. 501. PILOT PROGRAM ON FINANCIAL SUPPORT FOR ENTITIES 
                   THAT COORDINATE THE PROVISION OF SUPPORTIVE 
                   SERVICES TO FORMERLY HOMELESS VETERANS RESIDING 
                   ON CERTAIN MILITARY PROPERTY.

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

     SEC. 502. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT 
                   COORDINATE THE PROVISION OF SUPPORTIVE SERVICES 
                   TO FORMERLY HOMELESS VETERANS RESIDING IN 
                   PERMANENT HOUSING.

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

     SEC. 503. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT 
                   PROVIDE OUTREACH TO INFORM CERTAIN VETERANS 
                   ABOUT PENSION BENEFITS.

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

     SEC. 504. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT 
                   PROVIDE TRANSPORTATION ASSISTANCE, CHILD CARE 
                   ASSISTANCE, AND CLOTHING ASSISTANCE TO VETERANS 
                   ENTITLED TO A REHABILITATION PROGRAM.

       (a) Pilot Program Authorized.--
       (1) In general.--Subject to the availability of 
     appropriations authorized under subsection (g), the Secretary 
     of Veterans Affairs may carry out a pilot program to assess

[[Page 1105]]

     the feasibility and advisability of providing financial 
     assistance to eligible entities to establish new programs or 
     activities, or expand or modify existing programs or 
     activities, to provide to each eligible transitioning 
     individual who is entitled and eligible for a rehabilitation 
     program under chapter 31 of title 38, United States Code, the 
     following assistance:
       (A) Transportation assistance to facilitate such eligible 
     transitioning individual's participation in such 
     rehabilitation program or related activity. Such assistance 
     may include--
       (i) providing transportation;
       (ii) paying for or reimbursing transportation costs; and
       (iii) paying for or reimbursing other transportation-
     related expenses (including orientation on the use of 
     transportation) .
       (B) Child care assistance to facilitate such eligible 
     transitioning individual's participation in such 
     rehabilitation program or related activity. Such assistance 
     may include--
       (i) child care services; or
       (ii) reimbursement of expenses related to child care.
       (C) Clothing assistance, which may include personal 
     services in selecting, and payment of a monetary allowance to 
     cover the cost of purchasing, clothing and accessories 
     suitable for a job interview or related activity consistent 
     with such eligible transitioning individual's participation 
     in such rehabilitation program or related activity.
       (2) Eligible transitioning individual.--For purposes of 
     this section, an eligible transitioning individual is a 
     person--
       (A) described in section 3102 of title 38, United States 
     Code; or
       (B) who was separated or released from active duty in the 
     Armed Forces on or after October 1, 2006, because of a 
     service-connected disability.
       (b) Duration of Program.--The authority of the Secretary to 
     provide grants under a pilot program established under 
     subsection (a)(1) shall cease on the date that is three years 
     after the date of the commencement of the pilot program.
       (c) Grants.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     carry out the pilot program through the award of grants to 
     eligible entities to establish new programs or activities, or 
     to expand or modify existing programs or activities, as 
     described in subsection (a)(1).
       (2) Grant criteria.--
       (A) In general.--The Secretary shall establish criteria and 
     requirements for grants under the pilot program, including 
     criteria for eligible entities to receive such grants. The 
     criteria established under this subparagraph shall include 
     the following:
       (i) Specification as to the kinds of projects or activities 
     for which grants are available.
       (ii) Specification as to the number of projects or 
     activities for which grants are available.
       (iii) Provisions to ensure that grants awarded under the 
     pilot program do not result in duplication of ongoing 
     services.
       (B) Publication of criteria in federal register.--The 
     Secretary shall publish the criteria and requirements 
     established under subparagraph (A) in the Federal Register.
       (3) Funding limitation.--A grant under the pilot program 
     may not be used to support the operational costs of an 
     eligible entity.
       (d) Eligible Entities.--For purposes of this section, an 
     eligible entity is a public or nonprofit organization 
     (including a faith-based or community organization) that--
       (1) has the capacity to administer effectively a grant 
     under the pilot program, as determined by the Secretary of 
     Veterans Affairs;
       (2) demonstrates that adequate financial support will be 
     available to establish new programs or activities, or to 
     expand or modify existing programs or activities, as 
     described in subsection (a)(1) consistent with the plans, 
     specifications, and schedule submitted by the applicant to 
     the Secretary under subsection (e)(2);
       (3) agrees to meet the applicable criteria and requirements 
     established under subsection (c)(2) and described in 
     subsection (e)(2)(C); and
       (4) has the capacity, as determined by the Secretary, to 
     meet the criteria and requirements described in paragraph 
     (3).
       (e) Selection of Grant Recipients.--
       (1) Application.--An eligible entity seeking a grant under 
     the pilot program shall submit to the Secretary of Veterans 
     Affairs an application therefor in such form and in such 
     manner as the Secretary considers appropriate.
       (2) Elements.--Each application submitted under paragraph 
     (1) shall include the following:
       (A) The amount of the grant sought for the project or 
     activity.
       (B) Plans, specifications, and the schedule for 
     implementation of the project or activity in accordance with 
     criteria and requirements prescribed by the Secretary under 
     subsection (c)(2).
       (C) An agreement--
       (i) to provide the services for which the grant is sought 
     at locations accessible to eligible transitioning 
     individuals;
       (ii) to ensure the confidentiality of records maintained on 
     eligible transitioning individuals receiving services through 
     the pilot program; and
       (iii) to establish such procedures for fiscal control and 
     fund accounting as may be necessary to ensure proper 
     disbursement and accounting with respect to the grant and to 
     such payments as may be made under this section.
       (3) Applicant agreement.--The Secretary may not select an 
     eligible entity for a grant under the pilot program unless 
     the eligible entity agrees to the provisions listed in 
     paragraph (2)(C).
       (f) Recovery of Unused Grant Amounts.--
       (1) In general.--The United States shall be entitled to 
     recover from a grant recipient under this section the total 
     of all unused grant amounts made under this section to such 
     recipient in connection with such program if such grant 
     recipient--
       (A) does not establish a program or activity in accordance 
     with this section; or
       (B) ceases to furnish services under such a program for 
     which the grant was made.
       (2) Obligation.--Any amount recovered by the United States 
     under paragraph (1) may be obligated by the Secretary of 
     Veterans Affairs without fiscal year limitation to carry out 
     provisions of this section.
       (3) Limitation on recovery.--An amount may not be recovered 
     under paragraph (1)(A) as an unused grant amount before the 
     end of the three-year period beginning on the date on which 
     the grant is made.
       (g) Authorization of Appropriations.--There is authorized 
     to be appropriated from amounts made available under the 
     heading ``General Operating Expenses'', not more than 
     $5,000,000 in each of fiscal years 2010 through 2012 to carry 
     out this section.

     SEC. 505. ASSESSMENT OF PILOT PROGRAMS.

       (a) Progress Reports.--Not less than one year before the 
     expiration of the authority to carry out a pilot program 
     authorized by sections 501 through 504, the Secretary of 
     Veterans Affairs shall submit to Congress a progress report 
     on such pilot program.
       (b) Contents.--Each progress report submitted for a pilot 
     program under subsection (a) shall include the following:
       (1) The lessons learned by the Secretary of Veterans 
     Affairs with respect to such pilot program that can be 
     applied to other programs with similar purposes.
       (2) The recommendations of the Secretary on whether to 
     continue such pilot program.
       (3) The number of veterans and dependents served by such 
     pilot program.
       (4) An assessment of the quality of service provided to 
     veterans and dependents under such pilot program.
       (5) The amount of funds provided to grant recipients under 
     such pilot program.
       (6) The names of organizations that have received grants 
     under such pilot program.

        TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

     SEC. 601. GENERAL AUTHORITIES ON ESTABLISHMENT OF 
                   CORPORATIONS.

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

[[Page 1106]]

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

     SEC. 602. CLARIFICATION OF PURPOSES OF CORPORATIONS.

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

     SEC. 603. MODIFICATION OF REQUIREMENTS FOR BOARDS OF 
                   DIRECTORS OF CORPORATIONS.

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

     SEC. 604. CLARIFICATION OF POWERS OF CORPORATIONS.

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

     ``Sec. 7364. General powers

       ``(a) In General.--(1) A corporation established under this 
     subchapter may, solely to carry out the purposes of this 
     subchapter--
       ``(A) accept, administer, retain, and spend funds derived 
     from gifts, contributions, grants, fees, reimbursements, and 
     bequests from individuals and public and private entities;
       ``(B) enter into contracts and agreements with individuals 
     and public and private entities;
       ``(C) subject to paragraph (2), set fees for education and 
     training facilitated under section 7362 of this title, and 
     receive, retain, administer, and spend funds in furtherance 
     of such education and training;
       ``(D) reimburse amounts to the applicable appropriation 
     account of the Department for the Office of General Counsel 
     for any expenses of that Office in providing legal services 
     attributable to research and education agreements under this 
     subchapter; and
       ``(E) employ such employees as the corporation considers 
     necessary for such purposes and fix the compensation of such 
     employees.
       ``(2) Fees charged under paragraph (1)(C) for education and 
     training described in that paragraph to individuals who are 
     officers or employees of the Department may not be paid for 
     by any funds appropriated to the Department.
       ``(3) Amounts reimbursed to the Office of General Counsel 
     under paragraph (1)(D) shall be available for use by the 
     Office of the General Counsel only for staff and training, 
     and related travel, for the provision of legal services 
     described in that paragraph and shall remain available for 
     such use without fiscal year limitation.
       ``(b) Transfer and Administration of Funds.--(1) Except as 
     provided in paragraph (2), any funds received by the 
     Secretary for the conduct of research or education at a 
     Department medical center or centers, other than funds 
     appropriated to the Department, may be transferred to and 
     administered by a corporation established under this 
     subchapter for such purposes.
       ``(2) A Department medical center may reimburse the 
     corporation for all or a portion of the pay, benefits, or 
     both of an employee of the corporation who is assigned to the 
     Department medical center if the assignment is carried out 
     pursuant to subchapter VI of chapter 33 of title 5.
       ``(3) A Department medical center may retain and use funds 
     provided to it by a corporation established under this 
     subchapter. Such funds shall be credited to the applicable 
     appropriation account of the Department and shall be 
     available, without fiscal year limitation, for the purposes 
     of that account.
       ``(c) Research Projects.--Except for reasonable and usual 
     preliminary costs for project planning before its approval, a 
     corporation established under this subchapter may not spend 
     funds for a research project unless the project is approved 
     in accordance with procedures prescribed by the Under 
     Secretary for Health for research carried out with Department 
     funds. Such procedures shall include a scientific review 
     process.
       ``(d) Education Activities.--Except for reasonable and 
     usual preliminary costs for activity planning before its 
     approval, a corporation established under this subchapter may 
     not spend funds for an education activity unless the activity 
     is approved in accordance with procedures prescribed by the 
     Under Secretary for Health.
       ``(e) Policies and Procedures.--The Under Secretary for 
     Health may prescribe policies and procedures to guide the 
     spending of funds by corporations established under this 
     subchapter that are consistent with the purpose of such 
     corporations as flexible funding mechanisms and with Federal 
     and State laws and regulations, and executive orders, 
     circulars, and directives that apply generally to the receipt 
     and expenditure of funds by nonprofit organizations exempt 
     from taxation under section 501(c)(3) of the Internal Revenue 
     Code of 1986.''.
       (b) Conforming Amendment.--Section 7362(a), as amended by 
     section 602(a)(1) of this Act, is further amended by striking 
     the last sentence.

     SEC. 605. REDESIGNATION OF SECTION 7364A OF TITLE 38, UNITED 
                   STATES CODE.

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

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

     SEC. 606. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF 
                   CORPORATIONS.

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

[[Page 1107]]

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

                  TITLE VII--MISCELLANEOUS PROVISIONS

     SEC. 701. EXPANSION OF AUTHORITY FOR DEPARTMENT OF VETERANS 
                   AFFAIRS POLICE OFFICERS.

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

     SEC. 702. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS 
                   AFFAIRS POLICE OFFICERS.

       Section 903 is amended--
       (1) by amending subsection (b) to read as follows:
       ``(b)(1) The amount of the allowance that the Secretary may 
     pay under this section is the lesser of--
       ``(A) the amount currently allowed as prescribed by the 
     Office of Personnel Management; or
       ``(B) estimated costs or actual costs as determined by 
     periodic surveys conducted by the Department.
       ``(2) During any fiscal year no officer shall receive more 
     for the purchase of a uniform described in subsection (a) 
     than the amount established under this subsection.''; and
       (2) by striking subsection (c) and inserting the following 
     new subsection (c):
       ``(c) The allowance established under subsection (b) shall 
     be paid at the beginning of a Department police officer's 
     employment for those appointed on or after October 1, 2008. 
     In the case of any other Department police officer, an 
     allowance in the amount established under subsection (b) 
     shall be paid upon the request of the officer.''.
                                 ______
                                 
      By Mrs. LINCOLN (for herself, Ms. Snowe, and Mr. Isakson):
  S. 254. A bill to amend title XVIII of the Social Security Act to 
provide for the coverage of home infusion therapy under the Medicare 
Program; to the Committee on Finance.
  Ms. SNOWE. Mr. President, today I am pleased to join my colleague, 
Senator Lincoln of Arkansas, to introduce the Medicare Home Infusion 
Coverage Act. As we do so, we recognize that Medicare has serious 
fiscal challenges. Currently, the Part A, Hospital, Trust Fund faces 
insolvency in 2019, when expenditures will exceed projected 
contributions and require additional taxpayer support to maintain the 
care required by our seniors and so many disabled Americans. At the 
same time, today Medicare beneficiaries struggle under the burden of 
paying nearly half of their health care costs. So the legislation we 
are re-introducing is vital to addressing the fiscal issues affecting 
Medicare.
  Many serious conditions--including some cancers and drug-resistant 
infections--require the use of infusion therapy. Such treatment 
involves the administration of medication directly into the bloodstream 
via a needle or catheter. Specialized equipment, supplies, and 
professional services--such as sterile drug compounding, care 
coordination, and patient education and monitoring--are components of 
such therapy. Infusion treatment is an extensive medical treatment 
often lasting for several hours per day over a 6-to-8 week period.
  The unfortunate fact is that under current Medicare rules, patients 
requiring infusion therapy must either bear that cost themselves or 
endure costly and unnecessary hospitalization in order to receive 
coverage--raising costs for both beneficiaries and Medicare alike. 
Current Medicare regulations authorize payment for infusion drugs, but 
do not pay for the services, equipment, and supplies necessary to 
safely provide infusion therapy in the home. Not surprisingly, even 
though home infusion therapy may cost as little as $100 a day, too few 
seniors can bear that cost.
  The result is that patients are excessively hospitalized, producing 
costs of treatment as much as 10-20 times higher than treatment in the 
home. The process may even place the patient's health in jeopardy 
because unnecessary hospitalization places individuals at risk of 
exposure to a health care-acquired infection--which may be drug 
resistant and life-threatening.
  Private health plans have long understood that home infusion therapy 
is not only less costly, but safer as well. Thus, private insurance 
coverage for home infusion therapy is common. Private plans also 
recognize that patients benefit from avoiding hospitalization. At home 
they have a familiar, comfortable environment with their family 
conveniently at hand--no small concerns when fighting a serious 
illness.
  It is clear we must change the status quo, and achieve safer, more 
cost-effective treatment. By extending coverage of infusion therapy to 
the home, we will correct this inappropriate and unnecessary gap in 
Medicare coverage and take a significant step in reducing Medicare 
costs. This legislation offers an alternative to allowing our Medicare 
beneficiaries to be overcome with health care costs that are rising 
faster than inflation by reforming care delivery to emphasize high 
quality, lower cost services.
  I hope my colleagues will join us in support of this legislation so 
we may further the goals of improving patient safety and reducing our 
escalating health care costs.
  Mr. President, I ask unanimous consent that the text of the bill to 
be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 254

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Medicare Home Infusion 
     Therapy Coverage Act of 2009''.

     SEC. 2. MEDICARE COVERAGE OF HOME INFUSION THERAPY.

       (a) In General.--Section 1861 of the Social Security Act 
     (42 U.S.C. 1395x), as amended by section 152(b) of the 
     Medicare Improvements for Patients and Providers Act of 2008 
     (Public Law 110-275), is amended--
       (1) in subsection (s)(2)--
       (A) by striking ``and'' at the end of subparagraph (DD);
       (B) by adding ``and'' at the end of subparagraph (EE); and
       (C) by adding at the end the following new subparagraph:
       ``(FF) home infusion therapy (as defined in subsection 
     (hhh)(1));''; and
       (2) by adding at the end the following new subsection:

                        ``Home Infusion Therapy

       ``(hhh)(1) The term `home infusion therapy' means the 
     following items and services furnished to an individual, who 
     is under the

[[Page 1108]]

     care of a physician, which are provided by a qualified home 
     infusion therapy provider under a plan (for furnishing such 
     items and services to such individual) established and 
     periodically reviewed by a physician, which items and 
     services are provided in an integrated manner in the 
     individual's home in conformance with uniform standards of 
     care established by the Secretary (after taking into account 
     the standards commonly used for home infusion therapy by 
     Medicare Advantage plans and in the private sector and after 
     consultation with all interested stakeholders) and in 
     coordination with the provision of covered infusion drugs 
     under part D:
       ``(A) Professional services other than nursing services 
     provided in accordance with the plan (including 
     administrative, compounding, dispensing, distribution, 
     clinical monitoring and care coordination services) and all 
     necessary supplies and equipment (including medical supplies 
     such as sterile tubing and infusion pumps, and other items 
     and services the Secretary determines appropriate) to 
     administer infusion drug therapies to an individual safely 
     and effectively in the home.
       ``(B) Nursing services provided in accordance with the 
     plan, directly by a qualified home infusion therapy provider 
     or under arrangements with an accredited homecare 
     organization, in connection with such infusion, except that 
     such term does not include nursing services to the extent 
     they are covered as home health services.
       ``(2) For purposes of paragraph (1):
       ``(A) The term `home' means a place of residence used as an 
     individual's home and includes such other alternate settings 
     as the Secretary determines.
       ``(B) The term `qualified home infusion therapy provider' 
     means any pharmacy, physician, or other provider licensed by 
     the State in which the pharmacy, physician, or provider 
     resides or provides services, whose State authorized scope of 
     practice includes dispensing authority and that--
       ``(i) has expertise in the preparation of parenteral 
     medications in compliance with enforceable standards of the 
     U.S. Pharmacopoeia and other nationally recognized standards 
     that regulate preparation of parenteral medications as 
     determined by the Secretary and meets such standards;
       ``(ii) provides infusion therapy to patients with acute or 
     chronic conditions requiring parenteral administration of 
     drugs and biologicals administered through catheters or 
     needles, or both, in a home; and
       ``(iii) meets such other uniform requirements as the 
     Secretary determines are necessary to ensure the safe and 
     effective provision and administration of home infusion 
     therapy on a 7 day a week, 24 hour basis (taking into account 
     the standards of care for home infusion therapy established 
     by Medicare Advantage plans and in the private sector), and 
     the efficient administration of the home infusion therapy 
     benefit.

     A qualified home infusion therapy provider may subcontract 
     with a pharmacy, physician, provider, or supplier to meet the 
     requirements of this subsection.''.
       (b) Payment for Home Infusion Therapy.--Section 1834 of the 
     Social Security Act (42 U.S.C. 1395m) is amended by adding at 
     the end the following new subsection:
       ``(n) Payment for Home Infusion Therapy.--The payment 
     amount under this part for home infusion therapy is 
     determined as follows:
       ``(1) In general.--The Secretary shall determine a per diem 
     schedule for payment for the professional services, supplies, 
     and equipment described in section 1861(hhh)(1)(A) that 
     reflects the reasonable costs which must be incurred by 
     efficiently and economically operated qualified home infusion 
     therapy providers to provide such services, supplies, and 
     equipment in conformity with applicable State and Federal 
     laws, regulations, and the uniform quality and safety 
     standards developed under section 1861(hhh)(1) and to assure 
     that Medicare beneficiaries have reasonable access to such 
     therapy. The Secretary shall update such schedule from year 
     to year by the percentage increase in the consumer price 
     index for all urban consumers (United States city average) 
     for the 12-month period ending with June of the preceding 
     year.
       ``(2) Nursing services.--The Secretary shall develop a 
     methodology for the separate payment for nursing services 
     described in section 1861(hhh)(1)(B) provided in accordance 
     with the plan under such section which reflects the 
     reasonable costs incurred in the provision of nursing 
     services in connection with infusion therapy in conformity 
     with State and Federal laws, regulations, and the uniform 
     quality and safety standards developed pursuant to this Act 
     and to assure that Medicare beneficiaries have reasonable 
     access to nursing services for infusion therapy. The 
     Secretary shall update such schedule from year to year by the 
     percentage increase in the consumer price index for all urban 
     consumers (United States city average) for the 12-month 
     period ending with June of the preceding year.''.
       (c) Conforming Amendments.--
       (1) Payment reference.--Section 1833(a)(1) of the Social 
     Security Act (42 U.S.C. 13951(a)(1)), as amended by section 
     101(a)(2) of the Medicare Improvements for Patients and 
     Providers Act of 2008 (Public Law 110-275), is amended--
       (A) by striking ``and'' before ``(W)''; and
       (B) by inserting before the semicolon at the end the 
     following: ``, and (X) with respect to home infusion therapy, 
     the amounts paid shall be determined under section 1834(n)''.
       (2) Direct payment.--The first sentence of section 
     1842(b)(6) of such Act (42 U.S.C. 1395u(b)(6)) is amended--
       (A) by striking ``and'' before ``(H)''; and
       (B) by inserting before the period at the end the 
     following: ``, and (I) in the case of home infusion therapy, 
     payment shall be made to the qualified home infusion therapy 
     provider''.
       (3) Exclusion from durable medical equipment and home 
     health services.--Section 1861 of such Act (42 U.S.C. 1395x) 
     is amended--
       (A) in subsection (m)(5), by inserting ``and supplies used 
     in the provision of home infusion therapy'' after ``excluding 
     other drugs and biologicals''; and
       (B) in subsection (n), by adding at the end the following: 
     ``Such term does not include home infusion therapy, other 
     than equipment and supplies used in the provision of 
     insulin.''.
       (4) Application of accreditation provisions.--The 
     provisions of section 1865(b) of the Social Security Act (42 
     U.S.C. 1395bb(b)) apply to the accreditation of qualified 
     home infusion therapy providers in the manner they apply to 
     other suppliers.

     SEC. 3. MEDICARE COVERAGE OF HOME INFUSION DRUGS.

       (a) In General.--Section 1860D-2(e)(1) of the Social 
     Security Act (42 U.S.C. 1395w-102(e)(1)), as amended by 
     section 182 of the Medicare Improvements for Patients and 
     Providers Act of 2008 (Public Law 110-275), is amended--
       (1) in paragraph (1)--
       (A) by striking ``or'' at the end of subparagraph (A);
       (B) by striking the comma at the end of subparagraph (B) 
     and inserting ``; or''; and
       (C) by inserting before the flush matter following 
     subparagraph (B) the following new subparagraph:
       ``(C) an infusion drug (as defined in paragraph (5)),''; 
     and
       (2) by adding at the end the following new paragraph:
       ``(5) Infusion drug defined.--For purposes of this part, 
     the term `infusion drug' means a parenteral drug or 
     biological administered via an intravenous, intraspinal, 
     intra-arterial, intrathecal, epidural, subcutaneous, or 
     intramuscular access device inserted into the body, and 
     includes a drug used for catheter maintenance and declotting, 
     a drug contained in a device, vitamins, intravenous 
     solutions, diluents and minerals, and other components used 
     in the provision of home infusion therapy.''.
       (b) Infusion Drug Formularies.--For the first 2 years after 
     the effective date of this Act, notwithstanding any other 
     provision of law, prescription drug plans and MA-PD plans 
     under title XVIII of the Social Security Act shall maintain 
     open formularies for infusion drugs (as defined in section 
     1860D-2(e)(5) of such Act, as added by subsection (a)). The 
     Secretary of Health and Human Services shall request the 
     United States Pharmacopeia to develop, in consultation with 
     representatives of qualified home infusion therapy providers 
     and other interested stakeholders, a model formulary approach 
     for home infusion drugs for use by such plans after such 2-
     year period.
       (c) Part D Dispensing Fees.--Section 1860D-2(d)(1)(B) of 
     the Social Security Act (42 U.S.C. 1395w-102(d)(1)(B)) is 
     amended by inserting after ``any dispensing fees for such 
     drugs'' the following: ``, other than for an infusion drug''.

     SEC. 4. ENSURING BENEFICIARY ACCESS TO HOME INFUSION THERAPY.

       (a) Objectives in Implementation.--The Secretary of Health 
     and Human Services shall implement the Medicare home infusion 
     therapy benefit under the amendments made by this Act in a 
     manner that ensures that Medicare beneficiaries have timely 
     and appropriate access to infusion therapy in their homes and 
     that there is rapid and seamless coordination between drug 
     coverage under part D of title XVIII of the Social Security 
     Act and coverage for home infusion therapy services under 
     part B of such title. Specifically, the Secretary shall 
     ensure that--
       (1) the benefit is practical and workable with minimal 
     administrative burden for beneficiaries, qualified home 
     infusion therapy providers, physicians, prescription drug 
     plans, MA-PD plans, and Medicare Advantage plans, and the 
     Secretary shall consider the use of consolidated claims 
     encompassing covered part D drugs and part B services, 
     supplies, and equipment under such part B to ensure the 
     efficient operation of this benefit;
       (2) any prior authorization or utilization review process 
     is expeditious, allowing Medicare beneficiaries meaningful 
     access to home infusion therapy;
       (3) medical necessity determinations for home infusion 
     therapy will be made--
       (A) except as provided in subparagraph (B), by medicare 
     administrative contractors under such part B and communicated 
     to the appropriate prescription drug plans; or
       (B) in the case of an individual enrolled in a Medicare 
     Advantage plan, by the Medicare Advantage organization 
     offering the plan;


[[Page 1109]]


     and an individual may be initially qualified for coverage for 
     such benefit for a 90-day period and subsequent 90-day 
     periods thereafter;
       (4) the benefit is modeled on current private sector 
     coverage and coding for home infusion therapy; and
       (5) prescription drug plans and MA-PD plans structure their 
     formularies, utilization review protocols, and policies in a 
     manner that ensures that Medicare beneficiaries have timely 
     and appropriate access to infusion therapy in their homes.
       (b) Home Infusion Therapy Advisory Panel.--In implementing 
     such home infusion therapy benefit and meeting the objectives 
     specified in subsection (a), the Secretary shall establish an 
     advisory panel to provide advice and recommendations. Such 
     panel shall--
       (1) be comprised primarily of qualified home infusion 
     therapy providers and their representative organizations;
       (2) also include representatives of the following:
       (1) Patient organizations.
       (2) Hospital discharge planners, care coordinators, or 
     social workers.
       (3) Prescription drug plan sponsors and Medicare Advantage 
     organizations.
       (c) Report.--Not later than January 1, 2012, and every 2 
     years thereafter, the Comptroller General of the United 
     States shall submit a report to Congress on Medicare 
     beneficiary access to home infusion therapy. Each such report 
     shall specifically address whether the objectives specified 
     in subsection (a) have been met and shall make 
     recommendations to Congress and the Secretary on how to 
     improve the benefit and better ensure that Medicare 
     beneficiaries have timely and appropriate access to infusion 
     therapy in their homes.

     SEC. 5. EFFECTIVE DATE.

       The amendments made by this Act shall apply to home 
     infusion therapy furnished on or after January 1, 2010.
                                 ______
                                 
      By Mrs. FEINSTEIN (for herself, Mr. Kyl, Mr. Reid, Mr. Durbin, 
        Mr. McConnell, Mr. Bingaman, Mr. Ensign, Mr. Schumer, Mr. 
        Inhofe, Mrs. McCaskill, Mr. Kerry, Mr. Bayh, Mr. Alexander, Mr. 
        Grassley, Mr. Nelson of Florida, Mr. Johnson, and Ms. 
        Cantwell):
  S. 256. A bill to enhance the ability to combat methamphetamine; to 
the Committee on the Judiciary.
  Mrs. FEINSTEIN. Mr. President, I am pleased to introduce, along with 
Senators Kyl, Reid, Durbin, McConnell, Bingaman, Ensign, Schumer, 
Inhofe, McCaskill, Kerry, Bayh, Alexander, Grassley, Nelson of Florida, 
Johnson, and Cantwell the Combat Methamphetamine Enhancement Act of 
2009.
  This Act is designed to address problems that the Drug Enforcement 
Administration, DEA, has identified in the implementation of the Combat 
Methamphetamine Epidemic Act of 2005. I was pleased to join former 
Senator Talent in drafting, introducing, and securing the passage of 
the original bill. I am pleased to introduce this legislation today to 
ensure that it operates as Congress intended.
  The bill that I introduce today would clarify that all retailers, 
including mail order retailers, who sell products that contain 
chemicals often used to make methamphetamine--like ephedrine, 
pseudoepedrine and phenylpropanolamine--must self-certify that they 
have trained their personnel and will comply with the Combat Meth Act's 
requirements; require distributors to sell these products only to 
retailers who have certified that they will comply with the law; 
require the DEA to publish the list of all retailers who have filed 
self-certifications, on the DEA's website; and clarify that any 
retailer who negligently fails to file self-certification as required, 
may be subject to civil fines and penalties.
  The Combat Methamphetamine Epidemic Act that we passed in 2006 has 
been a resounding success. The number of methamphetamine labs in the 
United States has declined dramatically now that the ingredients used 
to make methamphetamine are harder to get.
  The Combat Meth Act that became effective in September 2006 included 
important new provisions for retailer self-certification, employee 
training, requiring products to be placed behind counters, packaging 
requirements, required sales logbooks, and limits on the amounts that a 
person can purchase in a given day and over a 30-day period.
  Now, because of that law's implementation, the number of 
methamphetamine labs decreased from about 12,000 labs to about 7,300 
labs a 41 percent decrease in just 1 year. Once the bill was enacted 
into law, the number of meth ``super labs'' in my home State of 
California declined from 30 in 2005 to only 17 in 2006.
  Fewer meth labs means more than just less illegal drug production. 
According to the Fresno Bee, the DEA has noted that in 2003, 3,663 
children were reported exposed to toxic meth labs nationwide but that 
number had been reduced to 319 in 2006.
  So things are moving in the right direction, and that is good news. 
But with more thousands of methamphetamine labs still operating in the 
U.S., and children still being exposed to their toxins, it is also 
clear that there is still work to be done.
  After the Combat Meth Act became law, DEA examined how the retailer 
self-certification process was working. On May 16, 2007, DEA sent 
letters to the 1,600 distributors who they believed were selling 
products that contained ephedrine or pseudoephedrine, asking them to 
turn over lists of the retail stores that they sell to, so that DEA 
could check to see how many of those retailers had self-certified as 
that law requires.
  Rather than actively assisting the DEA in its efforts, about \3/4\ of 
the distributors failed or declined to provide any information about 
the retail stores.
  The distributors who did cooperate provided DEA with the names of 
12,375 retail customers. When DEA checked those out, it found that 
about 8,300 of those retail stores had never self-certified as the law 
requires.
  Based on these findings, the DEA estimates that nationwide, as many 
as 30,000 additional retail sellers of products are not complying with 
the law.
  In short, retailers' non-compliance with the self-certification 
requirement appears to be widespread, and undercuts the effectiveness 
of the Combat Meth Act.
  Unfortunately, there is no effective way for law enforcement to 
determine the universe of who is, and who is not, obeying the law. 
Currently, there is no requirement that retailers notify the DEA before 
they start selling products with these listed chemicals.
  Retailers can likely avoid negative consequences if they are ever 
confronted with their failure to self-certify. Currently, the law 
imposes sanctions only for willful and reckless refusals to self-
certify. There is no punishment available if a retailer negligently 
fails to self-certify as required. Not even civil sanctions are 
available.
  In short, without distributors restricting the supply of these 
products to retailers who have self-certified, retailers may simply 
take their chances, rather than self-certifying as the law intended, 
figuring that they'll never get caught, or if they do get caught, that 
they will never be punished.
  It is unacceptable that, over two years after the Combat Meth Act 
imposed this requirement and became fully effective, tens of thousands 
of retailers still are not following the law. It is unacceptable that 
distributors of these products can continue to profit off of their 
sales to retailers who are not complying, or are even refusing to 
comply with the law.
  So this bill is designed to make the Combat Meth Act more effective, 
by putting in place a process that will ensure that every retailer who 
orders these products that can be used to make methamphetamine must 
comply with the law before they can get and resell the products.
  First, it will require that all retail sellers of products with these 
listed chemicals must file self-certifications, closing a loophole that 
now exists for mail-order retailers.
  Second, the DEA will be required to post all self-certified retailers 
on its website, so that advocacy groups and others who are concerned 
about methamphetamine in their communities can identify retailers who 
are selling these products without complying with the law, and can 
notify the authorities.
  Third, distributors of these products will only be allowed to sell to 
retailers who have self-certified, which they will

[[Page 1110]]

be able to verify by checking the DEA's public website. Once 
recalcitrant retailers are faced with the real and immediate economic 
consequence of a possible cut-off of their desire to purchase these 
products, I am confident that most will file self-certifications as the 
law requires.
  Finally, the bill clarifies that even a negligent failure to self-
certify, if proven, can give rise to civil sanctions.
  This is a common-sense bill, designed to strengthen the 
implementation of the Combat Methamphetamine Epidemic Act. This bill 
would create incentives to ensure that the self-certification process 
of the law is made both effective and enforceable.
  I urge my colleagues to support this legislation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 256

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Combat Methamphetamine 
     Enhancement Act of 2009''.

     SEC. 2. REQUIREMENT OF SELF-CERTIFICATION BY ALL REGULATED 
                   PERSONS SELLING SCHEDULED LISTED CHEMICALS.

       Section 310(e)(2) of the Controlled Substances Act (21 
     U.S.C. 830(e)(2)) is amended by inserting at the end the 
     following:
       ``(C) Each regulated person who makes a sale at retail of a 
     scheduled listed chemical product and is required under 
     subsection (b)(3) to submit a report of the sales transaction 
     to the Attorney General may not sell any scheduled listed 
     chemical product at retail unless such regulated person has 
     submitted to the Attorney General a self-certification 
     including a statement that the seller understands each of the 
     requirements that apply under this paragraph and under 
     subsection (d) and agrees to comply with the requirements. 
     The Attorney General shall by regulation establish criteria 
     for certifications of mail-order distributors that are 
     consistent with the criteria established for the 
     certifications of regulated sellers under paragraph 
     (1)(B).''.

     SEC. 3. PUBLICATION OF SELF-CERTIFIED REGULATED SELLERS AND 
                   REGULATED PERSONS LISTS.

       Section 310(e)(1)(B) of the Controlled Substances Act (21 
     U.S.C. 830(e)(1)(B)) is amended by inserting at the end the 
     following:
       ``(v) Publication of list of self-certified persons.--The 
     Attorney General shall develop and make available a list of 
     all persons who are currently self-certified in accordance 
     with this section. This list shall be made publicly available 
     on the website of the Drug Enforcement Administration in an 
     electronically downloadable format.''.

     SEC. 4. REQUIREMENT THAT DISTRIBUTORS OF LISTED CHEMICALS 
                   SELL ONLY TO SELF-CERTIFIED REGULATED SELLERS 
                   AND REGULATED PERSONS.

       Section 402(a) of the Controlled Substances Act (21 U.S.C. 
     842(a)) is amended--
       (1) in paragraph (13), by striking ``or'' after the 
     semicolon;
       (2) in paragraph (14), by striking the period and inserting 
     ``; or'';
       (3) by inserting after paragraph (14) the following:
       ``(15) to distribute a scheduled listed chemical product to 
     a regulated seller, or to a regulated person referred to in 
     section 310(b)(3)(B), unless such regulated seller or 
     regulated person is, at the time of such distribution, 
     currently registered with the Drug Enforcement 
     Administration, or on the list of persons referred to under 
     section 310(e)(1)(B)(v).''; and
       (4) inserting at the end the following: ``For purposes of 
     paragraph (15), if the distributor is temporarily unable to 
     access the list of persons referred to under section 
     310(e)(1)(B)(v), the distributor may rely on a written, 
     faxed, or electronic copy of a certificate of self-
     certification submitted by the regulated seller or regulated 
     person, provided the distributor confirms within 7 business 
     days of the distribution that such regulated seller or 
     regulated person is on the list referred to under section 
     310(e)(1)(B)(v).''.

     SEC. 5. NEGLIGENT FAILURE TO SELF-CERTIFY AS REQUIRED.

       Section 402(a) of the Controlled Substances Act (21 U.S.C. 
     842(a)(10)) is amended by inserting before the semicolon the 
     following: ``or negligently to fail to self-certify as 
     required under section 310 (21 U.S.C. 830)''.

     SEC. 6. EFFECTIVE DATE AND REGULATIONS.

       (a) Effective Date.--This Act and the amendments made by 
     this Act shall take effect 180 days after the date of 
     enactment of this Act.
       (b) Regulations.--In promulgating the regulations 
     authorized by section 2, the Attorney General may issue 
     regulations on an interim basis as necessary to ensure the 
     implementation of this Act by the effective date.
                                 ______
                                 
      By Mrs. FEINSTEIN (for herself, Mr. Grassley, and Mr. Bayh):
  S. 258. A bill to amend the Controlled Substances Act to provide 
enhanced penalties for marketing controlled substances to minors; to 
the Committee on the Judiciary.
  Mrs. FEINSTEIN. Mr. President, I am pleased to introduce, along with 
Senators Grassley and Bayh, the Saving Kids from Dangerous Drugs Act of 
2009.
  Over the last 2 years, Federal, State, and local law enforcement have 
increasingly seen drug dealers flavoring and marketing their illegal 
drugs to appeal to minors, using techniques like combing drugs with 
candy and other flavorings to entice younger users. This bill would 
increase the criminal penalties that apply when criminals do this. This 
bill will ensure these appalling tactics are criminalized and severely 
punished.
  The problem of flavoring illegal drugs to entice minors is well 
documented. A 2007 USA Today Article entitled ``Flavored Meth Use on 
the Rise'' stated that ``reports of candy-flavored methamphetamine are 
emerging around the nation, stirring concern among police and abuse 
prevention experts that drug dealers are marketing the drug to younger 
people.''
  The flavoring of meth to appeal to minors is widespread across the 
Nation. In California, police have made repeated seizures of 
strawberry-flavored meth and local drug counselors warn that it also 
comes in cola, cherry, and orange flavors.
  Strawberry flavoring packets were found in a meth lab raid in 
Arkansas in May of 2007. Similar seizures of flavored meth have been 
made in Minnesota, Mississippi, Missouri, Nevada, North Carolina, 
Oregon, and Virginia. Two people were arrested for manufacturing cotton 
candy flavored meth in Colorado in March of 2008.
  The candying and flavoring of controlled substances is not limited to 
methamphetamine. As recently as March of this year, the DEA seized 1\1/
2\ pounds of strawberry flavored powdered cocaine in Modesto, CA.
  DEA agents in California have also purchased cocaine with lemon, 
coconut, and cinnamon flavoring. It has also documented other 
controlled substances like marijuana and hash oil infused into candy 
bars and soda pop.
  Drug dealers are even selling boxes of ``Pot Tarts'' that look 
exactly like commercial available Pop Tarts.
  Federal, State and local law enforcement all agree that such 
flavoring is done to entice more minors to use these illegal drugs.
  This bill would help address this growing problem by criminalizing 
the flavoring, coloring and marketing of such drugs and would impose 
enhanced penalties for these offenses.
  Under current law, there is already an enhanced penalty if someone 
distributes drugs to a minor. The maximum sentence is doubled, and 
tripled for a repeat offense, and there is a minimum of at least a year 
in prison. But this enhancement only applies if there is an actual 
distribution of the drug to a minor. Even possession with intent to 
distribute flavored or candied drugs doesn't qualify.
  This bill would fix this loophole. If someone manufactures, creates, 
distributes, or possesses with intent to distribute a schedule I or II 
controlled substance that is combined with a candy, marketed or 
packaged to appear similar to a candy product, or modified by flavoring 
or coloring with the intent to sell to a minor, they would face 
enhanced penalties.
  The bill sends a strong and clear message to drug dealers--if you 
flavor or candy up your drugs to make them more appealing to our 
children, there will be a very heavy price to pay. It will make drug 
dealers think twice before flavoring up their drugs, and punish them 
appropriately if they don't.
  The bill is supported by the National Narcotics Officers Association 
Coalition, which is comprised of 44 State narcotics officers' 
associations.
  I urge my colleagues to join me in supporting this bill.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.

[[Page 1111]]

  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 258

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Saving Kids from Dangerous 
     Drugs Act of 2009''.

     SEC. 2. OFFENSES INVOLVING CONTROLLED SUBSTANCES MARKETED TO 
                   MINORS.

       Section 401 of the Controlled Substances Act (21 U.S.C. 
     841) is amended by adding at the end the following:
       ``(h) Offenses Involving Controlled Substances Marketed to 
     Minors.--
       ``(1) Unlawful acts.--Except as authorized under this 
     title, including paragraph (3), it shall be unlawful for any 
     person at least 18 years of age to knowingly or intentionally 
     manufacture, create, distribute, dispense, or possess with 
     intent to manufacture, create, distribute, or dispense, a 
     controlled substance listed in schedule I or II that is--
       ``(A) combined with a candy product;
       ``(B) marketed or packaged to appear similar to a candy 
     product; or
       ``(C) modified by flavoring or coloring the controlled 
     substance with the intent to distribute, dispense, or sell 
     the controlled substance to a person under 21 years of age.
       ``(2) Penalties.--Except as provided in section 418, 419, 
     or 420, any person who violates paragraph (1) of this 
     subsection shall be subject to--
       ``(A) 2 times the maximum punishment and at least 2 times 
     any term of supervised release authorized by subsection (b) 
     of this section for a first offense involving the same 
     controlled substance and schedule; and
       ``(B) 3 times the maximum punishment and at least 3 times 
     any term of supervised release authorized by subsection (b) 
     of this section for a second or subsequent offense involving 
     the same controlled substance and schedule.
       ``(3) Exceptions.--Paragraph (1) shall not apply to any 
     controlled substance that--
       ``(A) has been approved by the Secretary under section 505 
     of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355), 
     if the contents, marketing, and packaging of the controlled 
     substance have not been altered from the form approved by the 
     Secretary; or
       ``(B) has been altered at the direction of a practitioner 
     who is acting for a legitimate medical purpose in the usual 
     course of professional practice.''.
                                 ______
                                 
      By Mr. DORGAN (for himself, Ms. Mikulski, Mr. Feingold, Mr. 
        Durbin, Mr. Johnson, Mr. Brown, Mr. Leahy, Mr. Harkin, Mr. 
        Kennedy, Mr. Whitehouse, Mr. Kohl, Ms. Stabenow, and Mrs. 
        Feinstein):
  S. 260. A bill to amend the Internal Revenue Code of 1986 to provide 
for the taxation of income of controlled foreign corporations 
attributable to imported property; to the Committee on Finance.
  Mr. DORGAN. Mr. President, today I am introducing legislation with 
Senator Mikulski and 10 of our colleagues that I hope will be added to 
any economic stimulus package considered by Congress in the coming 
weeks. This bill will put the brakes on a tax break granted to U.S. 
companies that move U.S. jobs offshore.
  The U.S. economy is facing its most serious financial challenge since 
the Great Depression, and we must respond aggressively. I think a new 
economic stimulus plan is urgently needed to help prevent the economy 
from sliding deeper into a long-term recession. I agree with those who 
say that a major goal of the stimulus package should be to create more 
jobs, but I think we also have an opportunity to make a change to 
ensure that we keep the jobs we already have.
  Employers have been slashing jobs at an alarming rate--2.6 million 
jobs last year--to reduce operating costs. The manufacturing and 
construction sectors have been particularly hard hit during this 
downturn. The manufacturing sector laid off 791,000 workers in 2008, 
continuing the disturbing loss of more than 4 million U.S. 
manufacturing jobs since the end of 2000. Federal tax laws have 
contributed to this problem.
  There is one thing that Congress can do immediately to stem the loss 
of more manufacturing jobs: repeal the perverse tax subsidy in the 
Federal Tax Code for U.S. companies that move manufacturing operations 
and American jobs overseas. Not only will this help keep good-paying 
manufacturing jobs here at home, it will save American taxpayers more 
than $15 billion in revenue over the next decade.
  Unbelievably, there is an insidious tax subsidy that rewards U.S. 
firms that move their production overseas and then turn around and 
import those now foreign-made products back to the United States for 
sale. When a U.S. company closes down a U.S. manufacturing plant such 
as Huffy bicycles or Radio Flyer little red wagons, fires its American 
workers and moves those good-paying jobs to China or other locations 
abroad, U.S. tax law actually provide those companies with a large tax 
break called deferral--allowing them to avoid paying any U.S. income 
taxes on their foreign earnings until those profits are returned, if 
ever, to this country. If a company making the same product decides to 
stay in this country, on the other hand, it is required to pay 
immediate U.S. taxes on the profits it earns here.
  Repealing this jobs export tax subsidy will not hinder the ability of 
U.S. firms to compete against foreign competitors in foreign markets, 
as some special interests have claimed. It is targeted only to U.S. 
firms that move production abroad and then turn around and ship those 
products back to this country for sale.
  If there was ever a tax policy change that would help save U.S. 
manufacturing jobs and should be part of a robust economic stimulus 
plan, this is it. I urge my colleagues to cosponsor this legislation. 
With a new Congress and administration in place, now is the time to 
kill this ill-advised tax subsidy once and for all. I look forward to 
working with my colleagues on this important tax policy matter in the 
coming weeks.
                                 ______
                                 
      By Ms. STABENOW:
  S. 264. A bill to amend title XIX of the Social Security Act to 
encourage the use of certified health information technology by 
providers in the Medicaid program and the Children's Health Insurance 
Program, and for other purposes; to the Committee on Finance.
  Ms. STABENOW. Mr. President, I rise today to introduce the E-Centives 
Act, which will help ensure safety-net providers serving our most 
vulnerable citizens can acquire Health Information Technology, HIT.
  As I have spoken about many times, HIT promises to transform the 
delivery of health care in the United States, improving the overall 
efficiency and effectiveness of healthcare. Some specific quality 
improvements that result from HIT include reduction in errors that come 
from illegible handwriting; electronic systems that prompt prescription 
of generic rather than brand-name drugs; reduction in duplicate 
diagnostic tests; physician reminders regarding appropriate preventive 
care; clinical decision support systems that encourage use of evidence-
based medicine; identification of drug interactions and patient 
allergies; and assistance to physicians to manage patients with 
complex, chronic conditions.
  While HIT holds great promise for transforming health care, 
unfortunately not all providers have the financial means to adopt and 
use this technology. In fact, the cost of acquiring technology is a 
major barrier to adoption among health care providers. Cost is 
particularly burdensome to small practices and safety-net providers 
that often operate with low financial margins.
  Several organizations, including the Kaiser Commission on Medicaid 
and the Uninsured and the Healthcare Information and Management Systems 
Society, recognize the essential role that the Federal Government must 
play to assist providers in the Medicaid and Children's Health 
Insurance Program, CHIP, to acquire HIT. But absent Federal funding, we 
could see a ``digital divide'' in health care.
  The bill that I am introducing today will help accelerate investment 
in certified HIT by providers predominantly serving Medicaid and CHIP 
beneficiaries. The bill accomplishes this by providing authority to 
State Medicaid programs to reimburse providers at the enhanced SCHIP 
FMAP rate for the costs associated with the meaningful use of a 
certified electronic medical record. This bill also helps streamline 
the administration and enrollment process for the Medicaid program by

[[Page 1112]]

modifying the current regulation that governs the Medicaid Management 
Information System to include funding for electronic information and 
eligibility systems, patient registries for disease screening, and 
office staff training on electronic information and eligibility 
systems.
  I look forward to working with my colleagues to ensure that all 
health care providers and all Americans can see the benefit of health 
information technology. Widespread diffusion of HIT is a critical step 
in health care reform and making sure every American has the most 
efficient, optimal quality care.
                                 ______
                                 
      By Mrs. MURRAY (for herself and Ms. Stabenow):
  S. 267. A bill to provide funding for summer and year-round youth 
jobs and training programs; to the Committee on Health, Education, 
Labor, and Pensions.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
placed in the Record, as follows:

                                 S. 267

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Summer and Year-Round Jobs 
     for Youth Stimulus Act of 2009''.

     SEC. 2. SUMMER AND YEAR-ROUND YOUTH JOBS.

       (a) Findings.--Congress finds that--
       (1) a $1,000,000,000 investment in summer and year-round 
     employment for youth, through the program supported under 
     this section, can create up to 1,000,000 jobs for 
     economically disadvantaged youth and stimulate local 
     economies;
       (2) there is a serious and growing need for employment 
     opportunities for economically disadvantaged youth (including 
     young adults), as demonstrated by statistics from the Bureau 
     of Labor Statistics stating that, in December 2008--
       (A) the unemployment rate increased to 7.2 percent, as 
     compared to 4.9 percent in December 2007;
       (B) the unemployment rate for 16- to 19-year-olds rose to 
     20.8 percent, as compared to 16.9 percent in December 2007; 
     and
       (C) the unemployment rate for African-American 16- to 19-
     year-olds increased to 33.7 percent, as compared to 28 
     percent in December 2007;
       (3) research from Northwestern University has shown that 
     every $1 a youth earns has an accelerator effect of $3 on the 
     local economy;
       (4) summer and year-round jobs for youth help supplement 
     the income of families living in poverty;
       (5) summer and year-round jobs for youth provide valuable 
     work experience for economically disadvantaged youth;
       (6) often, a summer job provided under the Workforce 
     Investment Act of 1998 is an economically disadvantaged 
     youth's introduction to the world of work;
       (7) according to the Center for Labor Market Studies at 
     Northeastern University, early work experience is a very 
     powerful predictor of success and earnings in the labor 
     market, and early work experience raises earnings over a 
     lifetime by 10 to 20 percent;
       (8) participation in a youth jobs program can contribute to 
     a reduction in criminal and high-risk behavior for youth; and
       (9)(A) youth jobs programs benefit both youth and 
     communities when designed around principles that promote 
     mutually beneficial programs;
       (B) youth benefit from jobs that provide them with work 
     readiness skills and that help them make the connection 
     between responsibility on the job and success in adulthood; 
     and
       (C) communities benefit when youth are engaged 
     productively, providing much-needed services that meet real 
     community needs.
       (b) Definition.--In this section, the term ``green-collar 
     industries'' means industries throughout the economy of the 
     United States--
       (1) that promote energy efficiency, energy conservation, 
     and environmental protection, including promoting renewable 
     energy and clean technology;
       (2) that offer jobs with substantial pay and benefits; and
       (3) that are industries in which there is likely to be 
     continued demand for workers.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to the Secretary of Labor for youth 
     activities under the Workforce Investment Act of 1998 (29 
     U.S.C. 2801 et seq.), $1,000,000,000, which shall be 
     available for the period of January 1, 2009 through December 
     31, 2010, under the conditions described in subsection (d).
       (d) Conditions.--
       (1) Use of funds.--The funds appropriated under subsection 
     (c) shall be used for youth jobs and training programs, to 
     provide opportunities referred to in subparagraphs (C), (D), 
     (E), and (F) of section 129(c)(2) of such Act (29 U.S.C. 
     2854(c)(2)) and, as appropriate, opportunities referred to in 
     subparagraphs (A) and (G) of such section, except that no 
     such funds shall be spent on unpaid work experiences.
       (2) Limitation.--Such funds shall be distributed in 
     accordance with sections 127 and 128 of such Act (29 U.S.C. 
     2852, 2853), except that no portion of such funds shall be 
     reserved to carry out 128(a) or 169 of such Act (29 U.S.C. 
     2853(a), 2914).
       (3) Priority.--In using funds made available under this 
     section, a local area (as defined in section 101 of such Act 
     (29 U.S.C. 2801)) shall give priority to providing--
       (A) work experiences in public and nonprofit sector green-
     collar industries;
       (B) work experiences in other viable industries, including 
     health care; and
       (C) job referral services for youth to work experiences in 
     green-collar industries in the private sector or work 
     experiences in other viable industries in the private sector, 
     for which the employer involved agrees to pay the wages and 
     benefits, consistent with Federal and State child labor laws.
       (4) Measure of effectiveness.--The effectiveness of the 
     activities carried out with such funds shall be measured, 
     under section 136 of such Act (29 U.S.C. 2871), only with 
     performance measures based on the core indicators of 
     performance described in section 136(b)(2)(A)(ii)(I) of such 
     Act (29 U.S.C. 2871(b)(2)(A)(ii)(I)), applied to all youth 
     served through the activities.
       (e) Age-Related.--As used in this Act, and in the 
     provisions referred to in subsections (c) and (d) for 
     purposes of this Act--
       (1) a reference to a youth refers to an individual who is 
     not younger than age 14 and not older than age 24, and meets 
     any other requirements for that type of youth; and
       (2) a reference to a youth activity refers to an activity 
     covered in subsection (d)(1) that is carried out for a youth 
     described in paragraph (1).
                                 ______
                                 
      By Mrs. MURRAY (for herself and Ms. Stabenow):
  S. 268. A bill to provide funding for a Green Job Corps program, 
YouthBuild Build Green Grants, and Green-Collar Youth Opportunity 
Grants, and for other purposes; to the Committee on Health, Education, 
Labor and Pensions.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
placed in the Record, as follows:

                                 S. 268

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Green-Collar Youth Jobs, 
     Education, and Training Stimulus Act''.

     SEC. 2. FINDING.

       Congress finds that there is a serious and growing need for 
     employment opportunities for economically disadvantaged youth 
     (including young adults), as demonstrated by statistics from 
     the Bureau of Labor Statistics stating that, in December 
     2008--
       (1) the unemployment rate increased to 7.2 percent, as 
     compared to 4.9 percent in December 2007;
       (2) the unemployment rate for 16- to 19-year-olds rose to 
     20.8 percent, as compared to 16.9 percent in December 2007; 
     and
       (3) the unemployment rate for African-American 16- to 19-
     year-olds increased to 33.7 percent, as compared to 28 
     percent in December 2007.

     SEC. 3. PURPOSES.

       The purposes of this Act are--
       (1) to increase knowledge of the importance of building a 
     green economy;
       (2) to increase energy efficiency and renewable energy 
     usage;
       (3) to strengthen the protection of the environment;
       (4) to decrease carbon emissions; and
       (5) to increase the number of well-trained youth workers 
     who can obtain well-paying jobs in a range of green-collar 
     industries and other viable industries.

     SEC. 4. DEFINITIONS.

       In this Act:
       (1) Green-collar industries.--In this section, the term 
     ``green-collar industries'' means industries throughout the 
     economy of the United States--
       (A) that promote energy efficiency, energy conservation, 
     and environmental protection, including promoting renewable 
     energy and clean technology;
       (B) that offer jobs with substantial pay and benefits; and
       (C) that are industries in which there is likely to be 
     continued demand for workers.
       (2) Local board, low-income individual, secretary.--The 
     terms ``local board'', ``low-income individual'', and 
     ``Secretary'' have the meanings given the terms in section 
     101 of the Workforce Investment Act of 1998 (29 U.S.C. 2801).
       (3) Registered apprenticeship program.--The term 
     ``registered apprenticeship program'' means an industry 
     skills training program at the postsecondary level that 
     combines technical and theoretical training

[[Page 1113]]

     through structured on-the-job learning with related 
     instruction (in a classroom or through distance learning) 
     while an individual is employed, working under the direction 
     of qualified personnel or a mentor, and earning incremental 
     wage increases aligned to enhanced job proficiency, resulting 
     in the acquisition of a nationally recognized and portable 
     certificate, under a plan approved by the Office of 
     Apprenticeship or a State agency recognized by the Department 
     of Labor.

     SEC. 5. GREEN JOB CORPS PROGRAM.

       (a) Purposes.--The purposes of this section are--
       (1) to encourage youth participating in the Job Corps to 
     become informed energy- and environmentally-conscious 
     consumers;
       (2) to enable the youth to acquire and expand skills 
     related to green-collar industries; and
       (3) to address Job Corps construction needs and energy 
     costs and to make Job Corps centers more energy efficient, 
     including retrofitting facilities and restoring campuses.
       (b) Definitions.--In this section, the terms ``enrollee'', 
     ``graduate'', and ``Job Corps Center'' have the meanings 
     given the terms in section 142 of the Workforce Investment 
     Act of 1998 (29 U.S.C. 2882).
       (c) General Authority.--The Secretary is authorized to 
     reserve not more than $500,000,000 of the funds appropriated 
     under this Act to provide work experiences and training 
     described in subsection (d) in green-collar industries. The 
     Secretary shall provide the work experiences and training, in 
     conjunction with activities described in section 148 of the 
     Workforce Investment Act of 1998 (29 U.S.C. 2888), under 
     subtitle C of title I of such Act (29 U.S.C. 2881 et seq.) 
     (except that subsections (c) and (d) of section 159 of such 
     Act (29 U.S.C. 2899) shall not apply to such experiences and 
     training).
       (d) Use of Funds.--
       (1) Skill development program activities.--The Secretary 
     shall expand Job Corps skill development program activities 
     by updating occupational training programs (including making 
     changes in curriculum and equipment), including development 
     of necessary academic skills in green-collar industries 
     (including construction, facilities maintenance, and advanced 
     manufacturing).
       (2) Paid work opportunities.--As part of Job Corps career 
     training, the Secretary shall provide paid work 
     opportunities, in green-collar industries, primarily located 
     at Job Corps centers, in order to address Job Corps 
     construction needs and make those centers more energy 
     efficient, including retrofitting facilities and restoring 
     campuses. In carrying out this paragraph, the Secretary shall 
     give priority to projects that help conserve, develop, or 
     manage public natural resources or public recreational areas, 
     or support the public interest.
       (3) Consumer and leadership activities.--As part of the Job 
     Corps life skills program, the Secretary shall offer consumer 
     and leadership activities, to create a corps of intelligent 
     and informed energy- and environmentally-conscious consumers, 
     including activities that educate Job Corps members about how 
     they can contribute to minimize the effects of climate change 
     and become future leaders in their local communities who 
     preserve and strengthen energy- and environmentally-conscious 
     practices.
       (e) Report to Congress.--
       (1) Indicator.--For purposes of the Green Job Corps program 
     carried out under this section, the indicators of performance 
     shall be--
       (A) entry of graduates who participated in work experiences 
     described in subsection (d)(2) into unsubsidized employment 
     in a green-collar industry;
       (B) average wages received by such graduates upon entry 
     into such employment; and
       (C) number of such graduates who obtain an occupational or 
     education-related credential.
       (2) Assessment.--The Secretary shall prepare an assessment 
     of the Green Job Corps program that--
       (A) describes the use of funds made available under this 
     section to carry out the program and the progress achieved 
     through that program; and
       (B) provides information on the performance of the program 
     on the indicators of performance.
       (3) Report.--The Secretary shall include the assessment 
     described in paragraph (2) in the corresponding annual report 
     described in subsection (c) of section 159 of such Act (29 
     U.S.C. 2899), in lieu of submitting any of the information 
     described in subsection (c) or (d) of that section 159 with 
     respect to the Green Job Corps program.

     SEC. 6. YOUTHBUILD BUILD GREEN GRANTS.

       (a) General Authority.--The Secretary is authorized to 
     reserve $300,000,000 of the funds appropriated under this Act 
     to provide to eligible youth education, work experiences 
     (including service), and training, in green-collar 
     industries, especially concerning the weatherization and 
     energy retrofitting of homes of low-income individuals. The 
     Secretary shall provide the services described in this 
     subsection in conjunction with activities described in 
     section 173A(c) of the Workforce Investment Act of 1998 (29 
     U.S.C. 2918a(c)), under the YouthBuild program set forth in 
     section 173A of such Act (29 U.S.C. 2918a) (except that 
     paragraphs (3), (4), and (5) of subsection (c), and 
     subsection (d), of such section shall not apply to such 
     services).
       (b) Grants.--The Secretary is authorized to award from the 
     reserved funds, on a competitive basis, YouthBuild Build 
     Green grants to entities that are recipients of YouthBuild 
     grants under section 173A of such Act.
       (c) Application.--To be eligible to receive a grant under 
     this section, an entity shall submit an application to the 
     Secretary at such time, in such manner, and containing such 
     information as the Secretary may require.
       (d) Priority.--In awarding grants under this section, the 
     Secretary shall give priority to entities who--
       (1) demonstrate the ability to leverage additional 
     resources, which may include materials, personnel, and 
     supplies, from other public and private sources; and
       (2) demonstrate the ability to build a foundation of 
     public-private partnerships in a green-collar industry, 
     related to construction, for future projects carried out by 
     the entities.
       (e) Eligible Youth.--To be eligible to participate in the 
     program carried out under this section, a youth shall meet 
     the requirements of section 173A(e)(1) of the Workforce 
     Investment Act of 1998 (29 U.S.C. 2918a(e)(1)).
       (f) Use of Funds.--
       (1) Skills development and training.--An entity that 
     receives a grant under this section shall use not less than 
     90 percent of the funds made available through the grant to 
     provide to participants in the program carried out under this 
     section a combination of classroom education and job skills 
     development, through onsite training and work experiences 
     (including construction or rehabilitation of facilities) in a 
     construction trade that makes efficient use of green 
     technologies. Such education and skills development shall be 
     designed to prepare the participants for jobs in green-collar 
     industries in their communities and States.
       (2) Supervision and training.--The entity may use not more 
     than 10 percent of the grant funds for supervision and 
     training costs related to the activities described in 
     paragraph (1).
       (g) Report to Congress.--
       (1) Indicators.--For purposes of the program carried out 
     under this section, the indicators of performance shall be--
       (A) entry of individuals who completed their participation 
     in the program and who participated in activities described 
     in subsection (f)(1) into registered apprenticeship programs 
     in a construction trade in a green-collar industry or a 
     related trade; and
       (B) entry of such individuals, who participated in such 
     activities, into unsubsidized employment in a green-collar 
     industry.
       (2) Assessment.--The Secretary shall prepare an assessment 
     of the program that--
       (A) describes the use of funds made available under this 
     section to carry out the program and the progress achieved 
     through that program; and
       (B) provides information on the performance of the program 
     on the indicators of performance.
       (3) Report.--The Secretary shall annually submit to 
     Congress a report containing the assessment described in 
     paragraph (2).

     SEC. 7. GREEN-COLLAR YOUTH OPPORTUNITY GRANTS.

       (a) Definition.--The term ``community college'' means a 2-
     year institution of higher education, as defined in section 
     101 of the Higher Education Act of 1965 (20 U.S.C. 1001).
       (b) General Authority.--The Secretary is authorized to 
     reserve $200,000,000 of the funds appropriated under this Act 
     for work experiences and training in green-collar industries 
     for eligible youth. The Secretary shall provide the work 
     experiences and training in conjunction with activities 
     described in section 169(b) of the Workforce Investment Act 
     of 1998 (29 U.S.C. 2914(b)), under the Youth Opportunity 
     Grants program described in section 169 of that Act (29 
     U.S.C. 2914) (except that subsections (a)(3), (b)(2), (d), 
     (e)(2), (f), and (g) of such section shall not apply to such 
     work experiences and training).
       (c) Grants.--The Secretary is authorized to award from the 
     reserved funds, on a competitive basis, Green-Collar Youth 
     Opportunity Grants to eligible organizations.
       (d) Eligible Organizations.--
       (1) In general.--To be eligible to receive a grant under 
     this section, an organization shall be a local board 
     described in section 169(c) of the Workforce Investment Act 
     of 1998 (29 U.S.C. 2914(c)) an entity described in section 
     169(d) of such Act (29 U.S.C. 2914(d)), or an entity acting 
     of behalf of an eligible strategic partnership.
       (2) Eligible strategic partnership.--
       (A) In general.--For purposes of this subsection, an 
     eligible strategic partnership shall be composed of at least 
     1 representative of a local board serving a community, and of 
     each of the 8 types of organizations described in 
     subparagraph (B).
       (B) Types of organizations.--The types of organizations 
     referred to in subparagraph (A) are businesses, unions, 
     labor-management partnerships, schools (including community 
     colleges), public agencies including law enforcement, 
     nonprofit community organizations, economic development 
     entities, and

[[Page 1114]]

     philanthropic organizations, that are actively engaged in 
     providing learning, mentoring, and work opportunities to 
     eligible youth.
       (3) Fiscal and administrative agent.--The strategic 
     partnership shall designate an entity, which shall be a 
     member of the partnership, as the strategic partnership's 
     fiscal and administrative entity for the implementation of 
     activities under the grant.
       (e) Application.--To be eligible to receive a grant under 
     this section, an organization shall submit an application to 
     the Secretary at such time, in such manner, and containing 
     such information as the Secretary may require.
       (f) Priority.--In making grants under this section, the 
     Secretary shall give priority to organizations located in 
     communities described in subsection (c) or (d)(2) of section 
     169 of the Workforce Investment Act of 1998 (29 U.S.C. 2914).
       (g) Eligible Youth.--To be eligible to participate in a 
     program carried out under this section, a youth shall--
       (1) be not less than age 14 and not more than age 24;
       (2) reside in a community described in subsection (c) or 
     (d)(2) of section 169 of such Act; and
       (3) have multiple barriers to education and career success, 
     as specified by the Secretary.
       (h) Use of Funds.--An organization that receives a grant 
     under this section may use the funds made available through 
     the grant to provide programs of work experiences and 
     training in green-collar industries that include education 
     and paid work experiences. The work experiences shall involve 
     retrofitting buildings (including facilities of small 
     businesses) to achieve energy savings, or enhancing, 
     creating, or preserving public space, within the communities 
     served. In providing the programs, the organization may 
     provide any of the activities described in subsection (b)(1) 
     of that section 169.
       (i) Report to Congress.--
       (1) Indicators.--For purposes of the program carried out 
     under this section, the indicators of performance shall be--
       (A) acquisition of a high school diploma or its generally 
     recognized equivalent by individuals who completed their 
     participation in the program and who participated in training 
     described in subsection (b);
       (B) entry of such individuals, who participated in work 
     experiences described in subsection (b), into postsecondary 
     education linked to the green economy, including registered 
     apprenticeship programs in a green-collar industry; and
       (C) entry of such individuals, who participated in work 
     experiences described in subsection (b), into unsubsidized 
     employment in a green-collar industry.
       (2) Assessment.--The Secretary shall prepare an assessment 
     of the program that--
       (A) describes the use of funds made available under this 
     section to carry out the program and the progress achieved 
     through that program; and
       (B) provides information on the performance of the program, 
     including on the indicators of performance.
       (3) Report.--The Secretary shall annually submit to 
     Congress a report containing the assessment described in 
     paragraph (2).

     SEC. 8. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated to the Secretary for 
     activities described in this Act $1,000,000,000, which shall 
     be available for the period of January 1, 2009 through 
     December 31, 2010.
                                 ______
                                 
      By Mrs. MURRAY (for herself, Mr. Brown, and Ms. Stabenow):
  S. 269. A bill to provide funding for unemployment and training 
activities for dislocated workers and adults, and for other purposes; 
to the Committee on Health, Education, Labor, and Pensions.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
placed in the Record, as follows:

                                 S. 269

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Retooling America's Workers 
     for a Green Economy Act''.

     SEC. 2. FINDINGS.

       Congress finds the following:
       (1) In October 2008, the numbers of mass layoffs (involving 
     over 50 workers at one time) and initial unemployment claims 
     reached their highest levels since 2001. According to the 
     National Renewable Energy Laboratory, however, a major 
     barrier to more rapid adoption of clean and renewable energy 
     and energy efficiency measures is the lack of sufficient 
     workers skilled in green technology.
       (2) In December 2008, unemployment figures showed a sharp 
     deterioration in the economy. The unemployment rate rose from 
     6.8 percent in November, to 7.2 percent in December, of 2008. 
     Employers shed 524,000 jobs in December 2008, and 1,900,000 
     jobs were lost over just the last 4 months of 2008. These job 
     losses were widespread across most major industry sectors.
       (3) According to the Bureau of Labor Statistics, 11,100,000 
     people were unemployed in December 2008, an increase of 
     3,600,000 people since the recession started in December 
     2007. In December 2008, the number of workers who wanted to 
     work full-time but worked part-time because their hours were 
     cut or they could not find full-time jobs reached 8,000,000, 
     up 3,400,000 since December 2007.
       (4) Analysts say that the Nation has yet to see the worst 
     of the economic fallout. The latest prediction from HIS 
     Global Insight forecasts that unemployment will be an 
     estimated 8.6 percent by the end of 2009.
       (5) The reality of climate change and a shared desire to 
     protect the environment for future generations have the 
     potential to spur economic growth in green-collar jobs across 
     the industrial spectrum. In order to prepare United States 
     workers to build greener communities in both urban and rural 
     settings, the Nation will need to make an investment in 
     skills development for jobs in the current and future 
     economies.

     SEC. 3. PURPOSE.

       The purpose of this Act is to retool America's workers--
     including dislocated workers, those who are long-term 
     unemployed individuals, and those who are low-skilled 
     individuals, limited English proficient individuals, 
     individuals with disabilities, or older workers--for green-
     collar industries, for existing viable industries, and for 
     new and emerging industries so that the workers described in 
     this section can contribute to the long-term competitiveness 
     of the United States and its quality of life.

     SEC. 4. DEFINITIONS.

       In this Act:
       (1) In general.--The terms ``adult'', ``chief elected 
     official'', ``dislocated worker'', ``employment and training 
     activities'', ``individual with a disability'', ``local 
     area'', ``local board'', ``outlying area'', ``rapid response 
     activities'', ``Secretary'', ``State'', and ``State board'' 
     have the meanings given the terms in section 101 of the 
     Workforce Investment Act of 1998 (29 U.S.C. 2801).
       (2) Community college.--The term ``community college'' 
     means a 2-year institution of higher education, as defined in 
     section 101 of the Higher Education Act of 1965 (20 U.S.C. 
     1001).
       (3) Green-collar industries.--The term ``green-collar 
     industries'' means industries throughout the economy of the 
     United States--
       (A) that promote energy efficiency, energy conservation, 
     and environmental protection, including promoting renewable 
     energy and clean technology;
       (B) that offer jobs with substantial pay and benefits; and
       (C) that are industries in which there is likely to be 
     continued demand for workers.

     SEC. 5. ACTIVITIES FOR DISLOCATED WORKERS.

       (a) General Authority.--The Secretary is authorized to 
     reserve $2,000,000,000 of the funds appropriated under this 
     Act for rapid response activities, for dislocated worker 
     employment and training activities under chapter 5 of 
     subtitle B of title I of the Workforce Investment Act of 1998 
     (29 U.S.C. 2861 et seq.), or for employment and training 
     assistance and additional assistance under section 173(a) of 
     such Act (29 U.S.C. 2918(a)).
       (b) National Emergency Grants.--Of the reserved funds, the 
     Secretary may use not more than $500,000,000 to award 
     national emergency grants--
       (1) to provide employment and training assistance to 
     workers affected by major economic dislocations under section 
     173(a)(1) of such Act (29 U.S.C. 2918(a)(1)); and
       (2) to provide additional assistance under section 
     173(a)(3) of such Act (29 U.S.C. 2918(a)(3)) to a State or 
     local board that meets the requirements of that section (in a 
     case in which the expended funds involved were expended for 
     assistance described in paragraph (1)).
       (c) State Activities.--
       (1) In general.--After determining an amount from the 
     reserved funds to be used under subsection (b), the Secretary 
     may use the remaining funds to make allotments to States, and 
     outlying areas, consistent with the allotment formula under 
     section 132(b)(2) of such Act (29 U.S.C. 2862(b)(2)). Each 
     State or outlying area may use 25 percent of the State's or 
     outlying area's allotment for statewide rapid response 
     activities for permanent closures or mass layoffs described 
     in section 101(38) of such Act (42 U.S.C. 2801(38)) and 
     efforts to avert future permanent closures or mass layoffs 
     described in such section.
       (2) Use of dislocated workers to provide activities.--In 
     providing statewide rapid response activities, States or 
     entities designated by States (and outlying areas or entities 
     designated by outlying areas), working in conjunction with 
     local boards and chief elected officials, may enhance their 
     services by employing dislocated workers to provide outreach, 
     informal coaching, counseling or mentoring support, and 
     information to other dislocated workers or unemployed 
     persons.
       (d) Local Activities.--
       (1) In general.--Each State or outlying area shall use 75 
     percent of the State's or outlying area's allotment to make 
     allocations directly to local boards, for local areas,

[[Page 1115]]

     using the formula under section 133(b)(2)(B) of such Act (29 
     U.S.C. 2863(b)(2)(B)).
       (2) Priority.--A local board that receives an allocation 
     under paragraph (1) shall use the funds made available 
     through the allocation for dislocated worker employment and 
     training activities. In providing the activities the local 
     board shall give priority to providing the employment and 
     training activities, including on-the-job training, in viable 
     industries identified at the regional or local levels, 
     including green-collar industries.
       (e) Report to Secretary.--Each State, in submitting an 
     annual report under section 136(d) of such Act (29 U.S.C. 
     2871(d)), shall include information on entry of individuals 
     who participated in employment and training activities in 
     green-collar industries and other viable industries under 
     this section into unsubsidized employment in a green-collar 
     industry or other viable industry.
       (f) Report to Congress.--The Secretary shall annually 
     prepare and submit to the appropriate committees of Congress 
     information on entry of individuals who received services 
     under subsection (b) into unsubsidized employment in a green-
     collar industry or other viable industry.

     SEC. 6. ACTIVITIES FOR ADULTS WITH MULTIPLE BARRIERS TO 
                   EMPLOYMENT.

       (a) Purpose.--The purpose of this section is to fully 
     utilize the Nation's human capital by--
       (1) helping adults with multiple barriers to employment 
     acquire the skills to obtain jobs in viable industries, by 
     providing intensive services, training services, and other 
     employment and training activities; and
       (2) in particular, by providing employment and training 
     activities in green-collar industries and other viable 
     industries.
       (b) Definition.--The term ``adult with multiple barriers to 
     employment'' means an adult who is long-term unemployed, a 
     low-skilled individual, limited English proficient, an 
     individual with a disability, or an older worker, with 
     multiple barriers to finding a job in a viable industry.
       (c) General Authority.--The Secretary is authorized to 
     reserve $800,000,000 of the funds appropriated under this Act 
     to carry out this section. The Secretary shall use the 
     reserved funds to make allotments to States and outlying 
     areas, consistent with the allotment formula under section 
     132(b)(1) of the Workforce Investment Act of 1998 (29 U.S.C. 
     2862(b)(1)) to provide employment and training activities to 
     adults with multiple barriers to employment.
       (d) State Activities.--Each State or outlying area may use 
     10 percent of the State's or outlying area's allotment to 
     assist local boards in providing employment and training 
     activities to adults with multiple barriers to employment, 
     and assist the adults in attaining jobs in viable industries, 
     with as much flexibility as is practicable. In providing 
     assistance under this subsection, the State or outlying area 
     may provide aid that includes assistance with system 
     alignment (described in subsection (e)(1)(D), the provision 
     of capacity building and professional development activities 
     for staff, and the provision of enhanced regional sector-
     based labor market information.
       (e) Local Activities.--
       (1) In general.--Each State or outlying area shall use 90 
     percent of the State's or outlying area's allotment to make 
     grants, on a competitive basis, to local boards for local 
     areas, to provide employment and training activities to 
     adults with multiple barriers to employment.
       (2) Priority.--In making the grants, the chief executive 
     officer of the State or outlying area, in consultation with 
     the State board involved, shall give priority to those local 
     boards that--
       (A) align their local areas to create regions that reflect 
     natural labor markets or economic development districts;
       (B) reflect regional strategic partnerships described in 
     paragraph (3) among local boards, industry (including 
     business and labor), schools (including community colleges), 
     and other community organizations to provide coherent 
     programs of employment and training activities;
       (C) make special efforts to conduct outreach and provide 
     services to adults with multiple barriers to employment who 
     need to advance their careers or seek second careers due to 
     the economic downturn;
       (D) align adult education, career and technical education, 
     workforce investment, economic development, and related 
     systems and resources to provide career pathway strategies 
     for helping low-skilled individuals navigate through the 
     continuum of needed education and supports, to ultimately 
     achieve a postsecondary education credential or an industry-
     recognized certificate and a job leading to economic self-
     sufficiency;
       (E) provide an assurance that the local board will use at 
     least 90 percent of the grant funds for intensive services 
     described in section 134(d)(3)(C) and training services 
     described in section 134(d)(4)(D) of such Act (29 U.S.C. 
     2864(d)(3)(C), 2864(d)(4)(D)), without regard to the 
     eligibility requirements of section 134(d) of such Act (29 
     U.S.C. 2864(d)).
       (3) Strategic partnership.--
       (A) In general.--For purposes of this section, a strategic 
     partnership shall, in particular, be composed of at least 1 
     representative of a local board serving a community, and of 
     each of the 8 types of organizations described in 
     subparagraph (B).
       (B) Types of organizations.--The types of organizations 
     referred to in subparagraph (A) are businesses, unions, 
     labor-management partnerships, schools (including community 
     colleges), public agencies, nonprofit community 
     organizations, economic development entities, and 
     philanthropic organizations, that are actively engaged in 
     providing employment and training activities, including work 
     opportunities and support, to adults with multiple barriers 
     to employment.
       (f) Report to Secretary.--
       (1) In general.--Each State, in submitting an annual report 
     under section 136(d) of such Act (29 U.S.C. 2871(d)), shall 
     include information--
       (A) on acquisition of a recognized postsecondary education 
     credential or an industry-recognized certificate by adults 
     with multiple barriers to employment who participated in 
     employment and training activities under this section;
       (B) on entry of such adults, who participated in such 
     activities, into positions in unsubsidized employment in 
     viable industries; and
       (C) for adults referred to in subparagraph (B), on average 
     wages in such positions.
       (2) Refinements.--In establishing standards for the 
     reports, the Secretary shall refine indicators to eliminate 
     any unintended consequences for adults with multiple barriers 
     to employment, or such adults who may need and seek less than 
     full-time employment along a career path.

     SEC. 7. ENERGY EFFICIENCY AND RENEWABLE ENERGY WORKER 
                   TRAINING PROGRAM.

       The Secretary shall reserve $625,000,000 of the funds 
     appropriated under this Act to carry out section 171(e) of 
     the Workforce Investment Act of 1998 (29 U.S.C. 2916(e)).

     SEC. 8. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated to the Secretary of 
     Labor for activities described in this Act, $3,425,000,000, 
     which shall be available for the period of January 1, 2009 
     through December 31, 2010.
                                 ______
                                 
      By Mr. CASEY (for himself and Mr. Nelson, of Nebraska):
  S. 270. A bill to provide for programs that reduce the need for 
abortion, help women bear healthy children, and support new parents; to 
the Committee on Health, Education, Labor, and Pensions.
   Mr. CASEY. Mr. President, I rise today to speak about a member of 
the American family for whom we all care, but for whom we don't do 
nearly enough to support: pregnant women.
  I remember the times my wife Terese learned she was pregnant, and 
even though I can never experience it directly, I know through her and 
my sisters that there is one indelible and unforgettable moment when a 
woman finds out she is pregnant. For many women, this is a moment of 
great joy, the miracle of pregnancy. Perhaps it has been long awaited 
or perhaps it is something of a surprise, but it is welcome. Many of 
these women don't need help beyond what their families provide and 
others may receive adequate support within our existing framework of 
programs and services.
  But there is another circumstance that a pregnant woman may face. For 
that woman, the moment of discovery is not a moment of joy. For her, it 
is a moment of terror, or panic or even shame. She may be in a doctor's 
office or clinic or she may be at home. For her, that moment begins a 
crisis in which she feels overwhelmingly and perhaps almost unbearably 
alone. She could be wealthy, middle income or poor, but most likely 
poor. Whatever her income, she feels, very simply, all alone.
  A pregnant woman may have an abusive spouse or boyfriend who is 
tormenting her. She is all alone.
  Another pregnant woman may believe that she cannot support or care 
for a new baby at this point in her life. She is all alone.
  Another woman might believe that her financial situation is so 
precarious that she cannot care for and raise a child. She may feel 
alone and helpless.
  We know that 48 percent of all pregnancies are unintended and, 
excluding miscarriages, 54 percent of unintended pregnancies end in 
abortion. The response ``cannot afford a baby'' is the second most 
frequently cited reason why women choose to have an abortion and 73 
percent of women having abortions cited this reason as a contributing 
factor.
  A woman who is facing the challenges of an unplanned pregnancy that 
may be a crisis for her does not need a

[[Page 1116]]

lecture from a politician or a clinical reminder that she has a simple 
choice to make. The choice is never simple. Never. This woman needs 
support and love and understanding. She needs to be embraced in her 
time of crisis, not sent on her way to deal with it on her own. She 
needs our help to walk with her, not only throughout the nine months of 
her pregnancy, but also for the early months and years of her child's 
life.
  We in the Congress, in both the House and Senate and both parties, 
need to address this issue in a comprehensive way that meets these 
needs. Some members have initiated good efforts and we should applaud 
and support those efforts, but I believe that neither political party 
is doing enough for pregnant women in America today. While there is 
tremendous disagreement on how we can best do this, there is one 
significant area of common ground--one thing we all agree upon. We all 
want to reduce the number of abortions.
  Many women who have abortions do so very reluctantly, and while 
``choice'' is a term that is widely used in this debate, many women who 
face unplanned pregnancies do not feel they have a genuine choice. That 
is why I am introducing the Pregnant Women Support Act. With this bill, 
it is my fervent hope that a new dialogue--a common ground--will emerge 
on how we can reduce abortions by offering pregnant women real choices:
  This bill will: assist pregnant and parenting teens to finish high 
school and prepare for college or vocational training; help pregnant 
college students stay in school, offering them counseling as well as 
assistance with continuing their education, parenting support and 
classes, and child care assistance.
  It will provide counseling and shelter to pregnant women in abusive 
relationships who may be fearful of continuing a (pregnancy in a crisis 
situation; establish a national toll-free number and public awareness 
campaign to offer women support and knowledge about options and 
resources available to them when they face an unplanned pregnancy; give 
women free sonogram examinations by providing grants for the purchase 
of ultrasound equipment; provide parents with information about genetic 
disability testing, including support for parents who receive a 
diagnosis of Down Syndrome; ensure that pregnant women receive prenatal 
and postnatal care by eliminating pregnancy as a pre-existing condition 
in the individual healthcare market and also eliminating waiting 
periods for women with prior coverage; increase funding for nurse home 
visitation for pregnant and first time mothers. One example of this is 
the Nurse-Family Partnership, an evidence-based program and national 
model in which nurses mentor young first-time and primarily low-income 
mothers, establishing a supportive relationship with both mother and 
child.
  Studies have shown this program to be both cost effective and hugely 
successful in terms of life outcomes for both mothers and children; 
increase funding for the Women, Infants and Children Program, providing 
nutrition assessment, counseling and education, obesity prevention, 
breastfeeding support, prenatal and pediatric health care referrals, 
immunization screening and referral, and a host of other services for 
mothers and children; expand nutritional support for low-income parents 
by increasing the income eligibility level for food stamps; increase 
funding for the Child Care and Development Block Grant, the primary 
source of federal funding for child care assistance for low-income 
parents.
   I introduce this bill with the deepest conviction that we can find 
common ground. I believe that we can transform this debate by focusing 
upon the issues that unite us, not the issues that divide us. It's well 
known where I stand on these issues. I am a pro-life Democrat. I 
believe that life begins at conception and ends when we draw our last 
breath. I believe that the role of government is to protect, enrich, 
and value life for everyone, at every moment, from beginning to end. 
And I believe that we as a nation have to do more to support women and 
their children when they are most vulnerable--during pregnancy and 
early childhood.
  I support family planning programs because they avoid what can be a 
dark moment, when a woman, often alone, faces a pregnancy she feels she 
can't handle. I support family planning programs precisely because they 
reduce abortions. But that is not the issue I address today. Today, 
with this bill, I am focused on the woman who is pregnant and I am 
asking a question we should all be asking: ``What more can I do?'' 
``What more can we do for pregnant women who need our help?''
  I believe there is more common ground in America than we might 
realize--if only we focus on how we can truly help and support women 
who wish to carry their pregnancies to term and how we can give them 
and their babies what they really need to begin healthy and productive 
lives together.
  For the past 35 years, the abortion issue has been used mostly as a 
way to divide people, even as the number of abortions remains 
unacceptably high. We have to find a better way. I believe the Pregnant 
Women Support Act is part of that better way. We must work toward real 
solutions to the issue of abortion by targeting the underlying factors 
that often lead women to have abortions. This is precisely what the 
Pregnant Women Support Act will do.
  We need to walk in solidarity with pregnant women who face unplanned 
pregnancies and who need our support and help, not our judgment. That 
is exactly what this bill does for that woman who finds herself alone 
as she faces what may be the most difficult experience of her entire 
life: the woman who has no one to turn to for advice, for counsel, for 
support. I truly believe there are few things more terrifying than the 
prospect of supporting another human being when you have no support of 
your own.
  Reducing the number of abortions should not be a partisan issue. It 
should not pit Democrats against Republicans. I seek. common ground. I 
ask my colleagues on both sides of the aisle to join me in seeking real 
solutions that will unite us in providing life with dignity, before and 
after birth, for pregnant women, mothers and children. Surely we must 
all agree that no woman should ever have to face the crisis of an 
unplanned pregnancy alone.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.

                                 S. 270

       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 ``Pregnant 
     Women Support Act''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Definitions.

  TITLE I--PUBLIC AWARENESS AND ASSISTANCE FOR PREGNANT WOMEN AND NEW 
                                PARENTS

Sec. 101. Grants for increasing public awareness of resources available 
              to assist pregnant women in carrying their pregnancies to 
              term and to assist new parents.

      TITLE II--INCREASING WOMEN'S KNOWLEDGE ABOUT THEIR PREGNANCY

Sec. 201. Grants to health centers for purchase of ultrasound 
              equipment.

            TITLE III--PREGNANCY AS A PREEXISTING CONDITION

Sec. 301. Individual health insurance coverage for pregnant women.
Sec. 302. Continuation of health insurance coverage for newborns.

  TITLE IV--MEDICAID AND SCHIP COVERAGE OF PREGNANT WOMEN AND UNBORN 
                                CHILDREN

Sec. 401. Treatment of unborn children.
Sec. 402. Coordination with the maternal and child health program.

        TITLE V--DISCLOSURE OF INFORMATION ON ABORTION SERVICES

Sec. 501. Disclosure of information on abortion services.

  TITLE VI--SERVICES TO PATIENTS RECEIVING POSITIVE TEST DIAGNOSIS OF 
         DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITIONS

Sec. 601. Services to patients receiving positive test diagnosis for 
              down syndrome or other prenatally diagnosed conditions.

[[Page 1117]]

     TITLE VII--SUPPORT FOR PREGNANT AND PARENTING COLLEGE STUDENTS

Sec. 701. Sense of Congress.
Sec. 702. Definitions.
Sec. 703. Pregnant and parenting student services pilot program.
Sec. 704. Application; number of grants.
Sec. 705. Matching Requirement.
Sec. 706. Use of funds.
Sec. 707. Reporting.
Sec. 708. Authorization of appropriations.

          TITLE VIII--SUPPORT FOR PREGNANT AND PARENTING TEENS

Sec. 801. Grants to States.

  TITLE IX--IMPROVING SERVICES FOR PREGNANT WOMEN WHO ARE VICTIMS OF 
            DOMESTIC VIOLENCE, DATING VIOLENCE, AND STALKING

Sec. 901. Findings.
Sec. 902. Program to support pregnant women who are victims of domestic 
              violence.
Sec. 903. Homicide death certificates of certain female victims.

TITLE X--LIFE SUPPORT CENTERS FOR PREGNANT WOMEN, MOTHERS, AND CHILDREN

Sec. 1001. Life support centers pilot program.

               TITLE XI--PROVIDING SUPPORT TO NEW PARENTS

Sec. 1101. Increased support for WIC program.
Sec. 1102. Nutritional support for low-income parents.
Sec. 1103. Increased funding for the Child Care and Development Block 
              Grant program.
Sec. 1104. Teenage or first-time mothers; free home visits by 
              registered nurses for education on health needs of 
              infants.

           TITLE XII--COLLECTING AND REPORTING ABORTION DATA

Sec. 1201. Grants for collection and reporting of abortion data.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) In 2004, 839,226 abortions were reported to the Centers 
     for Disease Control and Prevention.
       (2) 48 percent of all pregnancies in America are 
     unintended. Excluding miscarriages, 54 percent of unintended 
     pregnancies end in abortion.
       (3) 57 percent of women who have abortions have incomes 
     below 200 percent of the poverty level.
       (4) ``Cannot afford a baby'' is the second most frequently 
     cited reason women choose to have an abortion; 73 percent of 
     women having abortions cited this reason as a contributing 
     factor.
       (5) This Act is an initiative to gather more complete 
     information about abortion, to reduce the abortion rate by 
     helping women carry their pregnancies to term and bear 
     healthy children, and by affirming the right of women to be 
     fully informed about their other options when they seek an 
     abortion.
       (6) The initiative will work to support women facing 
     unplanned pregnancies, new parents and their children by 
     providing comprehensive measures for health care needs, 
     supportive services and helpful prenatal information and 
     postnatal services.

     SEC. 3. DEFINITIONS.

       For purposes of this Act:
       (1) The term ``Secretary'' means the Secretary of Health 
     and Human Services.
       (2) The term ``State'' includes the 50 States, the District 
     of Columbia, the Commonwealth of Puerto Rico, the 
     Commonwealth of the Northern Mariana Islands, American Samoa, 
     Guam, the Virgin Islands, and any other territory or 
     possession of the United States.

  TITLE I--PUBLIC AWARENESS AND ASSISTANCE FOR PREGNANT WOMEN AND NEW 
                                PARENTS

     SEC. 101. GRANTS FOR INCREASING PUBLIC AWARENESS OF RESOURCES 
                   AVAILABLE TO ASSIST PREGNANT WOMEN IN CARRYING 
                   THEIR PREGNANCIES TO TERM AND TO ASSIST NEW 
                   PARENTS.

       (a) Grants.--The Secretary may make grants to States to 
     increase public awareness of resources available to pregnant 
     women to carry their pregnancy to term and to new parents.
       (b) Use of Funds.--The Secretary may make a grant to a 
     State under this section only if the State agrees to use the 
     grant for the following:
       (1) Identification of resources available to assist 
     pregnant women to carry their pregnancy to term or to assist 
     new parents, or both.
       (2) Conducting an advertising campaign to increase public 
     awareness of such resources.
       (3) Establishing and maintaining a toll-free telephone line 
     to direct people to--
       (A) organizations that provide support services for 
     pregnant women to carry their pregnancy to term;
       (B) adoption centers; and
       (C) organizations that provide support services to new 
     parents.
       (c) Prohibition.--The Secretary shall prohibit each State 
     receiving a grant under this section from using the grant to 
     direct people to an organization or adoption center that is 
     for-profit.
       (d) Identification of Resources.--The Secretary shall 
     require each State receiving a grant under this section to 
     make publicly available by means of the Internet (electronic 
     and paper form) a list of the following:
       (1) The resources identified pursuant to subsection (b)(1).
       (2) The organizations and adoption centers to which people 
     are directed pursuant to an advertising campaign or telephone 
     line funded under this section.
       (e) Authorization of Appropriations.--The Secretary shall 
     make such funds available as may be necessary to carry out 
     the activities of this section.

      TITLE II--INCREASING WOMEN'S KNOWLEDGE ABOUT THEIR PREGNANCY

     SEC. 201. GRANTS TO HEALTH CENTERS FOR PURCHASE OF ULTRASOUND 
                   EQUIPMENT.

       Part B of title III of the Public Health Service Act (42 
     U.S.C. 243 et seq.) is amended by inserting after section 
     317L the following:

     ``SEC. 317L-1. GRANTS FOR THE PURCHASE OR UPGRADE OF 
                   ULTRASOUND EQUIPMENT.

       ``(a) In General.--The Secretary may make grants for the 
     purchase of ultrasound equipment. Such ultrasound equipment 
     shall be used by the recipients of such grants to provide, 
     under the direction and supervision of a licensed medical 
     physician, ultrasound examinations to pregnant women 
     consenting to such services.
       ``(b) Eligibility Requirements.--An entity may receive a 
     grant under subsection (a) only if the entity meets the 
     following conditions:
       ``(1) The entity is a health center eligible to receive a 
     grant under section 330 (relating to community health 
     centers, migrant health centers, homeless health centers, and 
     public-housing health centers).
       ``(2) The entity agrees to comply with the following 
     medical procedures:
       ``(A) The entity will inform each pregnant woman upon whom 
     the ultrasound equipment is used that she has the right to 
     view the visual image of the unborn child from the ultrasound 
     examination and that she has the right to hear a general 
     anatomical and physiological description of the 
     characteristics of the unborn child.
       ``(B) The entity will inform each pregnant woman that she 
     has the right to learn, according to the best medical 
     judgment of the physician performing the ultrasound 
     examination or the physician's agent performing such exam, 
     the approximate age of the embryo or unborn child considering 
     the number of weeks elapsed from the probable time of the 
     conception of the embryo or unborn child, based upon the 
     information provided by the client as to the time of her last 
     menstrual period, her medical history, a physical 
     examination, or appropriate laboratory tests.
       ``(c) Application for Grant.--A grant may be made under 
     subsection (a) only if an application for the grant is 
     submitted to the Secretary and the application is in such 
     form, is made in such manner, and contains such agreements, 
     assurances, and information as the Secretary determines to be 
     necessary to carry out this section.
       ``(d) Annual Report to Secretary.--A grant may be made 
     under subsection (a) only if the applicant for the grant 
     agrees to report on an annual basis to the Secretary, in such 
     form and manner as the Secretary may require, on the ongoing 
     compliance of the applicant with the eligibility conditions 
     established in subsection (b).
       ``(e) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $3,000,000 for fiscal year 2010, and such sums 
     as may be necessary for each of the fiscal years 2011 through 
     2014.''.

            TITLE III--PREGNANCY AS A PREEXISTING CONDITION

     SEC. 301. INDIVIDUAL HEALTH INSURANCE COVERAGE FOR PREGNANT 
                   WOMEN.

       (a) Limitation on Imposition of Pre-Existing Condition 
     Exclusions and Waiting Periods for Women With Prior 
     Coverage.--Title XXVII of the Public Health Service Act (42 
     U.S.C. 300gg et seq.) is amended by inserting after section 
     2753 the following new section:

     ``SEC. 2754. PROVIDING INDIVIDUAL HEALTH INSURANCE COVERAGE 
                   WITHOUT REGARD TO PREEXISTING CONDITION 
                   EXCLUSION AND WAITING PERIODS FOR PREGNANT 
                   WOMEN WITHIN ONE YEAR OF CONTINUOUS PRIOR 
                   COVERAGE.

       ``In the case of a woman who has had at least 12 months of 
     creditable coverage before seeking individual health 
     insurance coverage, such individual health insurance 
     coverage, and the health insurance issuer offering such 
     coverage, may not impose any preexisting condition exclusion 
     relating to pregnancy as a preexisting condition, any waiting 
     period, or otherwise discriminate in coverage or premiums 
     against the woman on the basis that she is pregnant.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall take effect on October 1, 2009, and shall apply to 
     women who become pregnant on or after such date.

     SEC. 302. CONTINUATION OF HEALTH INSURANCE COVERAGE FOR 
                   NEWBORNS.

       (a) Group Health Plan Coverage.--Title XXVII of the Public 
     Health Service Act (42 U.S.C. 300gg et seq.) is amended by 
     inserting after section 2707 the following new section:

[[Page 1118]]



     ``SEC. 2708. CONTINUATION OF COVERAGE FOR NEWBORNS.

       ``(a) Notification.--In the case of a pregnant woman who is 
     covered under a group health plan, or under group health 
     insurance coverage, for other than family coverage, the plan 
     or issuer of the insurance shall provide notice to the woman 
     during the 5th month of pregnancy, during the 8th month of 
     pregnancy, and within 2 weeks after delivery, of the woman's 
     option to provide continuing coverage of the newborn child 
     under the group health plan or health insurance coverage 
     under subsection (b).
       ``(b) Option of Continued Coverage for Newborns.--In the 
     case of a pregnant woman described in subsection (a) who has 
     a newborn child under a group health plan or under group 
     health insurance coverage, the plan or issuer offering the 
     coverage shall provide the woman with the option of electing 
     coverage of the newborn child at least through the end of the 
     30-day period beginning on the date of birth of the child and 
     no waiting period or preexisting condition exclusion shall 
     apply with respect to the coverage of such a newborn child 
     under such plan or coverage. Such continuation coverage shall 
     remain in effect, subject to payment of applicable premiums, 
     for at least such period as the Secretary specifies.''.
       (b) Individual Health Insurance Coverage.--Such title is 
     further amended by inserting after section 2754, as added by 
     section 301, the following new section:

     ``SEC. 2755. CONTINUATION OF COVERAGE FOR NEWBORNS.

       ``The provisions of section 2708 shall apply with respect 
     to individual health insurance coverage and the issuer of 
     such coverage in the same manner as they apply to group 
     health insurance coverage and the issuer of such coverage.''.
       (c) Effective Date.--The amendments made by this section 
     shall take effect on January 1, 2010, and shall apply to 
     women who become pregnant on or after such date and children 
     who are born of such women.

  TITLE IV--MEDICAID AND SCHIP COVERAGE OF PREGNANT WOMEN AND UNBORN 
                                CHILDREN

     SEC. 401. TREATMENT OF UNBORN CHILDREN.

       (a) Codification of Current Regulations.--Section 
     2110(c)(1) (42 U.S.C. 1397(c)(1)) is amended by striking the 
     period at the end and inserting the following: ``, and 
     includes, at the option of a State, an unborn child.''.
       (b) Clarifications Regarding Coverage of Mothers.--Section 
     2103 (42 U.S.C. 1397cc) is amended by adding at the end the 
     following new subsection:
       ``(g) Clarifications Regarding Authority to Provide 
     Postpartum Services and Maternal Health Care.--Any State that 
     provides child health assistance to an unborn child under the 
     option described in section 2110(c)(1) may--
       ``(1) continue to provide such assistance to the mother, as 
     well as postpartum services, through the end of the month in 
     which the 60-day period (beginning on the last day of 
     pregnancy) ends; and
       ``(2) in the interest of the child to be born, have 
     flexibility in defining and providing services to benefit 
     either the mother or unborn child consistent with the health 
     of both.''.

     SEC. 402. COORDINATION WITH THE MATERNAL AND CHILD HEALTH 
                   PROGRAM.

       (a) In General.--Section 2102(b)(3) of the Social Security 
     Act (42 U.S.C. 1397bb(b)(3)) is amended--
       (1) in subparagraph (D), by striking ``and'' at the end;
       (2) in subparagraph (E), by striking the period and 
     inserting ``; and''; and
       (3) by adding at the end the following new subparagraph:
       ``(F) that operations and activities under this title are 
     developed and implemented in consultation and coordination 
     with the program operated by the State under title V in areas 
     including outreach and enrollment, benefits and services, 
     service delivery standards, public health and social service 
     agency relationships, and quality assurance and data 
     reporting.''.
       (b) Conforming Medicaid Amendment.--Section 1902(a)(11) of 
     such Act (42 U.S.C. 1396a(a)(11)) is amended--
       (1) by striking ``and'' before ``(C)''; and
       (2) by inserting before the semicolon at the end the 
     following: ``, and (D) provide that operations and activities 
     under this title are developed and implemented in 
     consultation and coordination with the program operated by 
     the State under title V in areas including outreach and 
     enrollment, benefits and services, service delivery 
     standards, public health and social service agency 
     relationships, and quality assurance and data reporting''.
       (c) Effective Date.--The amendments made by this section 
     take effect on October 1, 2009.

        TITLE V--DISCLOSURE OF INFORMATION ON ABORTION SERVICES

     SEC. 501. DISCLOSURE OF INFORMATION ON ABORTION SERVICES.

       (a) In General.--Health facilities that perform abortions 
     in or affecting interstate commerce shall obtain informed 
     consent from the pregnant woman seeking to have the abortion. 
     Informed consent shall exist only after a woman has 
     voluntarily completed or opted not to complete pre-abortion 
     counseling sessions.
       (b) Accurate Information.--Counseling sessions under 
     subsection (a) shall include the following information:
       (1) The probable gestational age and characteristics of the 
     unborn child at the time the abortion will be performed.
       (2) How the abortion procedure is performed.
       (3) Possible short-term and long-term risks and 
     complications of the procedure to be performed.
       (4) Options or alternatives to abortion, including, but not 
     limited to, adoption, and the resources available in the 
     community to assist women choosing these options.
       (5) The availability of post-procedure medical services to 
     address the risks and complications of the procedure.
       (c) Exception.--This section shall not apply when the 
     pregnant woman is herself incapable, under State law, of 
     making medical decisions. This section does not affect or 
     modify any requirement under State law for making medical 
     decisions for such patients.
       (d) Civil Remedies.--
       (1) Civil action.--Any female upon whom an abortion has 
     been performed or attempted without complying with the 
     informed consent requirements may bring a civil action in an 
     appropriate district court of the United States against the 
     person who performed the abortion in knowing or reckless 
     violation of this section for actual and punitive damages.
       (2) Certain authorities and requirements.--With respect to 
     an action under paragraph (1):
       (A) The court may award attorney's fees to the plaintiff if 
     judgment is rendered in favor of the plaintiff, and may award 
     attorney's fees to the defendant if judgment is rendered in 
     favor of the defendant and the court finds that the 
     plaintiff's case was frivolous and brought in bad faith.
       (B) The court shall determine whether the anonymity of the 
     female involved will be preserved from public disclosure if 
     the female has not consented to her identity being disclosed. 
     If the female's identity is to be shielded, the court shall 
     issue an order sealing the record and excluding individuals 
     from the courtroom to preserve her identity.
       (C) In the absence of the female's written consent, anyone 
     other than a public official who brings the action shall do 
     so under a pseudonym.
       (3) Rule of construction.--Nothing in this subsection may 
     be construed to conceal the identity of the plaintiff or of 
     the witnesses from the defendant.
       (e) Severability.--If any provision of this section 
     requiring informed consent for abortions is found 
     unconstitutional, the unconstitutional provision is severable 
     and the other provisions of this section remain in effect.
       (f) Preemption.--Nothing in this section shall prevent a 
     State from enacting and enforcing additional requirements 
     with respect to informed consent.

  TITLE VI--SERVICES TO PATIENTS RECEIVING POSITIVE TEST DIAGNOSIS OF 
         DOWN SYNDROME OR OTHER PRENATALLY DIAGNOSED CONDITIONS

     SEC. 601. SERVICES TO PATIENTS RECEIVING POSITIVE TEST 
                   DIAGNOSIS FOR DOWN SYNDROME OR OTHER PRENATALLY 
                   DIAGNOSED CONDITIONS.

       (a) Findings and Purposes.--
       (1) Findings.--The Congress finds as follows:
       (A) Pregnant women who choose to undergo prenatal genetic 
     testing should have access to timely, scientific, and 
     nondirective counseling about the conditions being tested for 
     and the accuracy of such tests, from health care 
     professionals qualified to provide and interpret these tests. 
     Informed consent is a critical component of all genetic 
     testing.
       (B) A recent, peer-reviewed study and two reports from the 
     Centers for Disease Control and Prevention on prenatal 
     testing found a deficiency in the data needed to understand 
     the epidemiology of prenatally diagnosed conditions, to 
     monitor trends accurately, and to increase the effectiveness 
     of health intervention.
       (2) Purposes.--It is the purpose of this section, after the 
     diagnosis of an unborn child with Down syndrome or other 
     prenatally diagnosed conditions, to--
       (A) increase patient referrals to providers of key support 
     services to assist parents in the care, or placement for 
     adoption, of a child with Down syndrome, or other prenatally 
     diagnosed conditions, as well as to provide up-to-date, 
     science-based information about life-expectancy and 
     development potential for a child born with Down syndrome or 
     other prenatally diagnosed condition;
       (B) provide networks of support services described in 
     subparagraph (A) through a Centers for Disease Control and 
     Prevention patient and provider outreach program;
       (C) improve available data by incorporating information 
     directly revealed by prenatal testing into existing State-
     based surveillance programs for birth defects and prenatally 
     diagnosed conditions; and
       (D) ensure that patients receive up-to-date, scientific 
     information about the accuracy of the test.
       (b) Amendment to the Public Health Service Act.--Part P of 
     title III of the Public Health Service Act (42 U.S.C. 280g et 
     seq.)

[[Page 1119]]

     is amended by adding at the end the following:

     ``SEC. 399U. SUPPORT FOR PATIENTS RECEIVING A POSITIVE TEST 
                   DIAGNOSIS OF DOWN SYNDROME OR OTHER PRENATALLY 
                   DIAGNOSED CONDITIONS.

       ``(a) Definitions.--In this section:
       ``(1) Down syndrome.--The term `Down syndrome' refers to a 
     chromosomal disorder caused by an error in cell division that 
     results in the presence of an extra whole or partial copy of 
     chromosome 21.
       ``(2) Health care provider.--The term `health care 
     provider' means any person or entity required by State or 
     Federal law or regulation to be licensed, registered, or 
     certified to provide health care services, and who is so 
     licensed, registered, or certified.
       ``(3) Prenatally diagnosed condition.--The term `prenatally 
     diagnosed condition' means any fetal health condition 
     identified by prenatal genetic testing or prenatal screening 
     procedures.
       ``(4) Prenatal test.--The term `prenatal test' means 
     diagnostic or screening tests offered to pregnant women 
     seeking routine prenatal care that are administered by a 
     health care provider based on medical history, family 
     background, ethnic background, previous test results, or 
     other risk factors.
       ``(5) Support.--The terms `support' and `supportive 
     services' mean services to assist parents to care for, and 
     prepare to care for, a child with Down Syndrome or another 
     prenatally diagnosed condition, and to facilitate the 
     adoption of such children as appropriate.
       ``(b) Information and Support Services.--The Secretary, 
     acting through the Director of the National Institutes of 
     Health, the Director of the Centers for Disease Control and 
     Prevention, or the Administrator of the Health Resources and 
     Services Administration, may authorize and oversee certain 
     activities, including the awarding of grants, contracts, or 
     cooperative agreements, to--
       ``(1) collect, synthesize, and disseminate current 
     scientific information relating to Down syndrome or other 
     prenatally diagnosed conditions;
       ``(2) coordinate the provision of, and access to, new or 
     existing supportive services for patients receiving a 
     positive test diagnosis for Down syndrome or other prenatally 
     diagnosed conditions, including--
       ``(A) the establishment of a resource telephone hotline and 
     Internet Website accessible to patients receiving a positive 
     test result;
       ``(B) the establishment of national and local peer-support 
     programs; and
       ``(C) the establishment of a national registry, or network 
     of local registries, of families willing to adopt newborns 
     with Down syndrome or other prenatally diagnosed conditions, 
     and links to adoption agencies willing to place babies with 
     Down syndrome or other prenatally diagnosed conditions, with 
     families willing to adopt;
       ``(3) establish a clearinghouse of information regarding 
     the scientific facts, clinical course, life expectancy, and 
     development potential relating to Down syndrome or other 
     prenatally diagnosed conditions; and
       ``(4) establish awareness and education programs for health 
     care providers who provide the results of prenatal tests for 
     Down syndrome or other prenatally diagnosed conditions, to 
     patients, consistent with the purpose described in section 
     601(a)(2)(A) of the Pregnant Women Support Act.
       ``(c) Data Collection.--
       ``(1) Provision of assistance.--The Secretary, acting 
     through the Director of the Centers for Disease Control and 
     Prevention, shall provide assistance to State and local 
     health departments to integrate the results of prenatal 
     testing into State-based vital statistics and birth defects 
     surveillance programs.
       ``(2) Activities.--The Secretary shall ensure that 
     activities carried out under paragraph (1) are sufficient to 
     extract population-level data relating to national rates and 
     results of prenatal testing.
       ``(d) Provision of Information by Providers.--Upon receipt 
     of a positive test result from a prenatal test for Down 
     syndrome or other prenatally diagnosed conditions performed 
     on a patient, the health care provider involved (or his or 
     her designee) shall provide the patient with the following:
       ``(1) Up-to-date, scientific, written information 
     concerning the life expectancy, clinical course, and 
     intellectual and functional development and treatment options 
     for an unborn child diagnosed with or child born with Down 
     syndrome or other prenatally diagnosed conditions.
       ``(2) Referral to supportive services providers, including 
     information hotlines specific to Down syndrome or other 
     prenatally diagnosed conditions, resource centers or 
     clearinghouses, and other education and support programs 
     described in subsection (b).
       ``(e) Privacy.--
       ``(1) In general.--Notwithstanding subsections (c) and (d), 
     nothing in this section shall be construed to permit or 
     require the collection, maintenance, or transmission, without 
     the health care provider obtaining the prior, written consent 
     of the patient, of--
       ``(A) health information or data that identify a patient, 
     or with respect to which there is a reasonable basis to 
     believe the information could be used to identify the patient 
     (including a patient's name, address, healthcare provider, or 
     hospital); and
       ``(B) data that are not related to the epidemiology of the 
     condition being tested for.
       ``(2) Guidance.--Not later than 180 days after the date of 
     enactment of this section, the Secretary shall establish 
     guidelines concerning the implementation of paragraph (1) and 
     subsection (d).
       ``(f) Reports.--
       ``(1) Implementation report.--Not later than 2 years after 
     the date of enactment of this section, and every 2 years 
     thereafter, the Secretary shall submit a report to Congress 
     concerning the implementation of the guidelines described in 
     subsection (e)(2).
       ``(2) GAO report.--Not later than 1 year after the date of 
     enactment of this section, the Government Accountability 
     Office shall submit a report to Congress concerning the 
     effectiveness of current healthcare and family support 
     programs serving as resources for the families of children 
     with disabilities.
       ``(g) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $5,000,000 for 
     each of the fiscal years 2010 through 2014.''.

     TITLE VII--SUPPORT FOR PREGNANT AND PARENTING COLLEGE STUDENTS

     SEC. 701. SENSE OF CONGRESS.

       It is the sense of Congress that--
       (1) pregnant college students should not have to make a 
     choice between keeping their baby and staying in school;
       (2) the pilot program under this title will help 
     interested, eligible institutions of higher education 
     establish pregnancy and parenting student services offices 
     that will operate independent of Federal funding no later 
     than 5 years after the date of the enactment of this title; 
     and
       (3) amounts appropriated to carry out other Federal 
     programs should be reduced to offset the costs of this title.

     SEC. 702. DEFINITIONS.

       In this title:
       (1) Eligible institution of higher education.--The term 
     ``eligible institution of higher education'' means an 
     institution of higher education (as such term is defined in 
     section 101 of the Higher Education Act of 1965 (20 U.S.C. 
     1001)) that has established and operates, or agrees to 
     establish and operate upon the receipt of a grant under this 
     title, a pregnant and parenting student services office 
     described in section 706.
       (2) Parent; parenting.--The terms ``parent'' and 
     ``parenting'' refer to a parent or legal guardian of a minor.
       (3) Secretary.--The term ``Secretary'' means the Secretary 
     of Education.

     SEC. 703. PREGNANT AND PARENTING STUDENT SERVICES PILOT 
                   PROGRAM.

       From amounts appropriated under section 708 for a fiscal 
     year, the Secretary shall establish a pilot program to award 
     grants to eligible institutions of higher education to enable 
     the eligible institutions to establish (or maintain) and 
     operate pregnant and parenting student services offices in 
     accordance with section 706.

     SEC. 704. APPLICATION; NUMBER OF GRANTS.

       (a) Application.--An eligible institution of higher 
     education that desires to receive a grant under this title 
     shall submit an application to the Secretary at such time, in 
     such manner, and containing such information as the Secretary 
     may require.
       (b) Requests for Additional Information.--The Secretary may 
     require an eligible institution submitting an application 
     under subsection (a) to provide additional information if the 
     Secretary determines such information is necessary to process 
     the application.
       (c) Number of Grants.--Subject to the availability of 
     appropriations under section 708, the Secretary shall award 
     grants under this title to no more than 200 eligible 
     institutions.

     SEC. 705. MATCHING REQUIREMENT.

       An eligible institution of higher education that receives a 
     grant under this title shall contribute to the conduct of the 
     pregnant and parenting student services office supported by 
     the grant an amount from non-Federal funds equal to the 
     amount of the grant. The non-Federal share may be in cash or 
     in kind, fairly evaluated, including services, facilities, 
     supplies, or equipment.

     SEC. 706. USE OF FUNDS.

       (a) In General.--An eligible institution of higher 
     education that receives a grant under this title shall use 
     grant funds to establish (or maintain) and operate a pregnant 
     and parenting student services office, located on the campus 
     of the eligible institution, that carries out the following 
     programs and activities:
       (1) Hosts an initial pregnancy and parenting resource 
     forum--
       (A) to assess pregnancy and parenting resources, located on 
     the campus or within the local community, that are available 
     to meet the needs described in paragraph (2); and
       (B) to set goals for--
       (i) improving such resources for pregnant, parenting, and 
     prospective parenting students; and
       (ii) improving access to such resources.
       (2) Annually assesses the performance of the eligible 
     institution and the office in meeting the following needs of 
     students enrolled in the eligible institution who are 
     pregnant or are parents:
       (A) The inclusion of maternity coverage and the 
     availability of riders for additional family members in 
     student health care.

[[Page 1120]]

       (B) Family housing.
       (C) Child care.
       (D) Flexible or alternative academic scheduling, such as 
     telecommuting programs.
       (E) Education to improve parenting skills for mothers and 
     fathers and to strengthen marriages.
       (F) Maternity and baby clothing, baby food (including 
     formula), baby furniture, and similar items to assist parents 
     and prospective parents in meeting the material needs of 
     their children.
       (G) Post-partum counseling and support groups.
       (3) Identifies public and private service providers, 
     located on the campus of the eligible institution or within 
     the local community, that are qualified to meet the needs 
     described in paragraph (2), and establishes programs with 
     qualified providers to meet such needs.
       (4) Assists pregnant and parenting students and their 
     spouses in locating and obtaining services that meet the 
     needs described in paragraph (2).
       (5) If appropriate, provides referrals for prenatal care 
     and delivery, infant or foster care, or adoption, to a 
     student who requests such information. An office shall make 
     such referrals only to service providers that primarily serve 
     the following types of individuals:
       (A) Parents.
       (B) Prospective parents awaiting adoption.
       (C) Women who are pregnant and plan on parenting or placing 
     the child for adoption.
       (D) Parenting or prospective parenting couples who are 
     married or who plan on marrying in order to provide a 
     supportive environment for each other and their child.
       (b) Expanded Services.--In carrying out the programs and 
     activities described in subsection (a), an eligible 
     institution of higher education receiving a grant under this 
     title may choose to provide access to such programs and 
     activities to a pregnant or parenting employee of the 
     eligible institution, and the employee's spouse.

     SEC. 707. REPORTING.

       (a) Annual Report by Institutions.--
       (1) In general.--For each fiscal year that an eligible 
     institution of higher education receives a grant under this 
     title, the eligible institution shall prepare and submit to 
     the Secretary, by the date determined by the Secretary, a 
     report that--
       (A) itemizes the pregnant and parenting student services 
     office's expenditures for the fiscal year;
       (B) contains a review and evaluation of the performance of 
     the office in fulfilling the requirements of this title, 
     using the specific performance criteria or standards 
     established under paragraph (2)(A); and
       (C) describes the achievement of the office in meeting the 
     needs listed in section 706(a)(2) of the students served by 
     the eligible institution, and the frequency of use of the 
     office by such students.
       (2) Performance criteria.--Not later than 180 days before 
     the date the annual report described in paragraph (1) is 
     submitted, the Secretary--
       (A) shall identify the specific performance criteria or 
     standards that shall be used to prepare the report; and
       (B) may establish the form or format of the report.
       (3) Additional information.--After reviewing an annual 
     report of an eligible institution of higher education, the 
     Secretary may require that the eligible institution provide 
     additional information if the Secretary determines that such 
     additional information is necessary to evaluate the pilot 
     program.
       (b) Report by Secretary.--The Secretary shall annually 
     prepare and submit a report on the findings of the pilot 
     program under this title, including the number of eligible 
     institutions of higher education that were awarded grants and 
     the number of students served by each pregnant and parenting 
     student services office receiving funds under this title, to 
     the appropriate committees of the Senate and the House of 
     Representatives.

     SEC. 708. AUTHORIZATION OF APPROPRIATIONS.

       There is authorized to be appropriated to carry out this 
     title not more than $10,000,000 for each of the fiscal years 
     2010 through 2014.

          TITLE VIII--SUPPORT FOR PREGNANT AND PARENTING TEENS

     SEC. 801. GRANTS TO STATES.

       The Secretary shall make grants to States to allow early 
     childhood education programs, including Head Start, to work 
     with pregnant or parenting teens to complete high school and 
     prepare for college or for vocational education.

  TITLE IX--IMPROVING SERVICES FOR PREGNANT WOMEN WHO ARE VICTIMS OF 
            DOMESTIC VIOLENCE, DATING VIOLENCE, AND STALKING

     SEC. 901. FINDINGS.

       The Congress finds as follows:
       (1) Pregnant and recently pregnant women are more likely to 
     be victims of homicide than to die of any other causes, and 
     evidence exists that a significant proportion of all female 
     homicide victims are killed by their intimate partners.
       (2) A 2001 study published by the Journal of the American 
     Medical Association found that murder is the number one cause 
     of death among pregnant women.
       (3) Research suggests that injury-related deaths, including 
     homicide and suicide, account for approximately one-third of 
     all maternal mortality cases, while medical reasons make up 
     the rest. Homicide is the leading cause of death overall for 
     pregnant women, followed by cancer, acute and chronic 
     respiratory conditions, motor vehicle collisions and drug 
     overdose, peripartum and postpartum cardiomyopthy, and 
     suicide.

     SEC. 902. PROGRAM TO SUPPORT PREGNANT WOMEN WHO ARE VICTIMS 
                   OF DOMESTIC VIOLENCE.

       (a) In General.--For fiscal year 2010 and each subsequent 
     fiscal year, the Attorney General, through the Director of 
     the Office on Violence Against Women, may award grants to 
     States, to be used for any of the following purposes:
       (1) To assist States in providing intervention services, 
     accompaniment, and supportive social services for eligible 
     pregnant women who are victims of domestic violence, dating 
     violence, or stalking.
       (2) To provide for technical assistance and training (as 
     described in subsection (c)) relating to violence against 
     eligible pregnant women to be made available to the 
     following:
       (A) Federal, State, tribal, territorial, and local 
     governments, law enforcement agencies, and courts.
       (B) Professionals working in legal, social service, and 
     health care settings.
       (C) Nonprofit organizations.
       (D) Faith-based organizations.
       (b) State Eligibility.--To be eligible for a grant under 
     subsection (a), a State shall--
       (1) submit to the Attorney General an application in such 
     time and manner, and containing such information, as 
     specified by the Attorney General; and
       (2) for a grant made for a fiscal year beginning on or 
     after the date that is one year after the date of the 
     enactment of this title, satisfy the requirement under 
     section 903, relating to female homicide victim 
     determinations and death certificates.
       (c) Technical Assistance and Training Described.--For 
     purposes of subsection (a)(2), technical assistance and 
     training is--
       (1) the identification of eligible pregnant women 
     experiencing domestic violence, dating violence, or stalking;
       (2) the assessment of the immediate and short-term safety 
     of such a pregnant woman, the evaluation of the impact of the 
     violence or stalking on the pregnant woman's health, and the 
     assistance of the pregnant woman in developing a plan aimed 
     at preventing further domestic violence, dating violence, or 
     stalking, as appropriate;
       (3) the maintenance of complete medical or forensic records 
     that include the documentation of any examination, treatment 
     given, and referrals made, recording the location and nature 
     of the pregnant woman's injuries, and the establishment of 
     mechanisms to ensure the privacy and confidentiality of those 
     medical records; and
       (4) the identification and referral of the pregnant woman 
     to appropriate public and private nonprofit entities that 
     provide intervention services, accompaniment, and supportive 
     social services.
       (d) Definitions.--For purposes of this title:
       (1) Accompaniment.--The term ``accompaniment'' means 
     assisting, representing, and accompanying a woman in seeking 
     judicial relief for child support, child custody, restraining 
     orders, and restitution for harm to persons and property, and 
     in filing criminal charges, and may include the payment of 
     court costs and reasonable attorney and witness fees 
     associated therewith.
       (2) Eligible pregnant woman.--The term ``eligible pregnant 
     woman'' means any woman who is pregnant on the date on which 
     such woman becomes a victim of domestic violence, dating 
     violence, or stalking or who was pregnant during the one-year 
     period before such date.
       (3) Intervention services.--The term ``intervention 
     services'' means, with respect to domestic violence, dating 
     violence, or stalking, 24-hour telephone hotline services for 
     police protection and referral to shelters.
       (4) State.--The term ``State'' includes the District of 
     Columbia, any commonwealth, possession, or other territory of 
     the United States, and any Indian tribe or reservation.
       (5) Supportive social services.--The term ``supportive 
     social services'' means transitional and permanent housing, 
     vocational counseling, and individual and group counseling 
     aimed at preventing domestic violence, dating violence, or 
     stalking.
       (6) Violence.--The term ``violence'' means actual violence 
     and the risk or threat of violence.
       (e) Authorization of Appropriations.--For the purpose of 
     making allotments under subsection (a), there are authorized 
     to be appropriated $4,000,000 for each of the fiscal years 
     2010 through 2014.

     SEC. 903. HOMICIDE DEATH CERTIFICATES OF CERTAIN FEMALE 
                   VICTIMS.

       For purposes of section 902(b)(2), the requirement under 
     this section is that not later than the date that is one year 
     after the date of the enactment of this title, a State shall 
     require, with respect to any homicide case initiated after 
     such one-year date and in which the victim is a female of 
     possible child-bearing age, each of the following:
       (1) A determination of which, if any, of the following 
     categories, described the victim:
       (A) The victim was pregnant on the date of her death.

[[Page 1121]]

       (B) The victim was not pregnant on the date of her death, 
     but had been pregnant during the 42-day period before such 
     date.
       (C) The victim was not pregnant on the date of her death, 
     but had been pregnant during the period beginning on the date 
     that was one year before such date of her death and ending on 
     the date that was 43 days before such date of her death.
       (D) The victim was not pregnant during the one-year period 
     before the date of her death.
       (E) It could not be determined whether or not the victim 
     had been pregnant during the one-year period before the date 
     of her death.
       (2) The determination made under paragraph (1) shall be 
     included in the death certificate of the victim.

TITLE X--LIFE SUPPORT CENTERS FOR PREGNANT WOMEN, MOTHERS, AND CHILDREN

     SEC. 1001. LIFE SUPPORT CENTERS PILOT PROGRAM.

       (a) In General.--The Secretary shall establish a pilot 
     program to fund comprehensive and supportive services for 
     pregnant women, mothers, and children. Such services may 
     include--
       (1) child care for infants and toddlers to allow mothers to 
     find jobs and finish their education;
       (2) relocation assistance to establish good and stable 
     homes;
       (3) educational support, such as preparation for pregnant 
     and parenting mothers for the recognized equivalent of a 
     secondary school diploma;
       (4) counseling, including adoption counseling;
       (5) parenting classes;
       (6) business skills training;
       (7) emergency aid in times of crisis;
       (8) nutrition education and food assistance; and
       (9) outreach to seniors, many of whom volunteer to help 
     with the children or who receive advice on helping raise 
     their own grandchildren.
       (b) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section no more than 
     $10,000,000 for each of the fiscal years 2010 through 2014.

               TITLE XI--PROVIDING SUPPORT TO NEW PARENTS

     SEC. 1101. INCREASED SUPPORT FOR WIC PROGRAM.

       (a) Findings.--Congress finds the following:
       (1) The special supplemental nutrition program for women, 
     infants, and children (WIC) authorized in section 17 of the 
     Child Nutrition Act of 1966 (42 U.S.C. 1786) served 
     approximately 8,100,000 women, infants, and children per 
     month in fiscal year 2006.
       (2) Half of all infants in the United States and 1 in 4 
     young children under age 5 get crucial health and nutrition 
     benefits from the WIC Program.
       (3) It is estimated that every dollar spent on WIC results 
     in between $1.92 and $4.21 in Medicaid savings for newborns 
     and their mothers.
       (4) The WIC program has been proven to increase the number 
     of women receiving prenatal care, reduce the incidence of low 
     birth weight and fetal mortality, reduce anemia, and enhance 
     the nutritional quality of the diet of mothers and children.
       (5) The WIC program's essential, effective nutrition 
     services include nutrition assessment, counseling and 
     education, obesity prevention, breastfeeding support and 
     promotion, prenatal and pediatric health care referrals and 
     follow-up, spousal and child abuse referral, drug and alcohol 
     abuse referral, immunization screening, assessment and 
     referral, and a host of other services for mothers and 
     children.
       (b) Authorization of Appropriations.--For the purpose of 
     carrying out the special supplemental nutrition program for 
     women, infants, and children (WIC) authorized in section 17 
     of the Child Nutrition Act of 1966 (42 U.S.C. 1786), there is 
     authorized to be appropriated such sums as may be necessary 
     for each of fiscal years 2010 through 2014, of which--
       (1) there is authorized to be appropriated $15,000,000 for 
     fiscal year 2010, and such sums as may be necessary for each 
     of fiscal years 2011 through 2014, for breast-feeding peer 
     counselors; and
       (2) there is authorized to be appropriated $14,000,000 for 
     fiscal year 2010, and such sums as may be necessary for each 
     of fiscal years 2011 through 2014, for infrastructure needs.

     SEC. 1102. NUTRITIONAL SUPPORT FOR LOW-INCOME PARENTS.

       Section 5(c)(2) of the Food and Nutrition Act of 2008 (7 
     U.S.C. 2014(c)(2)) is amended by striking ``30 per centum'' 
     and inserting ``85 percent''.

     SEC. 1103. INCREASED FUNDING FOR THE CHILD CARE AND 
                   DEVELOPMENT BLOCK GRANT PROGRAM.

       (a) Authorization of Appropriations.--Section 658B of the 
     Child Care and Development Block Grant Act of 1990 (42 U.S.C. 
     9858) is amended to read as follows:

     ``SEC. 658B. AUTHORIZATION OF APPROPRIATIONS.

       ``There are authorized to be appropriated to carry out this 
     subchapter $2,350,000,000 for fiscal year 2010 and such sums 
     as may be necessary for fiscal years 2011 through 2014.''.
       (b) Conforming Amendment.--Section 658E(c)(3)(D) of the 
     Child Care and Development Block Grant Act of 1990 (42 U.S.C. 
     9858c(c)(3)(D)) is amended by striking ``1997 through 2002'' 
     and inserting ``2010 through 2014''.

     SEC. 1104. TEENAGE OR FIRST-TIME MOTHERS; FREE HOME VISITS BY 
                   REGISTERED NURSES FOR EDUCATION ON HEALTH NEEDS 
                   OF INFANTS.

       (a) In General.--The Secretary may make grants to local 
     health departments to provide to eligible mothers, without 
     charge, education on the health needs of their infants 
     through visits to their homes by registered nurses.
       (b) Eligible Mother.--
       (1) In general.--For purposes of subsection (a), a woman is 
     an eligible mother if, subject to paragraph (2), the woman--
       (A) is the mother of an infant who is not more than 24 
     months of age; and
       (B)(i) the woman was under the age of 20 at the time of 
     birth; or
       (ii) the infant referred to in subparagraph (A) is the 
     first child of the woman.
       (2) Additional requirements for certain mothers.--In the 
     case of a woman described in paragraph (1)(B)(ii) who is 20 
     years of age or older, the woman is an eligible mother for 
     purposes of subsection (a) only if the woman meets such 
     standards in addition to the applicable standards under 
     paragraph (1) as the local health department involved 
     determines to be appropriate.
       (c) Certain Requirements.--A grant may be made under 
     subsection (a) only if the applicant involved agrees as 
     follows:
       (1) The program carried out under such subsection by the 
     applicant will be designed to instill in eligible mothers 
     confidence in their abilities to provide for the health needs 
     of their newborns, including through--
       (A) providing information on child development; and
       (B) soliciting questions from the mothers.
       (2) The registered nurses who make home visits under 
     subsection (a) will, as needed, provide referrals for health 
     and social services to serve the needs of the newborns.
       (3) The period during which the visits will be available to 
     an eligible mother will not be fewer than six months.
       (d) Authorized Services.--
       (1) Requirements.--A grant may be made under subsection (a) 
     only if the applicant involved agrees that the following 
     services will be provided by registered nurses in home visits 
     under subsection (a):
       (A) Information on child health and development, including 
     suggestions for child-developmental activities that are 
     enjoyable for parents and children.
       (B) Advice on parenting, including information on how to 
     develop a strong parent-child relationship.
       (C) Information on resources about parenting, including 
     identifying books and videos that are available at local 
     libraries.
       (D) Information on upcoming parenting workshops in the 
     local region.
       (E) Information on programs that facilitate parent-to-
     parent support services.
       (F) In the case of an eligible mother who is a student, 
     information on resources that may assist the mother in 
     completing the educational courses involved.
       (2) Additional services.--A grant under subsection (a) may 
     be expended to provide services during home visits under such 
     subsection in addition to the services specified in paragraph 
     (1).
       (e) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $3,000,000 for fiscal year 2010, and such sums 
     as may be necessary for each of fiscal years 2011 through 
     2014.

           TITLE XII--COLLECTING AND REPORTING ABORTION DATA

     SEC. 1201. GRANTS FOR COLLECTION AND REPORTING OF ABORTION 
                   DATA.

       (a) Grants.--The Secretary, acting through the Director of 
     the Centers for Disease Control and Prevention, may make 
     grants to States for collecting and reporting abortion 
     surveillance data.
       (b) Reporting Requirement.--
       (1) In general.--The Secretary may make a grant to a State 
     under this section only if the State agrees to submit a 
     report in each of fiscal years 2011 and 2013 on the State's 
     abortion surveillance data.
       (2) Contents.--Each report submitted by a State under this 
     subsection shall, with respect to the preceding 2 fiscal 
     years, include--
       (A) the number and characteristics of women obtaining 
     abortions in the State; and
       (B) the characteristics of these abortions, including the 
     approximate gestational age of the unborn child, the abortion 
     method, and any known physical or psychological 
     complications.
       (3) Personal information.--A report submitted by a State 
     under this subsection shall not contain the name of any woman 
     obtaining or seeking to obtain an abortion, any common 
     identifier (such as a social security number), or any other 
     identifier (including statistical information) that would 
     make it possible to identify in any manner or under any 
     circumstances an individual who has obtained or seeks to 
     obtain an abortion.

[[Page 1122]]

       (c) Confidentiality.--The Secretary shall maintain the 
     confidentiality of any individually identifiable information 
     reported to the Secretary under this section.
       (d) Report to Congress.--
       (1) In general.--Not later than the end of fiscal year 
     2013, the Secretary shall submit a report to the Congress on 
     the abortion surveillance data reported to the Secretary 
     under this section.
       (2) Personal information.--A report submitted by the 
     Secretary to the Congress under this subsection shall not 
     contain any name or other identifier described in subsection 
     (b)(3).
       (e) Authorization of Appropriations.--To carry out this 
     section, there are authorized to be appropriated such sums as 
     may be necessary for each of fiscal years 2010 through 2014.
                                 ______
                                 
      By Mr. HARKIN:
  S. 272. A bill to amend the Commodity Exchange Act to ensure that all 
agreements, contracts, and transactions with respect to commodities are 
carried out on a regulated exchange, and for other purposes; to the 
Committee on Agriculture, Nutrition, and Forestry.
  Mr. HARKIN. Mr. President, today, I am reintroducing legislation--the 
Derivatives Trading Integrity Act--which calls for establishing 
stronger standards of openness, transparency and integrity in the 
trading of financial swaps and other over-the-counter derivative 
contracts as a critical step toward rebuilding and restoring confidence 
in the financial system. Over the years, the Commodity Futures Trading 
Commission and laws enacted by Congress have allowed instruments that 
are in form and function futures contracts to be privately negotiated 
without the safeguards provided through trading on exchanges regulated 
by the Commodity Futures Trading Commission, CFTC.
  The economic downturn in this country is forcing us to examine all 
contributing factors to the crisis in our financial markets. By 
restoring reasonable safeguards and regulation of swaps, including 
credit default swaps, along with all other futures contracts, this 
legislation will go a long way to restore confidence in the markets and 
reestablish soundness and integrity in the financial system. My bill 
will end the unregulated ``casino capitalism'' that has engendered 
great risks in swaps trading. And it will bring these transactions out 
into the sunlight where they can be monitored and appropriately and 
responsibly regulated. This legislation will establish authority and 
safeguards to ensure that parties can meet their obligations to manage 
and reduce danger and risk to the entire financial system and economy.
  Virtually all contracts now commonly referred to as swaps fall under 
the definition of futures contracts and function basically in the same 
manner as futures contracts. This bill amends the Commodity Exchange 
Act to eliminate the distinctions in the regulatory treatment of 
futures contracts among ``excluded'' and ``exempt'' commodities, and 
the transactions in them, and regulated, exchange-traded commodities 
and transactions in them. Futures contracts for all commodities would 
be treated the same in the law and regulations.
  In addition, the bill eliminates the statutory exclusion of swap 
transactions from regulation, and it ends the Commodity Futures Trading 
Commission's authority to exempt such transactions from the general 
requirement that a contract for the purchase or sale of a commodity for 
future delivery can only trade on a regulated board of trade. In 
effect, this proposed change in the law means that all futures 
contracts must trade on a designated contract market or a derivatives 
transaction execution facility. The requirement for exchange trading 
would thus include over-the-counter trading of financial derivatives 
just as it does for futures contracts in physical commodities such as 
corn, soybeans and petroleum.
  We have seen large negative consequences from the lack of price 
transparency and the failure to properly measure and collateralize the 
risk in trading over-the-counter derivatives. The problems have not 
been seen in the trading of financial futures on regulated futures 
markets, subject to the oversight of the Commodity Futures Trading 
Commission.
  This legislation I am introducing will establish the standard that 
all futures contracts trade on regulated exchanges. The regulated 
exchanges will work with the Commodity Futures Trading Commission to 
ensure that trading on the exchange is fair and equitable and not 
subject to abuses. The Commodity Futures Trading Commission has the 
experience and expertise to oversee these matters.
  Bringing necessary openness, transparency, soundness, and integrity 
to trading in contracts which are now unregulated over-the-counter 
swaps and related derivatives is a key element in restoring trust and 
confidence in the financial system so that we can rebuild our economy 
on a solid foundation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 272

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Derivatives Trading 
     Integrity Act of 2009''.

     SEC. 2. REGULATION OF CERTAIN AGREEMENTS, CONTRACTS, AND 
                   TRANSACTIONS.

       (a) Definitions.--Section 1a of the Commodity Exchange Act 
     (7 U.S.C. 1a) is amended--
       (1) by striking paragraphs (10), (11), (13), (14), and 
     (33); and
       (2) by redesignating--
       (A) paragraph (12) as paragraph (10);
       (B) paragraphs (15) through (32) as paragraphs (11) through 
     (28), respectively; and
       (C) paragraph (34) as paragraph (29).
       (b) Exclusions.--Section 2 of the Commodity Exchange Act (7 
     U.S.C. 2) is amended--
       (1) by striking subsections (d), (e), (g), (h), and (i); 
     and
       (2) by redesignating subsection (f) as subsection (d).
       (c) Restriction of Futures Trading to Contract Markets or 
     Derivatives Transaction Execution Facilities.--Section 4 of 
     the Commodity Exchange Act (7 U.S.C. 6) is amended--
       (1) in subsection (a), in the matter preceding paragraph 
     (1), by striking ``Unless exempted by the Commission pursuant 
     to subsection (c), it shall'' and inserting ``It shall'';
       (2) by striking subsection (c); and
       (3) by redesignating subsection (d) as subsection (c).
       (d) Exempt Boards of Trade.--Section 5d of the Commodity 
     Exchange Act (7 U.S.C. 7a-3) is repealed.

     SEC. 3. CONFORMING AMENDMENTS.

       (a) Section 1a of the Commodity Exchange Act (7 U.S.C. 1a) 
     (as amended by section 2(a)(2)) is amended--
       (1) in paragraph (10)(A)(x), by striking ``(other than an 
     electronic trading facility with respect to a significant 
     price discovery contract)'';
       (2) in paragraph (25)--
       (A) in subparagraph (C), by inserting ``and'' after the 
     semicolon at the end;
       (B) in subparagraph (D), by striking ``; and'' and 
     inserting a period; and
       (C) by striking subparagraph (E); and
       (3) in paragraph (27), by striking ``section 2(c), 2(d), 
     2(f), or 2(g) of this Act'' and inserting ``subsection (c) or 
     (d) of section 2''.
       (b) Section 2(c) of the Commodity Exchange Act (7 U.S.C. 
     2(c)) is amended--
       (1) in paragraph (1)--
       (A) in the matter preceding subparagraph (A), by striking 
     ``5d,''; and
       (B) in subparagraph (F), by striking ``in an excluded 
     commodity''; and
       (2) in paragraph (2)(B)(i)(II)--
       (A) in item (cc), by striking ``section 1a(20) of this 
     Act'' each place it appears and inserting ``section 1a(16)''; 
     and
       (B) in item (dd), by striking ``section 1a(12)(A)(ii) of 
     this Act'' and inserting ``section 1a(10)(A)(ii)''.
       (c) Section 4a of the Commodity Exchange Act (7 U.S.C. 6a) 
     is amended--
       (1) in subsection (a)--
       (A) in the first sentence, by striking ``or on electronic 
     trading facilities with respect to a significant price 
     discovery contract''; and
       (B) in the second sentence, by striking ``or on an 
     electronic trading facility with respect to a significant 
     price discovery contract,'';
       (2) in subsection (b)--
       (A) in paragraph (1), by striking ``or electronic trading 
     facility with respect to a significant price discovery 
     contract''; and
       (B) in paragraph (2), in the matter preceding the proviso, 
     by striking ``or electronic trading facility with respect to 
     a significant price discovery contract''; and
       (3) in subsection (e)--
       (A) in the first sentence--
       (i) in the matter preceding the proviso--

       (I) by striking ``or by any electronic trading facility'';
       (II) by striking ``or on an electronic trading facility''; 
     and
       (III) by striking ``or electronic trading facility''; and

[[Page 1123]]

       (ii) in the proviso, by striking ``or electronic trading 
     facility''; and
       (B) in the second sentence, in the matter preceding the 
     proviso, by striking ``or electronic trading facility with 
     respect to a significant price discovery contract''.
       (d) Section 4g(a) of the Commodity Exchange Act (7 U.S.C. 
     6g(a)) is amended by striking ``and in any significant price 
     discovery contract traded or executed on an electronic 
     trading facility or''.
       (e) Section 4i of the Commodity Exchange Act (7 U.S.C. 6i) 
     is amended--
       (1) in the matter preceding paragraph (1), by striking ``or 
     any significant price discovery contract traded or executed 
     on an electronic trading facility''; and
       (2) in the matter following paragraph (2), by striking ``or 
     electronic trading facility''.
       (f) Section 5a of the Commodity Exchange Act (7 U.S.C. 7a) 
     is amended--
       (1) in subsection (b)(2)--
       (A) in subparagraph (D)(ii), by inserting ``or'' after the 
     semicolon at the end;
       (B) in subparagraph (E), by striking ``; or'' and inserting 
     a period; and
       (C) by striking subparagraph (F); and
       (2) in subsection (g)--
       (A) in the heading, by striking ``Election To Trade 
     Excluded and Exempt Commodities'' and inserting ``Excluded 
     Securities''; and
       (B) in paragraph (1)--
       (i) by striking ``excluded or exempt commodities other 
     than'' and inserting ``commodities other than an agricultural 
     commodity enumerated in section 1a(4) or''; and
       (ii) by striking ``, 2(d), or 2(g) of this Act, or exempt 
     under section 2(h) of this Act''.
       (g) Section 5b of the Commodity Exchange Act (7 U.S.C. 7a-
     1) is amended--
       (1) in subsection (a)(1), by striking ``section 
     2(a)(1)(C)(i), 2(c), 2(d), 2(f), or 2(g) of this Act or title 
     IV of the Commodity Futures Modernization Act of 2000, or 
     exempted under section 2(h) or 4(c) of this Act'' and 
     inserting ``subsection (a)(1)(C)(i), (c), or (d) of section 2 
     or title IV of the Commodity Futures Modernization Act of 
     2000 (Public Law 106-554; 114 Stat. 2763A457)''; and
       (2) in subsection (b), by striking ``section 2(c), 2(d), 
     2(f), or 2(g) of this Act or title IV of the Commodity 
     Futures Modernization Act of 2000, or exempted under section 
     2(h) or 4(c) of this Act'' and inserting ``subsection (c) or 
     (d) of section 2 or title IV of the Commodity Futures 
     Modernization Act of 2000 (Public Law 106-554; 114 Stat. 
     2763A457)''.
       (h) Section 5c of the Commodity Exchange Act (7 U.S.C. 7a-
     2) is amended--
       (1) in subsection (a)(1), by striking ``and section 2(h)(7) 
     with respect to significant price discovery contracts,'';
       (2) in subsection (b)--
       (A) in paragraph (1), by striking ``, derivatives 
     transaction execution facility, or electronic trading 
     facility with respect to a significant price discovery 
     contract'' and inserting ``or derivatives transaction 
     execution facility''; and
       (B) in paragraphs (2) and (3), by striking ``, derivatives 
     transaction execution facility, or electronic trading 
     facility'' each place it appears and inserting ``or 
     derivatives transaction execution facility''; and
       (3) in subsection (d)(1), in the matter preceding 
     subparagraph (A), by striking ``or 2(h)(7)(C) with respect to 
     a significant price discovery contract traded or executed on 
     an electronic trading facility,''.
       (i) Section 5e of the Commodity Exchange Act (7 U.S.C. 7b) 
     is amended by striking ``or revocation of the right of an 
     electronic trading facility to rely on the exemption set 
     forth in section 2(h)(3) with respect to a significant price 
     discovery contract,''.
       (j) Section 5f(b)(1) of the Commodity Exchange Act (7 
     U.S.C. 7b-1(b)(1)) is amended in the matter preceding 
     subparagraph (A), by striking ``section 5f'' and inserting 
     ``this section''.
       (k) Section 6(b) of the Commodity Exchange Act (7 U.S.C. 
     8(b)) is amended--
       (1) in the first sentence--
       (A) by striking ``or to revoke the right of an electronic 
     trading facility to rely on the exemption set forth in 
     section 2(h)(3) with respect to a significant price discovery 
     contract,''; and
       (B) by striking ``or electronic trading facility''; and
       (2) in the second sentence, in the matter preceding the 
     proviso, by striking ``or electronic trading facility''.
       (l) Section 12(e) of the Commodity Exchange Act (7 U.S.C. 
     16(e)) is amended by striking paragraph (2) and inserting the 
     following:
       ``(2) Effect.--This Act supersedes and preempts the 
     application of any State or local law that prohibits or 
     regulates gaming or the operation of bucket shops (other than 
     antifraud provisions of general applicability) in the case of 
     an agreement, contract, or transaction that is excluded from 
     this Act under--
       ``(A) subsection (c) or (d) of section 2; or
       ``(B) title IV of the Commodity Futures Modernization Act 
     of 2000 (Public Law 106-554; 114 Stat. 2763A457).''.
       (m) Section 15(b) of the Commodity Exchange Act (7 U.S.C. 
     19(b)) is amended by striking ``4(c) or''.
       (n) Section 22(b)(1)(A) of the Commodity Exchange Act (7 
     U.S.C. 25(b)(1)(A)) is amended by striking ``by section 
     2(h)(7) or sections 5 through 5c'' and inserting ``under 
     sections 5 through 5c''.
       (o) Section 13106(b)(1) of the Food, Conservation, and 
     Energy Act of 2008 (7 U.S.C. 2 note; Public Law 110-246) is 
     amended by striking ``section 1a(32)'' and inserting 
     ``section 1a''.

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