[Senate Report 112-88]
[From the U.S. Government Publishing Office]


                                                       Calendar No. 188
112th Congress                                                   Report
                                 SENATE
 1st Session                                                     112-88

======================================================================



 
               VETERANS PROGRAMS IMPROVEMENT ACT OF 2011

                October 11, 2011.--Ordered to be printed

         Mrs. Murray, from the Committee on Veterans' Affairs,
                        submitted the following

                              R E P O R T

                         [To accompany S. 914]

    The Committee on Veterans' Affairs (hereinafter, ``the 
Committee''), to which was referred the bill (S. 914), to amend 
title 38, United States Code (hereinafter, ``U.S.C.''), to 
authorize the waiver of the collection of copayments for 
telehealth and telemedicine visits of veterans, and for other 
purposes, having considered the same, reports favorably thereon 
with an amendment in the nature of a substitute, and recommends 
that the bill, as amended, do pass.

                              Introduction

    On May 9, 2011, Senator Begich introduced S. 914, which 
would authorize the waiver of the collection of copayments for 
telehealth and telemedicine visits of veterans. Senators 
Grassley and Tester are original cosponsors. The bill was 
referred to the Committee.
    On February 3, 2011, Senator Cornyn introduced S. 269, 
which would designate the Department of Veterans Affairs 
(hereinafter, ``VA'' or ``the Department'') medical center in 
Big Spring, Texas, as the ``George H. O'Brien, Jr., Department 
of Veterans Affairs Medical Center.'' Senator Hutchison is an 
original cosponsor. The bill was referred to the Committee.
    On February 14, 2011, Senator Mark Udall introduced S. 327, 
which would designate VA's telehealth clinic in Craig, 
Colorado, as the ``Major William Edward Adams Department of 
Veterans Affairs Clinic.'' Senator Bennet is an original 
cosponsor. The bill was referred to the Committee.
    On February 17, 2011, Senator Klobuchar introduced S. 411, 
the proposed ``Helping our Homeless Veterans Act of 2011.'' 
S. 411 would authorize VA to enter into agreements with States 
and nonprofit organizations to collaborate in the provision of 
case management services associated with certain supported 
housing programs for veterans. Senators Begich, Brown of 
Massachusetts, Casey, Cornyn, Inhofe, and Nelson of Florida are 
original cosponsors of the bill. Senators Blumenthal, Cantwell, 
Cardin, Coons, Durbin, Enzi, Hagan, Merkley, Mikulski, 
Murkowski, Pryor, and Tester were later added as cosponsors of 
the bill. The bill was referred to the Committee.
    On March 1, 2011, Ranking Member Burr introduced S. 423, 
which would provide authority for a retroactive effective date 
for awards of disability compensation in connection with 
applications that are fully-developed at submittal. The bill 
was referred to the Committee.
    On March 3, 2011, Senator Whitehouse introduced S. 486, the 
proposed ``Protecting Servicemembers from Mortgage Abuses Act 
of 2011.'' S. 486 would amend the Servicemembers Civil Relief 
Act (hereinafter, ``SCRA'') to enhance protections for members 
of the uniformed services related to mortgages, mortgage 
foreclosure, and eviction. Senators Merkley, Reed, Sanders, and 
Tester are original cosponsors of the bill. Senators Baucus, 
Blumenthal, Boxer, Durbin, Feinstein, Franken, Hagan, 
Lautenberg, Leahy, Mikulski, Nelson of Florida, and Pryor were 
later added as cosponsors of the bill. The bill was referred to 
the Committee.
    On March 9, 2011, Senator Webb introduced S. 536, which 
would provide that utilization of survivors' and dependents' 
educational assistance shall not be subject to the 48-month 
limitation on the aggregate amount of assistance utilizable 
under multiple veterans and related educational assistance 
programs. Senator Blumenthal was later added as a cosponsor of 
the bill. The bill was referred to the Committee.
    On March 29, 2011, Senator Baucus introduced S. 666, the 
proposed ``Veterans Traumatic Brain Injury Care Improvement Act 
of 2011.'' S. 666 would require VA to report on the feasibility 
and advisability of establishing a Polytrauma Rehabilitation 
Center (hereinafter, ``PRC'') or Polytrauma Network Site 
(hereinafter, ``PNS'') in the northern Rockies or Dakotas. 
Senators Conrad, Johnson of South Dakota, and Tester are 
original cosponsors of the bill. Senator Cantwell was later 
added as a cosponsor of the bill. The bill was referred to the 
Committee.
    On March 31, 2011, Senator Tester introduced S. 696, which 
would treat the sites operated by the Department's Readjustment 
Counseling Service (hereinafter, ``Vet Centers'') as VA 
facilities for purposes of payments or allowances for 
beneficiary travel to Department facilities. Senators Begich, 
Blumenthal, Johnson of South Dakota, Moran, and Wyden were 
later added as cosponsors of the bill. The bill was referred to 
the Committee.
    On March 31, 2011, Senator Warner introduced S. 698, which 
would codify the prohibition against the reservation of 
gravesites at Arlington National Cemetery (hereinafter, 
``ANC''). The bill was referred to the Committee.
    On April 8, 2011, Senator Harkin introduced S. 769, the 
proposed ``Veterans Equal Treatment for Service Dogs Act of 
2011.'' S. 769 would prevent the prohibition of the use of 
service dogs on VA property. Senator Isakson was an original 
cosponsor of the bill. Senators Begich, Hagan, Leahy, 
Murkowski, Pryor, Stabenow, and Wyden were later added as 
cosponsors of the bill. The bill was referred to the Committee.
    On April 13, 2011, Senator Snowe introduced S. 815, the 
proposed ``Sanctity of Eternal Rest for Veterans Act of 2011.'' 
S. 815 would guarantee that military funerals are conducted 
with dignity and respect. Senators Cardin, Coats, Conrad, 
Gillibrand, Hoeven, Hutchison, Johanns, Kirk, Pryor, Reid, 
Rockefeller, Rubio, and Shaheen are all original cosponsors of 
the bill. Senators Ayotte, Begich, Blunt, Boozman, Brown of 
Massachusetts, Cantwell, Collins, Coons, Cornyn, Enzi, Graham, 
Inhofe, Kerry, Lieberman, Manchin, McCaskill, Roberts, 
Stabenow, Webb, Whitehouse, and Wicker were later added as 
cosponsors of the bill. The bill was referred to the Committee.
    On May 3, 2011, Senator Akaka introduced S. 874, which 
would modify the provision of compensation and pension to 
surviving spouses of veterans in the months of death of the 
veterans and improve housing loan benefits for veterans. The 
bill was referred to the Committee.
    On May 10, 2011, Ranking Member Burr introduced S. 928, 
which would limit VA's authority to use bid savings on major 
medical facility projects to expand or change the scope of a 
major medical facility project of the Department. The bill was 
referred to the Committee.
    On May 11, 2011, Senator Boozman introduced S. 957, the 
proposed ``Veterans' Traumatic Brain Injury Rehabilitative 
Services' Improvements Act of 2011.'' S. 957 would improve the 
provision of rehabilitation services for veterans with 
traumatic brain injury (hereinafter, ``TBI''). Senator Begich 
is an original cosponsor. Senator Johnson of South Dakota was 
later added as a cosponsor of the bill. The bill was referred 
to the Committee.
    On May 17, 2011, Senator Sanders introduced S. 1017, the 
proposed ``Disabled Veteran Caregiver Housing Assistance Act of 
2011.'' S. 1017 would increase assistance for disabled veterans 
who are temporarily residing in housing owned by a family 
member. The bill was referred to the Committee.
    On May 25, 2011, Senator Blumenthal introduced S. 1060, the 
proposed ``Honoring All Veterans Act of 2011.'' S. 1060 would 
improve education, employment, independent living services, and 
health care for veterans; improve assistance for homeless 
veterans; and improve the administration of VA. The bill was 
referred to the Committee.
    On May 26, 2011, Senator McConnell introduced S. 1089, the 
proposed ``Veterans Health Care Improvement Act of 2011.'' 
S. 1089 would provide for the introduction of pay-for-
performance compensation mechanisms into VA contracts with 
community-based outpatient clinics (hereinafter, ``CBOCs'') for 
the provision of health care services. The bill was referred to 
the Committee.
    On May 26, 2011, Senator Brown of Ohio introduced S. 1123, 
which would improve the provision of benefits and assistance to 
veterans affected by natural or other disasters. The bill was 
referred to the Committee.
    On May 26, 2011, Senator Conrad introduced S. 1124, the 
proposed ``Veterans Telemedicine Act of 2011.'' S. 1124 would 
improve the utilization of teleconsultation, teleretinal 
imaging, telemedicine, and telehealth coordination services for 
the provision of health care to veterans. The bill was referred 
to the Committee.
    On May 26, 2011, Senator Conrad introduced S. 1127, the 
proposed ``Veterans Rural Health Improvement Act of 2011.'' 
S. 1127 would establish centers of excellence for rural health 
research, education, and clinical activities and recognize the 
rural health resource centers in the Office of Rural Health 
(hereinafter, ``ORH''). The bill was referred to the Committee.
    On June 6, 2011, Senator Blumenthal introduced S. 1147, the 
proposed ``Chiropractic Care Available to All Veterans Act of 
2011.'' S. 1147 would require the provision of chiropractic 
care and services to veterans at all VA medical centers and 
expand access to such care and services. Senators Grassley, 
Harkin, Moran, and Whitehouse are original cosponsors of the 
bill. Senators Murkowski and Tester were later added as 
cosponsors of the bill. The bill was referred to the Committee.
    On June 6, 2011, Committee Chairman Murray introduced 
S. 1148, the proposed ``Veterans Programs Improvement Act of 
2011.'' S. 1148 would improve the provision of assistance to 
homeless veterans and improve the regulation of fiduciaries who 
represent individuals for purposes of receiving benefits. The 
bill was referred to the Committee.
    On June 13, 2011, Senator Cantwell introduced S. 1184, 
which would revise the enforcement penalties for 
misrepresentation of a business concern as a small business 
concern owned and controlled by veterans or a small business 
concern owned and controlled by service-disabled veterans. The 
bill was referred to the Committee.
    On June 8, 2011, the Committee held a hearing on pending 
legislation. Testimony was offered by: Michael Cardarelli, 
Principal Deputy Under Secretary for Benefits, VA; Robert L. 
Jesse, MD, PhD, Principal Deputy Under Secretary for Health, 
VA; John McWilliam, Deputy Assistant Secretary, Veterans' 
Employment and Training Service, Department of Labor 
(hereinafter, ``DOL''); Jeff Steele, Assistant Legislative 
Director, The American Legion; Joseph A. Violante, National 
Legislative Director, Disabled American Veterans; Raymond 
Kelley, Director, National Legislative Service, Veterans of 
Foreign Wars of the United States; Jerry Ensminger, MSgt USMC 
(Ret.); and J. David Cox, RN, National Secretary-Treasurer, 
American Federation of Government Employees.

                           Committee Meeting

    After carefully reviewing the testimony from the foregoing 
hearing, the Committee met in open session on June 29, 2011, to 
consider, among other legislation, an amended version of 
S. 914, consisting of provisions from S. 914 as introduced and 
provisions from the other legislation noted above. The 
Committee voted, without dissent, to report favorably S. 914 as 
amended.

                     Summary of S. 914 as Reported

    S. 914, as reported (hereinafter, ``the Committee bill''), 
consists of 54 sections, summarized below:

    Section 1 would provide a short title and table of 
contents.
    Section 2 provides that certain references within the bill 
are references to title 38, U.S.C.

                      TITLE I--HEALTH CARE MATTERS

    Section 101 would provide VA with the authority to waive 
collection of copayments for telehealth and telemedicine visits 
of veterans.
    Section 102 would provide incentives for VA to further 
expand the use of teleconsultation, teleretinal imaging, and 
telemedicine.
    Section 103 would clarify that VA may make payments and 
allowances for beneficiary travel in connection with veterans 
receiving care from Vet Centers.
    Section 104 would require VA to allow the use of service 
dogs on VA property.
    Section 105 would require VA to add rehabilitative services 
to individualized care plans for veterans with TBI.
    Section 106 would require VA to establish centers of 
excellence for rural health research, education, and clinical 
activities and would recognize rural health resource centers in 
ORH.
    Section 107 would require VA to develop a policy to provide 
chiropractic services to veterans enrolled in VA health care 
system.
    Section 108 would provide reimbursement rates for ambulance 
services.
    Section 109 would provide for increased flexibility in 
establishing payment rates for nursing home care provided by 
State homes.
    Section 110 would allow VA to disclose certain information 
about a veteran to a State prescription monitoring program.
    Section 111 would require VA to develop a plan for 
improvements in recovery and collection of amounts for VA's 
Medical Care Collections Fund (hereinafter, MCCF'').

                  TITLE II--HOMELESS VETERANS MATTERS

    Section 201 would enhance VA's comprehensive service 
programs.
    Section 202 would modify VA's grant program for homeless 
veterans with special needs.
    Section 203 would modify the authority for provision of 
treatment and rehabilitation to certain veterans to include 
provision of treatment and rehabilitation to homeless veterans 
who are not seriously mentally ill.
    Section 204 would require VA to submit to Congress a plan 
to end veteran homelessness.
    Section 205 would extend certain authorities relating to 
homeless veterans.
    Section 206 would reauthorize appropriations for the 
Homeless Veterans Reintegration Program (hereinafter, 
``HVRP'').
    Section 207 would reauthorize appropriations for financial 
assistance for supportive services for very low-income veteran 
families in permanent housing.
    Section 208 would reauthorize appropriations for a grant 
program for homeless veterans with special needs.
    Section 209 would encourage collaboration in the provision 
of case management services to homeless veterans in the 
supported housing program.

                       TITLE III--HOUSING MATTERS

    Section 301 would provide a short title.
    Section 302 would extend the period of protections for 
members of the uniformed services relating to mortgages, 
mortgage foreclosure, and eviction and require a report on 
those protections.
    Section 303 would allow occupancy of property by a 
dependent child of a veteran to satisfy the occupancy 
requirement for VA housing loans.
    Section 304 would waive loan fees for individuals with 
disability ratings issued during pre-discharge programs.
    Section 305 would improve assistance for disabled veterans 
residing in housing owned by a family member.
    Section 306 would expand eligibility for specially adapted 
housing assistance for veterans with vision impairment.
    Section 307 would revise limitations on assistance 
furnished for acquisition and adaptation of housing for 
disabled veterans.

                   TITLE IV--COMPENSATION AND PENSION

    Section 401 would increase the rate of pension for disabled 
veterans married to another who both require regular aid and 
attendance (hereinafter, ``A&A'').
    Section 402 would provide authority for a retroactive 
effective date for awards of disability compensation in 
connection with applications that are fully developed at 
submittal.
    Section 403 would modify the month-of-death benefit for 
surviving spouses of veterans who die while entitled to 
compensation or pension.
    Section 404 would provide an automatic waiver of agency of 
original jurisdiction review of new evidence.

            TITLE V--MEMORIAL, BURIAL, AND CEMETERY MATTERS

    Section 501 would prohibit certain disruptions of funerals 
of members or former members of the Armed Forces.
    Section 502 would codify the prohibition against 
reservation of gravesites at ANC.
    Section 503 would expand eligibility for presidential 
memorial certificates to persons who died in the active 
military, naval, or air service.

                     TITLE VI--CONSTRUCTION MATTERS

    Section 601 would authorize fiscal year (hereinafter, 
``FY'') 2012 major medical facility projects.
    Section 602 would modify authorization for certain major 
medical facility construction projects previously authorized.
    Section 603 would authorize FY 2012 major medical facility 
leases.
    Section 604 would authorize appropriations for construction 
and leases.
    Section 605 would limit the authority of VA to use bid 
savings on major medical facility projects to expand the 
purpose of major medical facility projects.
    Section 606 would designate the VA Medical Center in Big 
Spring, Texas, as the George H. O'Brien, Jr., Department of 
Veterans Affairs Medical Center.
    Section 607 would designate the telehealth clinic in Craig, 
Colorado, as the Major William Edward Adams Department of 
Veterans Affairs Clinic.

          TITLE VII--OTHER ADMINISTRATIVE AND BENEFITS MATTERS

    Section 701 would provide assistance to veterans affected 
by natural disasters.
    Section 702 would revise the limitation on the aggregate 
amount of educational assistance available to individuals who 
receive both survivors' and dependents' educational assistance 
and other veterans and related educational assistance.
    Section 703 would enhance VA enforcement penalties for 
misrepresentation of a business concern as a small business 
concern owned and controlled by veterans or as a small business 
concern owned and controlled by service-disabled veterans.
    Section 704 would provide authority for certain persons to 
sign claims filed with VA on behalf of claimants.
    Section 705 would improve the process for filing jointly 
for Social Security and dependency and indemnity compensation.
    Section 706 would provide parity between part-time and 
full-time students under VA employee incentive scholarship 
program.
    Section 707 would require a report on pay-for-performance 
compensation under health care services contracts.
    Section 708 would extend the authority to obtain 
information from the Secretary of Treasury and the Commissioner 
of Social Security for income verification purposes.
    Section 709 would extend the authority for a VA regional 
office in the Republic of the Philippines.
    Section 710 would require a report on establishment of a VA 
PRC or PNS in the northern Rockies or Dakotas.
    Section 711 would modify the loan guaranty fee for certain 
initial loans.

                       Background and Discussion


                      TITLE I--HEATH CARE MATTERS

Sec. 101. Authority to waive collection of copayments for telehealth 
        and telemedicine visits of veterans.

    Section 101 of the Committee bill, which is derived from 
S. 914, as introduced, would provide VA with the authority to 
waive the collection of copayments from veterans for telehealth 
and telemedicine visits.
    Background. For purposes of providing greater access to 
care and reducing the amount of travel required for patients, 
especially in rural areas, VA delivers care through telehealth 
modalities such as telephone consultations, videoconferencing, 
and use of robotic technology. Telehealth visits can be made 
from patient homes or community-based outpatient clinics.
    In December 2008, a team led by Adam Darkins, MD, Chief 
Consultant, Care Coordination, in VA's Office of Patient Care 
Services, published a study entitled, ``Care Coordination/Home 
Telehealth: The Systematic Implementation of Health 
Informatics, Home Telehealth, and Disease Management to Support 
the Care of Veteran Patients with Chronic Conditions.'' That 
study found that VA patients using home telehealth experienced 
a 19-percent reduction in hospital admissions and a 25-percent 
reduction in the number of days patients were required to be 
cared for in bed. The reduction in bed days of care has since 
declined by 30 percent for those utilizing home telehealth, 
according to routine outcomes data from VA's Office of 
Telehealth Services from FY 2009 through FY 2010. Further, 
according to an October 2010 article, ``Telehealth in the VA: 
Telehealth Continues to Make Its Mark,'' by Dr. Darkins, 
patient satisfaction levels associated with home telehealth 
exceeded 85 percent, and they exceeded 90 percent for use of 
store-and-forward technology.
    A RAND Corporation study, ``Health Insurance and the Demand 
for Medical Care: Evidence from a Randomized Experiment,'' 
found that copayment rates were highly influential in whether 
enrollees sought medical care. Under current law, section 1710 
of title 38, U.S.C., VA charges full copayments for care 
delivered through telehealth technologies. Certain VA patients 
may be charged 15 dollars for primary care telehealth visits 
and 50 dollars for specialty care telehealth visits.
    In views submitted for the Committee's June 8 hearing on 
pending legislation, VA agreed that, in the Department's 
experience, copayments may have served as a disincentive for 
veterans to utilize this mode of treatment. VA further 
indicated that it is planning to waive copayments for veterans' 
use of in-home video telehealth.
    Committee Bill. Section 101 of the Committee bill would 
amend subchapter III of chapter 17 of title 38, U.S.C., by 
adding a new section 1722B. The new section would authorize VA 
to waive collections of copayments from veterans for the 
utilization of telehealth or telemedicine.
    The Committee expects that, as indicated by the RAND study 
and VA data, waiving the collection of copayments from veterans 
for telehealth and telemedicine visits would increase 
utilization of telehealth and telemedicine services by veterans 
and would provide cost savings to the Department.

Sec. 102. Teleconsultation, teleretinal imaging, and telemedicine.

    Section 102 of the Committee bill, which is derived from 
S. 1124, would require VA to implement a program of 
teleconsultation for the assessment of mental health and TBI at 
facilities that are unable to provide such assessments without 
utilizing contract or fee-basis care, require VA to implement 
incentives for Department medical centers to further expand use 
of telehealth technologies, assess the efficacy of such 
incentives, and offer telemedicine training for medical 
residents.
    Background. Telehealth is a form of clinical medicine where 
medical information is transferred via telephone, the Internet, 
or other networks for the purpose of monitoring health status, 
providing health education, consulting, and sometimes providing 
remote medical procedures or health examinations. Telehealth 
can take place in various situations--between providers and 
patients located in separate clinical settings, as well as with 
patients in their homes. Telehealth technology at veterans' 
health care facilities allows patients in remote rural areas to 
consult with medical specialists through this technology. This 
option can provide such veterans with access to care without 
having to drive long distances to reach a specialist.
    Tele-mental health services refer to behavioral health 
services that are provided using communication technology. 
These services include clinical assessment, individual and 
group psychotherapy, psycho-educational interventions, 
cognitive testing, and general psychiatry. The term tele-mental 
health describes a method of treatment in which a clinician 
uses various technologies to deliver mental health care to a 
patient who is at a different location. One major benefit of 
tele-mental health is that it eliminates travel that may be 
disruptive to or costly for the veteran. In addition, tele-
mental health is a useful tool in correctional and forensic 
settings where it is difficult to transport the patient to a 
clinician. Tele-mental health also allows mental health care 
providers to consult with or supervise one another.
    According to Dr. Darkins, the benefits of telehealth to VA 
are improved access to specialty care, especially in rural 
areas, reductions in travel for patients and staff, better 
utilization of scarce health care resources, and improved 
coordination of care.
    Additionally, VA data released in December 2010 show that, 
of the Operation Enduring Freedom and Operation Iraqi Freedom 
(hereinafter, ``OEF/OIF'') veterans who have accessed VA health 
care services, 45,606 have been diagnosed with TBI-related 
conditions at VA medical facilities. With approximately 41 
percent of enrolled veterans living in rural or highly rural 
areas, the Department faces a substantial need for increased 
telehealth and telemedicine in order to improve access to care.
    Committee Bill. Section 102 of the Committee bill would 
amend subchapter I of chapter 17 of title 38, U.S.C., by adding 
a new section 1709, which would require VA to provide mental 
health and TBI assessments through teleconsultation when 
necessary. Section 102 of the Committee bill would further 
require VA to implement incentives for Department medical 
centers to further expand use of telehealth technologies, 
assess the efficacy of such incentives, and offer telemedicine 
training for medical residents.
    Subsection (a) of new section 1709 would require VA to 
carry out a teleconsultation program of remote mental health 
and TBI assessments in VA facilities that are unable to provide 
such assessments without utilizing contract or fee-basis care. 
New subsection (a) would also require VA to promulgate 
technical and clinical care standards for teleconsultation 
service in consultation with the appropriate professional 
societies.
    Section 102(b) of the Committee bill would require VA to 
offer opportunities for training in telemedicine to medical 
residents in facilities that have and utilize telemedicine, 
consistent with medical residency program standards established 
by the Accreditation Council for Graduate Medical Education.
    Section 102(c) of the Committee bill would require VA to 
modify the Veterans Equitable Resource Allocation (hereinafter, 
``VERA'') system to include teleconsultation, teleretinal 
imaging, telemedicine, and telehealth coordination services. VA 
would also be required to assess, within one year of modifying 
the VERA system, the effect on the utilization of telehealth 
technologies and determine whether additional incentives are 
necessary to promote their utilization. VA would also be 
required to include telemedicine visits when calculating 
facility workload.

Sec. 103. Payments and allowances for beneficiary travel in connection 
        with veterans receiving care from Vet Centers.

    Section 103 of the Committee bill, which is derived from 
S. 696, would clarify that VA is authorized to offer travel 
benefits to veterans receiving care at Vet Centers. It would 
provide for a one-year authorization of travel benefits to 
veterans receiving care at Vet Centers while VA completes a 
review of the feasibility and advisability of providing this 
benefit.
    Background. Vet Centers provide readjustment counseling and 
other needed services to combat veterans, to certain surviving 
family members of servicemembers who die in the line of duty, 
and to active duty servicemembers. Vet Centers provide these 
services at a cost savings to the Department. According to VA, 
it costs an average of $613 per veteran for treatment at a Vet 
Center, while it costs $4,129 per veteran for care at a VA 
medical center (hereinafter ``VAMC''). According to VA data 
published in April 2011, 300 Vet Centers served 352,272 
veterans from the first quarter of FY 2002 through the first 
quarter of FY 2011.
    According to testimony submitted by the Department for the 
June 8 hearing on pending legislation, VA has begun a study to 
determine the potential efficacy and impacts of providing 
travel benefits to veterans who use Vet Centers.
    Committee Bill. Section 103 of the Committee bill would, in 
a freestanding provision, clarify that the Department is 
authorized to pay travel benefits to veterans receiving care at 
Vet Centers pursuant to existing authority under section 111(a) 
of title 38, U.S.C. It would also require VA to submit a report 
to Congress, no later than one year after the enactment of the 
Committee bill, on the feasibility and advisability of paying 
travel benefits to veterans receiving care at Vet Centers. 
Finally, this section of the Committee bill would authorize 
such sums as may be necessary to be appropriated for the 
Department to pay such expenses and allowances for the one-year 
period following the enactment of the Committee bill.

Sec. 104. Use of service dogs on property of the Department of Veterans 
        Affairs.

    Section 104 of the Committee bill, which is derived from 
S. 769, would require VA to admit service dogs into any 
Department owned or funded facility or property.
    Background. Section 1714(c) of title 38, U.S.C., authorizes 
VA to provide service dogs to veterans who are hearing 
impaired, veterans with spinal cord injury or dysfunction or 
other chronic impairment that substantially limits mobility, 
and veterans with mental illnesses, including post-traumatic 
stress disorder (hereinafter, ``PTSD'').
    On March 10, 2011, with the issuance of Veterans Health 
Administration (hereinafter, ``VHA'') Directive 2011-013, the 
Department authorized both veterans and members of the public 
with disabilities that require the assistance of a trained 
guide dog or trained service dog to enter VHA facilities and 
property accompanied by their trained guide dog or trained 
service dog, consistent with the same terms and conditions, and 
subject to the same regulations that govern the admission of 
members of the public to the property.
    According to the Department's proposed rule, RIN 2900-AN51 
posted June 16, 2011, the Department will recognize dogs 
acquired through organizations that provide service dogs and 
are accredited by Assistance Dogs International or 
International Guide Dog Federation and will only accept dogs 
trained by such accredited organizations for the service dog 
program.
    Committee Bill. Section 104 of the Committee bill would 
amend section 1714 of title 38, U.S.C., by adding a new 
subsection (e), which would require VA to grant full access to 
all service animals accompanying individuals at every VA 
facility according to the same regulations that govern the 
admission of the public to such facilities. The provision would 
apply not only to service dogs as provided for in section 
1714(c) of title 38, U.S.C., but would also include trained 
service animals that accompany individuals with disabilities 
not specified by that subsection. Further, VA would be 
authorized to prohibit service animals from roaming or running 
free and to require the animals to wear harnesses or leashes 
and be under the control of an individual at all times while at 
a Department owned or funded facility.

Sec. 105. Rehabilitative services for veterans with traumatic brain 
        injury.

    Section 105 of the Committee bill, which is derived from 
S. 957, would amend section 1710C of title 38, U.S.C., by 
expanding individualized rehabilitation and reintegration plans 
required by such section to include services designed to 
maintain levels of functioning in care for veterans with TBI.
    Background. TBI has become a common injury of the conflicts 
in Iraq and Afghanistan. Because of advances in medicine, 
servicemembers who would not have been expected to survive 
catastrophic injuries in previous conflicts return home from 
combat in Iraq and Afghanistan with unprecedented severe and 
complex injuries. The Department indicated in December 2010 
that 45,606 OEF/OIF veterans have accessed VA health care 
services and have been diagnosed with TBI-related conditions at 
VA medical facilities as of FY 2010. According to the Defense 
and Veterans Brain Injury Center, between 2000 and the first 
quarter of 2011, 212,742 cases of TBI were diagnosed. Many of 
these servicemembers require rehabilitative programs ranging 
from total care for the most basic needs to semi-independent 
living support.
    In addition to medical care, veterans with TBI may require 
additional services such as life-skills coaching, supported 
employment, and community reintegration therapy. Yet these 
services are not sufficiently made available to veterans. In 
testimony before the Committee on June 8, 2011, Jeff Steele, 
Assistant Director of The American Legion's National 
Legislative Commission, stated that the proposed section would 
``close gaps in both the duration and types of services 
provided to our wounded servicemembers who have sustained what 
are often profoundly debilitating traumatic brain injuries.''
    Committee Bill. Subsection (a) of section 105 of the 
Committee bill would amend section 1710C of title 38, U.S.C., 
by requiring VA to add rehabilitative services to the 
individualized rehabilitation and reintegration plans for care 
for veterans with TBI.
    Subsection (a) would further amend section 1710C of title 
38, U.S.C., by adding a new subsection (h) that would define 
rehabilitative services as including the definition of such 
term as provided for in section 1701 of title 38, U.S.C. 
(``professional, counseling and guidance services and treatment 
programs as are necessary to restore, to the maximum extent 
possible, the physical, mental, and psychological functioning 
of an ill or disabled person''), treatment and services to 
sustain functional gains, or other services that may maximize 
an individual's independence.
    Subsection (b) of section 105 of the Committee bill would 
amend section 1710D(a) of title 38, U.S.C., by requiring VA to 
include rehabilitative services in the comprehensive program 
for long-term rehabilitation of individuals with TBI.
    Subsection (c) of section 105 of the Committee bill would 
amend section 1710E(a) of title 38, U.S.C., by including 
rehabilitative services in the categories of services VA is 
authorized to provide to individuals with TBI through 
cooperative agreements for use of non-Department rehabilitation 
facilities.
    Subsection (d) of section 105 of the Committee bill would 
make a technical amendment to section 1710C(c)(2)(S).

Sec. 106. Centers of excellence for rural health research, education, 
        and clinical activities.

    Section 106 of the Committee bill, which is derived from 
S. 1127, would require VA, acting through the Director of ORH, 
to establish and operate centers of excellence for rural health 
research, education, and clinical activities.
    Background. According to VA data, 3.3 million veterans, who 
represent approximately 41 percent of the total population 
enrolled in VA's health care system, live in rural or highly 
rural areas. Insufficient access to care has been a particular 
problem for those in rural areas. A lack of providers, 
especially specialty care providers, long drive times, and 
other factors combine to present significant obstacles to 
accessing health care for rural veterans. Public Law 109-461, 
the Veterans Benefits, Health Care, and Information Technology 
Act of 2006, established ORH to address these issues.
    As part of the effort to improve care for rural veterans, 
in 2008, VA awarded a grant to the Fargo, North Dakota, VAMC 
and the Center for Rural Health at the University of North 
Dakota School of Medicine and Health Sciences to establish a 
multi-state Rural Health Resource Center. The Rural Health 
Resource Center is intended to help advance policies and 
strategies to improve access to care in rural areas.
    Committee Bill. Subsection (a) of section 106 of the 
Committee bill would amend subchapter II of chapter 73 of title 
38, U.S.C., to create a new section 7330B. Subsection (a) of 
this new section would require VA, acting through the Director 
of ORH, to create centers of excellence for rural health, 
education, and clinical activities. Subsection (b) of new 
section 7330B would require these centers to perform one or 
more of the following functions: collaborate with the VHA 
Office of Research and Development (hereinafter, ``ORD'') on 
rural health research; develop specific models for the 
Department to furnish care to rural veterans; develop 
innovative clinical activities and systems of care for rural 
veterans; and provide education and training on rural health 
issues for health care professionals. Subsection (c) of new 
section 7330B would authorize VA to designate an existing ORH 
rural health resource center as a center of excellence if it 
engages in one or more of the activities described in new 
subsection (b). Subsection (d) of new section 7330B would 
require that centers of excellence be eligible to compete for 
the awarding of funds from the Medical and Prosthetic Research 
Account.
    Subsection (b) of section 106 of the Committee bill would 
amend section 7308 of title 38, U.S.C., by adding a new 
subsection (d) to codify the existence and describe the 
purposes of rural health resource centers. Rural health 
resource centers would be required to improve the ORH's 
understanding of challenges faced by rural veterans, identify 
disparities in the availability of health care to rural 
veterans, create programs to enhance the delivery of health 
care to rural veterans, and develop best practices and products 
for the Department to use in providing services to rural 
veterans.
    Subsection (c) of section 106 of the Committee bill would 
designate the VAMC in Fargo, North Dakota, as a center of 
excellence for rural health research, education, and clinical 
activities.

Sec. 107. Provision of chiropractic services to veterans enrolled in 
        health care system of Department of Veterans Affairs.

    Section 107 of the Committee bill, which is derived from 
S. 1147, would require VA to develop and implement a 
comprehensive policy on the provision of chiropractic services.
    Background. Pursuant to Public Law 107-135, the Department 
of Veterans Affairs Health Care Programs Enhancement Act of 
2001, VA carries out a program to provide chiropractic services 
to veterans through VAMCs and CBOCs. VA is required to 
designate at least one site in each Veterans Integrated Service 
Network (hereinafter, ``VISN'') to offer chiropractic services. 
As of June 2011, 36 VAMCs and CBOCs provide chiropractic 
services.
    According to data published by the Department in April 
2011, more than 54 percent of OEF/OIF veterans who sought 
health care from the Department over the period of the first 
quarter of FY 2002 through the first quarter of FY 2011 were 
treated for musculoskeletal ailments. Chiropractic therapy can 
assist with some of these types of ailments and injuries.
    Committee Bill. Section 107 of the Committee bill would, in 
a freestanding provision, require VA to develop and implement a 
comprehensive policy on the provision of chiropractic services 
by June 1, 2012.
    Subsection (a) of section 107 of the Committee bill would 
require the scope of this policy to include: Department-wide 
protocols governing referrals and direct access to chiropractic 
services and governing the scope of practice of chiropractic 
providers; the definition of chiropractic services to be 
provided; the assurance of prompt and appropriate chiropractic 
services by VA when medically appropriate; Department programs 
of education and training of health care personnel on the 
benefits of chiropractic services; and Department programs of 
patient education for veterans suffering from back pain and 
related disorders. VA would also be required, in consultation 
with veterans service organizations (hereinafter, ``VSOs'') and 
other relevant organizations with expertise in chiropractic 
services, to develop and periodically revise such policy, in 
accordance with experience and evolving best practice 
guidelines.
    Subsection (b) of section 107 of the Committee bill would 
require VA to carry out the policy on chiropractic services at 
no less than two locations in each VISN and in locations deemed 
appropriate with respect to demand for chiropractic services.
    Subsection (c) of section 107 of the Committee bill would 
require VA to submit a report on the implementation of the 
chiropractic services policy not later than 180 days after the 
completion and initial implementation of such policy, and on 
October 1 of every fiscal year thereafter until FY 2020, to the 
Committees on Veterans' Affairs of the Senate and the House of 
Representatives. The report would be required to include a 
description of the policy, the performance measures used to 
determine the effectiveness of such policy, an assessment of 
the adequacy of VA chiropractic services based on patient 
surveys, an assessment of the training provided to VA health 
care personnel with respect to chiropractic services and 
appropriateness of referrals of patients for such services, an 
assessment of patient pain care education programs, and the 
number of episodes of chiropractic services provided, including 
through referrals to non-VA providers in the preceding fiscal 
year by facility.

Sec. 108. Reimbursement rate for ambulance services.

    Section 108 of the Committee bill, which is derived from 
by-request legislation submitted by the Department, would 
authorize VA to pay the lesser of the actual amount charged by 
an ambulance provider or the applicable amount in the Medicare 
fee schedule for ambulance services, unless VA has entered into 
a contract for such transportation with the provider.
    Background. Under current law, section 111 of title 38, 
U.S.C., VA is authorized to reimburse certain veterans for 
their transportation by ambulance to and from VA medical 
facilities based on the ``actual necessary expense.'' As a 
result, the Department pays significantly more than Medicare 
does for ambulance services.
    Committee Bill. Section 108 of the Committee bill would 
amend section 111(b)(3) of title 38, U.S.C., by adding a new 
subparagraph (C), which would authorize the Department to pay 
the lesser of the actual amount charged by the ambulance 
provider or the applicable amount in the Medicare fee schedule 
for ambulance services, unless VA has entered into a contract 
for such transportation with the provider. It is the 
Committee's expectation that the Department would realize cost 
savings by utilizing the authority of this provision.

Sec. 109. Increased flexibility in establishing payment rates for 
        nursing home care provided by State homes.

    Section 109 of the Committee bill, which is derived from 
by-request legislation submitted by the Department, would 
modify the payment methodology for State veterans homes by 
requiring the Department to enter into contracts or agreements 
with State veterans homes for payment for nursing home care of 
veterans.
    Background. Public Law 109-461, the Veterans Benefits, 
Health Care, and Information Technology Act of 2006, provided 
for new payment mechanisms between VA and State veterans homes. 
When fully implemented with Department regulations in 2009, the 
legislation had the consequence of causing significantly lower 
total amounts to be paid to many State veterans homes providing 
skilled nursing care to veterans with service-connected 
disabilities. State veterans homes are currently being paid 
less than what Medicare previously paid and less than the 
Department payment rate for providing the same care directly to 
the same veterans. As a result, many State veterans homes are 
not sufficiently compensated for their total cost of skilled 
nursing care for veterans with service-connected disabilities.
    The National Association of State Veterans Homes 
(hereinafter, ``NASVH''), whose members operate 142 State 
veterans homes with over 29,000 beds in all 50 states and 
Puerto Rico, submitted a statement to the Committee on June 22, 
2011. The NASVH statement asserts that, without the proposed 
section, current law will hinder the long-term care of veterans 
with service-connected disabilities, as well as endanger the 
financial welfare of many State veterans homes. Further, NASVH 
data show that State veterans homes provide long-term care for 
more than 50 percent of VA's long-term care patients at a cost 
that is equal to approximately 12 percent of VA's long-term 
care budget. This is due to the fact that the cost of providing 
long-term care for a veteran at a State veterans home is, on 
average, less than half of the cost of providing care at a VA 
long-term care facility.
    In an explanatory analysis submitted by the Department to 
accompany its submission for its by-request legislation, VA 
states that it believes moving to a contract- or provider 
agreement-based model will afford the most flexibility and 
fairness in negotiations between VA and State veterans homes 
and will ensure that State veterans homes are paid adequately 
and according to the complexity and severity of each veteran's 
condition. This approach would replace the current per diem 
grant payments for these veterans, which, according to VA, have 
been controversial since first implemented in 2009.
    Committee Bill. Section 109 of the Committee bill would 
amend section 1745(a) of title 38, U.S.C., by requiring VA to 
enter into contracts or provider agreements with State veterans 
homes for the purpose of providing nursing home care in these 
homes to veterans. Payment under the contract or provider 
agreement would be required to be based on a methodology 
developed in consultation with the State veterans home and to 
adequately reimburse the home for the care provided. This 
section would become effective on January 1, 2012.

Sec. 110. Access to State prescription monitoring programs.

    Section 110 of the Committee bill, which is derived from 
S. 1060 and a similar provision that was submitted by the 
Department as a component of by-request legislation, would 
authorize VA, to the extent necessary to prevent misuse and 
diversion of prescription medicines, to disclose information 
about a veteran or the dependent of a veteran to a State 
controlled substance monitoring program.
    Background. Programs that permit sharing of prescription 
drug information with State prescription monitoring programs 
have been used to reduce abuse, misuse, or illegal diversion of 
controlled substances by patients seeing multiple providers or 
using multiple pharmacies. While there is no standardized 
structure in prescription monitoring programs, in general, such 
programs include an electronic database, operated by a State 
government entity, which allows medical providers, law 
enforcement personnel, pharmacists, and other individuals who 
require access to such information for official purposes to 
access the database and contribute information to it.
    According to the White House Office of National Drug 
Control Policy (hereinafter, ``ONDCP''), one of the major ways 
to reduce prescription drug abuse is through monitoring. ONDCP 
is working to implement prescription drug monitoring programs 
in every State and enhance such programs to ensure they can 
share data between States and that they are used by health care 
providers. Prescription monitoring programs have been 
authorized by legislation in 48 States, with 34 of these States 
maintaining operational programs.
    Committee Bill. Subsection (a) of section 110 of the 
Committee bill would amend section 5701 of title 38, U.S.C., by 
adding a new subsection (l) that would authorize VA, to the 
extent necessary to prevent misuse and diversion of 
prescription medicines, to disclose information from certain 
claims records about a veteran or a dependent of a veteran to a 
State controlled substance monitoring program.
    Subsection (b) of section 110 of the Committee bill would 
amend section 7332(b)(2) of title 38, U.S.C., by adding a new 
subparagraph (G), to authorize VA to share prescription drug 
data on controlled substances with State prescription 
monitoring programs. This subsection would authorize the 
Department, to the extent necessary to prevent misuse and 
diversion of prescription medicines, to disclose information 
from certain medical records about a veteran or a dependent of 
a veteran to a State controlled substance monitoring program.

Sec. 111. Improvements for recovery and collection of amounts for 
        Department of Veterans Affairs Medical Care Collections Fund.

    Section 111 of the Committee bill, which is an original 
provision, would require VA to develop and implement a better 
process and system of controls to ensure accurate and full 
collections by the VA health care system, pursuant to existing 
authorities for billing and collections.
    Background. VHA utilizes fee-basis care to augment 
availability of health care for services they are unable, or it 
would be inefficient, to provide using Department facilities 
and providers.
    According to a VA Office of Inspector General (hereinafter, 
``OIG'') report entitled, ``Veterans Health Administration 
Audit of Medical Care Collection Fund Billings for Non-VA 
Care'' published May 25, 2011, VHA failed to bill third-party 
insurers for 46 percent of billable fee care claims. OIG 
identified a lack of an effective procedure for identifying 
billable care as the prime reason for this shortcoming.
    In two of the VA medical facilities OIG reviewed, staff did 
not regularly review claims to identify billable fee care and, 
consequently, these locations did not identify 140, or 93 
percent, of the 150 billable fee claims OIG reviewed.
    VA is currently transitioning all medical center billing to 
regional centers known as Consolidated Patient Account Centers 
(hereinafter, ``CPACs''). According to OIG's review, CPACs were 
no more successful in identifying billable fee claims than were 
medical facilities that have not yet begun to utilize a CPAC.
    By creating effective processes and tools for identifying 
billable fee claims, OIG estimates that VHA could increase 
collections by approximately $110.4 million each year, or $552 
million over the next five years.
    Committee Bill. Subsection (a) of section 111 of the 
Committee bill would, in a freestanding provision, require VA 
to develop and implement, within 180 days of enactment of the 
Committee bill, a plan to ensure the identification and 
collection of billable third-party revenue to be deposited in 
the MCCF. This provision would require the following elements 
to be included in the plan: an effective process to identify 
billable fee claims, effective and practicable policies and 
procedures to ensure billing and collection using current 
authorities, training of employees responsible for billing or 
collection of funds to enable them to comply with the 
provisions of this section, fee revenue goals for the 
Department, and an effective monitoring system to ensure the 
Department meets fee revenue goals and complies with such 
policies and procedures.
    Subsection (b) of section 111 of the Committee bill would 
require VA to monitor the billing and collection of funds from 
third parties for deposit into the MCCF.

                  TITLE II--HOMELESS VETERANS MATTERS

Sec. 201. Enhancement of comprehensive service programs.

    Section 201 of the Committee bill, which is derived from 
S. 1148, would enhance VA's homeless veterans' comprehensive 
service programs by broadening the pool of potential applicants 
and making other changes designed to improve the overall 
program.
    Background. Public Law 102-590, the Homeless Veterans 
Comprehensive Service Programs Act of 1992, established VA's 
Homeless Providers Grant and Per Diem Program (hereinafter, 
``GPD''). The grant program was intended to assist public and 
nonprofit private entities with the costs associated with 
establishing new programs and service centers to furnish 
supportive services and housing for homeless veterans through 
grants that may be used to acquire, renovate, or alter 
facilities. The grant program also allows funds to be used to 
procure vans to conduct outreach to, or provide transportation 
for, homeless veterans. The per diem program was intended to 
provide per diem payments, or in-kind assistance in lieu of per 
diem payments, to assist eligible entities that established 
programs after November 10, 1992, with the daily costs 
associated with providing supportive services and housing for 
homeless veterans.
    Section 2011 of title 38, U.S.C., sets forth the authority, 
criteria, and requirements for VA's grant program. The law 
requires VA to establish criteria and requirements for grants 
awarded under this section. Eligible entities for these grants 
are restricted to public or nonprofit private entities with the 
capacity to administer the grant effectively. An eligible 
entity must demonstrate that adequate financial support will be 
available to carry out the project for which the grant is 
sought consistent with the plans, specifications, and schedule 
submitted by the applicant. An eligible entity must also agree 
to meet, as well as have the capacity to meet, the applicable 
criteria and requirements established by VA. Currently, the 
specifications as to the kinds of projects for which the grants 
are available do not include new construction of facilities. In 
addition, the grants may not be used to support operational 
costs and the amount of the grant may not exceed 65 percent of 
the estimated cost of the project concerned.
    Section 2012 of title 38, U.S.C., sets forth the authority, 
criteria, and requirements for VA's per diem program. The law 
requires VA to provide to recipients of grants under section 
2011 of title 38 per diem payments for services furnished to 
any homeless veteran whom VA has referred to the grant 
recipient or for whom VA has authorized the provision of 
services. The per diem rate is defined as the estimated daily 
cost of care, not in excess of the per diem rate for VA's State 
Home Per Diem Program.
    While GPD has proven to be a vital part of VA's services 
for homeless veterans, funding challenges remain. VA's Advisory 
Committee on Homeless Veterans (hereinafter, ``ACHV''), which 
provides advice and makes recommendations to the Department on 
the provision of benefits and services to homeless veterans, 
stated in its 2010 Annual Report that ``the current system 
underfunds many providers, particularly those in high cost 
areas and those that offer intensive services to veterans with 
complex issues.''
    Challenges have also been identified regarding GPD's 
payment process and reporting requirements. The National 
Coalition for Homeless Veterans (hereinafter, ``NCHV'') 
recommended that ``[a] revised payment process would greatly 
benefit GPD grantees, the majority of which are modest 
community-based organizations.'' According to the NCHV, 
grantees should be paid for the annual cost of providing 
services as opposed to a per diem rate. The NCHV argues that 
grantees should be allowed to draw from these funds in 
anticipation of contractual activities. Currently, grantees 
must pay for services they provide up front and are later 
reimbursed.
    Committee Bill. Section 201 of the Committee bill would 
amend subchapter II of chapter 20 of title 38, U.S.C., to make 
a number of improvements. It would amend section 2011(b)(1)(A), 
the provision that sets forth the criteria for grants, to 
include new construction of facilities as a type of program for 
which such grants could be awarded. It would amend section 
2011(c), the provision that sets forth funding limitations on 
grantees, so as to specify that VA may not deny an application 
from an entity under this program solely on the basis that the 
entity proposes to use other funding sources, as long as such 
entity has a private nonprofit organization providing oversight 
and site control over the project. In connection with this 
change, the Committee bill would add a definition of a 
``private nonprofit organization.'' It is the Committee's 
expectation that these changes will modernize GPD to allow for 
the utilization of innovative project funding strategies, 
including the use of low-income housing tax credits and 
matching funds from other government sources to facilitate and 
hasten project development.
    With respect to the issue of the per diem payments, section 
201(b) of the Committee bill, in a freestanding provision, 
would require VA to study the method of compensating GPD 
community providers for their program expenses, including the 
adequacy of the reimbursement system, the adequacy of 
compensation in various geographic areas and for services of 
varying intensity levels, and the process by which grant 
recipients account for funds.
    The Committee bill would require VA to report to Congress, 
within 1 year of this bill's enactment, its findings with 
respect to the study undertaken and the procedures it has 
devised for more effective and efficient procedures for fiscal 
control and fund accounting by recipients of grants under 
sections 2011, 2012, and 2061 of title 38. VA would also be 
required to report to Congress on a more effective and 
efficient method for adequately reimbursing recipients of 
grants under section 2011 of title 38. Finally, the report 
would include any recommendations by VA for revising the method 
used to compensate recipients of per diem grants under section 
2012(a).
    This section of the Committee bill would ensure that VA 
will evaluate the effectiveness of its methods of payment and 
reimbursement and examine to whom reimbursements are made. Such 
a review is consistent with the Committee's belief that the 
long-term success of GPD requires flexibility and improvement 
to the program.
    The Committee bill would amend section 2013 of title 38, 
U.S.C., by authorizing the following appropriations: (1) 
$150,000,000 for each of FYs 2007 through 2009; (2) 
$175,100,000 for FY 2010; (3) $217,700,000 for FY 2011; (4) 
$250,000,000 for FY 2012; and (5) $150,000,000 for FY 2013 and 
each fiscal year thereafter.
    The Committee has heard from providers who have the 
capacity to allow veterans to transition in place and believe 
that VA could achieve better results for more homeless veterans 
by increasing flexibility to fund this model. These providers 
are of the opinion that allowing veterans to transition in 
place by offering temporary rental assistance with case 
management may be less disruptive for some homeless veterans, 
allowing them to live in regular rental housing in the 
community while transitioning into self-sufficiency with the 
help of case management, employment programs, and other 
services. It is the Committee's intent to increase flexibility 
in VA's existing funding model to allow for more efficient 
delivery of transitional housing services to homeless veterans.

Sec. 202. Modification of grant program for homeless veterans with 
        special needs.

    Section 202 of the Committee bill, which is derived from 
S. 1148, would modify the grant program for homeless veterans 
with special needs.
    Background. Under section 2061 of title 38, U.S.C., VA 
operates a program of grants to encourage development of 
programs for homeless veterans with special needs. Section 
2061(a) provides that these special needs grants may only be 
awarded to VA health care facilities and to providers receiving 
grant and per diem payments under VA's GPD Program. Section 
2061(b) defines homeless veterans with special needs as: (1) 
women, including women who have care of minor dependents; (2) 
frail elderly; (3) terminally ill; or (4) chronically mentally 
ill.
    The Committee has heard from organizations, such as the 
Vietnam Veterans of America, who are of the opinion that it is 
important to ensure that the program be expanded to include men 
who have care of minor dependents.
    Committee Bill. Subsection (a) of section 202 of the 
Committee bill would amend section 2061(a) of title 38, U.S.C., 
to expand the pool of eligible providers who may receive VA 
grants for programs to assist homeless veterans with special 
needs to those entities eligible to receive grant and per diem 
payments, but who may not be doing so. Thus, these grants would 
no longer be limited to existing VA health care facilities and 
current grant and per diem providers, but will allow those 
eligible for but not in receipt of grant and per diem payments 
to apply to the grant program for homeless veterans with 
special needs.
    Subsection (b) of section 202 of the Committee bill would 
amend section 2061(b) of title 38 to expand the definition of 
homeless veterans with special needs to include veterans who 
have care of minor dependents, regardless of gender.
    Subsection (c) of section 202 of the Committee bill would 
amend section 2061 of title 38 to allow grantees to provide 
services directly to any dependent who is under the care of a 
homeless veteran with special needs while the veteran receives 
services from the grant recipient.

Sec. 203. Modification of authority for provision of treatment and 
        rehabilitation to certain veterans to include provision of 
        treatment and rehabilitation to homeless veterans who are not 
        seriously mentally ill.

    Section 203 of the Committee bill, which is derived from 
S. 1148, would expand VA's authority to provide treatment and 
rehabilitation services to certain veterans who are homeless 
but not seriously mentally ill.
    Background. Section 2031 of title 38, U.S.C., authorizes VA 
to provide outreach services, care, treatment, rehabilitative 
services, and certain other assistance to veterans suffering 
from serious mental illness, including such veterans who are 
also homeless. A significant number of veterans are homeless 
for reasons other than mental illness. In February 2011, the 
Department of Housing and Urban Development (hereinafter, 
``HUD'') and VA jointly released a report entitled, ``Veterans 
Homelessness: A Supplemental Report to the 2009 Annual Homeless 
Assessment Report to Congress,'' which cites several risk 
factors that can lead to homelessness among veterans, including 
but not limited to, age, race, psychiatric illness, economic 
status prior to entry in the military, combat exposure, wartime 
trauma, social isolation, pre-military traumas, unemployment, 
and poor health.
    Committee Bill. Section 203 of the Committee bill would 
amend section 2031(a) of title 38 to expand VA's authority to 
provide outreach services, care, treatment, rehabilitative 
services, and certain other assistance to veterans suffering 
from serious mental illness and to veterans who are homeless. 
This section would allow VA to treat a homeless veteran under 
section 2031 even if that veteran does not suffer from a 
serious mental illness. The Committee believes that removing 
this unnecessary limitation will allow VA to better serve 
homeless veterans.

Sec. 204. Plan to end veteran homelessness.

    Section 204, which is derived from S. 1148, would require 
VA to submit to Congress a comprehensive plan to end 
homelessness among veterans.
    Background. Against a backdrop of an estimated 136,000 
veterans who experienced homelessness in FY 2009, VA developed 
a ``Five Year Plan to End Homelessness Among Veterans'' 
(hereinafter, ``5-Year Plan''). The six strategic pillars of 
the plan are: (1) outreach and education; (2) treatment; (3) 
prevention; (4) housing and supportive services; (5) income, 
employment, and benefits; and (6) community partnerships. While 
the plan lacked specific annual goals, timelines, and 
benchmarks, VA noted that performance metrics will include the 
number of veterans identified as homeless or at risk of being 
homeless and the number of these veterans who transition into 
stable housing situations, based on VA's assistance.
    As a part of VA's plan to end homelessness, each medical 
center has been charged with working with the community to 
create a 5-year plan to end veteran homelessness. The 2010 
Annual Report of the ACHV noted that ``there has been much made 
of local efforts however without a stronger national plan the 
effort may be unsustainable.''
    In 2010, VA participated in the Federal Strategic Plan to 
Prevent and End Homelessness. The plan is a roadmap for joint 
action by the 19-member United States Interagency Council on 
Homelessness, of which the Department is a member. It focuses 
on four key goals: (1) finish the job of ending chronic 
homelessness in 5 years; (2) prevent and end homelessness among 
veterans in 5 years; (3) prevent and end homelessness for 
families, youth, and children in 10 years; and (4) set a path 
to ending all types of homelessness. Like the VA plan, this 
plan lacks specific annual goals, timelines, and benchmarks, 
but states that they will measure progress based on annual 
changes in the number of veterans experiencing homelessness.
    Committee Bill. Section 204 would, in a freestanding 
provision, build upon the existing 5-Year Plan and the Federal 
Strategic Plan to Prevent and End Homelessness by requiring VA 
to submit to Congress a comprehensive plan to end homelessness 
among veterans. The Committee believes that, in order to 
sustain efforts to end homelessness among veterans we must have 
strong leadership at the Federal level to guide strong 
collaborations at the local level.
    The plan required under this section would include an 
analysis of VA and Federal government programs designed to 
prevent homelessness among veterans and assist veterans who are 
homeless. The plan would also include an evaluation of whether 
and how coordination between VA and other Federal government 
departments and agencies would contribute to ending 
homelessness among veterans. The plan would include 
recommendations for improving VA and Federal government 
homelessness programs, enhancing coordination of such programs, 
and eliminating programs that are no longer effective. 
Recommendations for new programs to prevent and end 
homelessness among veterans, including the cost of such 
programs, would also be included. A timeline for implementing 
the plan, including milestones to track implementation and 
benchmarks to measure outcomes and effectiveness, would be 
required. Finally, the report would include consideration of 
the circumstances and requirements that are unique to veterans 
located in rural areas.
    While VA has made important and meaningful progress through 
its 5-Year Plan and through its participation in the Federal 
Strategic Plan to Prevent and End Homelessness, the Committee 
believes that a comprehensive plan is necessary for several 
reasons. It would ensure that VA performs a comprehensive 
analysis of the existing Federal government plans, programs and 
services designed to end veteran homelessness in order to avoid 
duplication of programs or services. VA would also be required 
to set forth measurable goals and benchmarks for its 
comprehensive plan and a timeline for implementation. It would 
also help ensure that VA programs and services for homeless 
veterans are implemented consistently nationwide. Finally, it 
would allow Congress to ensure that adequate resources can be 
provided in order to achieve this mutual goal.

Sec. 205. Extension of certain authorities relating to homeless 
        veterans.

    Section 205, which is derived from S. 1148, would extend 
VA's authority for certain outreach, treatment, services, and 
programs to veterans with serious mental illnesses and to 
homeless veterans and their families.
    Background. While there is no exact measure of the number 
of homeless veterans, according to data from ``Veteran 
Homelessness: A Supplemental Report to the 2009 Annual Homeless 
Assessment Report to Congress,'' more than 136,000 people who 
spent at least one night in an emergency shelter or 
transitional housing program self-identified as a veteran in FY 
2009. Numerous others are considered at risk of becoming 
homeless due to poverty, a lack of support from family and 
friends, and precarious living conditions in overcrowded or 
substandard housing. Congress has authorized several 
initiatives in an effort to provide VA with the tools it needs 
to address veteran homelessness.
    Section 2031 of title 38, U.S.C., authorizes VA to provide 
outreach services, care, treatment, rehabilitative services, 
and certain other assistance to veterans suffering from serious 
mental illness. The two main health care programs administered 
by VA pursuant to this section are the Health Care for Homeless 
Veterans (hereinafter, ``HCHV'') program and the Domiciliary 
Care for Homeless Veterans program. The authority under this 
section is set to expire on December 31, 2011.
    Section 2033 of title 38, U.S.C., directs VA, subject to 
the availability of appropriations, to operate a program to 
expand and improve its provision of benefits and services to 
homeless veterans. VA administers this program through its 
Community Resource and Referral Center (hereinafter, ``CRRC'') 
program. The authority for this program is scheduled to expire 
on December 31, 2011.
    Section 2041 of title 38, U.S.C., authorizes VA to enter 
into agreements with a nonprofit or government organization in 
order to assist homeless veterans and their families in 
acquiring shelter. Under this section, VA can provide 
assistance to community-based and governmental service-
providers through the sale, lease, or donation of property 
acquired through default on a direct loan or loan guaranty. No 
agreements may be entered into after December 31, 2011.
    Finally, section 2066 of title 38, U.S.C., establishes 
within VA the ACHV. Membership is comprised of a range of 
stakeholders, including formerly homeless veterans, VSOs, State 
veterans affairs officials and experts on mental health and 
substance abuse. Under current law, the Committee shall cease 
to exist on December 30, 2011.
    The authorities described in this section have been 
extended several times, most recently in 2006, pursuant to 
Public Law 109-461, the Veterans Benefits, Health Care, and 
Information Technology Act of 2006.
    Committee Bill. Section 205 of the Committee bill would 
extend the authorities of many of VA's programs to address 
veteran homelessness.
    Section 205(a) would amend section 2031(b) of title 38 to 
extend the HCHV program and the Domiciliary Care for Homeless 
Veterans program through December 31, 2012.
    Section 205(b) of the Committee bill would amend section 
2033(d) of title 38 to extend the CRRC program through December 
31, 2014.
    Section 205(c) of the Committee bill would amend section 
2041(c) of title 38 to extend VA's authority to sell, lease, or 
donate property to house homeless veterans through December 31, 
2014.
    Section 205(d) of the Committee bill would amend section 
2066(d) of title 38 to extend the ACHV through December 31, 
2013.

Sec. 206. Reauthorization of appropriations for homeless veterans 
        reintegration program.

    Section 206 of the Committee bill, which is derived from 
S. 1148, would authorize for FY 2012 up to $50,000,000 to be 
appropriated for HVRP.
    Background. Section 2021 of title 38, U.S.C., authorizes 
the DOL to carry out HVRP, subject to the availability of 
appropriations. HVRP is a competitive grant program that awards 
funding to eligible applicants to provide employment assistance 
and case management to homeless veterans while linking them to 
supportive services available in the community.
    The program provides job placement, training, job 
development, career counseling, and resume preparation services 
they need in order to re-enter the labor force. Supportive 
services such as clothing, transportation assistance, and 
referral to housing, medical and substance abuse treatment 
resources are also provided to meet the needs of homeless 
veterans.
    Since its inception, HVRP has featured an outreach 
component using veterans who have experienced homelessness. In 
recent years, this successful technique was modified to allow 
the programs to utilize formerly homeless veterans in various 
other positions where there is direct client contact such as 
counseling, peer coaching, intake, and follow-up services. 
Section 2021 of title 38 authorizes up to $50,000,000 to be 
appropriated for each fiscal year, beginning in FY 2002 through 
FY 2011.
    Committee Bill. Section 206 of the Committee bill would 
amend section 2021(e)(1) of title 38, U.S.C., by authorizing up 
to $50,000,000 to be appropriated for HVRP in FY 2012.
    Reauthorization of appropriations for HVRP is necessary to 
substantively and materially reduce veteran homelessness and 
unemployment. The Committee believes that HVRP is an important 
component of the continuum of services available to homeless 
veterans, providing the means by which a veteran can 
successfully transition from homelessness to self-reliance.

Sec. 207. Reauthorization of appropriations for financial assistance 
        for supportive services for very low-income veteran families in 
        permanent housing.

    Section 207 of the Committee bill, which is derived from 
S. 1148, would authorize up to $100,000,000 to be appropriated 
for financial assistance and supportive services for very low-
income veteran families in permanent housing in FY 2012. The 
section would also authorize up to $1,000,000 to be 
appropriated to provide technical assistance regarding the 
planning, development, and provision of supportive services in 
the same fiscal year.
    Background. Public Law 110-387, the Veterans' Mental Health 
and Other Care Improvements Act of 2008, authorized the 
Department to develop the Supportive Services for Veteran 
Families Program (hereinafter, ``SSVF''). Under SSVF, VA is 
authorized to award grants to private nonprofit organizations 
and consumer cooperatives that provide supportive services to 
very low-income veteran families residing in or transitioning 
to permanent housing. Grantees provide a range of supportive 
services designed to promote housing stability to eligible very 
low-income veteran families. Such services include outreach 
services, case-management services, assistance obtaining 
benefits from VA and from other public agencies, health care 
services, daily living services, and other similar services.
    To receive supportive services under SSVF, a qualifying 
veteran family is defined as a single person or a family in 
which the head of household or the spouse of the head of 
household is a veteran. The veteran family's household income 
cannot exceed 50 percent of area median income, as adjusted, 
and the veteran family must be residing in permanent housing; 
must be homeless and scheduled to re-enter a stable housing 
situation within 90 days; or must have exited permanent housing 
within the previous 90 days.
    Section 2044 of title 38 authorizes $15,000,000 to be 
appropriated for FY 2009 for financial assistance and support 
services through SSVF, $20,000,000 in FY 2010, and $25,000,000 
in FY 2011. Also, $1,000,000 is authorized for each of FY 2009 
through 2011 for technical assistance. Delays attributed to the 
federal regulatory process resulted in the reprogramming of 
funding for FY 2009 and 2010. As a result, VA provided SSVF 
with $60,000,000 of funding for FY 2011. According to VA, 400 
grants were received for the most recent notice of funds 
availability in 2011. The 385 grants that met the thresholds of 
the program requested over $238,000,000 in funding.
    Committee Bill. Section 207 of the Committee bill would 
amend section 2044(e) of title 38 by authorizing up to 
$100,000,000 to be appropriated for FY 2012 for financial 
assistance and support services through SSVF. Section 207 would 
also amend section 2044(e) by authorizing for FY 2012 
$1,000,000 to be appropriated for technical assistance. 
Finally, section 207 would make a technical amendment to 
section 2044(e).

Sec. 208. Reauthorization of appropriations for grant program for 
        homeless veterans with special needs.

    Section 208, which is derived from S. 1148, would authorize 
appropriations for the grant program for homeless veterans with 
special needs through FY 2013.
    Background. Originally authorized pursuant to section 5 of 
Public Law 107-95, the Homeless Veterans Comprehensive 
Assistance Act of 2001, section 2061 of title 38, U.S.C., 
directs VA to carry out a program to make grants to health care 
facilities of VA and to grant and per diem providers in order 
to encourage development by those facilities and providers of 
programs for homeless veterans with special needs. The section 
defines veterans with special needs as those veterans who are 
(1) women, including women who have care of minor dependents; 
(2) frail elderly; (3) terminally ill; or (4) chronically 
mentally ill. The grant program is designed to help provide 
more intensive services to homeless veterans who require 
services above and beyond those provided by the grant and per 
diem program authorized under section 2011 of title 38. For 
each fiscal year, beginning in FY 2007 through FY 2011, 
$5,000,000 is authorized to be appropriated for the purposes of 
the program under section 2061.
    Committee Bill. Section 208 of the Committee bill would 
amend section 2061(d)(1) of title 38, as redesignated by 
section 202 of the Committee bill, to authorize appropriations 
for this grant program through FY 2013 at $5,000,000 per fiscal 
year.

Sec. 209. Collaboration in provision of case management services to 
        homeless veterans in supported housing program.

    Section 209 of the Committee bill, which is derived from 
S. 411, would require VA to consider entering into contracts to 
provide case management services to eligible homeless veterans 
who participate in the Housing and Urban Development Veterans 
Affairs Supportive Housing (hereinafter, ``HUD-VASH'') program.
    Background. HUD-VASH is a cooperative partnership between 
HUD and VA that provides long-term case management, supportive 
services, and permanent housing support for eligible homeless 
veterans. The HUD-VASH program began in 1992 under a memorandum 
of agreement between the two departments. Congress codified the 
program in section 12 of Public Law 107-95, the Homeless 
Veterans Comprehensive Assistance Act of 2001, by adding a new 
paragraph (19) to section 8(o) of the United States Housing Act 
of 1937 (42 U.S.C. 1437f(o)). Public Law 107-95 also authorized 
HUD to allocate 500 additional HUD-VASH vouchers in each of FY 
2003 through 2006. Public Law 109-461, the Veterans Benefits, 
Health Care, and Information Technology Act of 2006, authorized 
HUD to allocate 500 HUD-VASH vouchers in FY 2007 and to 
increase the amount in increments of 500 per fiscal year up to 
2,500 in FY 2011.
    The program is explicitly designed to provide permanent 
supportive housing to the most vulnerable homeless veterans by 
setting aside rental vouchers and providing intensive services. 
To be eligible, a veteran must be homeless, must be eligible 
for VA health care, and must need and participate in case 
management services in order to obtain and sustain permanent 
independent community housing. Eligible homeless veterans 
receive VA-provided case management and supportive services to 
promote stability and recovery from physical and mental health, 
substance use, and functional concerns contributing to, or 
resulting from, homelessness. The program goals include 
promoting maximal veteran recovery and independence in order to 
enable the veteran and his or her family to sustain permanent 
housing in the community. The case manager and the veteran set 
goals related to housing, income, employment and treatment with 
the ultimate goal of having the veteran fully reintegrate back 
into the community. To achieve this goal, the case manager 
works on employment and educational goals with the veteran so 
that the veteran can be more self-sufficient. There is also an 
annual review by the Public Housing Authority (hereinafter, 
``PHA'') that evaluates income eligibility and, when the 
veteran exceeds income eligibility, both VA and local PHAs 
assist the veteran with transitioning to alternative and more 
independent living arrangements.
    Congress appropriated funding in fiscal years 2008, 2009, 
and 2010 for a total of 30,000 new ``Housing Choice'' (section 
8) vouchers for the HUD-VASH program. Congress also 
appropriated funding in FY 2011 for another 7,960 new vouchers 
to participating PHAs to assist with rent payment. According to 
an analysis of data by the National Alliance to End 
Homelessness, approximately 63,000 veterans can be classified 
as chronically homeless. Given the limited number of vouchers, 
VA must continue efforts to target the most vulnerable veterans 
for participation in the program, as quickly as possible. While 
these efforts have been successful in many areas, there are 
still areas where the Department has trouble recruiting the 
appropriate number of case managers, where the Department has 
trouble identifying the appropriate veteran participants, where 
it takes substantially more time to house eligible veterans, or 
where there is an extreme lack of affordable housing options.
    In some areas, VA is beginning to utilize contract 
providers for case management. The Washington, DC, VAMC 
partnered with the District of Columbia Department of Human 
Services to run the VASH Plus program. Best practices 
identified through the program were the use of a vulnerability 
index to help identify and prioritize chronically homeless 
clients based on the risk of morbidity; the use of information 
technology solutions to streamline the information exchange 
between the client and the public agency; and collaboration 
with community partners to develop landlord relationships that 
helped identify housing, negotiate rental costs, and provide 
essentials for veterans moving into housing. Use of this model 
reduced the wait time from application to housing from an 
average of six months to an average of one month.
    Committee Bill. Section 209(a) of the Committee bill would, 
in a freestanding provision, require VA to consult with HUD and 
providers who participate in the local Continuum of Care 
(hereinafter, ``CoC'') and consider entering into contracts or 
agreements to provide case management services to homeless 
veterans who are eligible to participate in the HUD-VASH 
program. The Committee notes that, since 2008, the Department 
has improved its ability to target HUD-VASH vouchers to those 
with the greatest need and move veterans into housing more 
quickly. However, the Committee believes that there is still 
room for improvement and the best practices identified through 
the DC VASH Plus program could assist the Department in 
reaching the goal of ending veteran homelessness.
    The Committee recognizes that more veterans, and therefore 
more vouchers, are located in non-rural areas. However, the 
Committee notes that homeless veterans living at a greater 
distance from VAMCs still need services. VA needs to look for 
additional ways to extend its reach further into rural areas, 
to serve locations where chronically homeless veterans may be 
located in smaller numbers. The Committee is mindful that VASH 
Plus cannot and should not be done everywhere. However, the 
Committee is also aware of areas that might benefit from 
partnering with local providers to better serve chronically 
homeless veterans. Section 209(b) of the Committee bill defines 
this group as veterans who are eligible to receive a voucher 
and who are having trouble obtaining suitable housing, 
particularly those who do not live near VA facilities, those 
who live in areas with a shortage of low-income housing and 
need more intensive assistance than is usually provided, and 
those who reside in areas with significantly lower than average 
rates of obtaining suitable housing.
    The requirement to consider contracting for case management 
is intended to encourage VA to identify locations where 
contracting might allow the Department to better serve 
chronically homeless veterans. The Committee bill requires 
consultation with HUD and CoCs to help VA further strengthen 
relationships with community providers and identify suitable 
entities that have the capacity to serve this challenging 
population. The VASH Plus program has demonstrated the benefits 
of coordination with local providers. Therefore, even when the 
Department does not choose to contract out services to local 
providers, it should encourage VAMCs to strengthen its 
relationships and coordination with local homeless providers.
    Section 209(c) sets forth the parameters for entities that 
VA might contract with to include State or local government 
agencies, tribal organizations, or nonprofit agencies that 
agree to: provide case management services, maintain referral 
networks for additional entitlement and assistance programs, 
ensure the confidentiality of records, establish procedures for 
fiscal control and fund accounting, and submit information on 
their operations to VA annually. These agencies must also have 
demonstrated experience in identifying and serving homeless 
veterans, working collaboratively with HUD or VA, conducting 
outreach to and maintaining relationships with landlords, and 
mediating disputes between landlords and veterans.
    Section 209(d) requires VA to consult with HUD and the CoC 
while considering whether to enter into a contract or agreement 
with an organization.
    Section 209(e) would allow VA to provide training and 
technical assistance to any entities with which it collaborates 
to ensure compliance with program standards and the 
dissemination of best practice strategies, and the 
implementation of targeted treatment interventions through the 
``Housing First'' model. It would also make available $500,000 
per fiscal year from VA's Medical Services account to carry out 
the technical assistance program.
    Section 209(f) would require VA to produce an annual report 
on the consideration of potential collaborations and any 
collaboration that resulted.

                       TITLE III--HOUSING MATTERS

Sec. 301. Short title.

    Section 301 of the Committee bill would provide a short 
title, the ``Andrew Connolly Veterans' Housing Act,'' for Title 
III of the Committee bill.
    Background. Andrew Connolly served in the United States 
Army National Guard from November 2000 to August 2007. During 
his service, he completed two tours, the first in Egypt and the 
second in Iraq.
    A year after Andrew's tour in Iraq, he was diagnosed with 
cancer of the spine, a service-connected condition, which would 
soon lead to the loss of all function and feeling below the 
chest. At the same time, Andrew and his wife were caring for a 
newborn son with a neuromuscular disorder. This condition 
required his son to be on a ventilator and will confine his 
child to a wheelchair for the rest of his life.
    Andrew and his family were facing these challenges while 
living in a duplex built in the 1890's, which was not 
accessible and severely limited his ability to accomplish 
simple tasks. Today, Andrew is in a new house, made possible 
with a grant from VA's specially adapted housing program. This 
house was constructed specifically to allow Andrew to live as 
self-sufficiently as possible.
    At a May 3, 2011, hearing before the House Committee on 
Veterans' Affairs' Subcommittee on Economic Opportunity, Andrew 
Connolly described in detail how the adaptive housing 
assistance grant has allowed him to live more self-
sufficiently:

        Today I am in my new house. Today I took a shower by 
        myself in a 5 x 5 roll-in shower with handicapped 
        controls. Today I cooked my own breakfast because I 
        could reach all of the ingredients. Today I was able to 
        watch my son Brody sleeping in his bedroom because I 
        could roll through his doorway with my wheelchair.

    Committee Bill. Section 301 of the Committee bill would 
provide a short title, the ``Andrew Connolly Veterans' Housing 
Act,'' for Title III of the Committee bill. The Committee 
believes Andrew Connolly's story highlights the significant 
positive impact VA's adaptive housing assistance programs can 
have on disabled veterans and their families.

Sec. 302. Extended period of protections for members of uniformed 
        services relating to mortgages, mortgage foreclosure, and 
        eviction.

    Section 302 of the Committee bill, which is derived from 
S. 486, would extend from 9 months to 12 months after military 
service the period of protection against mortgage foreclosure 
and the period in which a court may stay a proceeding or adjust 
an obligation. It would also require the Comptroller General to 
report on certain foreclosure protections.
    Background. Congress has long recognized that the men and 
women of our military services should have civil legal 
protections so they can devote their entire energy to the 
defense needs of the nation.
    The earliest recognition of the need to provide civil 
protections for servicemembers in the United States dates back 
to the ``stay laws'' promulgated by Louisiana during the War of 
1812. Louisiana suspended all proceedings in civil cases for 
four months as the British were advancing on New Orleans.
    The development of the first modern version of the 
Soldiers' and Sailors' Civil Relief Act (hereinafter, 
``SSCRA'') was outlined at a hearing on the Soldiers' and 
Sailors' Civil Relief Bill before the Senate Subcommittee of 
the Committee on the Judiciary in 1917. Following the decision 
of the United States to enter the war in Europe in 1917, the 
first modern version of the SSCRA was drafted under 
instructions from the Judge Advocate General of the Army in six 
weeks by Major John Wigmore, the eminent Dean of Northwestern 
University's Law School, and others. In 1940, with the looming 
involvement of the United States in World War II, Congress 
again examined the needs of military personnel and reenacted 
the SSCRA almost verbatim. Both the SSCRA of 1918 and the SSCRA 
of 1940 provided legal protections to servicemembers in order 
to assist those who were struggling to meet financial and legal 
obligations while serving on active duty.
    In 2003, Public Law 108-189, the SCRA, clarified and 
strengthened many of the SSCRA protections afforded to 
servicemembers. Section 303(b) of the SCRA authorized a court 
to stay proceedings or adjust the obligation in the case of 
actions filed against servicemembers, during military service 
or within 90 days after a period of military service, to 
enforce a mortgage or trust deed entered into prior to service, 
if the servicemember's ability to comply with the obligation 
had been materially affected by military service. Section 
303(c) of the SCRA protected servicemembers against mortgage 
foreclosure without a court order during service and for a 
period of 90 days after a servicemember's period of military 
service.
    Section 2203 of Public Law 110-289, the Housing and 
Economic Recovery Act of 2008, amended the SCRA, by extending 
from 90 days to 9 months after military service the period of 
protection for servicemembers against mortgage foreclosure and 
the time period during which a court may stay proceedings or 
adjust obligations. These protections were scheduled to expire 
on December 31, 2010. Public Law 111-346, the Helping Heroes 
Keep Their Homes Act of 2010, extended the enhanced protections 
through December 31, 2012.
    Committee Bill. Section 302(a) of the Committee bill would 
amend section 303(b) of the SCRA, codified at 50 U.S.C. App. 
533(b), by extending from 9 months to 12 months after military 
service the period in which a court may stay proceedings or 
adjust an obligation, or to enforce an obligation on certain 
real or personal property owned by the servicemember. Section 
302(b) of the Committee bill would amend section 303(c) of the 
SCRA, codified at 50 U.S.C. App. 533(c), by extending from 9 
months to 12 months after military service the period of 
protection for a servicemember against sale, foreclosure, or 
seizure of property.
    Section 302(c) of the Committee bill would require the 
Comptroller General to submit a report to Congress on the 
foreclosure protections of the SCRA. Specifically, the report 
would include an assessment of the effects of these protections 
on the long-term financial well-being of servicemembers and 
their families; the number of servicemembers who faced 
foreclosure during a 90-, 270-, or 365-day period following 
their completion of a period of military service; the number of 
servicemembers who applied for a stay or adjustment; an 
assessment of the effect of applying for a stay or adjustment 
on the financial well-being of the servicemembers; and an 
assessment of the Secretary of Defense's partnerships with 
public and private-sector entities and recommendations on how 
the Secretary of Defense should modify such partnerships to 
improve financial education and counseling.
    The Committee believes that enhancing the foreclosure 
protections during these difficult economic times will help 
ensure the men and women of our military services have the 
civil legal protections necessary to ensure that they are able 
to devote their entire energy to the defense needs of the 
nation.

Sec. 303. Occupancy of property by dependent child of veteran for 
        purposes of meeting occupancy requirement for Department of 
        Veterans Affairs housing loans.

    Section 303 of the Committee bill, which is derived from 
S. 874, would allow a veteran's dependent child to satisfy the 
occupancy requirements necessary to qualify for a VA-backed 
home loan.
    Background. Current law, section 3704(c)(2) of title 38, 
U.S.C., states that, ``[i]n any case in which a veteran is in 
active-duty status as a member of the Armed Forces and is 
unable to occupy a property because of such status, the 
occupancy requirements [for purposes of obtaining a VA-backed 
home loan] shall be considered to be satisfied if the spouse of 
the veteran occupies the property and the spouse makes the 
certification required by paragraph (1) of this subsection.'' 
The structure of the American family often involves single 
parents. Under current law, a single veteran with a dependent 
child is disqualified from obtaining a VA-backed home loan if 
he or she is on active-duty status because he or she does not 
have a spouse to satisfy occupancy requirements.
    Committee Bill. Section 303 of the Committee bill would add 
to section 3704(c)(2) a provision allowing a veteran's 
dependent child who occupies or will occupy the property as a 
home to satisfy the occupancy requirements for purposes of 
qualifying for a VA-backed home loan if the veteran's attorney-
in-fact or a legal guardian of the veteran's dependent child 
makes the certification required by section 3704(c)(1) of title 
38.
    The Committee believes this provision would allow single-
parent veterans performing active-duty service to obtain a VA-
guaranteed home loan in situations where a veteran's dependent 
child will be occupying the home. The Committee also intends 
that this provision apply to situations where veterans, married 
to each other, are both deployed.

Sec. 304. Waiver of loan fee for individuals with disability ratings 
        issued during pre-discharge programs.

    Section 304 of the Committee bill, which is derived from 
S. 1148, would waive the housing loan fee for veterans rated 
eligible to receive compensation as the result of a pre-
discharge review of existing medical evidence, such as service 
medical and treatment records.
    Background. Under current law, section 3729(c) of title 38, 
U.S.C., a housing loan fee may not be collected if a veteran is 
rated eligible to receive compensation as a result of a pre-
discharge VA disability examination and rating. The time period 
between pre-discharge ratings and release from active-duty 
service can be quite long. During that time, many disabled 
servicemembers utilize their VA home loan benefit. Under 
current law, servicemembers who are rated eligible to receive 
compensation solely as the result of a pre-discharge review of 
existing medical evidence and not as the result of a VA 
examination are required to pay the housing loan fees until 
they have been discharged or released from active duty.
    Committee Bill. Section 304 of the Committee bill would 
amend section 3729(c) of title 38 by adding a provision that 
waives the collection of housing loan fees from a servicemember 
rated eligible to receive compensation based on a pre-discharge 
review of existing medical evidence that results in the 
issuance of a memorandum rating.
    The Committee believes this provision would ensure that all 
servicemembers eligible to receive compensation as the result 
of a pre-discharge program are eligible for the housing loan 
fee waiver, regardless of whether the eligibility was the 
result of an examination or a review of existing evidence.

Sec. 305. Improvements to assistance for disabled veterans residing in 
        housing owned by a family member.

    Section 305 of the Committee bill, which is derived from 
S. 1017, would increase the amount of assistance available to 
certain veterans with permanent and total service-connected 
disabilities to adapt a family member's residence in which the 
veteran is residing temporarily. It would also provide for 
annual automatic adjustments of the amounts of assistance and 
extend VA's authority to provide such assistance until December 
31, 2021.
    Background. Public Law 109-233, the Veterans' Housing 
Opportunity and Benefits Improvement Act of 2006, authorized VA 
to expand its previously existing adaptive housing assistance 
grants to include eligible individuals temporarily living in a 
home owned by a family member. These grants are known as 
Temporary Residence Adaptation (hereinafter, ``TRA'') grants. 
The benefit was extended to active duty servicemembers with the 
passage of Public Law 110-289, the Housing and Economic 
Recovery Act of 2008.
    Under current law, section 2102A of title 38, the TRA grant 
program allows veterans and servicemembers eligible under the 
Specially Adapted Housing (hereinafter, ``SAH'') and Special 
Housing Adaptation (hereinafter, ``SHA'') programs to use up to 
$14,000 and $2,000, respectively, to modify a family member's 
home. The TRA grant program is scheduled to expire on December 
31, 2011.
    Section 101 of Public Law 109-233 also required the 
Government Accountability Office (hereinafter, ``GAO'') to 
submit to Congress a report on VA's implementation of the TRA 
grant program. The interim report, ``Veterans Affairs: 
Implementation of Temporary Residence Adaptation Grants'' (GAO-
09-637R), and the final report, ``Opportunities Exist to 
Improve Potential Recipients' Awareness of the Temporary 
Residence Adaptation Grant'' (GAO-10-786) (hereinafter, ``GAO 
Reports''), both noted the limited participation in the TRA 
program. The interim report examined a number of reasons for 
the low usage and noted that veterans often chose to wait to 
take advantage of benefits to adapt their own home because the 
TRA grant counts against the overall amount available to an 
individual under the SAH or SHA grant program. One of the 
potential solutions GAO identified was increasing the maximum 
benefit available under SAH and SHA.
    Committee Bill. Section 305 of the Committee bill would 
amend section 2102A of title 38 by increasing the amount of 
assistance available for individuals with permanent and total 
service-connected disabilities that meet the criteria of 
section 2101(a)(2) of title 38 from $14,000 to $28,000. It 
would increase the amount of assistance available for 
individuals with permanent and total service-connected 
disabilities that meet the criteria of section 2101(b)(2) of 
title 38 from $2,000 to $5,000.
    It would add a new paragraph to section 2102A that would 
provide for automatic annual adjustments to the maximum grant 
amounts based on a cost-of-construction index already in effect 
for other SAH and SHA grants authorized under chapter 21 of 
title 38. Finally, the Committee bill would amend section 2102A 
of title 38 by extending VA's authority to provide assistance 
under the TRA grant program until December 31, 2021.
    The Committee believes that the enhancements made by 
section 305 of the Committee bill to the TRA grant program will 
increase participation in the program. Further, the extension 
of authority for the TRA grant program provides individuals 
suffering from catastrophic injuries or illnesses with more 
flexibility during their convalescent period.

Sec. 306. Expansion of eligibility for specially adapted housing 
        assistance for veterans with vision impairment.

    Section 306 of the Committee bill, which is derived from 
S. 1017, would expand eligibility for VA's adaptive housing 
assistance grants to veterans with a lesser degree of vision 
impairment than what is required under current law.
    Background. Under current law, section 2101(b) of title 38, 
U.S.C., a veteran with a permanent and total service-connected 
disability due to blindness in both eyes has to have visual 
acuity of 5/200 or less in order to qualify for certain 
adaptive housing assistance grants.
    According to the National Eye Institute, visual acuity is 
defined as the eye's ability to distinguish object details and 
shape with good contrast, using the smallest identifiable 
object that can be seen at a specified distance. It is measured 
by use of an eye chart and recorded as test distance/target 
size. Visual acuity of 5/200 means that an individual must be 5 
feet away from an eye chart to see a letter that an individual 
with normal vision could see from 200 feet.
    While VA had used the 5/200 or less standard of visual 
acuity for blindness over the last several decades, a consensus 
definition of what constitutes ``legal blindness'' has emerged.
    This consensus definition, which is the statutory 
definition used for the Social Security disability insurance 
program and the Supplemental Security Income program and which 
is less stringent than VA's standard, encompasses individuals 
with lesser degrees of vision impairment. The American Medical 
Association has espoused this definition since 1934 and defines 
blindness as a ``central visual acuity of 20/200 or less in the 
better eye with corrective glasses, or central visual acuity of 
more than 20/200 if there is a visual field defect in which the 
peripheral field is contracted to such an extent that the 
widest diameter of the visual field subtends an angular 
distance no greater than 20 degrees in the better eye.''
    In recognizing this consensus definition, Public Law 110-
157, the Dr. James Allen Veteran Vision Equity Act of 2007, 
amended the criteria for receiving special monthly compensation 
to allow veterans who are very severely disabled as the result 
of blindness and other severe disabilities to be eligible to 
receive a higher rate of disability compensation if their 
visual acuity in both eyes is 20/200 or less.
    Committee Bill. Section 306 of the Committee bill would 
amend section 2101(b) of title 38 by requiring central visual 
acuity of 20/200 or less in the better eye with the use of a 
standard correcting lens. It also provides that an eye with a 
limitation in the fields of vision such that the widest 
diameter of the visual field subtends an angle no greater than 
20 degrees shall be considered as having a central visual 
acuity of 20/200 or less.
    The Committee believes that this provision would bring the 
definition of blindness within chapter 21 of title 38 in line 
with consensus definitions and other disability rating 
provisions of title 38 and that veterans who are so seriously 
disabled as to meet the visual acuity standard of 20/200 or 
less should be able to take advantage of VA's adaptive housing 
assistance grants.

Sec. 307. Revised limitations on assistance furnished for acquisition 
        and adaptation of housing for disabled veterans.

    Section 307 of the Committee bill, which is derived from 
S. 1017, would exclude the TRA grant from counting towards the 
aggregate limitations on assistance for SAH and SHA grants.
    Background. Since 1948, VA has provided adaptive housing 
assistance grants to eligible individuals who have certain 
service-connected disabilities to construct an adapted home or 
modify an existing home to accommodate their disabilities. 
Today, VA provides adaptive housing assistance primarily 
through two programs--SAH and SHA. Both programs are codified 
under chapter 21 of title 38.
    The SAH grant program provides financial assistance to 
veterans and servicemembers who are entitled to compensation 
for permanent and total service-connected disability due to the 
loss or loss of use of multiple limbs, blindness and limb loss, 
or a severe burn injury. Eligible individuals may receive up to 
three SAH grants totaling no more than 50 percent of the cost 
of a specially adapted house, up to the aggregate maximum 
amount for fiscal year 2011 of $63,780. This amount is adjusted 
annually based on a cost-of-construction index. Grants may be 
used to construct a house or remodel an existing house, or they 
may be applied against the unpaid principal mortgage balance of 
a specially adapted house. The SHA grant program--which is 
similar to SAH but is for individuals with slightly less 
serious disabilities--may be used for slightly different 
purposes and cannot exceed $12,756 during fiscal year 2011. 
This amount is also adjusted annually based on a cost-of-
construction index.
    P.L. 109-233, the Veterans' Housing Opportunity and 
Benefits Improvement Act of 2006, authorized VA to expand its 
previously existing adaptive housing assistance grants to 
include eligible individuals temporarily living in a home owned 
by a family member. The TRA benefit, codified at section 2102A 
of title 38, U.S.C., allows veterans to apply for a grant to 
adapt the home of a family member with whom they are 
temporarily residing. The benefit was extended to active duty 
servicemembers with the passage of Public Law 110-289, the 
Housing and Economic Recovery Act of 2008. The TRA grant 
program enables veterans and servicemembers eligible under the 
SAH and SHA programs to use up to $14,000 and $2,000, 
respectively, to modify a family member's home.
    Under current law, section 2102(d), each TRA grant counts 
as one of the three grants allowed under either SAH or SHA. TRA 
grants also count toward the maximum allowable fiscal year 2011 
amount of $63,780 under SAH and $12,756 under SHA.
    As described in section 309, GAO's congressionally-mandated 
reports on the TRA grant program noted the limited 
participation in the TRA program. GAO found that one of the 
reasons for the low usage was that veterans often chose to wait 
to take advantage of benefits to adapt their own home because 
the TRA grant amount counts against the overall amount 
available to an individual under the SAH or SHA grant programs. 
One of the potential solutions GAO identified was no longer 
counting TRA grants against the maximum funds available under 
SAH and SHA.
    Committee Bill. Section 307 of the Committee bill would 
amend section 2102(d) of title 38 to exclude the TRA grant from 
the aggregate limitations on assistance furnished to an 
eligible veteran or servicemember pursuant to section 2102 of 
title 38. TRA grants would no longer be counted against the 
maximum funds available under SAH and SHA grants.
    The Committee believes this change would increase 
participation in the TRA grant program.

               TITLE IV--COMPENSATION AND PENSION MATTERS

Sec. 401. Increase in rate of pension for disabled veterans married to 
        one another and both of whom require regular aid and 
        attendance.

    Section 401 of the Committee bill, which is derived from 
S. 1060, would increase the benefit paid to married couples 
when both are veterans who qualify for A&A.
    Background. Veterans of a period of war who meet income, 
net worth, and other eligibility criteria are eligible to 
receive a pension based upon need. The amount of the pension 
also is based upon the number of dependents of the veteran. 
Additional benefits are paid if the veteran has a disability 
that results in housebound status or a need for A&A. In 
general, when a veteran is married to another veteran, the 
pension benefits paid are the same as for a veteran who is 
married to a non-veteran. However, in cases where one or both 
members of a veteran couple are housebound, the housebound 
veterans each receive an additional amount. If one member of 
the veteran couple is in need of A&A, that veteran receives an 
additional amount. However, if both members need A&A, one 
member receives the full additional amount and the other 
receives a reduced amount.
    In 1998, section 8206 of Public Law 105-178, the 
Transportation Equity Act for the 21st Century, increased the 
benefit for a veteran who requires aid and attendance by $600 
per year. Because of the way the bill was drafted, the benefit 
was increased for only one of the veterans in the rare case 
that a veteran is married to another veteran who requires A&A. 
The legislative history does not indicate any intent to treat 
these spouses differently. According to VA, there are fewer 
than 75 such cases. Therefore, under current law, a veteran who 
is married to another veteran and both qualify for A&A 
benefits, the benefit amount for one of the spouses is $825 per 
year lower than for the other spouse.
    Committee Bill. The Committee bill would increase the 
benefit paid to married couples where both members of the 
couple are veterans and both qualify for A&A by $825.00 per 
year.

Sec. 402. Authority for retroactive effective date for awards of 
        disability compensation in connection with applications that 
        are fully-developed at submittal.

    Section 402 of the Committee bill, which is derived from 
S. 423, would allow up to a 1 year retroactive effective date 
for certain awards of disability compensation that are based on 
claims that are fully-developed when submitted to VA.
    Background. Under section 221 of Public Law 110-389, the 
Veterans' Benefits Improvement Act of 2008, VA was required to 
conduct a pilot project to test ``the feasibility and 
advisability of providing expeditious treatment of fully 
developed compensation or pension claims to ensure that such 
claims are adjudicated not later than 90 days after the date on 
which such claim is submitted as fully developed.'' After 
carrying out that pilot at 10 VA regional offices, VA expanded 
the fully-developed claim process to all VA regional offices. 
At a July 14, 2010, hearing before the Committee, VA's Acting 
Under Secretary for Benefits explained that, ``if VA receives 
all of the available evidence when the claim is submitted, the 
remaining steps in the claims-decision process can be expedited 
without compromising quality.''
    However, under current law, there is a potential 
disincentive for veterans to file fully-developed claims. That 
is because, under section 5110(a) of title 38, U.S.C., the 
effective date of an award of disability compensation generally 
is the date on which VA received the application for those 
benefits. Although there are exceptions to that general rule, 
none of the exceptions would allow a retroactive effective date 
for veterans who file fully-developed claims. Accordingly, if a 
veteran takes time before filing a claim to gather the 
necessary information and evidence so as to ensure that the 
claim is fully-developed, the veteran could potentially lose 
out on benefits for the period between when the veteran began 
gathering the evidence and when he or she ultimately filed a 
fully-developed claim.
    Committee Bill. Section 402 of the Committee bill would 
amend section 5110 of title 38 to provide that the effective 
date of an award of disability compensation to a veteran who 
submitted a fully-developed claim would be based on the facts 
found but would not be earlier than 1 year before the date on 
which VA received the veteran's application. That change would 
take effect on the date of enactment and would not be applied 
to claims filed after September 30, 2012.
    It is the Committee's expectation that, by allowing an 
effective date up to 1 year earlier than the date on which a 
fully-developed claim is filed, more veterans will be 
encouraged to file fully-developed claims and in return receive 
faster decisions on their claims.

Sec. 403. Modification of month of death for surviving spouses of 
        veterans who die while entitled to compensation or pension.

    Section 403 of the Committee bill, which is derived from 
S. 874, would amend current law in order to clarify that a 
surviving spouse of a veteran who is receiving compensation or 
pension from VA is due the amount of benefits the veteran would 
have received for the entire month of the veteran's death, 
regardless of whether the surviving spouse is otherwise 
entitled to survivor benefits. Also, if at the time of death 
the veteran had a claim pending for compensation or pension 
that was subsequently granted, the surviving spouse would be 
eligible for any benefits or additional benefits due as accrued 
benefits for the month of death.
    Background. VA has experienced considerable difficulty in 
administering month-of-death payments for surviving spouses 
because of the confusion in current law among various 
provisions and because certain automated procedures used by VA 
for termination and recovery of benefits paid to veterans for 
the month of their deaths are not consistent with current law. 
As a demonstration of the scope of this situation, Committee 
oversight led VA to pay over $65 million to survivors who had 
been wrongfully denied benefits to which they were entitled for 
the month of death.
    Under current law, veterans' benefits for a specific month 
are paid in the month following the month to which they are 
attributable. No benefits are owed to a veteran for the month 
in which a veteran dies. For example, if a veteran is receiving 
VA compensation or pension for the month of January, the check 
or payment for January would be provided in February. If a 
veteran receiving such benefits dies in February, no benefits 
for the month of death would be payable to the veteran, meaning 
that no benefits would be provided in March. However, if the 
veteran had a surviving spouse, the month of death provision in 
current law, section 5310 of title 38, provides that the amount 
of benefits that the veteran would have received for February 
had the veteran not died is payable to the surviving spouse.
    Section 5310 also provides that, if the benefit payable to 
a surviving spouse as death compensation, dependency and 
indemnity compensation (hereinafter, ``DIC''), or death pension 
is less than the amount that the veteran would have received 
for that month but for the veteran's death, the greater benefit 
would be paid for the month of death.
    This latter provision has caused considerable confusion 
because it is not fully consistent with other provisions of 
current law concerning effective dates for survivor benefits. 
Under section 5110(d) of title 38, the effective date of an 
award of death compensation, DIC, or death pension for which 
application is received within 1 year from the date of a 
veteran's death is the first day of the month in which the 
death occurred. Thus, if the veteran dies in February, the 
effective date of DIC or death pension would be February 1 if 
the surviving spouse applied for benefits within 1 year of the 
veteran's death. If the application for survivor benefits is 
received after the 1-year period, the effective date is the 
date the application is received.
    Under section 5111(a) of title 38, payment of VA benefits, 
including survivor benefits, is not made for the month of the 
effective date of the benefit, but is paid for the first 
calendar month following the month in which the award became 
effective. For example, the first month for which benefits 
would be paid to the surviving spouse of a veteran dying in 
February, which would mean a February 1 effective date, would 
be the calendar month of March. As noted above, the check or 
payment for March would be issued at the beginning of April. 
Absent the month of death provision, the survivor would 
experience a gap in income with no benefit paid for either the 
deceased veteran or the surviving spouse in the month of March.
    Although section 5111(c)(1) of title 38 appears to provide 
an exception for month-of-death payments when the DIC or death 
pension for the month of death would be greater than the amount 
that would have been paid to the deceased veteran for that 
month had the veteran lived, the language of paragraph (1) of 
that section does not clearly authorize a payment with a 
different effective date or a different commencement date than 
provided by sections 5110 or 5111(a). Because a surviving 
spouse eligible for benefits as the survivor of a veteran who 
died in February would not have those benefits commence until 
March and would receive the first DIC payment in April, it 
appears that there are no circumstances under which a surviving 
spouse could qualify for payments of both a month-of-death 
benefit for the month of February and a survivor benefit for 
the same month.
    VA has information concerning the identity and status of 
any spouse receiving benefits as a dependent on the veteran's 
compensation or pension award, such as a veteran receiving 
additional compensation payable under section 1115 at the rate 
of 30 percent or higher or pension benefits for married 
veterans specified in section 1521. In cases involving such 
dependency relationships, VA has recently begun issuing month-
of-death benefits to surviving spouses upon notification of the 
death of a veteran, whose surviving spouse was a dependent on 
the veteran's compensation or pension award as of the date of 
death. In cases in which VA does not have information 
concerning the existence, identity, or status of a surviving 
spouse, VA is not able to comply with the requirement for a 
month-of-death payment without obtaining additional 
information. In such cases, VA is sending the veteran's estate 
a notice that includes information concerning the month-of-
death payment and advises the estate concerning the procedures 
necessary in order for a payment to be made.
    Committee Bill. Subsection (a) of section 403 of the 
Committee bill would amend subsection (a) and (b) of section 
5310 of title 38 to clarify that a payment for the month of a 
veteran's death would be made to a surviving spouse of a 
veteran who, at the time of the veteran's death, was receiving 
compensation or pension or to a surviving spouse of a veteran 
who is determined as having been entitled to receive 
compensation or pension for the month of the veteran's death.
    Subsection (a) of section 403 of the Committee bill would 
further amend subsection (a) of section 5310 to specify that 
the amount of a payment for the month of a veteran's death is 
the amount that the veteran would have received for that month 
if the veteran had not died and to specify that any benefits 
payable for the month of death for a veteran who was not 
receiving those benefits as of the date of death would be paid 
as accrued benefits.
    Subsection (a) of section 403 of the Committee bill would 
further amend subsection (b) of section 5310 of title 38 to 
clarify that, if a claim for entitlement to compensation or 
additional compensation under chapter 11 of title 38 or pension 
or additional pension under chapter 15 of title 38 was pending 
at the time of the veteran's death and the pending claim was 
subsequently granted, any additional benefits for the month of 
death would be paid as accrued benefits under section 5121 of 
title 38.
    Subsection (b) of section 403 of the Committee bill would 
amend subsection (c) of section 5111 of title 38 to provide 
that month-of-death payments under section 5310 are exempt from 
the delayed commencement of benefits provision otherwise 
applicable under section 5111.
    Subsection (c) of section 403 of the Committee bill would 
provide that the changes made by that section would apply in 
cases of deaths that occur on or after the date of enactment of 
this legislation.
    The Committee expects that section 403 of the Committee 
bill, if enacted, will remove any confusion in current law and 
improve VA's ability to pay a surviving spouse the benefits due 
for the month of a veteran's death.

Sec. 404. Automatic waiver of agency of original jurisdiction review of 
        new evidence.

    Section 404 of the Committee bill, which is derived from 
S. 1148, would automatically waive the review of certain new 
evidence by the agency of original jurisdiction (hereinafter, 
``AOJ'') so that certain new evidence submitted after the 
filing of a substantive appeal will be subject to initial 
review by the Board of Veterans' Appeals (hereinafter, 
``Board''), unless review by the AOJ is requested.
    Background. Current law precludes the Board's initial 
consideration of evidence submitted in connection with a claim, 
unless the claimant waives the right to initial consideration 
by the AOJ. Evidence must first be considered by the AOJ in 
order to preserve a claimant's statutory right under section 
7104 of title 38 to one review on appeal.
    This requirement frequently delays the final adjudication 
of claims because claimants often submit additional evidence in 
support of their claims following the filing of a substantive 
appeal. Under current procedures, upon submission of this new 
evidence, the AOJ must review the new evidence and the claims 
file and prepare a new decisional document called the 
supplemental statement of the case (hereinafter, ``SSOC''). If 
the claimant submits additional evidence to the Board without 
waiving the right to initial AOJ consideration, the Board must 
remand the claim to the AOJ for initial consideration. This 
process can occur multiple times if the veteran submits 
additional evidence after the AOJ issues the SSOC.
    Committee Bill. Section 404 of the Committee bill would 
amend section 7105 of title 38 by creating a new subsection, 
(e), to incorporate an automatic waiver of the right to initial 
consideration of certain evidence by the AOJ. The evidence 
subject to the waiver is evidence, in connection with the issue 
or issues with which disagreement has been expressed, submitted 
by the claimant, or his or her representative to the AOJ or the 
Board concurrently with or after the filing of a substantive 
appeal. Such evidence would be subject to initial consideration 
by the Board, unless the appellant or his or her representative 
requests in writing that the AOJ initially consider the 
evidence. The request would be required to be submitted with 
the evidence. These changes would take effect 180 days after 
enactment and apply with respect to claims for which a 
substantive appeal is filed on or after that date.
    The Committee believes that the establishment of an 
automatic waiver would necessarily improve the timeliness of 
processing appeals. This automatic waiver would reduce the 
amount of time it takes the AOJ to certify an appeal to the 
Board and avoid time-consuming remands for an initial review of 
new evidence. Further, the claimant's right to initial 
consideration by the AOJ is also protected by permitting 
claimants to obtain initial consideration by the AOJ by 
requesting such review in writing.

            TITLE V--MEMORIAL, BURIAL, AND CEMETERY MATTERS

Sec. 501. Prohibition on disruptions of funerals of members or former 
        members of the Armed Forces.

    Section 501 of the Committee bill, which is derived from 
S. 815, would increase the space and time restrictions and 
liability for those protesting at military funerals.
    Background. During the 109th Congress, two bills were 
passed to create limitations on protesting at military 
funerals. When introducing S. 4042, a bill to amend title 18, 
U.S.C., to prohibit disruptions of funerals of members or 
former members of the Armed Forces, which later became Public 
Law 109-464, Senator Durbin pointed out that in the 16 months 
leading up to the introduction of the bill, there had been 129 
intentional disruptions of military funerals, underlining the 
necessity for protecting the sanctity of military funerals.
    The passage of Public Law 109-464 had been preceded by the 
passage of Public Law 109-228, the Respect for America's Fallen 
Heroes Act. Although similar in nature and intent, these laws 
cover different jurisdictional areas and include differing 
definitions as to what constitutes prohibited behavior with 
respect to a military funeral.
    Specifically, Public Law 109-228 established a new section 
2413 in title 38, U.S.C., which prescribes specific limitations 
on demonstrations at cemeteries under the control of the 
National Cemetery Administration (hereinafter, ``NCA'') and 
ANC. Under section 2413, a person may not demonstrate on the 
property of a cemetery under the control of NCA or ANC without 
prior authorization. Also, a person may not demonstrate during 
the period beginning 60 minutes before and ending 60 minutes 
after a funeral or memorial service at these cemeteries if (1) 
the demonstration takes place within 150 feet of the road, 
pathway, or other egress or ingress point and includes ``any 
individual willfully making or assisting in the making of any 
noise or diversion that disturbs or tends to disturb the peace 
or good order of the funeral'', or (2) the demonstration is 
within 300 feet of the cemetery and impedes the access to or 
egress from the cemetery. Additionally, section 2413 
specifically defines demonstrations to include activities such 
as picketing, amplified speech, or distributing leaflets. By 
doing so, the statute only precludes a narrow subset of speech 
and does not prohibit all speech in or around the cemetery. The 
penalty for violating this section is up to 1 year in prison 
and/or a fine, as set forth in section 1387 of title 18, U.S.C.
    P.L. 109-464 established section 1388 of title 18, U.S.C. 
This law addresses disruptions at funerals of servicemembers or 
former servicemembers that take place in cemeteries other than 
NCA or part of ANC. The statute prohibits, within the period 
starting 60 minutes before and ending 60 minutes after a 
military funeral, any activity that takes place within the 
boundary of the funeral location or is within 150 feet of the 
point of intersection between the boundary of the funeral 
location and the entrance or other ingress or egress point of 
the funeral location and ``includes any individual willfully 
making or assisting in the making of any noise or diversion 
that is not part of such funeral and that disturbs or tends to 
disturb the peace or good order of such funeral with the intent 
of disturbing the peace or good order of that funeral.'' 
Section 1388 also prohibits any activity within the same 
timeframe that is within 300 feet of the boundary of the 
location of a funeral and ``includes any individual willfully 
and without proper authorization impeding the access to or 
egress from such location with the intent to impede the access 
to or egress from such location.'' Under section 1388(b), the 
penalty for violating this section is up to 1 year in prison 
and/or a fine.
    In March 2011, the United States Supreme Court ruled in 
Snyder v. Phelps, 131 S. Ct. 1207 (2011), that the Free Speech 
Clause of the First Amendment protected the Westboro Baptist 
Church from state tort liability for intentional infliction of 
emotional distress and intrusion upon seclusion. Although the 
Court spoke to what constituted protected speech in the case, 
the Court made no ruling on the Constitutionality of buffer 
zones in the context of military funerals. However, the Supreme 
Court did note: ``[E]ven protected speech is not equally 
permissible in all places and at all times * * *. Westboro's 
choice of where and when to conduct its picketing is not beyond 
the Government's regulatory reach--it is subject to reasonable 
time, place, or manner restrictions.'' (Internal quotations and 
citations omitted.)
    Committee Bill. Section 501 of the Committee bill would 
amend section 1388 of title 18, U.S.C., to expand the 
prohibition against certain activities at any funeral of a 
member or former member of the Armed Forces, which does not 
take place at a cemetery under the control of NCA or ANC.
    Under the Committee bill, it would be unlawful for any 
person to engage in a prohibited activity during the period 
beginning 120 minutes before and ending 120 minutes after a 
funeral of servicemembers or former members of the Armed 
Forces. Specifically, the bill would prohibit an activity 
during that time by individuals within 300 feet of the 
intersection between the boundary of the property where the 
funeral takes place and a road or other route of ingress to or 
egress from the funeral location, if the activity includes any 
individual ``willfully making or assisting in the making of any 
noise or diversion, that is not part of such funeral and that 
disturbs the peace and good order of such funeral, and with the 
intent of disturbing the peace and good order of such 
funeral.'' It would also prohibit during that time activity 
within 500 feet of the boundary of the funeral location, if the 
activity includes an individual willfully and with intent 
impeding or tending to impede the access to or egress from the 
funeral location.
    The Committee bill would establish a prohibition, within 
section 1388, for intentionally disturbing persons at the homes 
of surviving family members of the deceased servicemember or 
veteran. Specifically, it would be unlawful to engage in an 
activity during the period beginning 120 minutes before and 
ending 120 minutes after a military funeral, if the activity is 
on or near the boundary of the home of an immediate family 
member of the deceased person and the activity includes an 
individual willfully making a noise or diversion that disturbs 
or tends to disturb the peace of the individuals at that 
location and is intended to disturb that peace. The Committee 
believes it necessary to protect the sanctity of the homes of 
these grieving family members. This provision only precludes 
speech that disturbs and is directed at the family home, but 
does not prohibit other forms of protected speech within the 
surrounding area. In Frisby v. Schultz, 108 S. Ct. 2495 (1988), 
the Supreme Court acknowledged that people in their homes are 
captive audiences where, unlike in public, they cannot be 
expected to avoid speech which they may deem offensive. The 
Committee believes that the government has a significant 
interest in protecting servicemembers' families while they are 
grieving in the sanctity of their own homes. Like the Court in 
Frisby, the Committee believes that homes--and in this case, 
the homes of grieving family members--are the last refuge for 
its occupants.
    Under the Committee bill, section 1388 would be further 
amended by adding subsections on civil remedies, actual and 
statutory damages, and a rebuttable presumption. Specifically, 
subsection 1388(c) would provide that district courts of the 
United States would have jurisdiction to prevent and restrain 
violations of section 1388 and to adjudicate claims for relief 
under that section. It would also authorize the Attorney 
General to institute legal proceedings with regard to 
violations of section 1388. Further, subsection 1388(c) would 
provide that any person, including a surviving member of the 
deceased person's immediate family, who suffers injury due to 
conduct prohibited by section 1388 may sue in United States 
district court or other courts of competent jurisdiction and 
may recover damages found in new subsection 1388(d), the cost 
of the suit, and reasonable attorneys' fees. Finally, 
subsection 1388(c) would provide that a judgment in favor of 
the government in a criminal proceeding related to a violation 
of section 1388 would estop the defendant from denying the 
allegations with respect to that crime in a later civil 
proceeding.
    Further, section 1388 would be amended by the Committee 
bill by adding subsection 1388(d), which would provide that, in 
addition to any criminal penalty, a violator of section 1388 
would be liable in a civil proceeding for either actual or 
statutory damages. The person bringing forth the civil action 
may elect to recover either actual damages or statutory 
damages, which statutory damages would be set at a sum of not 
less than $25,000 or more than $50,000 per violation. 
Subsection 1388(d) would entitle the Attorney General to 
recover an award of statutory damages for each violation 
involved in the action notwithstanding those awarded to the 
immediate family of the deceased individual.
    The Committee bill would establish a new subsection 
1388(e), which would set forth a rebuttable presumption that a 
violation of section 1388 was committed willfully for the 
purposes of relief under the section, if the violator or person 
acting in concert with the violator did not have reasonable 
grounds to believe, due to the attention or publicity sought or 
other circumstance, that the conduct would not disturb the 
peace or good order of the funeral, impede or tend to impede 
the access to or egress from the funeral, or disturb or tend to 
disturb the peace on or near the residence of any surviving 
member of the deceased individual's family.
    Section 501 of the Committee bill would also amend section 
2413 of title 38, U.S.C., to expand the prohibition against 
certain demonstrations and disruptions at cemeteries under the 
control of NCA and ANC. The Committee bill would not affect the 
current prohibition, found in section 2413, against any person 
demonstrating on the property of a federally controlled 
cemetery without proper approval from the cemetery 
superintendent or director. However, under section 501, it 
would also be unlawful to engage in a demonstration in the 
period from 120 minutes prior to 120 minutes after a funeral or 
memorial service if: any part of the demonstration takes place 
within the boundary of the cemetery or takes place within 300 
feet of the intersection between the boundary of the cemetery 
and the road or other route of ingress and egress from the 
cemetery; includes anyone willfully making or assisting in 
making any noise or diversion that is not part of the funeral; 
disturbs or tends to disturb the peace or good order of the 
funeral; and is intended to disturb the peace or good order of 
the funeral. It would also be unlawful to demonstrate within 
500 feet of the boundary of the cemetery, if the demonstration 
includes anyone willfully and without proper authorization 
impeding or tending to impede the access to or the egress from 
the cemetery, with the intent to do so. The Committee bill 
would add subsection 2413(b), which would include the penalty 
for violating section 2413. The current penalties for a 
violation of section 2413 are found in section 1387 of title 
18, U.S.C. The Committee bill would add subsection 2413(b) to 
clarify what the penalties are directly in title 38.
    The Committee bill would amend section 2413 of title 38, 
U.S.C., by adding subsections on civil remedies, actual and 
statutory damages, and a rebuttable presumption. Specifically, 
subsection 2413(c) would provide that district courts would 
have jurisdiction to prevent and restrain violations of section 
2413 and to adjudicate claims for relief under that section. It 
would also authorize the Attorney General to institute legal 
proceedings with regard to violations of section 2413. Further, 
subsection 2413(c) would provide that any person, including a 
surviving member of the deceased person's immediate family who 
suffers injury due to conduct prohibited by section 2413, may 
sue in district court or other courts of competent jurisdiction 
and may recover damages found in new subsection 2413(d), the 
cost of the suit, and reasonable attorneys' fees. Finally 
subsection 2413(c) would provide that a judgment in favor of 
the government in a criminal proceeding related to a violation 
of section 2413 would estop the defendant from denying the 
allegations with respect to that crime in a later civil 
proceeding.
    The Committee bill includes a new subsection 2413(d), which 
would provide that, in addition to any criminal penalty, a 
violator of section 2413 would be liable in a civil proceeding 
for either actual or statutory damages. The person bringing 
forth the civil action may elect to recover either actual 
damages or statutory damages, which statutory damages would be 
set at a sum of not less than $25,000 or more than $50,000 per 
violation. Subsection 2413(d) would entitle the Attorney 
General to recover an award of statutory damages for each 
violation involved in the action notwithstanding those awarded 
to the immediate family of the deceased individual.
    Additionally, new subsection 2413(e) would establish a 
rebuttable presumption that a violation of 2413(a) was 
committed willfully for the purposes of determining relief, if 
the violator or a person acting in concert with the violator 
did not have a reasonable expectation to believe, either from 
the publicity sought or other circumstance, that the conduct 
would not disturb or tend to disturb the peace and good order 
of the military funeral, or impede or tend to impede the access 
to or egress from the funeral.
    The Committee understands the critical importance of the 
First Amendment and, specifically, the rights found within the 
Free Speech Clause. However, the freedom of speech in the 
United States is not unlimited. The Supreme Court has ruled 
that the time, place, and manner of speech can be limited by 
the government if the restriction is content neutral, serves a 
significant government interest, is narrowly tailored to serve 
a significant government interest, and leaves ample alternative 
channels for communication. As discussed below, the Committee 
believes that the changes to section 1388 of title 18, U.S.C., 
and section 2413 of title 38, U.S.C., meet this test and uphold 
the rights found within the Free Speech Clause, while at the 
same time protecting the sanctity and decorum of military 
funerals.
    The prohibitions in both sections are content neutral as 
they apply to all offenders, not a specific group or view 
point. The Committee believes that the restrictions in both 
sections are narrowly tailored to meet a significant government 
interest and thus would meet the thresholds outlined in 
previous Supreme Court cases. For example, section 1388 would 
only prohibit a very specific subset of speech: ``making or 
assisting in making of any noise or diversion * * * that is not 
part of such funeral and that disturbs or tends to disturb the 
peace or good order of such funeral.'' Also, to be prohibited, 
that speech must take place at the cemetery or within 300 feet 
of the boundary of the cemetery and the intersection with a 
road or access point to the funeral location and there must be 
an intent to disturb the peace and good order of the funeral. 
In addition, those restrictions would apply only during the 
period starting 120 minutes before and ending 120 minutes after 
a military funeral. Individuals and/or groups would be free to 
utilize their free speech rights outside of the 300 foot buffer 
or at a different time. The 300 foot buffer is designed to 
balance individual rights to protest, and at the same time 
protect families at a funeral who are captive for a set period 
of time while laying their military family members to rest. The 
Committee believes that the amended restrictions, which would 
be set forth by the Committee bill, are narrowly tailored so as 
to allow ample alternate channels for speech while protecting 
the sanctity and decorum of military funerals.
    Under sections 1388 and 2413, as would be amended by the 
Committee bill, it would be unlawful, during a limited period 
of time, for an individual to demonstrate or conduct activities 
within 500 feet of the boundary of a cemetery where a military 
funeral is to be held, and to impede or tend to impede the 
access to or egress from the funeral with the intent of doing 
so. The government has a significant interest in allowing the 
free flow of people and vehicles into and out of the location 
of a military funeral. Family members of a deceased 
servicemember should be able to attend the funeral and should 
not be precluded from access to the funeral. The 500 foot 
prohibition against impeding access does not restrict any more 
speech than is necessary to meet the government's interest.
    The Constitution enumerates a number of powers explicitly 
given to Congress to exercise. These powers provided under the 
Constitution, article I, section 8, include the power to 
provide for the common defense, raise and support armies, 
provide and maintain a navy, make rules for government and 
regulation of the land and naval forces, and provide for 
organizing and governing such part of the militia as may be 
employed in the service of the United States. The Committee 
believes that by further protecting the sanctity and dignity of 
military funerals, Congress is utilizing its authority to make 
laws that are necessary and proper to exercise its enumerated 
powers as listed above. In order for Congress to meet its 
obligations in article I, section 8, the dignity of 
servicemembers, veterans, and their families must be protected 
by specifically allowing fallen servicemembers and veterans to 
be laid to rest in a dignified way.
    A number of states have passed laws with the intent of 
protecting the dignity of military funerals within their 
jurisdiction. These state laws vary in scope and have no 
uniform time, place, and manner restrictions. The Committee 
believes that protecting the sanctity of a military funeral is 
of high national importance, and all families of deceased 
servicemembers should have the same protection, regardless of 
where they choose to bury their loved ones.
    The Committee bill amends both sections 1388 and 2413 by 
allowing the Attorney General to institute proceedings due to 
violations of either section. The amended sections also make 
violating either section a civil offense, where a finding in 
favor of the plaintiff carries the award of actual or statutory 
damages. The Committee notes that it does not appear that the 
Federal government has been enforcing the statutes as they are 
currently constructed. By allowing for civil actions to be 
brought by other injured parties, setting forth damages, and 
authorizing the Attorney General to start proceedings, the 
Committee believes there will be a uniform process for 
protecting the dignity of military funerals, both through 
governmental and non-governmental action.

Sec. 502. Codification of prohibition against reservation of gravesites 
        at Arlington National Cemetery.

    Section 502 of the Committee bill, which is derived from 
S. 698, would amend chapter 24 of title 38, U.S.C., by 
requiring that not more than one gravesite may be provided at 
ANC to an eligible veteran or member of the Armed Forces. The 
section would also prohibit the reservation of gravesites at 
ANC for individuals not yet deceased, and would require that 
the Army submit to Congress, within 180 days of the date of 
this section's enactment, a report on reservations made for 
interment at ANC.
    Background. Army Regulation 290-5, Paragraph 4-14, states 
that ANC selection of specific gravesites or sections is not 
authorized. Despite a stated policy against preferential 
treatment and the reservation of gravesites, The Washington 
Post reported that in recent years ANC had repeatedly provided 
preferential treatment to VIPs by setting aside select and 
prestigious gravesites for their future use. The March 2011 
article, titled ``Arlington Cemetery Struggles with old 
reservations,'' is excerpted in relevant part:

          Although [ANC] stopped formally taking reservations 
        in 1962, the practice of reserving choice grave sites 
        continued, if unofficially, under Raymond J. Costanzo, 
        who was superintendent from 1972 to 1990. [John C. 
        Metzler, Jr.], his successor, who ran the cemetery 
        until he was forced to retire last year, also 
        apparently allowed people to pick areas of the cemetery 
        where they wanted to be buried, Army officials said.
          The Army, which investigated the matter two decades 
        ago and is looking into it again, has a list from 1990 
        with ``senior officials'' who have plots that ``were de 
        facto reserved in violation of Army policy,'' according 
        to a memo obtained by The Post under the Freedom of 
        Information Act. Some of these officials were driven 
        around the cemetery by Costanzo, who told investigators 
        that he had allowed them to pick their spots.
          ``I take the position that if there is anything I can 
        do positively for a person, I will try to do that as 
        long as it is not a serious violation of any rule, 
        regulation, or law,'' he told investigators at the 
        time.

    Media reports regarding preferential treatment of and 
reservations for certain people, coupled with a 2010 
investigation of ANC by the Army Inspector General, reflect a 
series of problems with the previous management of ANC. As ANC 
works to build accountability and transparency in its 
management and operations, the issue of gravesite reservations 
remains a paramount concern.
    Committee Bill. Section 502 would codify the Army 
regulations that ban reserving gravesites and would provide 
accountability and transparency. The section would amend 
chapter 24 of title 38, U.S.C., by requiring that not more than 
one gravesite at ANC be provided to eligible veterans or 
members of the Armed Forces, unless a waiver is made by the 
Secretary of the Army as considered appropriate. This 
requirement would apply with respect to all interments at ANC 
after the date of the enactment of this section.
    Section 502 would also prohibit the reservation of 
gravesites at ANC for individuals not yet deceased. This 
prohibition would not apply with respect to the interment of an 
individual for whom a request for a reserved gravesite was 
approved by the Secretary of the Army before January 1, 1962--
when ANC formally stopped accepting reservations.
    A reporting requirement would also be imposed by the 
section. Not later than 180 days after the enactment of this 
section, the Army would be required to submit to Congress a 
report on reservations made for interment at ANC. The report 
would describe the number of requests for reservations at ANC 
that were submitted to the Secretary of the Army before January 
1, 1962. The report would also describe the number of 
gravesites at ANC that, on the day before the date of the 
enactment of this section, were reserved in response to such 
requests. The number of such gravesites that, on the day before 
the enactment of this section, were unoccupied would also be 
included in the report. Additionally, the report would list all 
reservations for gravesites at ANC that were extended by 
individuals responsible for the management of ANC in response 
to requests for such reservations made on or after January 1, 
1962.
    Finally, the report would detail the measures that the Army 
is taking to improve the accountability and transparency of 
gravesite reservations at ANC and any recommendations for 
legislative action necessary to improve such accountability and 
transparency.
    The Committee believes that this section is necessary to 
ensure that qualified servicemembers and veterans are honored 
at ANC without regard to rank or status. In light of the 
extraordinary sacrifices made by America's men and women in 
uniform, it is paramount that their burials at ANC occur with 
integrity, in a manner befitting such sacrifice, and in 
accordance with Army policy and regulation.

Sec. 503. Expansion of eligibility for presidential memorial 
        certificates to persons who died in the active military, naval, 
        or air service.

    Section 503 of the Committee bill, which is derived from 
S. 874, would expand eligibility for presidential memorial 
certificates to eligible friends and family of any 
servicemember who died in active military, naval or air 
service.
    Background. Under current law, section 112 of title 38, 
U.S.C., eligibility for presidential memorial certificates is 
limited to survivors of veterans who were discharged from 
service under honorable conditions. Under the statutory 
definition of ``veteran,'' for purposes of this section, an 
individual who died in active service, including an individual 
killed in action, technically is not a veteran because the 
individual was not ``discharged'' from service. Therefore, 
under current law, the survivors of such an individual are not 
eligible for a presidential memorial certificate for honoring 
the memory of the deceased individual.
    Committee Bill. Section 503 of the Committee bill would 
amend section 112 of title 38 by allowing VA to provide 
presidential memorial certificates to the next of kin, 
relatives, or friends of a servicemember who died in active 
military, naval, or air service.

                     TITLE VI--CONSTRUCTION MATTERS

Sec. 601. Authorization of fiscal year 2012 major medical facility 
        projects.

    Section 601 of the Committee bill would authorize VA to 
carry out the construction of new major medical facility 
projects in FY 2012 in Seattle, Washington, and in West Los 
Angeles, California.
    Background. Section 8104 of title 38, U.S.C., requires 
statutory authorization for all VA major medical facility 
construction projects prior to the appropriation or expenditure 
of funds. Two new projects warrant immediate FY 2012 
authorization: Seattle, Washington, and West Los Angeles, 
California.
    The Seattle project will correct seismic deficiencies 
identified at Building 100, which contains both the Nursing 
Tower and Community Living Center (hereinafter, ``CLC'') at the 
Seattle Campus. According to the Department, over 90 percent of 
all patient activity at this facility goes through Building 100 
on any given day. The nursing tower in Building 100 ranks 
eighth and the CLC in Building 100 ranks sixteenth among the 
buildings on the exceptionally high risk list of VA's Seismic 
Inventory report. The Seattle project has already received 
$4,300,000 in budget authority to begin design. The total 
estimated cost associated with this project is $51,800,000.
    The West Los Angeles project would seismically retrofit and 
renovate twelve buildings to house research, mental health, and 
homeless veterans programs. These buildings are designated as 
exceptionally high risk on VA's Seismic Inventory report and 
have a number of life safety and facility condition 
deficiencies. The West Los Angeles project has already received 
$15,500,000 in budget authority to begin design. The total 
estimated cost associated with this project is $346,900,000. 
For FY 2012, VA requested the authority to add Building 209 to 
the project and to obligate $20,000,000 of additional resources 
from prior year unobligated major construction funds to 
complete this renovation, for a total of $35,500,000.
    Committee Bill. Section 601 of the Committee bill would 
authorize appropriations of an amount not to exceed $51,800,000 
to conduct seismic corrections for Building 100 at the VAMC in 
Seattle, Washington. It would also authorize appropriations of 
an amount not to exceed $35,500,000 to conduct seismic 
corrections and renovation of various buildings at the VAMC in 
West Los Angeles, California.

Sec. 602. Modification of authorization for certain major medical 
        facility construction projects previously authorized.

    Section 602 of the Committee bill would modify previously 
authorized major medical facility construction projects in 
Fayetteville, Arkansas; Orlando, Florida; Palo Alto, 
California; San Juan, Puerto Rico; and St. Louis, Missouri.
    Background. Section 8104 of title 38, U.S.C., requires 
authorization of any major medical facility construction 
project or lease. Section 8104(d)(2)(A) of title 38 requires 
that unobligated funds that are a direct result of bid savings 
from major medical facility construction projects may only be 
obligated for major medical facility projects authorized in the 
current or previous fiscal years. VA requested that Congress 
modify previous authorizations for five major medical facility 
projects.
    Congress has authorized, through Public Law 109-461, the 
Veterans Benefits, Health Care, and Information Technology Act 
of 2006, up to $56,163,000 to be appropriated to construct a 
clinical addition at the VAMC in Fayetteville, Arkansas, to 
address projected workload growth. $93,000,000 was appropriated 
but $2,400,000 was reprogrammed to the Filipino Equity 
Compensation Fund in 2010. Due to a favorable market, VA has 
realized $16,000,000 in savings on this project and has 
requested authorization to reinvest $13,500,000 to address 
parking shortages by constructing a 522-space parking garage.
    VA was authorized through Public Law 109-461, the Veterans 
Benefits, Health Care, and Information Technology Act of 2006, 
to fund an amount up to $377,700,000 for land acquisition and 
construction of a 134-bed new medical facility, a large medical 
clinic, a 120-bed community living center, a 60-bed 
domiciliary, and support services in Orlando, Florida. This 
authority was increased by Public Law 110-387, the Veterans' 
Mental Health and Other Care Improvements Act of 2008, to up to 
$656,800,000. Congress appropriated $665,400,000. Due to a 
favorable market, VA has realized $111,243,000 in savings on 
this project and has requested authorization to reinvest 
$62,001,000 on energy projects and the creation of a 
Simulation, Learning, Education and Research Network Center.
    VA's Palo Alto Health Care System was authorized to 
construct a replacement Ambulatory Care Center, a replacement 
PRC, a blind rehabilitation facility, a 600 stall parking 
structure, and a research facility. The project received a 
$194,877,000 appropriation and was one of several Level I PRCs 
authorized through Public Law 110-252, the Supplemental 
Appropriations Act, 2008. VA has requested that this project be 
authorized at the total estimated cost of $716,600,000 for 
completion.
    The project in San Juan seismically upgrades the main 
hospital building, provides asbestos abatement, provides fire 
sprinklers, and allows VA to sustain operations in the wake of 
a natural disaster, better fulfilling the Department's role as 
the Coordinator of the Federal Response Plan in Puerto Rico. In 
addition, a new administrative building, parking structure, and 
outpatient clinic expansion will be built. Up to $225,900,000 
was authorized to be appropriated through Public Law 110-387, 
the Veterans' Mental Health and Other Care Improvements Act of 
2008. VA has requested additional budget authority to complete 
the project, for a total estimated cost of $277,000,000.
    The Jefferson Barracks campus of the St. Louis VAMC was 
authorized to receive up to $69,053,000 through Public Law 109-
461, to consolidate outpatient functions and relocate VA's 
Employee Education system and the NCA administrative 
operations. This consolidation would involve the demolition of 
underutilized buildings that would provide about 30 acres of 
land for cemetery expansion. VA has requested that this project 
be authorized at the total estimated cost of $346,300,000 for 
completion.
    Committee Bill. Section 602(a) of the Committee bill would 
amend section 803(3) of Public Law 109-461 to authorize an 
amount not to exceed $90,600,000 and would authorize a change 
of purpose, to include a parking garage in the major medical 
facility construction project at Fayetteville, Arkansas.
    Section 602(b) would amend section 802(11) of Public Law 
109-461, as amended by section 702(b)(4) of Public Law 110-387, 
the Veterans' Mental Health and Other Care Improvements Act of 
2008, to authorize a change of purpose, to include a 
Simulation, Learning, Education, and Research Network Center in 
the major medical facility construction project in Orlando, 
Florida.
    Section 602(c) would, in a freestanding provision, increase 
the authorized amount for the major medical facility 
construction project at Palo Alto, California, to $716,600,000.
    Section 602(d) would amend section 701(3) of Public Law 
110-387, to increase the authorized amount for the major 
medical facility construction project in San Juan, Puerto Rico, 
to $277,000,000.
    Section 602(e) would amend section 803(5) of Public Law 
109-461 to increase the authorized amount for the major medical 
facility improvements and cemetery construction project in St. 
Louis, Missouri, to $346,300,000.

Sec. 603. Authorization of fiscal year 2012 major medical facility 
        leases.

    Section 603 of the Committee bill would authorize eight 
leases for FY 2012: a CBOC in Columbus, Georgia; an outpatient 
clinic in Fort Wayne, Indiana; an outpatient clinic in Mobile, 
Alabama; an outpatient clinic in Rochester, New York; a CBOC in 
Salem, Oregon; an outpatient clinic in San Jose, California; an 
outpatient clinic in South Bend, Indiana; and a CBOC in 
Springfield, Missouri.
    Background. Section 8104 of title 38, U.S.C., requires 
authorization of any major medical facility construction 
project or lease. The Department has requested authorization 
for eight pending leases in order to improve health care.
    The Columbus, Georgia, replacement CBOC lease would 
consolidate two clinics whose leases have expired. This 
consolidation will allow patient and staff efficiencies as well 
as improve the patient continuum of care.
    The Department has indicated that the Ft. Wayne VAMC 
suffers from infrastructure deficiencies, space shortages, and 
patient privacy deficiencies. The Fort Wayne, Indiana, 
outpatient clinic lease would improve the quality of care 
delivered to veterans and allow the campus to decompress by 
housing mental health services, including substance abuse and 
PTSD care, in a new facility.
    The existing outpatient clinic in Mobile, Alabama, is 
housed in two floors of a functionally obsolete building in a 
neighborhood with rising crime rates. The clinic occupies 
35,345 net usable square feet, but is overcrowded and cannot 
implement new programs due to a lack of space. The space cannot 
be reconfigured due to columns and load bearing walls. A more 
appropriately sized facility would allow VA to incorporate the 
services provided at the existing clinic, in addition to new 
services such as home-based primary care and the patient 
aligned care team model.
    The existing Rochester, New York, CBOC was determined to 
have a space and parking shortage, despite leasing a total of 
41,190 net usable square feet and 184 parking spaces. This 
deficiency limits the specialty services that can be provided 
at the clinic. A new space would allow VA to serve area 
veterans through primary care, women's health, an OEF/OIF 
clinic, mental health services, homeless outreach services, 
home-based primary care, specialty and ancillary services, 
research, residency programs, and space for Veterans Benefits 
Administration and VSO presence.
    The 10,000 net usable square foot Salem, Oregon, CBOC is 
too small to support projected workload growth. The size limits 
the services the clinic can offer to just primary and specialty 
care, mental health, and other ancillary services. A new lease 
would improve the delivery of health care in the South Cascades 
market by allowing the CBOC to also offer eye care, 
rehabilitation, audiology, and speech pathology.
    The existing lease on the San Jose, California, CBOC is set 
to expire in 2016, with no additional option years and no 
opportunity for renewal. The CBOC treats over 10,000 veterans 
annually. Maintaining access to health care is critical for 
these veterans. The new Outpatient Clinic lease will allow VA 
to provide a number of services, including primary care, mental 
health, audiology, podiatry, optometry, radiology, laboratory, 
pharmacy, and telehealth.
    VA provides limited outpatient services through a CBOC in 
South Bend, Indiana. The remaining need is met by contracting 
for care and housing VA mental health providers at a contract 
facility. For needs that cannot be met locally, veterans must 
travel approximately two hours to the Fort Wayne VAMC. A new 
outpatient clinic lease will increase the continuity of care in 
South Bend, decrease outsourcing costs, allow VA to expand the 
type of services it offers, and reduce the travel time for 
veterans in need of health care.
    The Gene Taylor Outpatient Clinic in Mt. Vernon, Missouri, 
currently leases space from the State of Missouri at the 
Missouri Rehabilitation Center. The State has elected to close 
the center and has offered to extend the lease for an 
additional surcharge of over $1,000,000 per year. The space is 
undersized and ill-equipped to handle demand in the area, 
necessitating that VA contract with community providers for 
laboratory and radiology services. Springfield, Missouri, is an 
area that has a high veteran population. Relocating and 
expanding the CBOC from Mt. Vernon to Springfield will improve 
veteran access, increase clinical capacity, and improve 
efficiency.
    Committee Bill. Section 603(1) of the Committee bill would 
authorize the lease of a CBOC in Columbus, Georgia. The 
replacement clinic will support the parent facility at the 
Central Alabama Veterans Health Care System through the 
acquisition of approximately 55,000 net usable square feet of 
clinical space. The Committee bill would fully authorize the 
lease in the amount of $5,335,000.
    Section 603(2) of the Committee bill would authorize the 
lease of an Outpatient Clinic in Fort Wayne, Indiana. The 
replacement clinic will support the parent facility of the VA 
Northern Indiana Health Care System through the acquisition of 
approximately 27,000 net usable square feet of clinical space. 
The Committee bill would fully authorize the lease in the 
amount of $2,845,000.
    Section 603(3) of the Committee bill would authorize the 
lease of an Outpatient Clinic in Mobile, Alabama. The 
replacement clinic will support the parent facility of the VA 
Gulf Coast Veterans Health Care System in Biloxi, Mississippi, 
through the acquisition of approximately 65,125 net usable 
square feet of clinical space. The Committee Bill would fully 
authorize the lease in the amount of $6,565,000.
    Section 603(4) of the Committee bill would authorize the 
lease of an Outpatient Clinic in Rochester, New York. The 
replacement clinic will support the parent facility of the 
Canandaigua VAMC in Canandaigua, New York, through the 
acquisition of approximately 84,000 net usable square feet of 
clinical space and 672 parking spaces. The Committee bill would 
fully authorize the lease in the amount of $9,232,000.
    Section 603(5) of the Committee bill would authorize the 
lease of a CBOC in Salem, Oregon. The replacement clinic will 
support the parent facility of the Portland VAMC in Portland, 
Oregon, through the acquisition of approximately 26,000 net 
usable square feet of clinical space. The Committee bill would 
fully authorize the lease in the amount of $2,549,000.
    Section 603(6) of the Committee bill would authorize the 
lease of an Outpatient Clinic in San Jose, California, to 
replace the existing CBOC. The clinic will support the parent 
facility of the VA Palo Alto Health Care System in Palo Alto, 
California, through the acquisition of approximately 72,000 net 
usable square feet of clinical space and at least 576 parking 
spaces. The Committee bill would fully authorize the lease in 
the amount of $9,546,000.
    Section 603(7) of the Committee bill would authorize the 
lease of an Outpatient Clinic in South Bend, Indiana. The 
replacement clinic will support the parent facility of the VA 
Northern Indiana Health Care System in Fort Wayne, Indiana, 
through the acquisition of approximately 39,000 net usable 
square feet of clinical space. The Committee bill would fully 
authorize the lease in the amount of $6,731,000.
    Section 603(8) of the Committee bill would authorize the 
lease of a CBOC in Springfield, Missouri. The new clinic will 
support the parent facility of the Veterans Health Care System 
of the Ozarks in Fayetteville, Arkansas, through the 
acquisition of approximately 68,000 net usable square feet of 
clinical space. The Committee bill would fully authorize the 
lease in the amount of $6,489,000.

Sec. 604. Authorization of appropriations.

    Section 604 of the Committee bill would authorize 
appropriations for construction and leases.
    Background. Section 8104(a)(2) of title 38, U.S.C., 
prohibits the appropriation of funds for major medical facility 
construction projects or leases unless funds have been 
specifically authorized by law.
    Committee Bill. Section 604 of the Committee bill would, in 
a freestanding provision, authorize an appropriation for FY 
2012, or the year in which funds are appropriated, of 
$937,370,000 from the Construction, Major Projects, account for 
projects authorized in sections 601 and 602 of the Committee 
bill. It would also authorize an appropriation for FY 2012, or 
the year in which funds are appropriated, of $49,292,000 from 
the Medical Facilities account for the leases authorized in 
section 603 of the Committee bill.

Sec. 605. Limitation on authority of VA to use bid savings on major 
        medical facility projects to expand purpose of major medical 
        facility projects.

    Section 605 of the Committee bill, which is derived from 
S. 928, would limit the authority of VA to use bid savings to 
expand the purpose of previously authorized major medical 
facility projects.
    Background. Due to a favorable bid environment, VA has 
realized savings on several major construction projects. Under 
current law, section 8104(d) of title 38, U.S.C., VA may only 
use those savings on previously authorized projects; however, 
VA may currently use bid savings to expand upon the original 
purpose of a previously authorized project. Through its 
Strategic Capital Investment Planning process, VA has 
identified and prioritized up to $65 billion in anticipated 
construction needs over the next 10 years.
    Committee Bill. Section 605 of the Committee bill would 
limit VA's ability to use bid savings on major medical 
facilities to expand the purpose of a project. VA would be 
required to submit to the Committees on Veterans' Affairs and 
the Committees on Appropriations of the Senate and the House of 
Representatives notice of the source of the bid savings; the 
major medical facility project with respect to which VA intends 
to expand the purpose; a description of such expansion; and the 
amounts VA intends to obligate for such expansion.
    VA would not be authorized to expand the purpose of a 
project without Congressional authorization enacted in law. It 
is the Committee's intent that construction projects previously 
authorized, but not fully funded, be prioritized accordingly.

Sec. 606. Designation of George H. O'Brien Jr., Department of Veterans 
        Affairs Medical Center.

    Section 606 of the Committee bill, which is derived from 
S. 269, would designate the VAMC located in Big Spring, Texas, 
as the ``George H. O'Brien, Jr., Department of Veterans Affairs 
Medical Center.''
    Background. George H. O'Brien, Jr., served as a seaman in 
the United States Merchant Marines from December 1944 until May 
1946. In July 1946, while attending college at Texas Technical 
College, now known as Texas Tech University, he enlisted in the 
United States Marine Corps Reserve. After graduating from 
college in 1950, he was ordered to active duty and served in 
the Korean War until September 1952. He was awarded the Medal 
of Honor for his heroic actions during the Battle of the Hook 
on October 27, 1952, as detailed in the citation accompanying 
his award. He also received the Purple Heart Medal with gold 
star in lieu of a second award, the Korean Service Medal with 
two bronze stars, and the United Nations Service Medal, among 
other military honors. After his active duty service, O'Brien 
began a career as a petroleum geologist in Texas, while serving 
on the Marine Corps Scholarship Foundation as well as in the 
Medal of Honor Society. O'Brien was also an active volunteer at 
the VAMC in Big Spring, Texas.
    The Committee's Rules of Procedure (hereinafter, 
``Committee Rules'') put forward the requirements for the 
naming of Department facilities. According to those rules, a 
facility may be named for an individual only if that individual 
is deceased, and was a veteran who was instrumental to the 
construction or operation of the facility, received the Medal 
of Honor, or otherwise performed extraordinarily distinguished 
military service; was a member of Congress who was directly 
associated with such facility; an Administrator of Veterans 
Affairs, Secretary of Veterans Affairs, Secretary of Defense or 
of a branch of service, or a military or Federal civilian 
official of comparable rank; or the Chairman and Ranking Member 
agree the individual performed outstanding service for 
veterans. Further, each member of Congress representing the 
State in which the facility is located and the State chapter of 
each Congressionally-chartered VSO that has a national 
membership of at least 500,000, must indicate in writing their 
support for the naming proposal.
    Committee Bill. Section 606 of the Committee bill would, in 
a freestanding provision, name the VAMC in Big Spring, Texas, 
the ``George H. O'Brien, Jr., Department of Veterans Affairs 
Medical Center.''
    Because all members of the Texas Congressional delegation 
have expressed their support for naming this facility in 
writing, and the Texas chapters of all VSOs with national 
memberships of at least 500,000 individuals have endorsed this 
facility being named in honor of George H. O'Brien, Jr., this 
provision satisfies the Committee Rules regarding the naming of 
VA facilities.

Sec. 607. Designation of Major William Edward Adams Department of 
        Veterans Affairs Clinic.

    Section 607 of the Committee bill, which is derived from 
S. 327, would designate the VA telehealth clinic in Craig, 
Colorado, as the ``Major William Edward Adams Department of 
Veterans Affairs Clinic.''
    Background. Major Adams distinguished himself while serving 
as a U.S. Army helicopter pilot in Vietnam on May 25, 1971. 
Major Adams volunteered to fly a lightly armed helicopter in an 
attempt to evacuate three seriously wounded American soldiers 
from a small base that had come under attack. He made this 
decision with full knowledge that numerous anti-aircraft 
weapons were positioned around the base and that clear weather 
would make him visible to enemy gunners. As Major Adams 
approached the base, his aircraft came under heavy machine gun 
and rocket fire, but he continued his approach, simultaneously 
directing the attacks of supporting gunships while maintaining 
control of his own aircraft. He picked up the wounded soldiers, 
but his aircraft was then struck by enemy anti-aircraft fire 
and crashed, killing all aboard. In recognition of his heroism 
and sacrifice, Major Adams was posthumously awarded the Medal 
of Honor on August 8, 1974.
    The Committee Rules described in section 606 are also 
applicable to this section.
    Committee Bill. Section 607 of the Committee bill would 
name the VA telehealth clinic in Craig, Colorado, after Major 
William Edward Adams.
    Because all members of the Colorado Congressional 
delegation have expressed their support for naming this 
facility, in writing, and the Colorado chapters of all VSOs 
with national memberships of at least 500,000 individuals have 
endorsed this facility being named in honor of Major Adams, 
this provision satisfies the Committee Rules regarding the 
naming of VA facilities.

          TITLE VII--OTHER ADMINISTRATIVE AND BENEFIT MATTERS

Sec. 701. Assistance to veterans affected by natural disasters.

    Section 701 of the Committee bill, which is derived from 
S. 1123, would provide certain types of assistance to eligible 
veterans affected by a natural or other disaster.
    Background. In the wake of Hurricane Katrina and other more 
recent natural disasters, Congress has renewed its focus on 
Federal disaster response activities and resources for 
individuals affected by such disasters. While laws such as 
Public Law 93-288, the Robert T. Stafford Disaster Relief and 
Emergency Assistance Act, provide Federal assistance to 
individuals and families affected by natural disasters, current 
law is not specifically tailored to the needs of veterans, 
particularly veterans with service-connected disabilities 
affected by such disasters. This means that under current law 
targeted assistance is unavailable to those veterans who are 
particularly vulnerable and most in need of assistance in the 
event of a natural disaster.
    For example, VA adaptive housing assistance grants are 
available to eligible individuals who have certain service-
connected disabilities to construct an adapted home or to 
modify an existing home to accommodate their disabilities. 
However, limitations, such as caps on the total amount of 
assistance available under SAH or SHA grants may prevent a 
veteran from receiving additional assistance from VA to repair 
an adapted home damaged by a natural disaster.
    Similarly, under current law, section 3903 of title 38, 
U.S.C., if a veteran who has received a grant for the purchase 
of an automobile has that vehicle destroyed by a natural or 
other disaster, current statutory limitations would prevent VA 
from providing another grant to repair or replace the damaged 
vehicle.
    Committee Bill. Section 701 of the Committee bill would 
amend chapter 21 of title 38, U.S.C., by adding a new section 
which would provide assistance to a veteran whose home is 
destroyed or substantially damaged in a natural or other 
disaster and was previously adapted with assistance through the 
SAH or SHA grant program. Such assistance would not be subject 
to the limitations on assistance under section 2102. However, 
under this section, a grant award would not exceed the lesser 
of the reasonable cost of repairing or replacing the damaged or 
destroyed home in excess of the available insurance coverage on 
such home or the maximum grant amount to which the veteran 
would have been entitled under the SAH or SHA grant programs 
had the veteran not obtained the prior grant.
    Section 701 would amend section 3108 of title 38, U.S.C., 
by authorizing VA to extend the payment of a subsistence 
allowance to qualifying veterans participating in a 
rehabilitation program under chapter 31 of title 38. The 
extension would be authorized if the veteran has been displaced 
as a result of a natural or other disaster while being paid a 
subsistence allowance. If such circumstances are met, VA would 
be permitted to extend the payment of a subsistence allowance 
for up to an additional two months while the veteran is 
satisfactorily following a program of employment services.
    Section 701 would also amend section 3120 of title 38, 
U.S.C., by waiving the limitation on the number of veterans 
eligible to receive programs of independent living services and 
assistance in any case in which VA determines that an eligible 
veteran has been displaced as the result of, or has otherwise 
been adversely affected in the areas covered by, a storm or 
other disaster.
    Section 701 would amend section 3703 of title 38, U.S.C., 
to allow VA to guarantee a loan regardless of whether such loan 
is subordinate to a superior lien created by a public entity 
that has provided, or will provide, assistance in response to a 
major disaster.
    Additionally, section 701 would amend section 3903, U.S.C., 
of title 38 by authorizing VA to provide or assist in providing 
an eligible person receiving assistance through the Automobile 
Assistance Program with a second automobile. This assistance 
would be permitted only if VA receives satisfactory evidence 
that the automobile, previously purchased with assistance 
through this program was destroyed as a result of a natural or 
other disaster, the eligible person bore no fault, and the 
person would not receive compensation for the loss from a 
property insurer.
    Finally, section 701 would require VA to submit an annual 
report to Congress detailing the assistance provided or action 
taken by VA during the last fiscal year pursuant to the 
authority of this section. Required report provisions would 
include: a description for each natural disaster for which 
assistance was provided, the number of cases or individuals in 
which or to whom VA provided assistance, and for each such case 
or individual, a description of the assistance provided.
    The Committee believes these provisions would provide VA 
with the targeted authority necessary to assist veterans, many 
who are particularly vulnerable and most in need of assistance, 
in the wake of a natural or other disaster.

Sec. 702. Aggregate amount of educational assistance available to 
        individuals who receive both survivors' and dependents 
        educational assistance and other veterans and related 
        educational assistance.

    Section 702 of the Committee bill, which is derived from 
S. 536, would amend section 3695 of title 38 to modify the 
maximum number of months of educational assistance available to 
certain individuals.
    Background. Under chapter 35 of title 38, U.S.C., certain 
survivors and dependents of individuals who die or are disabled 
while on active duty are eligible for educational assistance 
benefits. Section 3511(a)(1) provides that each eligible person 
is entitled to the equivalent of 45 months of full-time 
benefits.
    P.L. 110-252, the Post-9/11 Veterans Educational Assistance 
Act of 2008, codified at chapter 33 of title 38, established a 
new program of educational assistance for individuals who 
served on active duty after September 11, 2001. This Act 
established a program of educational assistance in which 
individuals may earn up to a maximum of 36 months of full-time 
benefits.
    Further, under current law, section 3695 of title 38, an 
individual who is eligible for assistance under two or more 
specific educational programs may not receive in excess of the 
equivalent of 48 months of full-time benefits. This means that 
an eligible survivor or dependent who is entitled to receive 
education benefits under the chapter 35 program and who uses 
all 45 months of those benefits to obtain a college education, 
and who subsequently decides to enter the military, would only 
be able to earn the equivalent of three months of benefits 
under Public Law 110-252.
    Committee Bill. Section 702 of the Committee bill would 
amend section 3695 of title 38, U.S.C., to provide that an 
individual entitled to benefits under chapter 35 will not be 
subject to the 48-month limitation. However, the maximum 
aggregate period of benefits an individual may receive under 
chapter 35 and certain other educational assistance programs 
listed at section 3695 of title 38 would be capped at 81 
months.
    Section 702 would also revive a period of entitlement to 
education benefits in situations where an individual's 
entitlement to certain education benefits was reduced by the 
48-month limitation. The maximum period of assistance for 
individuals with revived benefits would also be capped at 81 
months.
    The Committee believes this change would allow individuals 
who use their survivors' or dependents' educational assistance 
benefits to also establish in their own right entitlement to 
the full range of benefits under Public Law 110-252.

Sec. 703. Department of Veterans Affairs enforcement penalties for 
        misrepresentation of a business concern as a small business 
        concern owned and controlled by veterans or as a small business 
        concern owned and controlled by service-disabled veterans.

    Section 703, which is derived from S. 1184 as introduced, 
would change the standard for enforcement of penalties for 
misrepresentation by businesses of their status as a small 
business concern owned and controlled by a veteran or service-
disabled veteran and the period of time for any consequent 
debarment.
    Background. Misrepresentation by businesses of their status 
as a veteran-owned small business (hereinafter, ``VOSB'') or a 
service-disabled veteran-owned small business (hereinafter, 
``SDVOSB'') remains a serious and ongoing concern. VA has taken 
steps to ensure increased contracting opportunities for VOSBs 
and SDVOSBs are utilized by legitimate business concerns. VA 
has added to its acquisition regulations the misrepresentation 
of VOSB/SDVOSB status as a specific cause for debarment for a 
period of up to 5 years. Also, VA has instituted a separate and 
distinct Debarment Committee to review, examine, and refer 
those who misrepresent themselves to VA's debarring official.
    Committee Bill. Section 703 would amend section 8127 of 
title 38 by changing the standard for enforcement of penalties 
for misrepresentation by businesses of their status as a small 
business concern owned and controlled by a veteran or service-
disabled veteran. Under this amendment, only those businesses 
determined by VA to have deliberately misrepresented their 
status would be liable for such misrepresentation. Section 703 
would also require that those businesses liable for 
misrepresentation be debarred from contracting with VA for a 
period of not less than 5 years. The debarment of a business 
concern would include the debarment of all principals in the 
business concern for a period of not less than 5 years. 
Finally, the section would require that commencement of a 
debarment action occur not later than 30 days after a 
determination by VA of deliberate misrepresentation and that 
the action be completed no later than 90 days after such 
determination.
    While VA's current measures reflect the Department's 
commitment to an equitable debarment process, consistent with 
an appropriate level of due process, the Committee is aware 
that some misrepresentations of VSOB/SDVOSB status requirements 
may be the result of an innocent mistake. Given this, it is 
important that the standard for enforcement of penalties for 
misrepresentation account for such instances where the 
misrepresentation is inadvertent and not deliberate.
    To ensure equity and due process, it is also important that 
a minimum period of time for debarment, during which a business 
concern and its principals are prohibited from contracting with 
VA, be adopted and uniformly applied.

Sec. 704. Authority for certain persons to sign claims filed with 
        Secretary of Veterans Affairs on behalf of claimants.

    Section 704 of the Committee bill, which is derived from 
S. 1148, would authorize certain individuals to sign claims 
filed with VA on behalf of claimants who are under age 18, are 
mentally incompetent, or are physically unable to sign a form.
    Background. Some claimants for VA benefits are so disabled 
as to be incapable of understanding the information on a 
benefits application form. Under current law, section 5101 of 
title 38, U.S.C., VA lacks specific authority to authorize a 
court-appointed representative or caregiver to sign an 
application form allowing the adjudication of the claim to 
proceed. However, the Social Security Administration 
(hereinafter, ``SSA'') has specific authority in section 
404.612 of title 20 of the Code of Federal Regulations to 
permit certain individuals, such as court-appointed 
representatives, to sign a claim form on behalf of an 
individual unable to understand and sign a claim form.
    Committee Bill. Section 704 of the Committee bill would 
amend section 5101 of title 38 to modify the application 
process for claims filed with VA. This amendment would allow a 
court-appointed representative, a caregiver, an attorney-in-
fact or an agent authorized to act on behalf of the claimant 
under a durable power of attorney to sign applications from 
individuals who are under 18 years of age, mentally 
incompetent, or physically unable to sign a form. If an 
individual is in the care of an institution, the manager or 
principal officer of the institution would be allowed to sign 
the form. These changes would apply with respect to claims 
filed on or after the date of enactment.
    This change will give VA the same authority that SSA has 
with respect to claimants who are unable to complete 
applications for benefits without requiring assistance. The 
Committee does not intend that this provision alter VA's 
responsibility to evaluate and appoint a fiduciary in cases 
where the beneficiary is determined to be incompetent to manage 
his or her benefits.

Sec. 705. Improvement of process for filing jointly for social security 
        and dependency and indemnity compensation.

    Section 705 of the Committee bill, which is derived from 
S. 1148, would codify VA's current practice of allowing any 
claim for survivor benefits filed with SSA to establish the 
effective date for DIC benefits.
    Background. Under current law, section 5105 of title 38, VA 
and SSA are required to develop and use joint applications for 
survivors who apply for both DIC and Social Security survivor 
benefits. Section 5105 further provides that, if such a joint 
application form is filed with either VA or SSA, it will be 
deemed an application for both DIC and Social Security 
benefits. However, at present, SSA applications are primarily 
online and VA's are paper-based.
    In a recent court case, Van Valkenburg v. Shinseki, 23 Vet. 
App. 113 (2009), VA represented to the Court that ``there has 
never been an individual `jointly prescribed form' promulgated 
between VA and SSA,'' and that ``in practice, a claim for 
survivor's benefits can be filed on any form, with either VA or 
SSA, when the applicant reflects an intent to seek such 
benefits.'' The Court accepted VA's representation that ``any 
claim, sufficient to reflect an intent to apply for survivor's 
benefits, that is filed with SSA will suffice to establish the 
effective date of DIC.''
    Committee Bill. Section 705 of the Committee bill would 
amend section 5105 of title 38 to permit--but not require--the 
development of a joint form for SSA and VA survivor benefits. 
This provision of the Committee bill would also amend section 
5105 so that any form indicating an intent to apply for 
survivor benefits would be deemed an application for both DIC 
and Social Security benefits. This is intended to codify VA's 
practice under which any indication of intent to apply for 
Social Security survivor benefits is also treated as an 
application for VA DIC benefits.

Sec. 706. Parity between part-time and full-time students under 
        employee incentive scholarship program.

    Section 706 of the Committee bill, which is derived from 
by-request legislation submitted by the Department, would 
require that any employee of the Department participating in 
the Employee Incentive Scholarship Program (hereinafter, 
``EISP'') be liable for the amount paid for a program should 
the employee fail to maintain VA employment during the program.
    Background. Section 7675 of title 38, U.S.C., limits 
liability for breach of the EISP agreement to part-time student 
participants. Currently, all other VA employee recruitment and 
retention incentive programs have a service obligation and 
liability component that affects both full-time and part-time 
employees.
    Committee Bill. Section 706 of the Committee bill would 
replace section 7675(b)(1)(E) of title 38, U.S.C., with a new 
subparagraph that would impose on full-time student 
participants in the EISP the same liability as is currently 
imposed on part-time students for breach of the EISP agreement 
if they leave VA employment prior to completion of their 
education program.

Sec. 707. Report on pay-for-performance compensation under health care 
        services contract.

    Section 707 of the Committee bill, which is derived from 
S. 1089, would require VA to submit to the Committees on 
Veterans' Affairs of the Senate and the House of 
Representatives a report on the feasibility and advisability of 
implementing pay-for-performance mechanisms in VA health care 
contracts at community-based outpatient clinics.
    Background. VA Directive 1663, issued in August 2006, 
allows VAMCs to purchase non-VA care from affiliated medical 
schools, groups, hospitals, and other providers, through 
contracts or fee-for-service care. These contracts are 
generally allowed if: a VA facility cannot provide a clinical 
service, the facility cannot recruit a needed clinician, it is 
not in VA's best interest to provide such service, only a 
portion of a clinician's time is needed, or it is cost-
effective to share a service or space with another entity 
rather than to develop a capacity within VA.
    Throughout VHA, many CBOCs deliver health care on a 
contract basis. CBOCs typically are associated with VAMCs and 
refer patients to those facilities when needed. In FY 2010, VA 
operated 798 CBOCs, 183 of which were operated by contract.
    The Independent Budget for FY 2012 (hereinafter, ``IB'') 
supports VA health care contracts when VA facilities are not 
capable of providing necessary care to veterans. The IB states, 
however, that VA does not track such care, its related costs, 
outcomes, or veteran satisfaction levels.
    Committee Bill. Section 707 of the Committee bill would, in 
a freestanding provision, require VA to submit a report on pay-
for-performance compensation mechanisms, where providers are 
rewarded for meeting pre-established targets for delivery of 
health care services, in VA health care contracts at CBOCs.
    Subsection (a) of section 707 of the Committee bill would 
require VA to submit, within 180 days after enactment of the 
Committee bill, a report to the Committees on Veterans' Affairs 
of the Senate and the House of Representatives, which would 
include information on VA's use of pay-for-performance 
mechanisms in contracts for health care services at CBOCs.
    Subsection (b) of section 707 of the Committee bill would 
specify the required elements to be included in the report. 
Such requirements would include an assessment of the 
feasibility and advisability of using pay-for-performance 
compensation mechanisms in VA health care contracts with CBOCs; 
information on the number of CBOCs operating under pay-for-
performance compensation mechanisms as of the date of enactment 
of the Committee bill; and the impact this mechanism has had in 
providing incentives to deliver high quality care and to better 
assure patient satisfaction.
    Subsection (c) of section 707 of the Committee bill would 
require VA to incorporate the views and experiences of 
representatives of at least two private health care systems 
that have utilized pay-for-performance compensation mechanisms 
in the operation of medical clinics, to determine if such 
mechanisms had an effect on the delivery of quality, timely 
medical care in the private sector.

Sec. 708. Extension of authority to obtain information from Secretary 
        of Treasury and Commissioner of Social Security for income 
        verification purposes.

    Section 708 of the Committee bill, which is derived from 
S. 1148, would extend for 2 years, until September 30, 2013, 
VA's authority to obtain information from the Internal Revenue 
Service (hereinafter, ``IRS'') or the SSA for income 
verification purposes for needs-based benefits.
    Background. Under current law, certain benefit programs 
administered by VA, such as pensions for wartime veterans, are 
available only to beneficiaries whose annual income is below a 
certain level. VA must have access to verifiable income 
information in order to ensure that those receiving benefits 
under its income-based programs are not earning a greater 
annual income than the law permits.
    Section 6103(l)(7)(D)(viii) of title 26, U.S.C., authorizes 
the release of certain income information by the IRS or the SSA 
to VA for the purposes of verifying the incomes of applicants 
for VA needs-based benefits. Section 5317(g) of title 38, 
U.S.C., provides VA with temporary authority to obtain and use 
this information. Under current law, this authority expires on 
September 30, 2011.
    Committee Bill. Section 708 of the Committee bill would 
amend subsection 5317(g) of title 38 to extend VA's authority 
to obtain income information from the IRS or the SSA until 
September 30, 2013.

Sec. 709. Extension of authority for regional office of Department of 
        Veterans Affairs in Republic of the Philippines.

    Section 709 of the Committee bill, which is derived from 
S. 1148, would extend until December 31, 2012, VA's authority 
to operate a regional office in the Republic of the 
Philippines.
    Background. Filipino veterans who served under the command 
of the United States during World War II have been granted 
limited benefits. Section 315(b) of title 38, U.S.C., 
authorizes VA to maintain a regional office in the Republic of 
the Philippines until December 31, 2011, to administer these 
benefits. Congress has periodically extended this authority, 
most recently in Public Law 111-275, the Veterans' Benefits Act 
of 2010.
    P.L. 111-275 also directed GAO to conduct a report on the 
regional office in the Republic of the Philippines. The report, 
which is due to the House and Senate Committees on Veterans' 
Affairs and Appropriations no later than October 13, 2011, is 
required to contain a description of the activities of the 
regional office and an assessment of the costs and benefits of 
maintaining the regional office in the Republic of the 
Philippines.
    Committee Bill. Section 709 would authorize VA to maintain 
a regional office in the Republic of the Philippines until 
December 31, 2012.

Sec. 710. Report on establishment of a Polytrauma Rehabilitation Center 
        or Polytrauma Network Site of the Department of Veterans 
        Affairs in the northern Rockies or Dakotas.

    Section 710 of the Committee bill, which is derived from 
S. 666, would require VA to submit to Congress a report on the 
feasibility and advisability of establishing a VA PRC or PNS in 
the northern Rockies or Dakotas, not later than 180 days after 
the enactment of the Committee bill.
    Background. Polytrauma refers to the cumulative condition 
resulting from exposure to a single event which has caused 
multiple and complex injuries. Such injuries can impact the 
brain, limbs, spinal cord, and musculoskeletal system, and in 
turn, can adversely affect hearing, vision, and cognition.
    An April 2008 RAND Corporation study, ``Invisible Wounds: 
Mental Health and Cognitive Care Needs of America's Returning 
Veterans,'' estimated that 320,000 veterans reported 
experiencing TBI during deployment, from mild concussions to 
severe wounds. Of those who reported experiencing a probable 
TBI, 57 percent were never evaluated by a physician. Veterans 
with severe polytrauma who do not live in proximity to a 
polytrauma care facility face difficulties in receiving 
necessary treatment.
    The VA Polytrauma System of Care provides treatment to 
veterans with polytrauma through four PRCs, located in Palo 
Alto, Tampa, Richmond, and Minneapolis. These PRCs offer 
comprehensive inpatient and outpatient treatment. A fifth PRC 
is, as of the date of this report, being constructed at the 
VAMC in San Antonio, Texas. There are also 22 PNSs that provide 
a full range of comprehensive follow-on medical and 
rehabilitative services, both inpatient and outpatient.
    Committee Bill. Section 710 of the Committee bill would, in 
a freestanding provision, require the VA to conduct a study and 
report to Congress, not later than 180 days after enactment of 
the Committee bill, on the feasibility and advisability of 
establishing a PRC or PNS in the northern Rockies or Dakotas. 
This section would specify that the Fort Harrison VAMC be one 
of the sites evaluated for potential placement of a PRC or a 
PNS.
    The report would be required to include an assessment of 
the adequacy of existing services provided at Department 
facilities and the availability of the types of services that 
would otherwise be provided by a PRC or PNS. The report would 
also be required to include a comparative assessment of the 
effectiveness of TBI rehabilitation programs in urban versus 
rural settings, an assessment of whether the low cost of living 
in the region could reduce the financial burden on families of 
a veteran undergoing TBI care and thereby improve that care, 
and whether any stress caused by living in an urban area can 
impede therapies to prevent or remediate the development of 
secondary neurologic conditions related to TBI. The Department 
would be required to consult with State and local government 
entities in preparing this report.

Sec. 711. Modification of loan guaranty fee for certain initial loans.

    Section 711 of the Committee bill would modify VA's 
authority to levy a loan guaranty fee for initial guaranteed 
housing loans.
    Background. Under VA's home loan guaranty program, VA may 
guarantee a loan made to eligible servicemembers, veterans, 
reservists, and un-remarried surviving spouses for the purchase 
(or refinancing) of houses, condominiums, and manufactured 
homes.
    Section 3729(b)(2) of title 38, U.S.C., sets forth a loan 
fee table that lists funding fees, expressed as a percentage of 
the loan amount, for different types of loans.
    Committee Bill. Section 711 of the Committee bill would 
amend the fee schedule set forth in section 3729(b)(2) of title 
38 by extending VA's authority to collect certain fees and by 
adjusting the amount of the fees. Specifically, the section 
would strike clauses (i) and (ii), redesignate current clause 
(iii) as clause (i), and insert a new clause (ii), and 
redesignate current clause (iv) as (iii). New clause (iii) 
would additionally be amended by striking ``October 1, 2011'' 
and inserting October 1, 2012.
    The practical effect of these changes would be to maintain 
the current home loan guaranty fees, 2.15 percent for active 
duty and 2.4 percent for Reservists, until October 1, 2011. 
After that date, and until October 1, 2012, the rates would be 
decreased to 1.5 percent for active duty and 1.75 percent for 
Reservists, rather than allowing them to decrease, according to 
current law, on October 1, 2011 to 1.4 percent for active duty 
and 1.65 percent for Reservists, which would now be scheduled 
to occur on October 1, 2012.
    These amendments would take effect on the later of October 
1, 2011, and the date of the enactment of this section.

                      Committee Bill Cost Estimate

    In compliance with paragraph 11(a) of rule XXVI of the 
Standing Rules of the Senate, the Committee, based on 
information supplied by the Congressional Budget Office 
(hereinafter, ``CBO''), estimates that, on net, the Committee 
bill would decrease direct spending by $7 million over the 
2012-2021 period.
    In addition, CBO estimates that implementing the Committee 
bill would have a discretionary cost of $1.3 billion over the 
2012-2016 period, assuming appropriation of the specified and 
estimated amounts. The Committee bill contains no 
intergovernmental or private-sector mandates as defined in the 
Unfunded Mandates Reform Act. The cost estimate provided by 
CBO, setting forth a detailed breakdown of costs, follows:

                               Congressional Budget Office,
                                   Washington, DC, August 30, 2011.
Hon. Patty Murray,
Chairman,
Committee on Veterans' Affairs,
U.S. Senate, Washington, DC.

    Dear Madam Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 914, the Veterans 
Programs Improvement Act of 2011.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Ann E. 
Futrell.
            Sincerely,
                                      Douglas W. Elmendorf,
                                                          Director.

  Enclosure.

S. 914--Veterans Programs Improvement Act of 2011

    Summary: S. 914 would authorize the construction of several 
major medical facility projects, expand programs for homeless 
veterans and make other changes to health care, compensation, 
housing, education, and other programs offered by the 
Department of Veterans Affairs (VA). In total, CBO estimates 
that implementing the bill would have a discretionary cost of 
$1.3 billion over the 2012-2016 period, assuming appropriation 
of the specified and estimated amounts.
    In addition, CBO estimates that enacting the bill would 
decrease direct spending by $7 million over the 2012-2021 
period. Pay-as-you-go procedures apply because enacting the 
legislation would affect direct spending. Enacting S. 914 would 
not affect revenues.
    S. 914 contains no intergovernmental mandates as defined in 
the Unfunded Mandates Reform Act (UMRA).
    S. 914 would impose a private-sector mandate, as defined in 
UMRA, on certain mortgage holders and other creditors. Based on 
information from industry sources, CBO expects that the cost of 
the mandate would fall below the annual threshold for private-
sector mandates ($142 million in 2011, adjusted annually for 
inflation).
    Estimated cost to the Federal Government: The estimated 
budgetary impact of S. 914 is summarized in Table 1. The costs 
of this legislation fall within budget function 700 (veterans 
benefits and services).

         Table 1.--Estimated Budgetary Effects of S.914, The Veterans Programs Improvement Act  of 2011
----------------------------------------------------------------------------------------------------------------
                                                                      By fiscal year, in millions of dollars--
                                                                  ----------------------------------------------
                                                                    2012    2013   2014   2015   2016  2012-2016
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Estimated Authorization Level....................................   1,304     42     -5     -6     -7      1,328
Estimated Outlays................................................     347    344    313    215     77      1,296

                                           CHANGES IN DIRECT SPENDINGa

Estimated Budget Authority.......................................     -18      0      1      2     -1        -16
Estimated Outlays................................................     -18      0      1      2     -1        -16
----------------------------------------------------------------------------------------------------------------
aIn addition to the changes in direct spending shown above, enacting S.914 would have effects beyond 2016 (see
  Table 3). CBO estimates that over the 2012-2021 period, S.914 would decrease net direct spending by $7million.

    Basis of estimate: For this estimate, CBO assumes the 
legislation will be enacted near the start of fiscal year 2012, 
that the necessary amounts will be appropriated each year, and 
that outlays will follow historical patterns for similar and 
existing programs.

Spending subject to appropriation

    CBO estimates that implementing S. 914 would have a 
discretionary cost of $1.3 billion over the 2012-2016 period, 
assuming appropriation of the specified and estimated amounts 
(see Table 2). Most of the bill's estimated costs stem from 
provisions that would authorize appropriations for medical 
construction projects.
    Medical Facilities. Title VI would authorize funding to 
construct, renovate, and lease several medical facilities. CBO 
estimates that implementing title VI would cost about $1 
billion over the 2012-2016 period, assuming appropriation of 
the authorized and estimated amounts.
    Major Construction Projects. Section 602 would authorize 
the appropriation of $850 million to construct and modify 
medical facilities in Palo Alto, California; St. Louis, 
Missouri; and San Juan, Puerto Rico. CBO estimates that, if 
appropriated, those amounts would result in discretionary costs 
of $824 million over the 2012-2016 period.

                  Table 2.--Estimated Changes in Spending Subject to Appropriation Under S.914
----------------------------------------------------------------------------------------------------------------
                                                                      By fiscal year, in millions of dollars--
                                                                  ----------------------------------------------
                                                                    2012    2013   2014   2015   2016  2012-2016
----------------------------------------------------------------------------------------------------------------
                                               Medical Facilities
Major Construction Projects
    Authorization Level..........................................     850      0      0      0      0        850
    Estimated Outlays............................................      37    229    277    204     77        824
Leases for Medical Facilities
    Estimated Authorization Level................................      50     22     22     22     22        138
    Estimated Outlays............................................      45     22     22     22     22        133
Seismic Corrections and Renovations
    Estimated Authorization Level................................      68      0      0      0      0         68
    Estimated Outlays............................................       3     18     22     16      6         65
                                                                  ----------------------------------------------
    Subtotal, Medical Facilities
        Estimated Authorization Level............................     968     22     22     22     22      1,056
        Estimated Outlays........................................      85    269    321    242    105      1,022

                                                   Health Care
Reimbursement for Ambulance Services
    Estimated Authorization Level................................     -45    -48    -51    -53    -56       -253
    Estimated Outlays............................................     -41    -47    -50    -53    -55       -246
Travel Reimbursements for Vet Centers
    Estimated Authorization Level................................       7     14     14     15     15         65
    Estimated Outlays............................................       6     13     14     15     15         63
Telehealth and Telemedicine Programs
    Estimated Authorization Level................................       2      3      4      6      8         23
    Estimated Outlays............................................       2      3      4      6      8         23
Chiropractic Care
    Estimated Authorization Level................................       1      1      2      2      2          8
    Estimated Outlays............................................       1      1      2      2      2          8
Centers of Excellence for Rural Health
    Estimated Authorization Level................................       *      1      1      1      1          4
    Estimated Outlays............................................       *      1      1      1      1          4
State Prescription Monitoring Programs
    Estimated Authorization Level................................       1      *      *      *      *          1
    Estimated Outlays............................................       1      *      *      *      *          1
                                                                  ----------------------------------------------
    Subtotal, Health Care
        Estimated Authorization Level............................     -34    -29    -30    -29    -30       -152
        Estimated Outlays........................................     -31    -29    -29    -29    -29       -147

                                                Homeless Veterans
Extension of Certain Authorities for Homeless Veterans
    Estimated Authorization Level................................     107     37      *      0      0        144
    Estimated Outlays............................................      96     43      4      0      0        143
Supportive Services for Low-Income Families
    Authorization Level..........................................     101      0      0      0      0        101
    Estimated Outlays............................................      91      9      *      *      0        100
Homeless Providers Grants and Per Diem Program
    Authorization Level..........................................     100      0      0      0      0        100
    Estimated Outlays............................................      90      9      0      0      0         99
Workforce Reintegration Program
    Authorization Level..........................................      50      0      0      0      0         50
    Estimated Outlays............................................       4     31     14      1      0         50
Homeless Veterans with Special Needs
    Authorization Level..........................................       5      5      0      0      0         10
    Estimated Outlays............................................       5      5      *      *      *         10
Case Management Services for HUD-VASH Program
    Estimated Authorization Level................................       1      1      1      1      1          5
    Estimated Outlays............................................       1      1      1      1      1          5
Services for Homeless Veterans
    Estimated Authorization Level................................       1      *      0      0      0          1
    Estimated Outlays............................................       1      *      *      *      *          1
                                                                  ----------------------------------------------
    Subtotal, Homeless Veterans
        Estimated Authorization Level............................     365     43      1      1      1        411
        Estimated Outlays........................................     288     98     19      2      1        408

                                                Other Provisions
VA Office in Philippines
    Estimated Authorization Level................................       5      6      2      0      0         12
    Estimated Outlays............................................       5      6      2      0      0         12
Reports and Plans
    Estimated Authorization Level................................       *      *      *      *      *          1
    Estimated Outlays............................................       *      *      *      *      *          1
                                                                  ----------------------------------------------
    Subtotal, Other Provisions
        Estimated Authorization Level............................       5      6      2      0      0         13
        Estimated Outlays........................................       5      6      2      0      0         13
                                                                  ----------------------------------------------
Total Changes to Spending Subject to Appropriation
    Estimated Authorization Level................................   1,304     42     -5     -6     -7      1,328
    Estimated Outlays............................................     347    344    313    215     77      1,296
----------------------------------------------------------------------------------------------------------------
Notes: VA = Department of Veterans Affairs; HUD-VASH = Housing and Urban Development-Department of Veterans
  Affairs Supported Housing; * = less than $500,000.

    Leases for Medical Facilities. Section 603 would authorize 
the appropriation of $50 million for leasing eight medical 
facilities. Based on information from VA's 2012 budget request, 
CBO expects that VA would enter into 20-year lease agreements 
for those facilities. CBO estimates that in addition to the 
specified amounts authorized to be appropriated in 2012, VA 
would incur additional costs of $22 million a year starting in 
2013. (Costs are higher in the first year than in other years 
because VA would pay up front for necessary improvements and 
upgrades.) CBO estimates that entering into those leases would 
cost $133 million over the 2012-2016 period, assuming 
appropriation of the authorized and estimated amounts.
    Seismic Corrections and Renovations. Section 601 would 
authorize the appropriation of $87 million for seismic 
corrections and renovations at facilities in Los Angeles and 
Seattle, Washington. Based on VA's current estimated 
construction costs and the amounts that have already been 
appropriated for those projects, CBO estimates that VA would 
require additional funding of $68 million in 2012. CBO 
estimates that implementing those projects would cost a total 
of $65 million over the 2012-2016 period, assuming 
appropriation of the estimated amounts.
    Health Care. Title I contains sections that would change 
reimbursements for certain VA health care services and related 
travel, as well as expand health care services. CBO estimates 
that implementing title I would reduce costs by a net of $147 
million over the 2012-2016 period, assuming appropriation of 
the authorized and estimated amounts.
    Reimbursement for Ambulance Services. Section 108 would 
allow VA to pay the provider of ambulance services the lesser 
of the actual charge or the amount determined by the Medicare 
fee schedule for ambulance services. Under current law, VA does 
not have a standard fee for ambulance services; rather they 
reimburse the transportation costs for certain veterans based 
upon the ``actual necessary expense'' as submitted by the 
provider. CBO expects that paying Medicare rates for ambulance 
services would lower such costs by roughly 20 percent 
(comparable to the difference between Medicare Part B physician 
payment rates and those of the private sector). On that basis, 
CBO estimates that using the Medicare fee schedule would reduce 
spending for ambulance services by $246 million over the 2012-
2016 period, assuming appropriations for such benefits 
continue.
    Travel Reimbursements for Vet Centers. VA is required to 
reimburse the travel expenses of certain veterans seeking 
vocational rehabilitation, counseling, or treatment at a VA 
facility or other approved locations at a general rate of 41.5 
cents per mile. According to the Veterans Health 
Administration, there are nearly 10 million claims made each 
year for travel reimbursement.
    Section 103 would require Vet Centers to be treated as VA 
facilities for the purpose of reimbursement for travel. Based 
on information from VA, CBO estimates that under the bill VA 
would approve between 280,000 and 300,000 new travel claims 
each year from Vet Center patients over the 2012-2016 period. 
Based on information from VA regarding recent travel claims, 
CBO estimates that VA would pay an average of $47 per claim in 
2012, rising to $50 per claim in 2016. Assuming appropriation 
of the necessary amounts, a one-year phase-in period, and 
annual adjustments for inflation, CBO estimates that 
implementing this provision would cost $63 million over the 
2012-2016 period.
    Telehealth and Telemedicine Programs. Section 101 would 
prohibit the VA from charging copayments to veterans for any 
telehealth or telemedicine consultations. VA currently charges 
copayments of $15 for primary care visits and $50 for specialty 
care visits. Based on information from the department, CBO 
estimates that in 2012 VA will have a workload of over 67,000 
such consultations for which it will receive $2 million in 
copayments. In recent years, those programs have experienced a 
25 percent annual rate of growth in workload. Some of that 
growth represents new workload in terms of medical visits that 
would not have been made for reasons of distance or other 
difficulty in accessing VA care. The remainder of the growth is 
accounted for by veterans using telehealth and telemedicine in 
place of physical visits to a VA facility. CBO expects that 
eliminating the copayments for virtual visits would accelerate 
the shift from regular visits, which would continue to incur 
copayments.
    CBO estimates that implementing this provision would 
decrease collections by $2 million in 2012, growing to $8 
million by 2016.
    Such collections are offsets to discretionary 
appropriations. As part of the annual appropriations process, 
the Congress gives VA authority to spend those collections. 
Therefore, maintaining the same level of health care services 
for veterans would necessitate additional funding each year to 
make up for the loss of copayments under this provision. Thus, 
CBO estimates that implementing this provision would cost $23 
million over the 2012-2016 period, assuming appropriation of 
the necessary amounts.
    Chiropractic Care. Section 107 would require VA to provide 
comprehensive chiropractic services at two or more locations in 
each of the 21 Veterans Integrated Services Networks (VISNs), 
which are VA's regional networks of medical facilities, and in 
other locations as the Secretary determines appropriate. Nine 
VISNs currently meet those requirements and the remaining 12 
VISNs each provide care at one location. VA reports that the 
average salary for a chiropractor is roughly $115,000. After 
adjusting for inflation, CBO estimates that providing 
chiropractic care at one additional location in each of those 
12 VISNs would cost $8 million over the 2012-2016 period, 
assuming appropriation of the necessary amounts.
    Centers of Excellence for Rural Health. Section 106 would 
require VA to establish centers of excellence for research, 
education, and clinical activities related to providing health 
care in rural areas. CBO assumes VA would use existing 
facilities, but would increase personnel. CBO estimates that 
establishing the centers of excellence would cost $4 million 
over the 2012-2016 period, assuming appropriation of the 
necessary amounts.
    State Prescription Monitoring Programs. Section 110 would 
allow VA to share information on prescription drug usage with 
state programs that seek to minimize misuse of prescription 
drugs. CBO estimates minimal costs to establish and maintain 
the necessary IT capabilities. CBO estimates that implementing 
this provision would cost $1 million over the 2012-2016 period, 
assuming the availability of appropriated funds.
    Homeless Veterans. Title II includes several provisions 
that would extend and expand programs providing assistance to 
homeless veterans. CBO estimates that implementing title VI 
would cost $408 million over the 2012-2016 period, assuming 
appropriation of the necessary amounts.
    Extension of Certain Authorities for Homeless Veterans. 
Section 205 would extend, for various periods, the expiring 
authorities for several programs that provide services to 
homeless veterans. CBO estimates that extending such programs 
would cost $143 million over the 2012-2016 period, assuming 
appropriation of the necessary amounts.
    Supportive Services for Low-Income Families. Section 207 
would extend through 2012 a VA program that provides grants to 
entities serving certain low-income families and authorize the 
appropriation of $101 million for that program in 2012.
    The program, which expires in 2011, provides grants to 
entities that help the families of low-income veterans that are 
homeless, making the transition to permanent housing, or 
already in permanent housing. Those entities provide a variety 
of services including outreach, case management, and assistance 
accessing VA or other public benefits. CBO estimates that 
implementing that provision would cost $100 million over the 
2012-2016 period, assuming appropriation of the specified 
amount.
    Homeless Providers Grants and Per Diem (GPD) Program. 
Section 201 would increase the annual amounts authorized for 
the VA's Homeless Providers Grant and Per Diem Program (GPD) 
from $150 million to $250 million in 2012.\1\ The GPD program 
provides capital grants for constructing, renovating, or 
acquiring buildings and per diem payments to fund operating 
costs. After factoring in historical spending patterns for this 
program, CBO estimates that implementing that provision would 
cost $99 million over the 2012-2016 period, assuming 
appropriation of the specified amount.
---------------------------------------------------------------------------
    \1\Section 201 also would authorize the appropriation of an 
additional $68 million for fiscal year 2011. However, since CBO assumes 
this bill will be enacted near the start of 2012, the estimate does not 
include that funding.
---------------------------------------------------------------------------
    Workforce Reintegration Program. Section 206 would 
authorize the appropriation of $50 million a year for 2012 for 
the homeless veteran reintegration program at VA. CBO estimates 
that implementing that provision would cost $50 million over 
the 2012-2016 period, assuming appropriation of the specified 
amount.
    Homeless Veterans with Special Needs. Section 208 would 
authorize the appropriation of $5 million a year for 2012 and 
2013 to provide support to health care facilities and providers 
that offer services to homeless veterans who are: women, 
elderly, terminally ill, or chronically mentally ill. CBO 
estimates that implementing that provision would cost $10 
million over the 2012-2016 period, assuming appropriation of 
the specified amounts.
    Case Management Services for Housing and Urban Development-
Department of Veterans Affairs Supported Housing (HUD-VASH) 
Program. Section 209 would authorize the VA to enter into 
contracts or agreements with other entities in the provision of 
case management services to certain homeless veterans in the 
HUD-VASH program. This section also would provide training 
grants to collaborating entities. The HUD-VASH program is a 
collaboration between HUD and VA to provide permanent housing 
to homeless veterans and their families. Veterans enrolled in 
the HUD-VASH program receive case management and supportive 
services through VA. Based on information from VA, CBO expects 
that, under this provision, contract case managers would be 
added as necessary. CBO estimates that VA would add an 
additional 10 case managers on a part-time basis. CBO estimates 
that implementing this provision would cost $5 million over the 
2012-2016 period, assuming the availability of appropriated 
funds.
    Services for Homeless Veterans. Section 203 would expand 
the provision of certain services provided to homeless veterans 
suffering from mental illness to include all homeless veterans. 
The underlying authority to provide those services is extended 
elsewhere in the bill through December 31, 2012. CBO expects 
that the primary effect of this provision would be to ensure 
that all homeless veterans are eligible for temporary housing. 
Based upon information from VA, CBO estimates that under this 
provision, placements into temporary housing would increase by 
nearly 10 percent, or about 1,500. On average, per diem costs 
are roughly $55 per day and the average length of stay is about 
50 days. On that basis, CBO estimates that implementing section 
203 would cost $1 million over the 2012-2013 period, assuming 
the availability of appropriated funds.
    Other Provisions. Several other provisions would increase 
discretionary costs. Implementing those requirements would, CBO 
estimates, have a total cost of $13 million over the 2012-2016 
period, assuming appropriation of the necessary amounts.
    VA Office in Philippines. Section 709 would extend the 
authority to maintain a VA Office in the Philippines from 
December 31, 2011, to December 31, 2013. Based on information 
from VA, the cost of maintaining that office is about $6 
million a year; therefore, CBO estimates that implementing 
section 709 would cost $12 million over the 2012-2014 period, 
assuming appropriation of the necessary amounts.
    Reports and Plans. S. 914 would require several reports and 
plans to be completed by VA. CBO estimates that those 
provisions, collectively, would cost about $1 million over the 
2012-2016 period, assuming availability of appropriated funds.

Direct spending

    S. 914 contains provisions that would both increase and 
decrease direct spending. CBO estimates that, on net, enacting 
S. 914 would decrease direct spending by $7 million over the 
2012-2021 period (see Table 3).
    Extension of Income Verification. Section 708 would extend 
VA's authority to verify income reported by recipients of VA 
pension benefits by allowing it to acquire information on 
income from the Internal Revenue Service (IRS). The 
authorization allowing the IRS to provide income information to 
VA was made permanent by Public Law 110-245, but the 
authorization allowing VA to acquire the information is 
scheduled to expire on September 30, 2011. Section 708 would 
extend that authority through September 30, 2013.
    Over the last several years, VA saved, on average, $4 
million each year in new pension benefit payments by using the 
IRS data to verify veterans' incomes. CBO estimates that the 
incremental savings from utilizing the IRS data for income 
verification would be about $4 million in new savings each 
year. Those savings would compound, rising to about $8 million 
in 2013. After adjusting for cost-of-living increases and 
mortality rates, savings would decline starting in 2014 after 
the authority to use IRS data expires. CBO estimates that 
section 708 would reduce direct spending by $56 million over 
the 2012-2021 period.
    Fees for Guaranteed Loans. Section 711 would increase the 
fees that VA charges for guaranteeing certain mortgages made to 
veterans. VA guarantees lenders a payment of up to 25 percent 
of the outstanding loan balance (subject to some limitations on 
the original loan amount) in the event that the veteran 
defaults. Such guarantees enable veterans to get better loan 
terms, for example, lower interest rates or smaller down 
payments. VA charges fees to some veterans for its guarantee to 
offset the costs of subsequent defaults.
    Under current law, veterans who get a mortgage with a VA 
guarantee and who don't make a down payment are required to pay 
an up-front fee equal to 2.15 percent of the principal for 
loans taken in 2011. In 2012 and thereafter the fee for such 
loans declines to 1.40 percent. Veterans of the reserve 
components pay an additional fee of 0.25 percent for loan 
guarantees. Fees for all veterans are higher if they have 
previously used the loan-guarantee benefit.
    Section 711 would increase the guarantee fee for loans with 
no down payment made in 2012 to 1.50 percent of the principal. 
Reserve veterans would continue to pay the additional 0.25 
percent premium. In 2013 and thereafter, the fee would decline 
to 1.40 percent, consistent with current law. Raising the fee 
in 2012 would increase collections by VA, lowering the subsidy 
cost of the loan guarantees and reducing direct spending by $32 
million in 2012, CBO estimates.

                           Table 3.--Estimated Changes in Direct Spending Under S.914
----------------------------------------------------------------------------------------------------------------
                                                Outlays by fiscal year, in millions of dollars--
                               ---------------------------------------------------------------------------------
                                2012  2013  2014  2015  2016  2017  2018  2019  2020  2021  2012-2016  2012-2021
----------------------------------------------------------------------------------------------------------------
                                           CHANGES IN DIRECT SPENDING
Extension of Income               -4    -8    -7    -6    -6    -6    -5    -5    -5    -4      -31        -56
 Verification.................
Fees for Guaranteed Loans.....   -32     0     0     0     0     0     0     0     0     0      -32        -32
Survivors and Dependents           1     2     2     2     2     2     3     3     3     4        9         24
 Educational Benefits.........
Retroactive Effective Date for    15     0     0     0     0     0     0     0     0     0       15         15
 Disability Compensation
 Claims.......................
Assistance for Veterans            1     1     1     1     1     1     1     1     1     1        5         10
 Affected by Natural Disasters
Specially Adapted Housing          0     3     3     3     *     *     *     *     *     *        9         10
 Assistance...................
Occupancy of Housing by            *     1     1     1     1     1     1     1     1     1        4          9
 Dependent Children...........
Waiver of Loan Fee............     *     *     *     *     *     *     1     1     1     1        1          5
Temporary Residence Adaptation     1     1     1     1     1     1     1     1     1     1        4          7
 Grants.......................
Increased Pension for Married      *     *     *     *     *     *     *     *     *     *        *          1
 Veterans Requiring Aid and
 Attendance...................
                               ---------------------------------------------------------------------------------
    Total Changes                -18     0     1     2    -1    -1     2     2     2     4      -16         -7
----------------------------------------------------------------------------------------------------------------
Notes: Components may not sum to totals because of rounding; * = less than $500,000.

    Survivors and Dependents Educational Benefits. Spouses and 
children of certain deceased or totally disabled veterans are 
eligible for up to 45 months of veterans' educational benefits. 
If the survivors and dependents are eligible for additional 
educational benefits because of their own military service or 
through the transfer of benefits, they are limited to a total 
of 48 months of benefits. Beginning October 1, 2011, section 
702 would allow such survivors and dependents to use a maximum 
of 81 months of benefits. Based on information from VA and the 
Department of Defense, CBO estimates that approximately 130 
survivors and dependents each year would use the additional 
benefits. If enacted, we estimate that section 702 would 
increase direct spending by $24 million over the 2012-2021 
period.
    Retroactive Effective Date for Disability Compensation 
Claims. Section 402 would allow VA to pay up to a year's worth 
of retroactive payments to veterans who submit fully developed 
claims. This provision would expire on September 30, 2012.
    Based on information from VA, less than 1 percent of all 
disability claims are adjudicated as fully developed claims. Of 
the roughly 930,000 new claims that were adjudicated by VA in 
2010, approximately 5,200 were processed and adjudicated as 
fully developed. Of those 5,200 claims, 83 percent were 
disability compensation claims that resulted in 1,300 
accessions (24 percent) and 3,000 (59 percent) reopened claims. 
CBO expects that a similar trend would continue for 2012.
    Under section 402, a veteran that submitted a fully 
developed claim would be eligible for one year's worth of 
retroactive payments, should his or her claim be approved. Some 
veterans currently receive a retroactive benefit because they 
submitted an informal claim in advance of the fully developed 
claim. Those veterans receive payments for the period between 
the submission of the first and second applications. CBO 
estimates that about 25 percent of veterans submit informal 
claims ahead of their fully developed claim. Therefore, CBO 
estimates that about 970 new veterans and about 2,400 reopened 
cases would be eligible for a year's worth of retroactive 
payments.
    Using information from VA, CBO estimates that in 2012, the 
average new veteran will enter the rolls with a 40 percent 
disability rating resulting in an annual payment of about 
$7,680. Veterans who reopened their cases and received an 
increase will be--on average--eligible for a 10 percent 
increase in their disability rating, resulting in a one-year 
retroactive payment of roughly $3,240. Therefore, CBO estimates 
that enacting section 402 would increase direct spending in 
2012 by about $15 million.
    Assistance for Veterans Affected by Natural Disasters. 
Section 701 would provide additional amounts of assistance to 
certain veterans with service-connected disabilities who are 
affected by natural disasters. That assistance includes:

     Additional grants for certain veterans whose homes 
and automobiles that had been acquired or adapted using a grant 
from VA were destroyed or damaged in a natural or other 
disaster;
     Additional payments of a subsistence allowance for 
certain veterans who were displaced because of a natural or 
other disaster; and
     Additional services to achieve independence in 
daily living for those who were displaced because of a natural 
or other disaster.

    Based on information from VA, the Federal Emergency 
Management Agency, the Department of Transportation, the 
Insurance Information Institute, and the Insurance Services 
Office, CBO estimates that an average of about 600 veterans 
each year would qualify for the additional assistance offered 
under section 701. If enacted, that assistance is estimated to 
increase direct spending by about $10 million over the 2012-
2021 period, CBO estimates.\2\
---------------------------------------------------------------------------
    \2\As the timing and magnitude of natural or other disasters cannot 
be forecast with certainty, the actual costs of providing assistance to 
veterans affected by natural or other disasters may differ 
significantly from the amounts contained in this estimate.
---------------------------------------------------------------------------
    Specially Adapted Housing Assistance. Under current law, 
veterans who are entitled to compensation for permanent and 
total service-connected disability due to blindness in both 
eyes with visual acuity of at most 5/200 are also eligible to 
receive assistance to purchase, construct, or modify a home to 
meet their specific needs. Section 306 would reduce the 
required standard of visual acuity from 5/200 to 20/200. Based 
on information from VA, CBO estimates that under this provision 
about 1,200 previously ineligible veterans and 20 additional 
veterans each year would qualify for housing adaptation 
assistance and that, on average, each of those veterans would 
receive about $7,600 to meet their needs. If enacted, reducing 
the standard of visual acuity to 20/200 would increase direct 
spending by $10 million over the 2012-2021 period, CBO 
estimates.
    Occupancy of Housing by Dependent Children. To qualify for 
a home mortgage with a VA loan guarantee, a veteran must occupy 
the home as his or her primary dwelling. Section 303 would 
allow that requirement to be met by a dependent child of a 
veteran if the veteran's active-duty status prevents him from 
residing in the house at the time the loan is issued. Based on 
information from VA, CBO expects that relaxing the occupancy 
requirement will result in a small increase in the number of 
loans that VA guarantees. CBO estimates that enacting this 
provision would increase direct spending by $9 million over the 
2012-2021 period.
    Waiver of Loan Fee. Veterans who receive compensation for 
service-related disabilities are exempt from the fee that most 
veterans pay to VA for guaranteeing a home mortgage loan. 
Veterans who have submitted a claim for disability 
compensation, but whose claims have not been adjudicated by VA 
must pay the fee if the loan closes before VA resolves the 
claim. Under section 304, veterans who have been assessed as 
eligible for disability compensation during an exam that took 
place prior to their discharge from military service or who 
have received a memorandum from VA indicating a preliminary 
disability rating also would be exempt from paying the loan 
fee.
    Veterans are only in such limbo status temporarily. Thus, 
the size of the veteran population who are awaiting 
adjudication of their claim is relatively stable, as those 
whose cases have been decided are replaced by new claimants. 
CBO expects that no more than 200 such veterans would apply for 
a VA-guaranteed loan in any year. Exempting those veterans from 
the loan fee would increase direct spending by $5 million over 
the 2012-2021 period, CBO estimates.
    Temporary Residence Adaptation (TRA) Grants. Under current 
law, veterans who are classified by VA as totally disabled and 
who have certain mobility limitations are entitled to receive 
housing grants of up to $12,756 or $63,780 (based on the 
severity of their disabilities) to be used to purchase, 
construct, or modify a home to meet their specific needs. Under 
a pilot program, qualifying veterans may use up to $14,000 from 
the larger grant or $2,000 from the smaller grant to adapt the 
home of a family member when the veteran resides with that 
family member temporarily. Any amount used to adapt the home of 
a family member reduces the amount that remains available to be 
used later for the veteran's own home. This pilot program is 
scheduled to expire on December 31, 2011.
    Sections 305 and 307 would extend the pilot program through 
December 31, 2021, increase the maximum grant amounts to modify 
a relative's home from $14,000 and $2,000 to $28,000 and 
$5,000, respectively, and no longer require that those amounts 
be subtracted from a veteran's total grant amount. Based on 
recent rates of usage of TRA grants, CBO estimates that about 
25 veterans would benefit from those combined provisions each 
year, with each veteran receiving about $27,000 in adaptive 
housing assistance to modify a family member's home. If 
enacted, those provisions would increase direct spending by $7 
million over the 2012-2021 period, CBO estimates.
    Increased Pension for Married Veterans Requiring Aid and 
Attendance (A&A). Section 401 would increase the annual pension 
payable to married veterans when both spouses require regular 
A&A. Under current law, when two married veterans are in need 
of regular A&A, they are eligible to receive an annual combined 
pension of $30,480. Section 20 would increase that combined 
annual payment amount to $31,305.
    There are currently about 75 married couples who are both 
receiving pensions and both in need of regular A&A. Based on 
information from VA, CBO estimates that the number of eligible 
couples will decline slightly over the next decade. Therefore, 
we estimate that enacting section 401 would increase direct 
spending by about $1 million over the 2012-2021 period.
    Presidential Memorial Certificates. Section 503 would 
expand the VA's Presidential Memorial Certificate program to 
include survivors of individuals who die while serving in the 
active military, naval, or air service. Through the 
Presidential Memorial Certificate program, a relative or friend 
can request a certificate signed by the President that 
expresses the country's recognition of a veteran's service. 
Eligibility for a certificate is currently limited to survivors 
of veterans who were honorably discharged from military 
service. Based on information from VA, CBO expects fewer than 
100 additional requests would be made each year under this 
provision; therefore, CBO estimates section 503 would increase 
direct spending by less than $500,000 over the 2012-2021 
period. Costs for the Presidential Memorial Certificates are 
paid out of the veterans' burial account, which is a mandatory 
program.
    Extended Foreclosure Protection. Section 302 would prevent 
a lender from foreclosing on a servicemembers mortgage within 
12 months after they leave active duty. The Servicemembers 
Civil Relief Act provides such foreclosure protection for a 
nine-month period. Federal agencies such as VA and the Federal 
Housing Administration, which currently guarantee the mortgages 
of some servicemembers, are responsible for the payment of any 
interest that accrues between the period when the member stops 
paying the mortgage and the agency finally settles with the 
holder of the loan. Therefore, delaying certain foreclosures 
could result in additional costs to the federal government. 
Because of the small number of affected mortgages, and the 
relatively small increase in the forbearance period, CBO 
estimates that such costs would not be significant.
    Pay-As-You-Go Considerations: The Statutory Pay-As-You-Go 
Act of 2010 establishes budget-reporting and enforcement 
procedures for legislation affecting direct spending or 
revenues. S. 914 would modify several programs that provide 
benefits to veterans. The net changes in outlays that are 
subject to those pay-as-you-go procedures are shown in the 
following table.

    Table 4.--CBO Estimate of Pay-As-You-Go Effects for S.914 as ordered reported by the  Senate Committee on
                                       Veterans' Affairs on June 29, 2011
----------------------------------------------------------------------------------------------------------------
                                                    By fiscal year, in millions of dollars--
                               ---------------------------------------------------------------------------------
                                2012  2013  2014  2015  2016  2017  2018  2019  2020  2021  2012-2016  2012-2021
----------------------------------------------------------------------------------------------------------------
                                 NET INCREASE OR DECREASE (-) IN DIRECT SPENDING

Statutory Pay-As-You-Go Impact   -18     0     1     2    -1    -1     2     2     2     4      -16         -7
----------------------------------------------------------------------------------------------------------------

    Estimated impact on state, local, and tribal governments: 
S. 914 contains no intergovernmental mandates as defined in 
UMRA. States that provide nursing home care to eligible 
veterans would be required to comply with a new payment 
structure to receive federal reimbursement. Any costs to those 
governments would be incurred voluntarily as a condition of 
federal assistance.
    Estimated impact on the private sector: Section 302 would 
extend the expiration date by three months (from the original 
nine months) the time after a servicemember's period of 
military service under which the member receives enhanced 
protection under the Servicemembers Civil Relief Act relating 
to mortgages, mortgage foreclosures, and evictions. That action 
constitutes a mandate on mortgage holders. The cost of 
complying with the mandate would be the loss associated with 
delayed mortgage payments, delayed foreclosure, and interest-
rate limitations. Based on historical separation rates, 
foreclosure rates, and mortgage-interest rates, CBO expects 
that the cost of the mandate would be small relative to the 
annual threshold for private-sector mandates ($142 million in 
2011, adjusted annually for inflation).
    Previous CBO estimates: On May 16, 2011, CBO transmitted a 
cost estimate for H.R. 1407, the Veterans' Compensation Cost-
of-Living Adjustment Act of 2011, as ordered reported by the 
House Committee on Veterans' Affairs on May 12, 2011. Section 
305 of S. 914 contains language similar to that in H.R. 1407. 
The difference in the estimated costs between the two 
provisions reflects different levels of assistance payable to 
qualifying veterans and different expiration dates.
    On May 16, 2011, CBO transmitted a cost estimate for H.R. 
1627, the Honoring American Veterans Act of 2011, as ordered 
reported by the House Committee on Veterans Affairs on May 12, 
2011. Section 502 of S. 914 contains language similar to 
section 3 of H.R. 1627 and the corresponding estimates of costs 
are identical.
    Estimate prepared by: Federal Costs: Ann E. Futrell, Bill 
Ma, David Newman, and Dwayne Wright; Impact on State, Local, 
and Tribal Governments: Lisa Ramirez-Branum; Impact on the 
Private Sector: Elizabeth Bass.
    Estimate approved by: Peter H. Fontaine, Assistant Director 
for Budget Analysis.

                      Regulatory Impact Statement

    In compliance with paragraph 11(b) of rule XXVI of the 
Standing Rules of the Senate, the Committee has made an 
evaluation of the regulatory impact that would be incurred in 
carrying out S. 914. The Committee finds that S. 914 would not 
entail any regulation of individuals or businesses or result in 
any impact on the personal privacy of any individuals and that 
the paperwork resulting from enactment would be minimal.

                 Tabulation of Votes Cast in Committee

    In compliance with paragraph 7 of rule XXVI of the Standing 
Rules of the Senate, the following is a tabulation of votes 
cast in person or by proxy by members of the Committee on 
Veterans' Affairs at its June 29, 2011, meeting. The Committee 
voted, without dissent, to report S. 914 as amended to the 
Senate.

                             Agency Report

    On June 8, 2011, Robert L. Jesse, M.D., PhD., Principal 
Deputy Under Secretary for Health, Veterans Health 
Administration, Department of Veterans Affairs, appeared before 
the Committee and submitted testimony on various bills 
incorporated into the Committee bill. In addition, on June 28, 
2011, VA provided views on various bills incorporated into the 
Committee bill. Excerpts from both the testimony and Department 
views are reprinted below:

   STATEMENT OF ROBERT L. JESSE, M.D., PH.D., PRINCIPAL DEPUTY UNDER 
 SECRETARY FOR HEALTH, VETERANS HEALTH ADMINISTRATION, U.S. DEPARTMENT 
                          OF VETERANS AFFAIRS

    Good Morning Chairman Murray, Ranking Member Burr and 
Members of the Committee: Thank you for inviting me here today 
to present the Administration's views on several bills that 
would affect Department of Veterans Affairs (VA) benefits 
programs and services. Joining me today are Michael Cardarelli, 
Principal Deputy Under Secretary for Benefits, Richard Hipolit, 
Assistant General Counsel, and Walter A. Hall, Assistant 
General Counsel. We do not yet have cleared views on S. 411, 
S. 491, S. 873, S. 874, S. 914, S. 1017, S. 1060, S. 1089, 
S. 1104, S. 1123, S. 1124, and S. 1127 and the draft bill 
entitled ``Veterans Programs Improvements Act of 2011.'' Also, 
we do not have estimated costs associated with implementing 
S. 396, S. 666, S. 910, S. 935, and section 9 of S. 951. We 
will forward the views and estimated costs to you as soon as 
they are available.

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S. 423, PROVIDING AUTHORITY FOR A RETROACTIVE EFFECTIVE DATE FOR AWARDS 
  OF DISABILITY COMPENSATION IN CONNECTION WITH APPLICATIONS THAT ARE 
                      FULLY-DEVELOPED AT SUBMITTAL

    S. 423 would amend 38 U.S.C. Sec. 5110(b) to authorize a 
potentially retroactive award of disability compensation to a 
Veteran whose compensation application was fully developed as 
of the date submitted to VA. The effective date of a 
compensation award based on the submittal of a fully developed 
application would be ``fixed in accordance with the facts 
found,'' but could not be earlier than the date one year before 
the date the application was received by VA. The bill would 
allow VA to prescribe what constitutes a fully-developed claim 
for purposes of this provision.
    VA does not support this bill because it would result in 
the inequitable treatment of Veterans who cannot submit a 
``fully-developed'' claim. Currently, section 5110 authorizes a 
retroactive compensation award in two instances, both based on 
the timing of the application. VA may award compensation 
retroactively if VA receives the application within one year 
from the date of a Veteran's discharge or release from service 
or, in cases of increased compensation, if VA receives the 
application within one year of the date that an increase in 
disability is ascertainable. In either case, the timing of the 
application, and hence the eligibility for a retroactive award, 
is within a Veteran's control. The retroactive award S. 423 
would authorize, however, is based not on the timing of the 
application, but rather on the nature of the claim and the 
evidence needed to decide the claim, matters that are not 
within a Veteran's control. S. 423 would essentially penalize 
Veterans who cannot submit an application with the evidence 
necessary to decide the claim. The bill would result in 
retroactive compensation awards to Veterans whose claims 
involve simple factual issues or evidence within their 
possession or readily obtainable, but not to Veterans whose 
claims involve complex factual issues or evidentiary 
development, but are no less meritorious than the simple 
claims.
    In addition, S. 423 would likely result in litigation over 
whether a claim was fully developed when submitted because VA's 
decision to obtain or request further evidence would preclude a 
retroactive award.
    Although VA does not support S. 423, it appreciates the 
attempt to create an incentive for Veterans to file fully 
developed claims. VA believes a more balanced approach would 
create that incentive. VA has implemented a Fully Developed 
Claim (FDC) Program at all regional offices as a result of the 
Veterans' Benefits Improvement Act of 2008, Public Law 110-389, 
signed by the President on October 10, 2008. This law required 
VA to assess the feasibility and advisability of expeditiously 
adjudicating fully developed compensation or pension claims. 
Under the FDC program, a Veteran who submits a formal claim for 
benefits within one year from the date of VA's acknowledgement 
of receipt of the Veteran's informal claim may be awarded 
benefits effective from the date VA received the informal 
claim. Because the acknowledgement letter will include 
information about the evidence necessary to substantiate a 
claim for benefits, Veterans will be able to facilitate the 
processing of their claim by submitting evidence in conjunction 
with their formal claim. Thus, the timing of the application, 
not whether a fully developed claim is received, is 
determinative of whether retroactive benefits can be awarded. 
Further, this extra time allows any claimant the opportunity to 
assemble his or her claim package for submission, while still 
affording them the benefit of the FDC program and the potential 
of an earlier effective date.
    VA estimates that enactment would result in benefit costs 
of $54.9 million for fiscal year 2012, $315.7 million over five 
years, and $761.7 million over ten years.

        S. 486, PROTECTING SERVICEMEMBERS FROM MORTGAGE ABUSES 
                              ACT OF 2011

    S. 486 would extend the Servicemembers Civil Relief Act 
(SCRA) period of protections relating to real and personal 
property from 9 months to 24 months. This bill would also 
change violations of SCRA from a misdemeanor to a felony and 
increase civilian penalty amounts.
    VA defers to the Departments of Defense and Justice 
regarding the merits of this bill. We are unable at this time 
to provide cost estimates associated with enactment of this 
bill, but will provide that information in writing for the 
record.

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    S. 536, PROVIDE THAT UTILIZATION OF SURVIVORS' AND DEPENDENTS' 
 EDUCATIONAL ASSISTANCE SHALL NOT BE SUBJECT TO THE 48-MONTH LIMITATION

    S. 536 would amend section 3695(a)(4) of title 38, United 
States Code, to exempt individuals eligible for VA education 
benefits under the chapter 35 Survivors' and Dependents' 
Educational Assistance (DEA) program from the 48-month 
limitation on the use of educational assistance under multiple 
Veterans' and related educational assistance programs. This 
amendment would allow an individual to receive up to 45 months 
of benefits under the DEA program and up to 48 months of 
benefits under other educational assistance programs 
administered by VA. The amendment would take effect on the date 
of enactment of S. 536. By its own terms, however, it would not 
revive any entitlement to educational assistance under chapter 
35 or any other provision of law listed in section 3695(a) that 
terminated prior to that date.
    Under current law, section 3695(a) limits to 48 months the 
aggregate entitlement for any individual who receives 
educational assistance under two or more programs. This 
provision applies, in part, to the Montgomery GI Bill Active 
Duty (MGIB-AD/chapter 30), the Vietnam Era Assistance Program 
(VEAP/chapter 32), the Post-9/11 GI Bill (chapter 33), the 
Survivors' and Dependents' Educational Assistance program 
(chapter 35), the Montgomery GI Bill Selected Reserve (MGIB-SR/
chapter 1606), and the Reserve Educational Assistance Program 
(REAP/chapter 1607).
    Beginning on the date of enactment of this bill, as noted 
above, VA would not consider an individual's chapter 35 
entitlement when applying the 48-month limitation in section 
3695(a). The amendment also would be applicable to those 
individuals who, as of the day before enactment, had not used a 
total of 48 months of benefits entitlement (regardless of 
whether the 48 months included receipt of chapter 35 benefits). 
Thus, those individuals with remaining entitlements under other 
educational assistance programs administered by VA on the 
bill's date of enactment would have their entitlement to such 
programs determined without consideration of the benefits they 
used under chapter 35.
    VA does not have the specific data necessary to cost this 
proposal. While VA can determine the number of participants who 
used prior VA training and the amount of entitlement used in 
previous programs, we cannot extract the specific Survivors' 
and Dependents' Educational Assistance program population 
affected by this proposal. The system used to process chapter 
35 claims stores and retrieves information for beneficiaries 
using the Veteran's file number. Although information specific 
to the individual is stored in the record, the system uses the 
file number to search for multiple records. As a result, a 
query of the chapter 35 file numbers would provide information 
on Veterans rather than the beneficiaries of the Survivors' and 
Dependents Educational Assistance program. Further, VA has no 
way of determining how many servicemembers elected not to 
participate in the MGIB-AD program because of prior chapter 35 
benefits or how many individuals potentially eligible for the 
Post-9/11 GI Bill are or were eligible for chapter 35 benefits.
    VA supports the intent of S. 536 and favors enactment of 
the bill, subject to Congress finding offsetting savings. While 
we are unable to extract a specific population and are unable 
to provide costs, we estimate that a student who used 45 months 
of benefits under the Survivors' and Dependents' Educational 
Assistance program would receive an additional $51,336 for a 
full 36 months of training under the Montgomery GI Bill--Active 
Duty program. Similarly, we estimate that a student in receipt 
of benefits at the 100 percent eligibility tier under the Post-
9/11 GI Bill program would receive an additional $87,544 for 36 
months of benefits.

           *       *       *       *       *       *       *


       S. 666, VETERANS TRAUMATIC BRAIN INJURY CARE IMPROVEMENT 
                              ACT OF 2011

    S. 666, the ``Veterans Traumatic Brain Injury Care 
Improvement Act of 2011,'' would require the Secretary to 
submit to Congress a report on the feasibility and advisability 
of establishing a Polytrauma Rehabilitation Center or 
Polytrauma Network Site for VA in the northern Rockies or the 
Dakotas.
    VA shares the concern for providing treatment facilities 
for polytrauma in this region. Consequently, in 2010, VA 
completed an assessment of need and determined that an enhanced 
Polytrauma Support Clinic Team with a strong telehealth 
component at the Ft. Harrison, Montana, VA facility would meet 
the needs and the workload volume of Veterans with mild to 
moderate Traumatic Brain Injury (TBI) residing in the catchment 
area of the Montana Healthcare System. It would also facilitate 
access to TBI rehabilitation care for other Veterans from the 
northern Rockies and the Dakotas through telehealth. VA has 
initiated hiring actions to fill additional positions needed to 
enhance the Polytrauma Support Clinic Team at Fort Harrison. We 
anticipate these positions will be in place by the end of 2011. 
However, establishment of a Polytrauma Rehabilitation Center or 
Polytrauma Network Site, which would focus on the treatment of 
moderate to severe TBI, is not feasible or advisable in this 
area based on the needs of the population served. Because of 
the action already being taken by VA, this bill is not 
necessary, and we thus cannot support it.
    The estimated cost of staffing the Polytrauma Support 
Clinic Team at Ft. Harrison would be $1.5 million in the first 
year, $6.2 million for five years, and $13.0 million over ten 
years. We do not have estimated costs for implementing the bill 
but will provide them when they are available.
    Mr. Chairman, we would be pleased to provide the Committee 
with more detailed information about our findings and decisions 
regarding the northern Rockies and the Dakotas.

  S. 696, TREATMENT OF VET CENTERS AS DEPARTMENT OF VETERANS AFFAIRS 
   FACILITIES FOR PURPOSES OF PAYMENTS OR ALLOWANCES FOR BENEFICIARY 
                    TRAVEL TO DEPARTMENT FACILITIES

    S. 696 would require VA to make beneficiary travel payments 
to persons traveling to and from Vet Centers if those persons 
would otherwise be eligible for these payments under VA's 
authority to pay beneficiary travel. VA is very interested in 
the possibility of expanding this benefit to include travel to 
and from Vet Centers, but recommends that no action be taken on 
this bill at this time. In an effort to better assess the 
various factors potentially affecting implementation of such a 
travel benefit, VA began a 6-month analysis on May 1, 2011 at 
three Vet Centers to identify a model process for administering 
benefits. The analysis will: assess the likely utilization of 
the benefit; identify issues associated with administering this 
benefit; determine the potential impact this benefit would have 
on the Vet Center culture and Veterans' privacy concerns; 
develop a model that can determine the upper and lower bounds 
for demand for this benefit; and create a behavioral model that 
can estimate potential changes in Veteran utilization of Vet 
Center services.
    This analysis will include focus groups of Veterans 
utilizing Vet Center services to assess various cultural 
variables, such as the effect this benefit might have on the 
Vet Center environment and services, as well as Veteran support 
for the implementation of this program. VA will also survey 
Veterans receiving Vet Center services to identify their 
interest, the average distance they travel to a Vet Center, and 
the number of visits they typically make each month. VA will 
also review data from the existing beneficiary travel program 
to estimate economic and behavioral impacts on utilization 
rates. VA believes this to be a prudent approach that will 
allow us to determine the likely impacts of such a change, 
prepare for any changes in demand for Vet Center services, and 
include a budget request sufficient to support these benefits 
or any other changes resulting from enactment. VA will provide 
an update to Congress at the end of this analysis with its 
results, conclusions and recommendations.
    Given available data, VA estimates the cost of S. 696 in 
fiscal year 2012 to be $3.7 million, $23.3 million over five 
years, and $63.2 million over ten years. VA notes these 
estimates may change based on the results of the aforementioned 
analysis, and VA will provide an updated cost estimate to the 
Committee when we have completed this analysis.

S. 698, CODIFYING THE PROHIBITION AGAINST THE RESERVATION OF GRAVESITES 
                     AT ARLINGTON NATIONAL CEMETERY

    S. 698 would limit to one the number of gravesites at 
Arlington National Cemetery that may be provided to a Veteran 
or a Member of the Armed Forces who is eligible for interment 
at that cemetery and the Veteran's or Member's family members 
who are eligible for interment there. The bill would also 
prohibit pre-need reservations of gravesites at Arlington 
National Cemetery and would require the Secretary of the Army 
to submit to Congress a report on reservations made at 
Arlington National Cemetery.
    VA defers to DOD regarding S. 698 because the Secretary of 
the Army is responsible for the management and operation of 
Arlington National Cemetery.

           *       *       *       *       *       *       *


     S. 769, VETERANS EQUAL TREATMENT FOR SERVICE DOGS ACT OF 2011

    S. 769 would prohibit the Secretary from excluding from any 
VA facilities or property or any facilities or property that 
receive funding from VA, service dogs trained for use by 
Veterans enrolled in the VA health care system who were 
provided service dogs for reasons of hearing impairment, spinal 
cord injury or dysfunction or other chronic impairment that 
substantially limits mobility, and mental illness including 
Post Traumatic Stress Disorder.
    VA acknowledges that trained service dogs can have a 
significant role in maintaining functionality and promoting 
maximum independence of Veterans with disabilities. VA 
recognizes the need for Veterans with disabilities to be 
accompanied by their trained service dog on VA properties 
consistent with the same terms and conditions, and subject to 
the same regulations as generally govern the admission of 
members of the public to the property. However, S. 769 is 
unnecessary. Under existing statutory authority in 38 U.S.C. 
901, VA can implement national policy for all VA properties, 
and in fact did so for VHA facilities and property on March 10, 
2011 (VHA Directive 2011-2013), directing that both Veterans 
and members of the public with disabilities who require the 
assistance of a trained guide dog or trained service dog be 
authorized to enter VHA facilities and property accompanied by 
their trained guide dog or trained service dog consistent with 
the same terms and conditions, and subject to the same 
regulations that govern the admission of members of the public 
to the property. We would be glad to provide a copy of the 
Directive for the record. This Directive requires each Veterans 
Integrated Service Network (VISN) Director to ensure all VHA 
facilities have a written policy on access for guide and 
service dogs meeting the requirements of the national policy by 
June 30, 2011. In addition, VA intends to initiate rulemaking 
that will establish criteria for service dog access to all VA 
facilities and property in a manner consistent with the same 
terms and conditions, and subject to the same regulations as 
generally govern the admission of members of the public to the 
property while maintaining a safe environment for patients, 
employees, visitors, and the service dog.
    We note that VA's new Directive is much broader in scope 
than S. 769 which would only apply to certain Veterans and not 
members of the public. In particular, it would only apply to 
that subset of Veterans who are enrolled in VA's health care 
system and who were provided service dogs for reasons of 
hearing impairment, spinal cord injury or dysfunction or other 
chronic impairment that substantially limits mobility, and 
mental illness including Post Traumatic Stress Disorder 
pursuant to 38 U.S.C. 1714. VA's policy allows not only all 
Veterans with a disability that requires the assistance of a 
trained guide dog or trained service dog, but also members of 
the public including Veterans' families and friends with 
disabilities, to be accompanied by their trained guide dogs or 
trained service dogs in VHA facilities or properties.
    The bill also prohibits the Secretary from excluding 
service dogs from any facility or on any property that receives 
funding from the Secretary. Such a prohibition is unnecessary 
because it duplicates other statutes discussed below.
    Any non-VA facilities and properties with which S. 769 is 
concerned that are also owned or controlled by the Federal 
Government must under current law at 40 U.S.C. Sec. 3103, admit 
on the same terms and conditions, and subject to the same 
regulations, as generally govern the admission of the public to 
the property, specially trained and educated guide dogs or 
other service animals accompanying individuals with 
disabilities. Other non-VA properties not otherwise owned or 
controlled by the Federal Government, including but not limited 
to professional offices of health care providers, hospitals, 
and other service establishments, will almost certainly meet 
the definition of a place of public accommodation or public 
entity under the Americans with Disabilities Act of 1990 as 
prescribed in regulations at 28 CFR Sec. Sec. 35.104 and 
36.104, and therefore be required to modify their policies, 
practices, or procedures to permit the use of a service animal 
by an individual with a disability in accordance with 28 CFR 
Sec. Sec. 35.136 and 36.302. We would note that VA facilities 
are not subject to the Americans with Disabilities Act of 1990, 
but are subject to the Rehabilitation Act. The Rehabilitation 
Act does not specifically address the issue of service dogs in 
buildings or on property owned or controlled by the Federal 
Government, but does prohibit discrimination against 
individuals with disabilities, including those who use service 
animals, in federally-funded or -conducted programs and 
activities. In addition, as explained above, there are other 
existing authorities that address the issue of bringing guide 
dogs and other service animals onto VA property.
    VA estimates that there would be no costs associated with 
implementing this bill.

           *       *       *       *       *       *       *


     S. 815, SANCTITY OF ETERNAL REST FOR VETERANS ACT OF 2011 OR 
                         THE SERVE ACT OF 2011

    S. 815, the ``Sanctity of Eternal Rest for Veterans Act of 
2011'' or the ``SERVE Act of 2011,'' would amend titles 18 and 
38, United States Code, to guarantee that military funerals are 
conducted with dignity and respect. Section 2 of the bill would 
state the purpose of the bill, to provide necessary and proper 
support for the recruitment and retention of the U.S. Armed 
Forces and militia employed in the service of the United States 
by protecting the dignity of their members' service and the 
privacy of persons attending their members' funerals. It would 
also state Congress' findings regarding the constitutional 
authority for the bill. Section 3 of the bill would amend title 
18, United States Code, making it unlawful to engage in certain 
activities within a certain distance from, and during a certain 
period in relation to, any funeral of a member or former member 
of the Armed Forces not located at a cemetery under the control 
of the National Cemetery Administration (NCA) or a part of 
Arlington National Cemetery. It would provide for punishment by 
fine or imprisonment or both, give U.S. district courts 
jurisdiction to entertain suits for enjoining violations of the 
provision and complaints for damages resulting from conduct 
that violates the provision, authorize the Attorney General to 
institute proceedings, and authorize suits to recover damages. 
Although this section of the bill is inapplicable to NCA 
cemeteries, VA supports its enactment because it would 
establish a unified approach to preserve the dignity of funeral 
services and reinforces the commitment to protect the privacy 
of attendees during their time of bereavement.
    Section 4 of the bill would make several changes to 38 
U.S.C. Sec. 2413 to make it align with the title 18 provisions 
applicable to non-NCA cemeteries. Section 2413 currently 
prohibits certain demonstrations: (1) on the property of an 
NCA-controlled national cemetery or of Arlington National 
Cemetery without official approval; and (2) during a period 
beginning one hour before and ending one hour after a funeral, 
memorial service, or ceremony is held if any part of the 
demonstration takes place within a certain distance of such a 
cemetery, disturbs the peace, or impedes access to or egress 
from such a cemetery. The effect of the amendment is to expand 
the time period during which demonstrations are prohibited to 
begin two hours before and end two hours after a funeral, and 
increase the distance restriction for demonstrations from 150 
feet to 300 feet of the cemetery or a road, pathway, or other 
route of ingress or egress from the cemetery. It would increase 
protections against willful conduct which causes or assists in 
making noise or diversion that disturbs the funeral or memorial 
service, or unauthorized conduct that impedes the access to or 
egress from the cemetery by the funeral procession by 
increasing the boundary limits for engaging in such prohibited 
conduct from 300 feet to within 500 feet of the cemetery where 
the funeral is held. The bill provides for punishment by fine 
or imprisonment or both, gives U.S. district courts 
jurisdiction to entertain suits for enjoining violations of the 
provision and complaints for damages resulting from conduct 
that violates the provision, authorizes the Attorney General to 
institute proceedings, and authorizes suits to recover damages. 
The bill also contains a clerical amendment to revise the 
heading for section 2413.
    VA supports section 4 of this bill to ensure the privacy 
and protection of grieving families during funeral, memorial 
and ceremonial services meant to honor these fallen heroes who, 
through their service, paid the ultimate price. If enacted, 
S. 815 would have no monetary impact on NCA's current practice 
of coordinating with local law enforcement and community 
supporters.

           *       *       *       *       *       *       *


S. 928, LIMITING THE AUTHORITY OF THE SECRETARY OF VETERANS AFFAIRS TO 
USE BID SAVINGS ON MAJOR MEDICAL FACILITY PROJECTS OF THE DEPARTMENT OF 
   VETERANS AFFAIRS TO EXPAND OR CHANGE THE SCOPE OF A MAJOR MEDICAL 
                   FACILITY PROJECT OF THE DEPARTMENT

    S. 928 would amend title 38, Section 8104(d)(2) of the 
United States Code, to limit the authority of the Secretary of 
VA to use bid savings on major medical facility projects of the 
Department, to expand or change the scope of a major medical 
facility project of the Department, and for other purposes. The 
Secretary would be required to submit a notice to the 
Committees identifying the major medical facility project that 
is the source of the bid savings, the major medical facility 
project to be expanded or changed in scope, describe the 
expansion or change in scope, and identify the amounts intended 
to be obligated for the expansion or change in scope. The 
Secretary would then be required to wait until legislation is 
enacted before making a contract obligation. However, ample 
congressional notification requirements for changes or 
expansions in scope are already in place. VA thus opposes this 
legislation as unnecessary.

           *       *       *       *       *       *       *


   S. 957, VETERANS' TRAUMATIC BRAIN INJURY REHABILITATIVE SERVICES 
                        IMPROVEMENTS ACT OF 2011

    In 2008, Congress established several programs targeted at 
the comprehensive rehabilitation of Veterans and members of the 
Armed Services receiving VA care and services for Traumatic 
Brain Injuries (TBI). In general, S. 957 seeks to improve those 
programs (established by 38 U.S.C. Sec. Sec. 1710C-E) by 
requiring rehabilitative services, as defined by the bill and 
discussed below, to be an integral component of those on-going 
programs. With two exceptions, we have no objection to S. 957.
    Currently, the provisions of 38 U.S.C. Sec. 1710C set forth 
the requirements for an individualized rehabilitation and 
reintegration plan that must be developed for each Veteran or 
member of the Armed Forces receiving VA inpatient or outpatient 
rehabilitative hospital care or medical services for a TBI. VA 
Handbook 1172.04, Physical Medicine and Rehabilitation 
Individualized Rehabilitation and Community Reintegration Care 
Plan, implements section 1710C.
    Section 2(a) of S. 957 would amend some of the mandated 
requirements in section 1710C. Specifically, it would clarify 
that the goal of each individualized plan is to maximize the 
individual's independence and quality of life. It would also 
require, as part of a plan's stated rehabilitative objectives, 
the sustaining of improvements made in the areas of physical, 
cognitive, and vocational functioning. Section 2(a) of the bill 
would further require that each such plan include 
rehabilitation objectives for improving and sustaining 
improvements in the individual's behavioral functioning as well 
as mental health.
    These amendments would not alter VA's policy or operations 
in any significant way, as VA's primary aim for Veterans with 
serious or severe injuries has always been, and continues to 
be, maximizing their independence, health, and quality of life. 
It is out of these concerns that VA has developed robust 
rehabilitation therapy programs to help them learn or re-learn 
skills and develop resources for sustaining gains made in their 
rehabilitation.
    Section 2(a) of the bill would require the individual plans 
to include access, as warranted, to all appropriate 
rehabilitative services of the TBI continuum of care. The law 
now requires these plans to provide access, as warranted, to 
rehabilitative components of the TBI continuum of care (which 
includes, as appropriate, access to long-term care services).
    Current law also requires that each individualized plan 
include a description of the specific ``rehabilitation 
treatments and other services'' needed to achieve the patient's 
rehabilitation and reintegration goals. Section 2(a) of the 
bill would replace all references to ``treatments'' in the 
affected provision with ``services.'' This would ostensibly 
broaden the scope of rehabilitative benefits available to these 
patients beyond what is deemed to be treatment per se.
    It would also add to each plan the specific objective of 
improving (and sustaining improvements in) the patient's 
behavioral functioning. That addition, together with the 
existing rehabilitation objective to improve a patient's 
cognitive functioning, would effectively encompass all relevant 
mental health issues related to TBI. For that reason, we 
believe the bill's other amendment to separately include a 
rehabilitation objective for improving ``mental health'' would 
create confusion or redundancy. We thus recommend that language 
be deleted.
    Most notably, section 2(a) of S. 957 would establish a new 
definition of the term ``rehabilitative services,'' for 
purposes of all of VA's specially targeted, statutory programs 
for TBI-patients (i.e., 38 U.S.C. Sec. Sec. 1710C-E). Such 
services would include not only those that fall under the 
current statutory definition found in 38 U.S.C. 1701 but also 
``services (which may be of ongoing duration) to sustain, and 
prevent loss of, functional gains that have been achieved.'' 
Plus, they would include ``any other services or supports that 
may contribute to maximizing an individual's independence and 
quality of life.'' This last definition is overly broad and 
could be read to include services or items well beyond the 
field of health care. It is also unworkable. What maximizes an 
individual's ``quality of life'' is highly subjective, and, as 
such, the term defies consistent interpretation and 
application. Quite simply, we believe enactment of that last 
provision of the proposed new definition would conflict with, 
and exceed, our primary statutory mission, which is to provide 
medical and hospital care. It should therefore be deleted, 
leaving only the first two prongs of the definition.
    Next, as briefly alluded to above, the individualized 
rehabilitation and reintegration plans required by section 
1710C must include access, where appropriate, to long-term care 
services. The eligibility and other requirements of VA's 
mandated comprehensive program of long-term care for the 
rehabilitation of post-acute TBI are found in 38 U.S.C. 
Sec. 1710D. Section 2(b) of S. 957 would require the Secretary 
to include rehabilitative services (as that term would be 
defined by Sec. 2(a) of the bill) in the comprehensive program. 
It would also eliminate the word ``treatment'' in the 
description of the interdisciplinary teams to be used in 
carrying out that program. We have no objection to this 
proposed revision.
    Last, Congress authorized VA, under specified 
circumstances, to furnish hospital care and medical services 
required by an individualized rehabilitation and reintegration 
plan through a cooperative agreement. (A cooperative agreement 
may be entered only with an appropriate public or private 
entity that has established long-term neurobehavioral 
rehabilitation and recovery programs.) This authority is found 
at 38 U.S.C. 1710E. Section 2(c) of S. 957 would add 
``rehabilitative services'' (again as defined by Sec. 2(a) of 
the bill) to the types of services that may be provided under 
those agreements. We have no objection to this proposed 
revision.
    Section 2(d) of S. 957 is merely a technical amendment to 
correct a typographical error in section 1710C(c)(2)(S) of 
title 38, United States Code. We would also like to point out 
another technical issue. Current law permits inclusion of 
``educational therapists'' among the TBI-experts responsible 
for conducting a comprehensive assessment of each patient. (It 
is this assessment which serves as the basis for the 
individualized plans discussed above.) This categorization of 
professionals is no longer used in the field of medical 
rehabilitation.
    Aside from the two (substantive) modifications discussed 
above (deleting the phrase ``any other services or supports 
that may contribute to maximizing an individual's independence 
and quality of life'' from the new definition of the term 
``rehabilitative services,'' and deleting the bill's amendment 
to separately include a rehabilitation objective for improving 
``mental health''), we have no objection to S. 957, and no new 
costs would be associated with its enactment.

         S. 1148, THE VETERANS PROGRAMS IMPROVEMENT ACT OF 2011

    On June 6, Chairman Murray introduced S. 1148, the Veterans 
Programs Improvement Act of 2011. We note that the bill carries 
many provisions proposed by the Administration, in its draft 
Veterans Benefits Improvement Act of 2011, transmitted to the 
Senate on May 19, 2011. We have not had the opportunity to 
review the bill closely regarding its technical aspects, but we 
offer here our support of the general intent of those 
provisions, and VA's appreciation for your including them for 
consideration. We believe they are very worthy of the 
Committee's endorsement. We also look forward to reviewing the 
other titles of the bill which address VA's programs to combat 
homelessness as well as VBA's fiduciary program.

    This concludes my prepared statement. Madam Chairman, we 
would be pleased to respond to whatever questions you may have.
                                ------                                



                                ------                                

                         The Secretary of Veterans Affairs,
                                     Washington, DC, June 28, 2011.
Hon. Patty Murray,
Chairman,
Committee on Veterans' Affairs,
U.S. Senate, Washington, DC.

    Dear Madam Chairman: The agenda for the Senate Committee on 
Veterans Affairs' June 8, 2011, legislative hearing included a 
number of bills that the Department of Veterans Affairs was 
unable to address in our testimony. We are aware of the 
Committee's interest in receiving our views on those bills in 
advance of the June 29 mark-up. By this letter, we are 
providing our views and cost estimates on S. 411, S. 491, 
S. 914, S. 1017, sections 202 and 305 of S. 1060, S. 1104, 
S. 1127, and titles I and III of S. 1148. We will provide views 
on the remaining bills in a separate letter.
    This Office of Management and Budget advises that there is 
no objection to the submission of this letter from the 
standpoint of the Administration.
    We appreciate this opportunity to comment on this 
legislation and look forward to working with you and the other 
Committee Members on these important legislative issues.
            Sincerely,
                                           Eric K. Shinseki

  Enclosure.

                               Enclosure 
                                VA Views

          S. 411 ``HELPING OUR HOMELESS VETERANS ACT OF 2011''

    S. 411 would authorize VA to enter into agreements with 
certain entities to collaborate in the provision of case 
management services as part of the HUD-Veterans Affairs 
Supportive Housing (HUD-VASH) program. In addition, S. 411 
would require the Department of Veterans Affairs (VA), in 
consultation with the Department of Housing and Urban 
Development (HUD), to ensure that the distribution of vouchers 
to Veterans under the HUD-VASH program meets the needs of 
Veterans in rural areas and underserved Veterans in 
metropolitan areas or on Indian lands. This bill would expand 
VA's existing authority to provide case management services and 
collaborate with other entities. VA supports this bill, 
although we do have one technical comment and a suggestion for 
improving this bill.
    S. 411 specifically authorizes VA to enter into these 
agreements with tribal organizations. However, tribal lands do 
not have public housing agencies and because public housing 
agencies are the sole mechanism for issuing section 8 Housing 
Choice Vouchers to Veterans, S. 411 would not expand the HUD-
VASH program to Veterans living on Indian lands. We note that 
there are other HUD programs available to Veterans on Indian 
lands.
    In order to maximize care coordination and to implement and 
sustain a shared case management model that supports permanent 
housing, VA proposes including a provision in S. 411 to 
authorize VA to provide Technical Assistance (TA) to community 
partners. TA would focus on compliance with documentation and 
program evaluation standards, implementing best practices 
strategies to coordinate with VA treatment, and other 
supportive services that promote rapid access and sustainment 
of permanent supportive housing. TA would also support site 
visits for monitoring and promoting the coordination and 
creation of shared learning communities, as well as the 
development of webinars that teach shared best practices. TA 
would encourage a ``Housing First'' treatment intervention for 
homeless Veterans by targeting the chronic homeless and the 
most vulnerable Veterans. Money management and addressing unmet 
health care needs of homeless Veterans are other essential 
components that TA would further enhance. Through these 
efforts, VA will continue to work with local public housing 
agencies and support interventions with homeless Veterans in 
crisis by utilizing motivational interviewing to promote 
treatment.
    VA estimates that there would be no costs associated with 
implementing S. 411. If S. 411 is amended to include a 
provision authorizing VA to provide technical assistance, VA 
anticipates the cost associated with this bill would be 
$300,000 in fiscal year (FY) 2012 and $750,000 over the next 
three fiscal years. VA only anticipates the need for additional 
funds for technical assistance for the first three fiscal 
years. After that, VA believes the costs could be rolled into 
the homeless program's operating budget.

           *       *       *       *       *       *       *


             S. 914 TO AUTHORIZE WAIVER OF COPAYMENTS FOR 
                      TELEHEALTH AND TELEMEDICINE

    S. 914 would add a new section to title 38, U.S.C., that 
would authorize VA to waive copayment requirements for 
Veterans' telehealth and telemedicine visits. VA opposes this 
legislation because it would create an inequity in billing 
practices for services provided to Veterans. We believe it 
would be inappropriate to waive copayments for Veterans who 
receive telehealth services at a VA facility while Veterans who 
see their VA provider in person in the same facility would be 
charged a copayment.
    Under existing authority, no Veteran is charged a copayment 
for telephone calls, since in many cases they are used simply 
as a means to check on the progress of a Veteran, not to 
deliver care. VA believes the use of video consultation into 
the home is analogous to that of a telephone call and that 
copayments for clinical video telehealth services provided 
directly into a patient's home should be considered for 
exclusion from copayments. VA plans under its existing 
authority (38 U.S.C. 1710(g)) to exempt copayments for video 
consultations when the Veteran is located at his or her home.
    Recent VA experience demonstrates that copayments for home-
telehealth may have resulted in a reduced use of this 
intervention. To ensure convenient and cost effective care to 
populations of patients who will otherwise delay care and incur 
larger costs from emergency room visits and hospital 
admissions, VA will take the appropriate action to exempt 
copayments for in-home video telehealth care for Veterans. 
Because VA already has the authority to waive or modify the 
imposition of copayments for such care, legislation is not 
required.
    If copayments are not collected for all telehealth or 
telemedicine services, VA estimates a revenue loss of $2.2 
million in FY 2012, $18.0 million over 5 years, and $72.9 
million over 10 years.

        S. 1017 ``DISABLED VETERAN CAREGIVER HOUSING ASSISTANCE 
                             ACT OF 2011''

    S. 1017 would increase the amount of Specially Adapted 
Housing (SAH) assistance available to disabled Veterans who 
reside temporarily in housing owned by family members, and 
would also expand SAH eligibility for the visually impaired. 
Provided Congress identifies appropriate and acceptable 
offsetting PAYGO cost savings, VA supports this legislation.
    Section 2 of the bill would amend 38 U.S.C. 2102A, SAH 
assistance for disabled Veterans and Servicemembers who reside 
temporarily in housing owned by a family member. In general, 
subsection (a) would increase, from $14,000 to $28,000, the 
amount of assistance available for individuals eligible for SAH 
grants under section 2101(a), and would increase the amount 
from $2,000 to $5,000 for individuals eligible for SAH grants 
under section 2101(b). Subsection (b) would eliminate the 
December 31, 2011, termination date currently in effect, and 
make such assistance permanent. Subsection (c) would tie the 
newly increased amounts to the same cost-of-construction index 
as that authorized for grants made pursuant to sections 2101(a) 
and 2101(b), meaning that the grants would adjust upwards with 
the costs of inflation.
    We note that both this section and sections 303 and 304 of 
S. 1148 would make similar improvements to section 2102A. The 
relevant sections of S. 1148 would extend the authority of 
assistance for individuals residing temporarily in housing 
owned by a family member through 2021 and would implement a 
cost-of-construction index. These provisions are substantively 
the same as sections 306 and 307 of VA's draft bill, the 
``Veterans Benefits Programs Improvement Act of 2011.'' VA 
supports both of these provisions.
    Section 3 would amend 38 U.S.C. 2101(b) to expand SAH 
eligibility for the visually impaired. Under current law, an 
individual is not eligible for what is commonly called a 
``2101(b) grant'' unless his or her visual acuity is 5/200 or 
less, an exceptionally stringent standard in comparison to 
other areas of law. Many grant applicants who are considered 
legally blind by other commonly-held standards are ineligible 
for 2101(b) grants because their visual impairments, though 
profound, are not severe enough to meet the standard set under 
current law. For example, under the Social Security 
Administration's eligibility standards for supplemental 
security income (SSI), individuals are considered legally blind 
with visual acuity of 20/200 or less, or a peripheral field of 
vision of 20 degrees or less. Additionally, VA's 
Servicemembers' Group Life Insurance Traumatic Injury 
Protection Program's eligibility standard related to visual 
acuity is ``20/200 or less.'' However, since the standard for 
``blindness'' for the 2101(b) grant is ``5/200 visual acuity or 
less,'' a Veteran or Servicemember who is legally blind for 
purposes of SSI or VA life insurance would not be eligible for 
a 2101(b) grant.
    By establishing a qualifying degree of blindness at visual 
acuity of 20/200 best-corrected visual acuity or less, or as a 
field of vision subtending an angle of 20 degrees or less, the 
bill would bring the SAH requirements in line with more 
commonly recognized standards. It would also make the 2101(b) 
grant available to a wider range of Veterans and 
Servicemembers, including those who use rehabilitative low-
vision adaptive medical devices.
    Section 4 of S. 1017 would no longer count grants 
authorized under 38 U.S.C. 2102A (commonly referred to as ``TRA 
grants'') against the aggregate dollar amount of SAH assistance 
available to eligible individuals. Under current law, an 
eligible individual may receive up to three grants of SAH 
assistance totaling in aggregate not more than $63,780 for a 
2101(a) grant or $12,756 in the case of a 2101(b) grant. If an 
individual receives a TRA grant, the amount is subtracted from 
the total amount of assistance available, leaving him or her 
with fewer funds for future adaptations to a permanent 
residence.
    If section 4 were enacted, a veteran who had previously 
adapted a family member's residence using a TRA grant would be 
able to adapt his or her own permanent residence as if the TRA 
grant funds had not been used. Although the TRA grant would 
still count as one of the three allowable uses, it would not 
reduce the amount of assistance available for a grant 
authorized under section 2101(a) or 2101(b).
    VA estimates benefits costs of enactment to be $3.4 million 
in the first year, $13.0 million over five years, and $20.6 
million over ten years. VA does not identify any increase in 
General Operating Expense (GOE) cost associated with these 
provisions.

             S. 1060 ``HONORING ALL VETERANS ACT OF 2011''

Section 202
    Section 202 would dramatically change VA's Grant and Per 
Diem (GPD) program, which has been a key factor in reducing 
Veteran homelessness. The GPD Program is designed to support 
transitional housing for Veterans. VA generally supports the 
spirit of the section, but is apprehensive that this 
legislation will result in policy problems and lead to 
significantly higher costs.
    Currently, payments to eligible programs receiving grants 
to provide services to homeless Veterans are made on a per diem 
basis. Section 202(a)(2)(A) would eliminate all references to 
``per diem'' in 38 U.S.C. 2012 and change the basis of grants 
from the ``daily cost of care'' to the ``annual cost of 
furnishing services.'' It would also remove the prohibition on 
VA providing a rate in excess of the rate authorized for State 
domiciliaries and grant the Secretary the discretion to set a 
maximum amount payable to grant recipients.
    Section 202(a)(2)(B) would direct the Secretary to adjust 
the rate of payment to reflect anticipated changes in the cost 
of furnishing services and take into account the cost of 
services in different geographic areas. Section 202(a)(2)(C) 
would remove the requirement that the Secretary consider other 
available sources of funding and would leave it to his or her 
discretion. Section 202(a)(2)(E) would require the Secretary to 
make quarterly payments based on the estimated annual basis and 
would require recipients to declare the actual amount paid by 
quarter for services and repay any outstanding balances if the 
amount spent by the recipient is less than the estimated 
quarterly disbursement. Similarly, if recipients spend more 
than the estimated amount, determined on a quarterly basis, the 
Secretary would be required to make an additional payment equal 
to that sum. It would limit payment to recipients to the amount 
of the annual payment as determined by the Secretary. Section 
202(a)(3) would allow grant recipients to use VA grants to 
match other payments or grants from other providers. Finally, 
section 202(a)(4) would repeal a ``grandfather'' provision 
extending the time period for certain grantees to satisfy 
applicable requirements of the Life Safety Code of the National 
Fire Protection Association, as this provision expired in 
December 2006.
    Although VA is not opposed to the concept of making its per 
diem authorities more flexible to better reflect the actual 
cost of providing services, especially in different geographic 
regions, VA is currently evaluating the impact of shifting from 
the ``per diem'' or ``daily cost of care'' approach to an 
``annual cost of furnishing services'' paid and reconciled on a 
quarterly basis. Though this change may offer VA's partners 
needed capital and funds at the beginning of the fiscal year to 
support their work, it would require significantly more 
detailed auditing as well as increased direct oversight by VA. 
Furthermore, the requirement in section 202(a)(2)(E), to 
reconcile payments each quarter, would allow more immediate 
accounting of unpaid balances and/or over-billings; however, 
this approach would impose significant administrative burdens, 
requiring VA to monitor and process GPD provider accounts 
nationwide. VA would welcome the opportunity to discuss these 
issues with Congress but asks that section 202 be deferred 
until VA can fully evaluate its impact.
    VA does not oppose removing the existing rate cap pursuant 
to section 202(a)(2)(B). Currently, the statute limits VA's GPD 
per diem payments to the rate for state domiciliary care. The 
difference between what VA pays and the actual cost of 
expenditures is absorbed by the provider. Allowing the 
Secretary to establish the basis and the formula for payment 
based on cost and geographic location would increase the 
sustainability of community-based providers and promote 
increased and more comprehensive services for Veterans.
    Although section 202 would no longer require the Secretary 
to consider the availability of other sources of income for 
grant recipients, the Secretary would in all likelihood 
consider the availability of other funds when evaluating a 
grant application. GPD Program Office experience has shown that 
the availability of other sources of income is often an 
indicator of a viable GPD project.
    VA supports the authorization in section 202(a)(2)(D) for 
VA operational payments to be used in conjunction with grants 
from other federal programs. The purpose of the payment 
contained in 38 U.S.C. 2012 is to pay for operational costs for 
a specific program operation.
    VA estimates the cost of this section to be $450.0 million 
in the first year, $2.8 billion over 5 years and $6.9 billion 
over 10 years.
Section 305
    Section 305 would authorize VA to disclose information 
about Veterans and their dependents to State prescription 
monitoring programs to the extent necessary to prevent misuse 
and diversion of prescription medications. VA supports section 
305 of this bill. It would enhance the ability of VA clinicians 
to provide treatment to VA beneficiaries by improving the 
visibility of both VA and non-VA prescriptions for controlled 
substance medications. VA estimates the cost associated with 
implementing this section would be $361,501 in FY 2012, $1.3 
million over 5 years, and $2.4 million over 10 years.

           *       *       *       *       *       *       *


S. 1127 CENTERS OF EXCELLENCE FOR RURAL HEALTH RESEARCH, EDUCATION, AND 
                          CLINICAL ACTIVITIES

    Section 2(a) of S. 1127 would require the Secretary to 
establish and operate at least one and not more than five 
centers of excellence for rural health research, education, and 
clinical activities through the Director of the Office of Rural 
Health. These centers would be geographically dispersed and 
would be established to: 1) conduct research on the furnishing 
of health services in rural areas; 2) develop specific models 
to be used by the Department in furnishing health services to 
Veterans in rural areas; 3) provide education and training for 
health care professionals of the Department on the furnishing 
of health services to Veterans in rural areas; and 4) develop 
and implement innovative clinical activities and systems of 
care for the Department for the furnishing of health services 
to Veterans in rural areas. The activities of clinical and 
scientific investigation at each center would receive priority 
in the award of VA funds for medical and prosthetics research 
to the extent that these funds are awarded to projects for 
research in the care of rural Veterans. Section 2(c) would also 
recognize that there are Veterans rural health resource centers 
which serve as satellite offices of the Office of Rural Health.
    VA supports section 2(c), but opposes section 2(a). The 
Office of Rural Health (ORH) currently supports rural program 
resource centers and implements research initiatives that are 
largely duplicative of the activities proposed for the Centers 
of Excellence. Specifically, ORH currently funds three Veterans 
Rural Health Resource Centers (VRHRC). These Centers function 
as field-based clinical laboratories for demonstration 
projects. A number of these projects are focused on developing 
models of care, as well as the implementation of innovative 
clinical practices and systems of care. VRHRC staff members 
also serve as rural health experts for the field. They provide 
training and education to VA and non-VA service providers 
caring for rural Veterans. ORH also supports VISN Rural 
Consultants (VRCs). In each VISN, there is a VRC who serves as 
the primary interface between ORH and VISN rural activities. 
The VRCs work closely with internal and external stakeholders 
to introduce, implement, and evaluate ORH-funded projects. The 
VRCs are also instrumental in conducting outreach to develop 
strong partnerships with community members, state agencies, 
rural health providers, and special interest groups. Since 
being established, ORH has funded well over 500 projects across 
the VA health care system. These projects cover a wide range of 
areas, including education, home based primary care, long-term 
care, mental health, case management, telehealth, primary care, 
and specialty care.
    ORH is funded by Medical Services appropriations, which 
cannot be used to conduct research. Rather ORH supports 
demonstration and pilot projects. ORH has established 
partnerships within VA, namely VA Health Services Research & 
Development (HSR&D), to conduct relevant rural health research.
    ORH has already committed considerable resources to 
implementing and evaluating models of care in rural areas, 
developing and providing education to rural providers, and 
developing innovative clinical activities and systems of care. 
Although ORH does not conduct research, collaborations with 
HSR&D have allowed for ORH to be involved in rural health 
research activities. Furthermore, HSR&D currently has a very 
extensive rural health portfolio including studies on access, 
health disparities, and developing new models of care 
appropriate for rural areas. The research findings are then 
shared with ORH and are used to form rural health policies and 
programs. Funding the proposed Centers of Excellence would be 
duplicative of activities that are already being addressed.
    If this bill provision is passed, it would be more cost 
effective to add this function in our existing VRHRCs rather 
than to establish three new Centers of Excellence.
    VA estimates the cost of adding a research component to 
each of the three existing VRHRCs to be $3 million dollars per 
year. However, VA estimates the cost of establishing three new 
independent and separate Centers of Excellence to be $7.5 
million dollars per year.

         S. 1148 ``VETERANS PROGRAMS IMPROVEMENT ACT OF 2011''

                   TITLE I--HOMELESS VETERANS MATTERS

Section 101
    Section 101(a) would amend 38 U.S.C. 2011(a) by expanding 
the kinds of projects for which grants are available to include 
the new construction of facilities. Section 101(a)(3)(A) would 
also amend section 2011(c) to prohibit the Secretary from 
denying a grant application based only on the fact that an 
entity proposes to use funding from other private or public 
sources, as long as a private nonprofit organization will 
provide oversight and site control for the project. Section 
101(a)(3)(B) would also define the term private non-profit 
organization to include a for profit limited partnership or 
limited liability corporation whose managing or general partner 
is a non-profit as defined under this section.
    Section 101(b) would also require the Secretary to conduct 
a study of the method used to make per diem payments under 38 
U.S.C. 2012 and develop an improved method for reimbursing 
grants under section 2011. The Secretary would be required to 
submit a report of the findings within a year after enactment 
of this bill.
    Last, section 101(c) would amend 38 U.S.C. 2013 to increase 
the amount authorized to be appropriated to $250,000,000 for FY 
2012 and each fiscal year thereafter.
    VA does not support the provisions of section 101(a)(3)(B) 
and has concerns about section 101(c), but supports section 
101(b). Section 101(a)(3)(B) would amend the definition of 
private nonprofit organization, to include a private nonprofit 
organization ``that has received, or has temporary clearance to 
receive, tax-exempt status under * * * section 501(c) of the 
Internal Revenue Code of 1986 * * *'' as well as allow 
additional entities to become eligible for grants under the 
Grant and Per Diem (GPD) Program.
    VA believes that the ``temporary clearance'' proposed in 
this subsection does not adequately ensure the capability of 
the grant applicant to administer federal funds. This change 
would void the reason for the final determination by the 
Internal Revenue Service (IRS) as to organizational suitability 
for nonprofit status, increasing the risk that unsuitable grant 
applicants would apply for GPD projects. Furthermore, the 
``temporary clearance'' provision is not needed because the IRS 
can expedite applications for tax-exempt status.
    Additionally, VA does not believe section 501(c)(2) 
entities should be included in the definition of a private 
nonprofit organization. In general, section 501(c)(2) provides 
a tax-free means of managing and protecting real estate and 
other assets. Inclusion of a section 501(c)(2) organization in 
the definition of a ``nonprofit organization'' does not seem 
necessary.
    VA also finds the inclusion of sections 101(a)(3)(B)(ii) 
and 101(a)(3)(B)(iii) unnecessary and potentially burdensome. 
Under the present statute, 38 U.S.C. 2011, eligible applicants 
include nonprofit organizations, state or local government 
agencies, or Indian tribal governments. Additionally, IRS rules 
allow under the definition of organization, limited liability 
corporations to apply for section 501(c)(3) status. 
Consequently there is no need to specifically include limited 
liability companies in the statutory definition of a 
``nonprofit organization.''
    VA has no objection to the section 101(b)'s requirement to 
conduct a study and develop a payment method under 38 U.S.C. 
2011 and 2012; however, VA proposes that Congress grant VA more 
than one year to conduct the study and provide the report to 
Congress. Based on past program office experience, it is 
generally not feasible to analyze findings, implement changes, 
draft findings, and report to Congress within one year after 
the date of the enactment. VA estimates the study proposed in 
section 101(b) would cost approximately $300,000.
    VA supports in principle raising the authorized 
appropriation amounts in section 101(c) but has concerns about 
the proposed annual appropriation level. VA estimates that the 
proposed maximum annual authorization level of $250 million 
would be inadequate for this important program after fiscal 
year 2015. We recommend that a specific authorization funding 
level be dropped from the statute.
    VA estimates that there would be no additional costs 
associated with this provision as the budget through FY 2013 
includes the program.
Section 102
    Section 102 would amend 38 U.S.C. 2061 by expanding 
eligibility for the grant program to entities eligible for 
grants and per diem payments under sections 2011 and 2012 of 
title 38. It would also broaden the definition of homeless 
Veterans with special needs to include any Veteran who cares 
for minor dependents, not just women. Last, this section would 
allow recipients of grants under section 2061 to use grant 
amounts to provide services directly to a dependent of a 
homeless Veteran if the Veteran is receiving services from the 
recipient.
    In principle, VA supports section 102 and agrees that 
modifications are needed to fully realize the potential of 
special needs grants through the GPD Program. Specifically, VA 
has no objection to the inclusion of subparts (a), (b), and (c) 
in section 102. However, VA believes the modifications as 
written are insufficient to adequately meet the needs of the 
special needs population presently served by the GPD Program.
    VA respectfully suggests that the Committee consider the 
language in sections 303 to 305 of VA's draft bill, the 
``Veterans Health Care Act of 2011,'' which was transmitted to 
Congress on June 7, 2011, relating to GPD special needs grants. 
These provisions would amend 38 U.S.C. 2061 and also create a 
new section for establishment of per diem programs for homeless 
Veterans with special needs. VA considers the language in Title 
III, sections 303-305 of VA's draft bill an effective way to 
meet the needs of the special needs population served by GPD 
Program grants.
    We will provide costs associated with implementing this 
section as soon as they are available. If section 102 is 
amended to contain the proposed special needs amendments in 
sections 303 through 305 of VA's draft bill, the costs would be 
$15.2 million in FY 2012, $79.9 million over 5 years, and 
$217.7 million over 10 years.
Section 103
    Section 103 would amend 38 U.S.C. 2031(a) by authorizing VA 
to provide services listed in section 2031 to homeless 
Veterans, regardless of whether such Veterans suffer from 
serious mental illness (SMI). VA fully supports the draft bill 
language in section 103. In the drive to end homelessness among 
Veterans, VA recognizes the need to provide homeless Veterans 
with emergency housing, case management services, and outreach 
services. Consequently, VA fully supports removing the 
requirement in 38 U.S.C. 2031 that a Veteran must have a co-
occurring SMI before receiving Health Care for Homeless 
Veterans (HCHV) program services.
    While co-occurring disorders such as SMI have traditionally 
been the markers of homelessness among Veterans and have been 
well documented in relevant research, conditioning the 
provision of services on the existence of SMI unnecessarily 
limits the scope of services to thoroughly address the 
condition of homelessness.
    HCHV program field experience has shown that there are many 
Veterans who are homeless for reasons other than mental health-
related issues. Therefore, expanding the scope of 38 U.S.C. 
2031 would allow VA to better reach and serve Homeless 
Veterans.
    VA estimates the cost of this section to be $3.5 million in 
the first year, $19.1 million over 5 years and $42.1 million 
over 10 years.
Section 104
    Section 104 of S. 1148 would require VA to submit to 
Congress a comprehensive plan to end homelessness among 
Veterans. VA does not support this provision because VA has 
already formulated and is presently implementing a 
comprehensive strategic plan to end Veteran homelessness. VA's 
Plan to End Homelessness Among Veterans Initiative is built 
upon six strategies: Outreach/Education, Treatment, Prevention, 
Housing/Supportive Services, Income/Employment/Benefits and 
Community Partnerships. These six strategies encompass a wide 
continuum of interventions and services to prevent and end 
homelessness among Veterans. Homeless Veterans will benefit 
from the expansion of existing program capacity and treatment 
services, as well as the implementation of new programs focused 
on homelessness prevention and increased access to permanent 
housing with supportive services. Although the provision of 
safe housing is fundamental, programming will include mental 
health stabilization, substance use disorder treatment 
services, enhancement of independent living skills; vocational 
and employment services, and assistance with permanent housing 
searches and placement. VA does not anticipate any additional 
costs associated with implementing section 104.
Section 105
    VA fully supports section 105(a) that would extend 
authority for the Health Care for Homeless Veterans (HCHV) 
Program through December 31, 2014. The HCHV Program, as 
authorized by 38 U.S.C. 2031, allows VA to provision care and 
services to homeless Veterans suffering from serious mental 
illness (SMI). Specifically, the HCHV Program provides 
emergency housing, outreach services, and case management 
services. This authority has been extended several times since 
November 21, 1997. The most recent extension of this authority 
was from December 31, 2006 through December 31, 2011.
    As an essential component of VA's Plan to End Homelessness 
Among Veterans, VA fully supports any effort to extend this 
important authority.
    VA also supports section 105(b) that would amend 38 U.S.C. 
2033 to extend by an additional three years until December 31, 
2014, VA's authority to expand and improve benefits to homeless 
Veterans. Section 2033 authorizes VA, subject to 
appropriations, to operate a program to expand and improve the 
provision of benefits and services to homeless Veterans. The 
program includes establishing sites under VA jurisdiction to be 
centers for the provision of comprehensive services to homeless 
Veterans (also known as Community Resource and Referral Centers 
(CRRCs)). This authority has been extended several times since 
November 21, 1997. The most recent extension of this authority 
was from December 31, 2006 through December 31, 2011. CRRCs are 
an important component of VA's Plan to End Homelessness Among 
Veterans, and VA fully supports any effort to extend this 
authority.
    VA estimates there would be no additional costs associated 
with these provisions.
    Subsection (c) of section 105 would extend through 
December 31, 2014, the Secretary's authority to enter into 
agreements with non-profit organizations for the purpose of 
selling, leasing, or donating homes acquired through the 
guaranteed loan program. VA supports this provision. Under 
current law, 38 U.S.C. 2041, this authority is set to expire on 
December 31, 2011. The proposed extension would allow VA to 
continue using homes acquired through the guaranteed loan 
program to help provide shelter to homeless Veterans.
    VA estimates that enactment of section 105(c) will result 
in no additional costs.
    Section 105(d) would amend 38 U.S.C. 2066 to extend 
Congressional authority to continue the Advisory Committee for 
Homeless Veterans for an additional two years until 
December 30, 2013. This Committee was Congressionally-mandated 
by Public Law 107-95. The mission of the Committee is to 
provide advice and make recommendations to the Secretary on 
issues affecting homeless Veterans and determine if VA and 
other programs and services are meeting the needs of homeless 
Veterans. VA has implemented many of the Committee's 
recommendations through policy and regulatory changes to 
enhance access and services for homeless Veterans.
    The costs associated with the Advisory Committee were 
$114,000 in FY 2010 and we estimate an increase in 3 to 5 
percent in the additional two years of operation for hotel 
room, air travel, and meeting space.
Section 106
    VA supports section 106 which would re-authorize 
appropriations for the Department of Labor's (DOL) Homeless 
Veterans Reintegration Program (HVRP) for fiscal years 2012 and 
2013. HVRP is a grant program intended to assist homeless 
Veterans rejoin the workforce. Grantees provide homeless 
Veterans with job training and employment placement assistance, 
as well as related supportive services such as transitional 
housing, transportation and referral to treatment services. In 
Fiscal Year 2011, DOL used HVRP funds to restart its 
Incarcerated Veterans Transition Program (IVTP), under which 
grantees provide HVRP services to Veterans reentering their 
communities from prison or jail. HVRP grantees conduct regular 
outreach to identify homeless Veterans, and often refer them to 
VA for health care. Veterans ineligible for services from the 
Veterans Health Administration may often be able to access 
needed services through HVRP. The HVRP program, especially the 
IVTP component, is therefore an extremely valuable, 
complementary resource for VHA Justice Program's staff. 
Reauthorization will contribute to achieving VA's Plan to End 
Homelessness Among Veterans.
    Reauthorization would be cost-neutral for VA. VHA Justice 
Programs staff coordinate with HVRP grantees and serve the 
Veterans they refer to VA, but these staff are funded under 
separate authority.
Section 107
    Section 107 would amend 38 U.S.C. 2044(e) to extend VA's 
authority to provide financial assistance to entities approved 
to provide and coordinate the provision of supportive services 
for very low-income Veteran families occupying permanent 
housing to fiscal year 2012. Section 107 would also make 
available $100 million from the amounts appropriated to the 
Department of Medical Services to carry out section 2044. Last, 
this provision makes a technical amendment to correct a 
grammatical error in subsection 2044(e).
    Although VA fully supports the reauthorization of 
appropriations for the Supportive Services for Veteran Families 
(SSVF) Program under section 107, VA respectfully suggests that 
the Committee consider the language in section 306 of VA's 
draft bill, the ``Veterans Health Care Act of 2011,'' which was 
transmitted to Congress on June 7, 2011. Section 306 would 
extend Congressional authority to continue the SSVF Program 
permanently. Additionally, beginning in fiscal year 2014, VA 
would be authorized to fund the program with the amounts deemed 
necessary. This modification would give VA maximum flexibility 
to redirect resources to prevention efforts as the VA's Plan to 
End Homelessness Among Veterans reduces the overall number of 
homeless Veterans.
    The current statute authorizes funding for the SSVF Program 
through the end of fiscal year 2011. However, at the current 
level of funding, VA can only provide approximately 85 grants 
nationwide, leaving significant areas of the country, both 
urban and rural, without services.
    The SSVF Program is the only VA homeless program that is 
national in scope that can provide direct services to both 
Veterans and their family members. Recent Community 
Homelessness Assessment, Local Education and Networking Groups 
(CHALENG) reports indicate that homeless and formerly homeless 
Veterans consider family concerns as their highest unmet need. 
Additionally, homeless prevention is one of the key strategies 
in eliminating Veteran homelessness. Currently, approximately 
1.3 million Veterans live in poverty. Estimates from the 2009 
Annual Homelessness Assessment Report (AHAR) indicate that ten 
percent of all Veterans in poverty will become homeless at some 
point during the year. Prevention services are critical to 
reducing this incidence of homelessness. Continued 
authorization of the SSVF Program would allow VA to serve over 
20,000 Veteran families in FY 2012. As the SSVF Program is one 
of the cornerstones of VA's Plan to End Homelessness Among 
Veterans and the Federal Strategic Plan to Prevent and End All 
Homelessness, its reauthorization at levels that allow for 
national access is critical to the success of both efforts.
    The cost of the SSVF program is contained in the current 
VHA Homeless Veteran program budgets so there are no additional 
cost associated with this section.
Section 108
    Pursuant to 38 U.S.C. 2061, VA makes grants for homeless 
Veterans with special needs to VA health care facilities and 
GPD providers. The ``grants'' to GPD providers are in the form 
of supplemental per diem payments for additional operating 
expenses not covered by per diem payments under the GPD 
program. The section 2061 grant authority expires on 
September 30, 2011.
    Section 108 which would amend 38 U.S.C. 2061 to extend by 
an additional 2 years, until December 31, 2013, VA's authority 
to offer grants to health care facilities and grant and per 
diem providers for the development of programs for homeless 
Veterans with special needs. Veterans with special needs are 
those who are: women, including women who have care of minor 
dependents; frail, elderly; terminally ill; or chronically 
mentally ill.
    VA supports section 108, however respectfully requests that 
the Committee consider adopting the language found in section 
303 of VA's draft bill, the ``Veterans Health Care Act of 
2011,'' which was transmitted to Congress on June 7, 2011, 
which would grant permanent authority to offer capital grants 
for homeless Veterans with special needs.
    VA estimates the costs associated with this section to be 
$5 million for the first fiscal year and $10 million over two 
years.

          TITLE III--OTHER ADMINISTRATIVE AND BENEFITS MATTERS

Section 301
    Section 301 would amend 38 U.S.C. 3704(c) to allow a 
Veteran's dependent child to satisfy the occupancy requirements 
of VA home loans. Currently, only a Veteran or a Veteran's 
spouse may satisfy the requirement, which means that a single 
parent on active duty may be prevented from obtaining a VA-
guaranteed loan. The proposed change would make it easier for 
those serving in the Armed Forces to use their VA home loan 
benefits.
    VA supports section 301, noting it is identical to section 
3 of S. 874 and substantively the same as section 301 of VA's 
draft bill, the ``Veterans Benefits Programs Improvement Act of 
2011,'' which was transmitted to Congress on May 19, 2011.
    VA estimates that enactment of this provision would result 
in additional loan subsidy costs of $370 thousand the first 
year, $3.9 million over the first five years and $10.8 million 
over ten years.
Section 302
    Section 302 would amend 38 U.S.C. 3729(c) to allow an 
individual to receive a fee waiver if, during a pre-discharge 
program, he or she receives a disability rating for purposes of 
VA compensation based on existing medical evidence, such as 
service medical and treatment records. VA supports this 
provision, noting that it is substantively the same as section 
304 of VA's draft bill, the ``Veterans Benefits programs 
Improvement Act of 2011,'' which was transmitted to Congress on 
May 19, 2011. Under current law, the loan fee may be waived if 
the Veteran receives a pre-discharge rating based on a VA 
examination and rating. This provision would extend the waiver 
to individuals rated eligible for VA compensation based on 
existing evidence.
    VA estimates that there would be no additional costs 
associated with implementing section 302.
Section 303
    Section 303 would amend 38 U.S.C. 2102A(e) by extending, 
through December 31, 2021, the Secretary's authority to provide 
Specially Adapted Housing assistance to eligible individuals 
residing temporarily with family members. VA supports this 
provision, noting that it is substantively the same as section 
306 of VA's draft bill, the ``Veterans Benefits Programs 
Improvement Act of 2011.'' Under current law, the authority is 
set to expire on December 31, 2011.
    VA estimates that there would be no additional costs 
associated with implementing section 303.
Section 304
    Section 304 would amend 38 U.S.C. 2102A(b) to provide that 
amounts of assistance payable under that section to certain 
individuals who reside temporarily in housing owed by family 
members be adjusted on an annual basis based on a cost-of-
construction index already in effect for other Specially 
Adapted Housing grants authorized under chapter 21 of title 38, 
United States Code. The proposal is substantively the same as 
section 307 of VA's draft bill, the ``Veterans Benefits 
Programs Improvement Act of 2011.'' VA supports this provision 
to ensure that seriously disabled Veterans temporarily living 
with family members may have continued access to residences 
that suit the Veterans' day to day needs.
    VA estimates that there would be no additional costs 
associated with implementing section 304.
Section 305
    Section 305 of S. 1148 would extend eligibility for 
Presidential memorial certificates to the survivors of any 
Servicemember who died in active military, naval or air 
service. An alternate version of this provision was introduced 
in S. 874, and section 305 is identical to a provision the 
Secretary proposed on May 19, 2011. VA strongly supports 
enactment of this provision.
    Under current law, eligibility for a Presidential memorial 
certificate is limited to survivors of Veterans who were 
discharged under honorable conditions. Under the statutory 
definition of ``Veteran'' generally applicable to title 38, 
United States Code, an individual who died in active service, 
including an individual killed in action, technically is not a 
``Veteran'' because the individual was not ``discharged or 
released'' from service. Therefore, under current law, the 
survivors of such an individual are not eligible for a 
Presidential memorial certificate to honor the memory of the 
individual. Section 305 would authorize VA to provide a 
Presidential memorial certificate to the next of kin, 
relatives, or friends of such individuals, who have made the 
supreme sacrifice for our country, and express our country's 
grateful recognition of the individual's service in the Armed 
Forces. We estimate that this eligibility expansion would 
result in discretionary costs of $8,924 the first year, $44,436 
over five years, and $88,416 over ten years.
Section 306
    Section 306 would amend 38 U.S.C. 7105 to incorporate an 
automatic waiver of the right to initial consideration of 
certain evidence by the agency of original jurisdiction (AOJ). 
The evidence that would be subject to the waiver is evidence 
that the claimant or his or her representative submits to VA 
concurrently with or after filing the substantive appeal. Such 
evidence would be subject to initial consideration by the Board 
of Veterans' Appeals unless the appellant or his or her 
representative requests in writing that the AOJ initially 
consider the evidence. Such request would be required to be 
submitted with the evidence. The amendment made under this 
provision would become effective 180 days after enactment of 
this provision. Section 306 is very similar to section 204 of 
VA's draft bill, the ``Veterans Benefits Programs Improvement 
Act of 2011,'' which was transmitted to Congress on May 19, 
2011. VA strongly supports its enactment.
    Current law precludes the Board's initial consideration of 
evidence submitted in connection with a claim, unless the 
claimant waives the right to initial consideration by the AOJ. 
Evidence must first be considered by the AOJ in order to 
preserve a claimant's statutory right under 38 U.S.C. 7104 to 
one review on appeal, which the Board provides on behalf of the 
Secretary. The requirement that the AOJ initially consider all 
evidence, unless the claimant waives the right, frequently 
delays the final adjudication of claims because claimants often 
submit additional evidence after perfecting their appeals to 
the Board by filing a substantive appeal. Under current 
procedures, each time a claimant, after filing a substantive 
appeal, submits more evidence without waiving the right to 
initial AOJ consideration, the AOJ must review the evidence 
submitted and issue a supplemental statement of the case that 
addresses it. If a claimant submits relevant evidence to the 
Board without waiving the right to initial AOJ consideration, 
the Board must remand the claim to the AOJ for initial 
consideration and preparation of a supplemental statement of 
the case. The effect of the bill would not be to deprive 
claimants of the right to initial consideration by the AOJ. It 
would permit claimants to obtain initial consideration by the 
AOJ by requesting such review in writing.
    The establishment of an automatic waiver would necessarily 
improve the timeliness of processing appeals as a whole. 
Because the Board bases its decisions on a de novo review of 
all the evidence of record, many more appeals could be more 
quickly transferred to the Board following the receipt of a 
substantive appeal. AOJs would spend less time responding to 
appellants who submit additional evidence following the filing 
of a substantive appeal, and the Board would avoid time-
consuming remands in cases when the appellant submits evidence 
directly to the Board. By presuming a waiver of AOJ review of 
new evidence, the Board would be able to adjudicate claims 
without the delay of a remand, thereby getting final decisions 
to Veterans more quickly and reducing the increased appellate 
workload caused by the reworking of remanded claims.
    We anticipate that enactment of section 306 would have no 
measurable monetary costs or savings. The potential benefits 
that would result from enactment of the proposal include 
expedited adjudication of claims on appeal and a reduction in 
the time spent processing appeals, both at AOJs and the Board, 
allowing more time for deciding new claims.
Section 307
    Section 307 would permit VA to continue to use income 
information from other agencies in making certain benefits 
determinations by extending the sunset provision for using 
income data from the Internal Revenue Service (IRS) and the 
Social Security Administration (SSA) from September 30, 2011, 
to September 30, 2016, and extending the sunset provision for 
using income data from the U.S. Department of Health and Human 
Services (HHS) from September 30, 2011, to September 30, 2021. 
VA supports this provision, noting that it is substantively the 
same as sections 502 and 503 of VA's draft bill, the ``Veterans 
Benefits Programs Improvement Act of 2011.'' VA estimates that 
enactment of section 307 would result in a net savings of $159 
million over 5 years with respect to the IRS/SSA extension and 
a net savings of $13 million over 10 years with respect to the 
HHS extension.
Section 308
    Section 308 would permit the VA Regional Office in Manila, 
Philippines, to maintain its operations until December 31, 
2012. Section 504 of VA's draft bill, the ``Veterans Benefits 
Programs Improvement Act of 2011,'' which was transmitted to 
Congress on May 19, 2011, proposed extending to December 31, 
2016, the authority to maintain a regional office in the 
Philippines. Although section 308 would provide a shorter 
extension, VA nevertheless supports enactment. It is more cost 
effective to maintain the facility in Manila than it would be 
to transfer its functions and hire equivalent numbers of 
employees to perform those functions on the U.S. mainland. In 
addition, VA's presence in Manila significantly enhances the 
ability to manage potential fraud. For these reasons, there is 
no increased cost associated with this provision.

           *       *       *       *       *       *       *

                                ------                                

    On June 8, 2011, John McWilliam, Deputy Assistant 
Secretary, Veterans' Employment and Training Service, 
Department of Labor, appeared before the Committee and 
submitted testimony on S. 1060, among other issues. Excerpts 
from this statement are reprinted below:

  STATEMENT OF JOHN MCWILLIAM, DEPUTY ASSISTANT SECRETARY, VETERANS' 
       EMPLOYMENT AND TRAINING SERVICE, U.S. DEPARTMENT OF LABOR

    Chairman Murray, Ranking Member Burr, and distinguished 
Members of the Committee, I am pleased to appear before you 
today to discuss legislation pending in this Committee aimed at 
helping our returning Servicemembers transition back to 
civilian life.
    The Veterans' Employment and Training Service (VETS) 
proudly serves Veterans and transitioning Servicemembers by 
providing resources and expertise to assist and prepare them to 
obtain meaningful careers, maximize their employment 
opportunities and protect their employment rights.
    Secretary Solis has been an incredible source of guidance 
and support, and has made Veterans and VETS one of her top 
priorities. Our programs are an integral part of Secretary 
Solis's vision of ``Good Jobs for Everyone'' and her unwavering 
commitment to help Veterans and their families get into the 
middle class and maintain stability. We strive to achieve this 
vision through four main programs:

     Jobs for Veterans State Grants;
     Transition Assistance Program Employment 
Workshops;
     Homeless Veterans' Reintegration Programs; and
     Uniformed Services Employment and Reemployment 
Rights Act.

    Your letter of invitation seeks input on a significant 
number of bills at this hearing, and you ask VETS to 
specifically provide input on S. 951, the ``Hiring Heroes Act 
of 2011.'' We have done so in subsequent portions of this 
testimony, in addition to providing comments on the proposed 
``Honoring All Veterans Act of 2011,'' which would require the 
Department of Labor (DOL), through the Assistant Secretary of 
the Office of Disability Employment Policy (ODEP), to initiate 
a program providing technical assistance to employers of 
Veterans who have a Traumatic Brain Injury or Post Traumatic 
Stress Disorder.
    As the remaining pieces of proposed legislation being 
addressed at this hearing fall under the purview of other 
departments, VETS defers to those departments and I will 
restrict my testimony to the appropriate sections of S. 951, 
and the ``Honoring All Veterans Act of 2011'' that have a 
direct impact on DOL and the Veterans' Employment and Training 
Service.
    In addition to the invitation for today's hearing, VETS has 
received a follow-up request to comment on Senator Casey's 
proposed ``Veteran Transition Assistance Program Audit Act of 
2011.'' Due to time constraints, VETS was unable to conduct a 
thorough review in time for today's hearing, but we look 
forward to providing our comments for the record and continuing 
to work with Senator Casey and this entire Committee to ensure 
that our Servicemembers receive the best assistance possible as 
they transition back to civilian life.

           *       *       *       *       *       *       *


           DRAFT BILL: ``HONORING ALL VETERANS ACT OF 2011''

    The stated purpose of this bill is to: ``improve education, 
employment, independent living services, and health care for 
veterans, to improve assistance for homeless veterans, and to 
improve the administration of the Department of Veterans 
Affairs, and for other purposes.'' Accordingly, we defer to VA 
and DOD for most of the sections of the bill.
    Section 105: This section would require the Secretary of 
Labor, through the Assistant Secretary for the Office of 
Disability Employment Policy, to initiate a program to provide 
technical assistance to prospective employers, employers of 
covered Veterans and entities in the workforce system to assist 
Veterans who have Traumatic Brain Injury or Post Traumatic 
Stress Disorder in the area of employment.
    DOL believes that this section is unnecessary. ODEP, in 
cooperation with VETS, created the America's Heroes at Work 
(AHAW) program in 2008 to fulfill this need. We are currently 
in the process of transitioning the leadership and funding for 
this program to our office, and propose to work with the 
Committee to determine if AHAW needs further enhancements.

                               CONCLUSION

    We are reminded everyday of the tremendous sacrifices made 
by our Veterans, Servicemembers and their families. Secretary 
Solis and the Veterans' Employment and Training Service believe 
that America must honor those sacrifices by providing the 
Nation's bravest with the best possible programs and services 
that we have to offer. We look forward to continuing our work 
with this Committee to do just that.

    I again thank this Committee for your commitment to our 
Nation's Veterans and for the opportunity to testify before 
you. We would be happy to work with your staffs to provide 
technical assistance on any of these or future bills, and I 
would be happy to respond to any questions.
                                ------                                

    On June 8, 2011, the Department of Defense, submitted 
testimony on various bills incorporated into the Committee 
bill. Excerpts from this statement are reprinted below:

              STATEMENT OF THE U.S. DEPARTMENT OF DEFENSE

    Chairman Murray, Ranking Member Burr, and Members of this 
distinguished Committee thank you for extending the invitation 
to the Department of Defense to address pending legislation 
that would significantly affect our Servicemembers: S. 277, the 
proposed ``Caring for Camp Lejeune Veterans Act of 2011;'' 
S. 486, the proposed ``Protecting Servicemembers from Mortgage 
Abuses Act of 2011;'' S. 491, the proposed ``Honor America's 
Guard-Reserve Retirees Act of 2011;'' S. 698, the proposed bill 
to amend title 38, United States Code, to codify the 
prohibition against the reservation of gravesites at Arlington 
National Cemetery, and for other purposes; S. 951, the proposed 
``Hiring Heroes Act of 2011.''

           *       *       *       *       *       *       *

    The Department supports the proposed bill S. 486 as 
drafted, with one caveat: the mortgage protections of section 
533 should only be extended to 12 months rather than to the 
proposed 24 months.

           *       *       *       *       *       *       *

    The Department recommends modifying S. 698 according to 
details provided in this testimony.

           *       *       *       *       *       *       *

    The Department defers to the VA on S. 1060. DOD does not 
have any specific concerns.

SUMMARY OF THE DEPARTMENT'S VIEWS ON PENDING LEGISLATION

           *       *       *       *       *       *       *


                                 S. 486

    The Department of Defense (DOD) supports the proposed bill 
S. 486 as drafted, with one caveat: the mortgage protections of 
section 533 should only be extended to 12 months rather than to 
the proposed 24 months.
    Although DOD hesitates to recommend against any protection 
extended to Servicemembers, we believe that a three-month 
extension more fairly balances the equities of all parties, 
including the lending industry, and would help ensure that no 
backlash against the Servicemember--perhaps in the form of 
decreased credit opportunities--is ever considered.
    An extension to 12 months would align the foreclosure 
protections of section 533 with the current 12-month interest 
rate cap of section 527 (for pre-service mortgage obligations). 
This would help reduce confusion over the current, unevenly-
extended protections.

           *       *       *       *       *       *       *


                                 S. 698

    S. 698 would amend title 38, United States Code, to codify 
the prohibition against the reservation of gravesites at 
Arlington National Cemetery. As drafted, S. 698 would prohibit 
more than one gravesite per eligible veteran and would also 
prohibit gravesite reservations prior to the time of need with 
an exception for written ``requests'' for a reserved gravesite 
made prior to January 1, 1962 regardless of current eligibility 
requirements. Current Army regulations establish a ``one-
gravesite-per-family'' policy. This rule has been in effect 
since 1961. One important element of Army policy is that the 
Army may allow exceptions to the ``one-gravesite-per-family'' 
policy when strict adherence to the policy is not feasible. 
This policy is set forth at 32 CFR Sec. 553.18(a) and Army 
Regulation 290-5 Sec. 2-5(a). S. 698, as drafted, does not, but 
in the Department's view should, provide the Secretary of the 
Army with the requisite authority to make an appropriately 
justified exception to the ``one-gravesite-per-family'' policy. 
The Department recommends modifying S. 698 accordingly.
    Similarly, the Army currently prohibits reserving 
gravesites prior to time of need and does not honor gravesite 
reservations unless (1) the reservation was made in writing 
before the ``one-gravesite-per-family'' policy was established, 
(2) an eligible person was interred before the one-gravesite-
per-family policy was established, and (3) the person holding 
the reservation for the adjacent gravesite is eligible for 
interment at Arlington National Cemetery under current Army 
eligibility rules. This policy is set forth at 32 CFR 
Sec. 553.18 and Army Regulation 290-5 Sec. 2-5. This exception 
to the prohibition on reservations is necessary because prior 
to the ``one-gravesite-per-family'' policy, individuals were 
not interred at depths that would accommodate two or three 
subsequent burials in the same gravesite like they are today.
    As drafted, proposed section 2410A(b) in S. 698 reflects 
the Army's current policy prohibiting reservations. Section 
1(c)(2) of S. 698, however, creates an exception to the 
prohibition on reservations for those who have a ``written 
request for a reserved gravesite [that] was submitted to the 
Secretary of the Army before January 1, 1962.'' This exception 
would alter current Army policy by allowing reservations for 
those with only a reservation request rather than an approved 
reservation before 1962. The requirement for a valid 
reservation, not just a request, is necessary to implement 
S. 698. The Department has no objection to the reporting 
requirement contained in section 1(d) of S. 698.

           *       *       *       *       *       *       *

    On June 8, 2011, Mercedes Marquez, Assistant Secretary for 
Community Planning and Development, Department of Housing and 
Urban Development, submitted testimony on S. 411. This 
statement is reprinted below:

   STATEMENT OF MERCEDES MARQUEZ, ASSISTANT SECRETARY FOR COMMUNITY 
    PLANNING AND DEVELOPMENT, U.S. DEPARTMENT OF HOUSING AND URBAN 
                              DEVELOPMENT

           S. 411, HELPING OUR HOMELESS VETERANS ACT OF 2011

    Chairman Murray, Ranking Member Burr, Distinguished Members 
of the Senate Committee on Veterans' Affairs, I am pleased to 
be able to submit this testimony on behalf of the U.S. 
Department of Housing and Urban Development (HUD) regarding 
S. 411, Helping our Homeless Veterans Act of 2011.

                               BACKGROUND

    This bill proposes two amendments to U.S. Code Title 38: 
Inserting section 2045, allowing the VA to ``enter into 
agreements with eligible entities to collaborate in the 
provision of case management services'' as part of the HUD-VA 
Supportive Housing (HUD-VASH) program; and section 2046, which 
calls for ``the distribution of rental vouchers to veterans in 
rural areas and underserved veterans in metropolitan areas or 
on Indian lands in each region of the United States.''
    HUD and the Administration share the goal of this 
legislation to better meet the needs of homeless veterans. One 
year ago this month, the President released Opening Doors: The 
Federal Strategic Plan to Prevent and End Homelessness, which 
calls for ending veteran homelessness by 2015, and includes 
strategies to help achieve the goal. HUD is working closely 
with the Department of Veterans Affairs to ensure our programs 
are coordinated to effectively and efficiently meet the needs 
of homeless veterans. One of the key successes, to date, is the 
HUD-VASH program. This program combines rental assistance 
provided by HUD with services and health care provided by VA. 
By jointly working to improve the program, the ability to more 
swiftly identify and house homeless veterans has been greatly 
enhanced.

                        GEOGRAPHIC DISTRIBUTION

    S. 411 seeks to ensure that resources are provided to 
homeless veterans who reside in rural communities--some of whom 
may be in areas that are long distances from VA medical 
centers. The current allocation methodology uses relative need 
and performance to distribute vouchers, and provides vouchers 
to many rural areas that demonstrate relative need via data 
provided to HUD and VA. While HUD agrees that there should be 
geographic diversity in the distribution of vouchers, it should 
be noted HUD and VA data show that the most significant need 
remains in urban centers. On the other hand, the Administration 
is committed to addressing veterans' homelessness wherever it 
exists, and a more efficient way to meet rural veterans' needs 
may be through HUD's Continuum of Care programs. As part of the 
Administration's funding request for the new Homeless Emergency 
and Rapid Transition to Housing (HEARTH) Act, HUD included in 
its FY 2012 budget funding to implement the Rural Housing 
Stability Assistance Program (RHSP). This would provide 
assistance in rural areas to individuals and families 
(including veterans) who are homeless, in imminent danger of 
losing housing, or in worst case housing situations. The HEARTH 
Act also authorizes the new Emergency Solutions Grant (ESG) 
program, which provides funding for homelessness prevention, 
shelter, and rapid re-housing services. HUD looks forward to 
working with the Committee and our Administration partners to 
determine the most effective ways of addressing homelessness 
among veterans in urban and rural areas.

                              CONTRACTING

    One component of the bill that we believe could have a 
significant positive impact on assisting homeless veterans 
involves the provision of services through VA contracts with 
local non-profits and other agencies to provide case management 
and to connect to HUD housing resources. As demonstrated by the 
success of the HUD-VA--U.S. Interagency Council on Homelessness 
(USICH) Washington, DC. Pilot Initiative, contracting and 
collaborating with local providers can greatly enhance the 
provision of needed services in some communities. Through a 
joint effort between Washington, DC's Department of Human 
Services and the D.C. Housing Authority, the eligibility 
process was streamlined and as a result, vouchers were 
allocated at a substantially faster pace and clients with 
vouchers were quickly housed. These very positive, initial 
results from the first pilot suggest that this model should be 
looked at further in other communities that the Departments 
deem appropriate.

                               TARGETING

    We have learned through our HUD-VASH efforts in recent 
years that a key to success in ending veteran homelessness is 
effective targeting. Therefore we have concerns about the 
potential impact of this bill on those targeting efforts. While 
the title of the bill indicates that the targeted population 
will be homeless veterans, the text of the bill in a number of 
cases uses the term ``underserved veterans,'' suggesting that 
the program could be modified to serve more than veterans who 
are homeless. The current HUD-VASH assistance is designed to 
house the neediest veterans, many of whom are chronically 
homeless. We would argue in favor of keeping that targeting to 
this population as a priority at this time.

                            CASE MANAGEMENT

    The bill includes a broad definition of case management 
services, which could complicate the efforts of HUD, the VA, 
and organizations that would be contracted to provide needed 
services to homeless veterans. For example, the bill includes 
activities such as rental assistance, legal assistance, and 
mental health or substance abuse counseling as part of case 
management. HUD looks forward to working with the Committee and 
VA to clarify the definition of case management in the 
legislation in order to help improve coordination and 
efficiency, as well as oversight.

                              TRIBAL LANDS

    HUD recognizes the need for improved housing and services 
for veterans on Tribal Lands, and we are eager to explore 
options for helping to achieve this goal. While persons living 
in tribal areas are individually eligible for HUD-VASH, under 
current law the tribal areas themselves are not eligible for 
any Housing Choice Voucher (HCV) program (including HUD-VASH), 
or for McKinney-Vento Act/homeless programs. However, it should 
be noted that the Native American Housing Assistance and Self-
Determination Act (NAHASDA) authorizes assistance to Indian 
Tribes or their Tribally Designated Housing Entities (TDHE) 
through the Indian Housing Block Grant (IHBG). IHBG can be used 
to develop rental assistance programs similar to HCV. We 
believe it is important to take into account these mechanisms 
for providing services to veterans on Tribal Lands as part of 
the effort to consider what changes to the existing system make 
sense. And, again, we look forward to discussing these matters 
with Members of the Committee.

                               CONCLUSION

    The HUD-VASH model has served as a vital tool for ending 
veteran homelessness, and HUD is encouraged that Senator 
Klobuchar and the Committee continue to seek ways to improve 
the program. HUD looks forward to working with the Committee to 
further discuss how the intent of the S. 411's provisions can 
best be realized.

                        Changes in Existing Law

    In compliance with paragraph 12 of Rule XXVI of the 
Standing Rules of the Senate, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italic, existing law in which no change is 
proposed is shown in roman).

Title 18. Crimes and Criminal Procedure

           *       *       *       *       *       *       *


Part I. Crimes

           *       *       *       *       *       *       *


Chapter 67. Military and Navy

           *       *       *       *       *       *       *


SEC. 1388. PROHIBITION ON DISRUPTIONS OF FUNERALS OF MEMBERS OR FORMER 
                    MEMBERS OF THE ARMED FORCES

    [(a) Prohibition.--For any funeral of a member or former 
member of the Armed Forces that is not located at a cemetery 
under the control of the National Cemetery Administration or 
part of Arlington National Cemetery, it shall be unlawful for 
any person to engage in an activity during the period beginning 
60 minutes before and ending 60 minutes after such funeral, any 
part of which activity--
          [(1) (A) takes place within the boundaries of the 
        location of such funeral or takes place within 150 feet 
        of the point of the intersection between--
                  [(i) the boundary of the location of such 
                funeral; and
                  [(ii) a road, pathway, or other route of 
                ingress to or egress from the location of such 
                funeral; and
          [(B) includes any individual willfully making or 
        assisting in the making of any noise or diversion that 
        is not part of such funeral and that disturbs or tends 
        to disturb the peace or good order of such funeral with 
        the intent of disturbing the peace or good order of 
        that funeral; or
          [(2)(A) is within 300 feet of the boundary of the 
        location of such funeral; and
          [(B) includes any individual willfully and without 
        proper authorization impeding the access to or egress 
        from such location with the intent to impede the access 
        to or egress from such location.
    [(b) Penalty.--Any person who violates subsection (a) shall 
be fined under this title, imprisoned for not more than 1 year, 
or both.
    [(c) Definitions.--In this section:
          [(1) The term ``Armed Forces'' has the meaning given 
        the term in section 101 of title 10.
          [(2) The term ``funeral of a member or former member 
        of the Armed Forces'' means any ceremony or memorial 
        service held in connection with the burial or cremation 
        of a member or former member of the Armed Forces.
          [(3) The term ``boundary of the location'', with 
        respect to a funeral of a member or former member of 
        the Armed Forces, means--
                  [(A) in the case of a funeral of a member or 
                former member of the Armed Forces that is held 
                at a cemetery, the property line of the 
                cemetery;
                  [(B) in the case of a funeral of a member or 
                former member of the Armed Forces that is held 
                at a mortuary, the property line of the 
                mortuary;
                  [(C) in the case of a funeral of a member or 
                former member of the Armed Forces that is held 
                at a house of worship, the property line of the 
                house of worship; and
                  [(D) in the case of a funeral of a member or 
                former member of the Armed Forces that is held 
                at any other kind of location, the reasonable 
                property line of that location.]
    (a) Prohibition.--For any funeral of a member or former 
member of the Armed Forces that is not located at a cemetery 
under the control of the National Cemetery Administration or 
part of Arlington National Cemetery, it shall be unlawful for 
any person to engage in an activity during the period beginning 
120 minutes before and ending 120 minutes after such funeral, 
any part of which activity--
          (1)(A) takes place within the boundaries of the 
        location of such funeral or takes place within 300 feet 
        of the point of the intersection between--
                  (i) the boundary of the location of such 
                funeral; and
                  (ii) a road, pathway, or other route of 
                ingress to or egress from the location of such 
                funeral; and
          (B) includes any individual willfully making or 
        assisting in the making of any noise or diversion--
                  (i) that is not part of such funeral and that 
                disturbs or tends to disturb the peace or good 
                order of such funeral; and
                  (ii) with the intent of disturbing the peace 
                or good order of such funeral;
          (2)(A) is within 500 feet of the boundary of the 
        location of such funeral; and
          (B) includes any individual--
                  (i) willfully and without proper 
                authorization impeding or tending to impede the 
                access to or egress from such location; and
                  (ii) with the intent to impede the access to 
                or egress from such location; or
          (3) is on or near the boundary of the residence, 
        home, or domicile of any surviving member of the 
        deceased person's immediate family and includes any 
        individual willfully making or assisting in the making 
        of any noise or diversion--
                  (A) that disturbs or tends to disturb the 
                peace of the persons located at such location; 
                and
                  (B) with the intent of disturbing such peace.
    (b) Penalty.--Any person who violates subsection (a) shall 
be fined under this title or imprisoned for not more than 1 
year, or both.
    (c) Civil Remedies.--
          (1) District courts.--The district courts of the 
        United States shall have jurisdiction--
                  (A) to prevent and restrain violations of 
                this section; and
                  (B) for the adjudication of any claims for 
                relief under this section.
          (2) Attorney general.--The Attorney General may 
        institute proceedings under this section.
          (3) Claims.--Any person, including a surviving member 
        of the deceased person's immediate family, who suffers 
        injury as a result of conduct that violates this 
        section may--
                  (A) sue therefor in any appropriate United 
                States district court or in any court of 
                competent jurisdiction; and
                  (B) recover damages as provided in subsection 
                (d) and the cost of the suit, including 
                reasonable attorneys' fees.
          (4) Estoppel.--A final judgment or decree rendered in 
        favor of the United States in any criminal proceeding 
        brought by the United States under this section shall 
        estop the defendant from denying the essential 
        allegations of the criminal offense in any subsequent 
        civil proceeding brought by a person or by the United 
        States.
    (d) Actual and Statutory Damages.--
          (1) In general.--In addition to any penalty imposed 
        under subsection (b), a violator of this section is 
        liable in an action under subsection (c) for actual or 
        statutory damages as provided in this subsection.
          (2) Actions by private persons.--A person bringing an 
        action under subsection (c)(3) may elect, at any time 
        before final judgment is rendered, to recover the 
        actual damages suffered by him or her as a result of 
        the violation or, instead of actual damages, an award 
        of statutory damages for each violation involved in the 
        action.
          (3) Actions by attorney general.--In any action under 
        subsection (c)(2), the Attorney General is entitled to 
        recover an award of statutory damages for each 
        violation involved in the action notwithstanding any 
        recovery under subsection (c)(3).
          (4) Statutory damages.--A court may award, as the 
        court considers just, statutory damages in a sum of not 
        less than $25,000 or more than $50,000 per violation.
    (e) Rebuttable Presumption.--It shall be a rebuttable 
presumption that the violation was committed willfully for 
purposes of determining relief under this section if the 
violator, or a person acting in concert with the violator, did 
not have reasonable grounds to believe, either from the 
attention or publicity sought by the violator or other 
circumstance, that the conduct of such violator or person would 
not disturb or tend to disturb the peace or good order of such 
funeral, impede or tend to impede the access to or egress from 
such funeral, or disturb or tend to disturb the peace of any 
surviving member of the deceased person's immediate family who 
may be found on or near the residence, home, or domicile of the 
deceased person's immediate family on the date of the service 
or ceremony.
    (f) Definitions.--In this section--
          (1) the term ``Armed Forces'' has the meaning given 
        the term in section 101 of title 10 and includes 
        members and former members of the National Guard who 
        were employed in the service of the United States; and
          (2) the term ``immediate family'' means, with respect 
        to a person, the immediate family members of such 
        person, as such term is defined in section 115 of this 
        title.

           *       *       *       *       *       *       *


Title 38. Veterans' Benefits

           *       *       *       *       *       *       *


Part I. General Provisions

           *       *       *       *       *       *       *


Chapter 1. General

           *       *       *       *       *       *       *


SEC. 111. PAYMENTS OR ALLOWANCES FOR BENEFICIARY TRAVEL

           *       *       *       *       *       *       *


    (b)(1) * * *

           *       *       *       *       *       *       *

    (3)(A) * * *

           *       *       *       *       *       *       *

    (C) In the case of transportation of a person under 
subparagraph (B) by ambulance, the Secretary may pay the 
provider of the transportation the lesser of the actual charge 
for the transportation or the amount determined by the fee 
schedule established under section 1834(l) of the Social 
Security Act (42 U.S.C. 1395m(l)) unless the Secretary has 
entered into a contract for that transportation with the 
provider.

           *       *       *       *       *       *       *


SEC. 112. PRESIDENTIAL MEMORIAL CERTIFICATE PROGRAM

    (a) At the request of the President the Secretary may 
conduct a program for honoring the memory of deceased veterans, 
discharged under honorable conditions, and persons who died in 
the active military, naval, or air service, by preparing and 
sending to eligible recipients a certificate bearing the 
signature of the President and expressing the country's 
grateful recognition of the [veteran's] deceased individual's 
service in the Armed Forces. The award of a certificate to one 
eligible recipient will not preclude authorization of another 
certificate if a request is received from some other eligible 
recipient.

           *       *       *       *       *       *       *


Chapter 3. Department of Veterans Affairs

           *       *       *       *       *       *       *


SEC. 315. REGIONAL OFFICES

    (a) * * *
    (b) The Secretary may maintain a regional office in the 
Republic of the Philippines until [December 31, 2011] December 
31, 2012.

           *       *       *       *       *       *       *


Part II. General Benefits

           *       *       *       *       *       *       *


 Chapter 15. Pension for Non-Service-Connected Disability or Death or 
for Service

           *       *       *       *       *       *       *


Subchapter II. Veterans' Pensions

           *       *       *       *       *       *       *


                NON-SERVICE-CONNECTED DISABILITY PENSION

SEC. 1521. VETERANS OF A PERIOD OF WAR.

           *       *       *       *       *       *       *


    (f)(1) * * *
    (2) If either such veteran is in need of regular aid and 
attendance, the annual rate provided by paragraph (1) of this 
subsection shall be $23,396. If both such veterans are in need 
of regular aid and attendance, such rate shall be [$30,480] 
$31,305.

           *       *       *       *       *       *       *


   Chapter 17. Hospital, Nursing Home, Domiciliary, and Medical Care

SEC.

SUBCHAPTER I. GENERAL

           *       *       *       *       *       *       *


1708. TEMPORARY LODGING.

1709. TELECONSULTATION.

           *       *       *       *       *       *       *


   SUBCHAPTER III. MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND 
          NURSING HOME CARE AND MEDICAL TREATMENT OF VETERANS

1721. POWER TO MAKE RULES AND REGULATIONS.

           *       *       *       *       *       *       *


1722A. COPAYMENT FOR MEDICATIONS.

1722B. COPAYMENTS: WAIVER OF COLLECTION OF COPAYMENTS FOR TELEHEALTH 
                    AND TELEMEDICINE VISITS OF VETERANS.

           *       *       *       *       *       *       *


Subchapter I. General

           *       *       *       *       *       *       *


SEC. 1708. TEMPORARY LODGING

           *       *       *       *       *       *       *


SEC. 1709. TELECONSULTATION

    (a) Teleconsultation.--(1) The Secretary shall carry out a 
program of teleconsultation for the provision of remote mental 
health and traumatic brain injury assessments in facilities of 
the Department that are not otherwise able to provide such 
assessments without contracting with third party providers or 
reimbursing providers through a fee basis system.
    (2) The Secretary shall, in consultation with appropriate 
professional societies, promulgate technical and clinical care 
standards for the use of teleconsultation services within 
facilities of the Department.
    (b) Teleconsultation Defined.--In this section, the term 
``teleconsultation'' means the use by a health care specialist 
of telecommunications to assist another health care provider in 
rendering a diagnosis or treatment.

           *       *       *       *       *       *       *


Subchapter II. Hospital, Nursing Home, or Domiciliary Care and Medical 
Treatment

           *       *       *       *       *       *       *


SEC. 1710C. TRAUMATIC BRAIN INJURY: PLANS FOR REHABILITATION AND 
                    REINTEGRATION INTO THE COMMUNITY

    (a) * * *
          (1) develop an individualized plan for the 
        rehabilitation and reintegration of the individual into 
        the community with the goal of maximizing the 
        individual's independence; and

           *       *       *       *       *       *       *

    (b) * * *
          (1) Rehabilitation objectives for improving (and 
        sustaining improvement in) the physical, cognitive, 
        behavioral, and vocational functioning of the 
        individual with the goal of maximizing the independence 
        and reintegration of such individual into the 
        community.
          (2) Access, as warranted, to all appropriate 
        rehabilitative services and rehabilitative components 
        of the traumatic brain injury continuum of care, and 
        where appropriate, to long-term care services.
          (3) A description of specific rehabilitative 
        [treatments] services and other services to achieve the 
        objectives described in paragraph (1), which shall set 
        forth the type, frequency, duration, and location of 
        such [treatments and] services.

           *       *       *       *       *       *       *

    (c) Comprehensive assessment.--
          (1) * * *
          (2) * * *
                  (A) A neurologist.

           *       *       *       *       *       *       *

                  (S) An [opthamologist] ophthalmologist.

           *       *       *       *       *       *       *

    (h) Rehabilitative Services Defined.--For purposes of this 
section, and sections 1710D and 1710E of this title, the term 
``rehabilitative services'' includes--
          (1) rehabilitative services, as such term is defined 
        in section 1701 of this title;
          (2) treatment and services (which may be of ongoing 
        duration) to sustain, and prevent loss of, functional 
        gains that have been achieved; and
          (3) any other rehabilitative services or supports 
        that may contribute to maximizing an individual's 
        independence.

SEC. 1710D. TRAUMATIC BRAIN INJURY: COMPREHENSIVE PROGRAM FOR LONG-TERM 
                    REHABILITATION

    (a) Comprehensive Program.--In developing plans for the 
rehabilitation and reintegration of individuals with traumatic 
brain injury under section 1710C of this title, the Secretary 
shall develop and carry out a comprehensive program of long-
term care and rehabilitative services (as defined in section 
1710C of this title) for postacute traumatic brain injury 
rehabilitation that includes residential, community, and home-
based components utilizing interdisciplinary [treatment] teams.

           *       *       *       *       *       *       *


SEC. 1710E. TRAUMATIC BRAIN INJURY: USE OF NON-DEPARTMENT FACILITIES 
                    FOR REHABILITATION

    (a) Cooperative Agreements.--The Secretary, in implementing 
and carrying out a plan developed under section 1710C of this 
title, may provide hospital care and medical services, 
including rehabilitative services (as defined in section 1710C 
of this title), through cooperative agreements with appropriate 
public or private entities that have established long-term 
neurobehavioral rehabilitation and recovery programs.

           *       *       *       *       *       *       *


SEC. 1714. FITTING AND TRAINING IN USE OF PROSTHETIC APPLIANCES; GUIDE 
                    DOGS; SERVICE DOGS

           *       *       *       *       *       *       *


    (e)(1) Subject to paragraph (3), the Secretary shall admit 
service animals described in paragraph (2) to any building or 
property of the Department on the same terms and conditions, 
and subject to the same regulations, as otherwise generally 
govern the admission of the public to such buildings or 
properties.
    (2) The service animals described in this paragraph are 
service dogs provided under subsection (c) and other guide dogs 
or service animals that accompany individuals with disabilities 
and that are especially trained and educated to accompany such 
individuals.
    (3) The Secretary may prohibit service animals described in 
paragraph (2) from running free in or roaming buildings or 
properties described in paragraph (1) and may require such 
service animals to adorn guiding harnesses or leashes and be 
under the control of an individual at all times while in such 
buildings or on such properties.

           *       *       *       *       *       *       *


   Subchapter III. Miscellaneous Provisions Relating to Hospital and 
Nursing Home Care and Medical Treatment of Veterans

           *       *       *       *       *       *       *


SEC. 1722A. COPAYMENT FOR MEDICATIONS

           *       *       *       *       *       *       *


SEC. 1722B. COPAYMENTS: WAIVER OF COLLECTION OF COPAYMENTS FOR 
                    TELEHEALTH AND TELEMEDICINE VISITS OF VETERANS

    The Secretary may waive the imposition or collection of 
copayments for telehealth and telemedicine visits of veterans 
under the laws administered by the Secretary.

           *       *       *       *       *       *       *


Subchapter V. Payments to State Homes

           *       *       *       *       *       *       *


SEC. 1745. NURSING HOME CARE AND MEDICATIONS FOR VETERANS WITH SERVICE-
                    CONNECTED DISABILITIES

    (a)(1) [The Secretary shall pay each State home for nursing 
home care at the rate determined under paragraph (2)] The 
Secretary shall enter into a contract (or agreement under 
section 1720(c)(1) of this title) with each State home for 
payment by the Secretary for nursing home care provided in the 
home, in any case in which such care is provided to any veteran 
as follows:

           *       *       *       *       *       *       *

    [(2) The rate determined under this paragraph with respect 
to a State home is the lesser of--
          [(A) the applicable or prevailing rate payable in the 
        geographic area in which the State home is located, as 
        determined by the Secretary, for nursing home care 
        furnished in a non-Department nursing home (as that 
        term is defined in section 1720(e)(2) of this title); 
        or
          [(B) a rate not to exceed the daily cost of care, as 
        determined by the Secretary, following a report to the 
        Secretary by the director of the State home.]
    (2) Payment under each contract (or agreement) between the 
Secretary and a State home under paragraph (1) shall be based 
on a methodology, developed by the Secretary in consultation 
with the State home, to adequately reimburse the State home for 
the care provided by the State home under the contract (or 
agreement).

           *       *       *       *       *       *       *


Chapter 20. Benefits For Homeless Veterans

           *       *       *       *       *       *       *


             Subchapter II. Comprehensive Service Programs

SEC. 2011. GRANTS

           *       *       *       *       *       *       *


    (b) * * *
          (1) * * *
                  (A) [expansion, remodeling, or alteration of 
                existing buildings, or acquisition of 
                facilities,] new construction of facilities, 
                expansion, remodeling, or alteration of 
                existing facilities, or acquisition of 
                facilities for use as service centers, 
                transitional housing, or other facilities to 
                serve homeless veterans; and

           *       *       *       *       *       *       *

    (c) Funding Limitations.--[A grant] (1) A grant under this 
section may not be used to support operational costs. [The 
amount]
    (2) The amount of a grant under this section may not exceed 
65 percent of the estimated cost of the project concerned.
    (3)(A) The Secretary may not deny an application from an 
entity that seeks a grant under this section to carry out a 
project described in subsection (b)(1)(A) solely on the basis 
that the entity proposes to use funding from other private or 
public sources, if the entity demonstrates that a private 
nonprofit organization will provide oversight and site control 
for the project.
    (B) In this paragraph, the term ``private nonprofit 
organization'' means the following:
          (i) An incorporated private institution, 
        organization, or foundation--
                  (I) that has received, or has temporary 
                clearance to receive, tax-exempt status under 
                paragraph (2), (3), or (19) of section 501(c) 
                of the Internal Revenue Code of 1986;
                  (II) for which no part of the net earnings of 
                the institution, organization, or foundation 
                inures to the benefit of any member, founder, 
                or contributor of the institution, 
                organization, or foundation; and
                  (III) that the Secretary determines is 
                financially responsible.
          (ii) A for-profit limited partnership or limited 
        liability company, the sole general partner or manager 
        of which is an organization that is described by 
        subclauses (I) through (III) of clause (i).
          (iii) A corporation wholly owned and controlled by an 
        organization that is described by subclauses (I) 
        through (III) of clause (i).

           *       *       *       *       *       *       *


SEC. 2013. AUTHORIZATION OF APPROPRIATIONS

    There is authorized to be appropriated to carry out this 
[subchapter $150,000,000 for fiscal year 2007 and each fiscal 
year thereafter.] subchapter amounts as follows:
          (1) $150,000,000 for each of fiscal years 2007 
        through 2009.
          (2) $175,100,000 for fiscal year 2010.
          (3) $217,700,000 for fiscal year 2011.
          (4) $250,000,000 for fiscal year 2012.
          (5) $150,000,000 for fiscal year 2013 and each fiscal 
        year thereafter.

                 Subchapter III. Training and Outreach

SEC. 2021. HOMELESS VETERANS REINTEGRATION PROGRAMS

           *       *       *       *       *       *       *


    (e) * * *
          (1) * * *

           *       *       *       *       *       *       *

                  (G) $50,000,000 for fiscal year 2012.

           *       *       *       *       *       *       *


Subchapter IV. Treatment and Rehabilitation for Seriously Mentally Ill 
                         and Homeless Veterans

SEC. 2031. GENERAL TREATMENT

    (a) In providing care and services under section 1710 of 
this title to veterans suffering from serious mental illness[, 
including] and to veterans who are homeless, the Secretary may 
provide (directly or in conjunction with a governmental or 
other entity)--

           *       *       *       *       *       *       *

    (b) The authority of the Secretary under subsection (a) 
expires on [December 31, 2011] December 31, 2012.

           *       *       *       *       *       *       *


SEC. 2033. ADDITIONAL SERVICES AT CERTAIN LOCATIONS

           *       *       *       *       *       *       *


    (d) The program under this section shall terminate on 
[December 31, 2011] December 31, 2014.

           *       *       *       *       *       *       *


                    Subchapter V. Housing Assistance

SEC. 2041. HOUSING ASSISTANCE FOR HOMELESS VETERANS

           *       *       *       *       *       *       *


    (c) The Secretary may not enter into agreements under 
subsection (a) after [December 31, 2011] December 31, 2014.

           *       *       *       *       *       *       *


SEC. 2044. FINANCIAL ASSISTANCE FOR SUPPORTIVE SERVICES FOR VERY LOW-
                    INCOME VETERAN FAMILIES IN PERMANENT HOUSING

           *       *       *       *       *       *       *


    (e) Funding.--
          (1) From amounts appropriated to the Department for 
        Medical Services, there shall be available to [carry 
        out subsection (a), (b), and (c)] carry out subsections 
        (a), (b), and (c) amounts as follows:
                  (A) $15,000,000 for fiscal year 2009.
                  (B) $20,000,000 for fiscal year 2010.
                  (C) $25,000,000 for fiscal year 2011.
                  (D) $100,000,000 for fiscal year 2012.
          (2) * * *
          (3) There is authorized to be appropriated $1,000,000 
        for each of the fiscal years 2009 through [2011] 2012 
        to carry out the provisions of subsection (d).

           *       *       *       *       *       *       *


                    Subchapter VII. Other Provisions

SEC. 2061. GRANT PROGRAM FOR HOMELESS VETERANS WITH SPECIAL NEEDS

    (a) Establishment.--The Secretary shall carry out a program 
to make grants to health care facilities of the Department and 
[to grant and per diem providers] to entities eligible for 
grants and per diem payments under sections 2011 and 2012 of 
this title in order to encourage development [by those 
facilities and providers] by those facilities and entities of 
programs for homeless veterans with special needs.
    (b) Homeless Veterans With Special Needs.--For purposes of 
this section, homeless veterans with special needs include 
homeless veterans who are--
          (1) women[, including women who have care of minor 
        dependents];
          (2) frail elderly;
          (3) terminally ill; [or]
          (4) chronically mentally ill[.]; or
          (5) individuals who have care of minor dependents.
    (c) Provision of Services to Dependents.--A recipient of a 
grant under subsection (a) may use amounts under the grant to 
provide services directly to a dependent of a homeless veteran 
with special needs who is under the care of such homeless 
veteran while such homeless veteran receives services from the 
grant recipient under this section.
    (d) [(c)] Funding.--
          (1) From amounts appropriated to the Department for 
        ``Medical Services'' for each of fiscal years 2007 
        through [2011] 2013, $5,000,000 shall be available for 
        each such fiscal year for the purposes of the program 
        under this section.

           *       *       *       *       *       *       *


SEC. 2066. ADVISORY COMMITTEE ON HOMELESS VETERANS

           *       *       *       *       *       *       *


    (d) Termination.--The Committee shall cease to exist 
[December 31, 2011] December 31, 2013.

           *       *       *       *       *       *       *


      Chapter 21. Specially Adapted Housing for Disabled Veterans

SEC.

2101. ACQUISITION AND ADAPTATION OF HOUSING: ELIGIBLE VETERANS.

           *       *       *       *       *       *       *


2108. SPECIALLY ADAPTED HOUSING ASSISTIVE TECHNOLOGY GRANT PROGRAM.

2109. SPECIALLY ADAPTED HOUSING DESTROYED OR DAMAGED BY NATURAL 
                    DISASTERS.

SEC. 2101. ACQUISITION AND ADAPTATION OF HOUSING: ELIGIBLE VETERANS

           *       *       *       *       *       *       *


    (b) Adaptations to residence of veteran.
          (1) * * *
          [(2) A veteran is described in this paragraph if the 
        veteran is entitled to compensation under chapter 11 of 
        this title for a permanent and total service-connected 
        disability that meets any of the following criteria:
                  [(A) The disability is due to blindness in 
                both eyes with 5/200 visual acuity or less.
                  [(B) The disability includes the anatomical 
                loss or loss of use of both hands.
                  [(C) The disability is due to a severe burn 
                injury (as so determined).]
          (2) A veteran is described in this paragraph if the 
        veteran is entitled to compensation under chapter 11 of 
        this title for a service-connected disability that 
        meets any of the following criteria:
                  (A) The disability is due to blindness in 
                both eyes, having central visual acuity of 20/
                200 or less in the better eye with the use of a 
                standard correcting lens. For the purposes of 
                this subparagraph, an eye with a limitation in 
                the fields of vision such that the widest 
                diameter of the visual field subtends an angle 
                no greater than 20 degrees shall be considered 
                as having a central visual acuity of 20/200 or 
                less.
                  (B) A permanent and total disability that 
                includes the anatomical loss or loss of use of 
                both hands.
                  (C) A permanent and total disability that is 
                due to a severe burn injury (as so determined).

           *       *       *       *       *       *       *


SEC. 2102. LIMITATIONS ON ASSISTANCE FURNISHED

           *       *       *       *       *       *       *


    (d)(1) The aggregate amount of assistance available to an 
individual [under sections 2101(a) and 2102A] under section 
2101(a) of this title shall be limited to $60,000.
    (2) The aggregate amount of assistance available to an 
individual [under sections 2101(b) and 2102A] under section 
2101(b) of this title shall be limited to $12,000.

           *       *       *       *       *       *       *


SEC. 2102A. ASSISTANCE FOR INDIVIDUALS RESIDING TEMPORARILY IN HOUSING 
                    OWNED BY A FAMILY MEMBER

           *       *       *       *       *       *       *


    (b) Amount of Assistance.--(1) The assistance authorized 
under subsection (a) may not exceed--
          (A) [(1)] [$14,000] $28,000, in the case of an 
        individual described in section 2101(a)(2) of this 
        title; or
          (B) [(2)] [$2,000] $5,000, in the case of an 
        individual described in section 2101(b)(2) of this 
        title.
    (2) Effective on October 1 of each year (beginning in 
2012), the Secretary shall use the same percentage calculated 
pursuant to section 2102(e) of this title to increase the 
amounts described in paragraph (1) of this subsection.

           *       *       *       *       *       *       *

    (e) Termination.--No assistance may be provided under this 
section after [December 31, 2011] December 31, 2021.

           *       *       *       *       *       *       *


SEC. 2108. SPECIALLY ADAPTED HOUSING ASSISTIVE TECHNOLOGY GRANT 
                    PROGRAM.

           *       *       *       *       *       *       *


SEC. 2109. SPECIALLY ADAPTED HOUSING DESTROYED OR DAMAGED BY NATURAL 
                    DISASTERS

    (a) In General.--Notwithstanding the provisions of section 
2102 of this title, the Secretary may award a grant to a 
veteran whose home was previously adapted with assistance of a 
grant under this chapter in the event the adapted home which 
was being used and occupied by the veteran was destroyed or 
substantially damaged in a natural or other disaster, as 
determined by the Secretary.
    (b) Use of Funds.--A grant awarded under subsection (a) 
shall be available to acquire a suitable housing unit with 
special fixtures or moveable facilities made necessary by the 
veteran's disability, and necessary land therefor.
    (c) Limitations.--The amount of the grant awarded under 
subsection (a) may not exceed the lesser of--
          (1) the reasonable cost, as determined by the 
        Secretary, of repairing or replacing the damaged or 
        destroyed home in excess of the available insurance 
        coverage on such home; or
          (2) the maximum grant amount to which the veteran 
        would have been entitled under subsection (a) or (b) of 
        section 2102 of this title had the veteran not obtained 
        the prior grant.

           *       *       *       *       *       *       *


             Chapter 24. National Cemeteries and Memorials

SEC.

2400. ESTABLISHMENT OF NATIONAL CEMETERY ADMINISTRATION; COMPOSITION OF 
                    ADMINISTRATION.

           *       *       *       *       *       *       *


2410. BURIAL OF CREMATED REMAINS IN ARLINGTON NATIONAL CEMETERY.

2410A. ARLINGTON NATIONAL CEMETERY: OTHER ADMINISTRATIVE MATTERS.

           *       *       *       *       *       *       *


2413. PROHIBITION ON CERTAIN DEMONSTRATIONS AND DISRUPTIONS AT 
                    CEMETERIES UNDER CONTROL OF THE NATIONAL CEMETERY 
                    ADMINISTRATION AND AT ARLINGTON NATIONAL CEMETERY.

           *       *       *       *       *       *       *


SEC. 2410A. ARLINGTON NATIONAL CEMETERY: OTHER ADMINISTRATIVE MATTERS

    (a) One Gravesite.--(1) Not more than one gravesite may be 
provided at Arlington National Cemetery to a veteran or member 
of the Armed Forces who is eligible for interment or inurnment 
at such cemetery.
    (2) The Secretary of the Army may waive the prohibition in 
paragraph (1) as the Secretary of the Army considers 
appropriate.
    (b) Prohibition Against Reservation of Gravesites.--A 
gravesite at Arlington National Cemetery may not be reserved 
for an individual before the death of such individual.

           *       *       *       *       *       *       *


[SEC. 2413. PROHIBITION ON CERTAIN DEMONSTRATIONS AT CEMETERIES UNDER 
                    CONTROL OF THE NATIONAL CEMETERY ADMINISTRATION AND 
                    AT ARLINGTON NATIONAL CEMETERY

    [(a) Prohibition.--No person may carry out--
          [(1) a demonstration on the property of a cemetery 
        under the control of the National Cemetery 
        Administration or on the property of Arlington National 
        Cemetery unless the demonstration has been approved by 
        the cemetery superintendent or the director of the 
        property on which the cemetery is located; or
          [(2) with respect to such a cemetery, a demonstration 
        during the period beginning 60 minutes before and 
        ending 60 minutes after a funeral, memorial service, or 
        ceremony is held, any part of which demonstration--
                  [(A)(i) takes place within 150 feet of a 
                road, pathway, or other route of ingress to or 
                egress from such cemetery property; and
                  [(ii) includes, as part of such 
                demonstration, any individual willfully making 
                or assisting in the making of any noise or 
                diversion that disturbs or tends to disturb the 
                peace or good order of the funeral, memorial 
                service, or ceremony; or
                  [(B) is within 300 feet of such cemetery and 
                impedes the access to or egress from such 
                cemetery.
    [(b) Demonstration.--For purposes of this section, the term 
``demonstration'' includes the following:
          [(1) Any picketing or similar conduct.
          [(2) Any oration, speech, use of sound amplification 
        equipment or device, or similar conduct that is not 
        part of a funeral, memorial service, or ceremony.
          [(3) The display of any placard, banner, flag, or 
        similar device, unless such a display is part of a 
        funeral, memorial service, or ceremony.
          [(4) The distribution of any handbill, pamphlet, 
        leaflet, or other written or printed matter other than 
        a program distributed as part of a funeral, memorial 
        service, or ceremony.]

SEC. 2413. PROHIBITION ON CERTAIN DEMONSTRATIONS AND DISRUPTIONS AT 
                    CEMETERIES UNDER CONTROL OF THE NATIONAL CEMETERY 
                    ADMINISTRATION AND AT ARLINGTON NATIONAL CEMETERY

    (a) Prohibition.--It shall be unlawful for any person--
          (1) to carry out a demonstration on the property of a 
        cemetery under the control of the National Cemetery 
        Administration or on the property of Arlington National 
        Cemetery unless the demonstration has been approved by 
        the cemetery superintendent or the director of the 
        property on which the cemetery is located; or
          (2) with respect to such a cemetery, to engage in a 
        demonstration during the period beginning 120 minutes 
        before and ending 120 minutes after a funeral, memorial 
        service, or ceremony is held, any part of which 
        demonstration--
                  (A)(i) takes place within the boundaries of 
                such cemetery or takes place within 300 feet of 
                the point of the intersection between--
                          (I) the boundary of such cemetery; 
                        and
                          (II) a road, pathway, or other route 
                        of ingress to or egress from such 
                        cemetery; and
                  (ii) includes any individual willfully making 
                or assisting in the making of any noise or 
                diversion--
                          (I) that is not part of such funeral, 
                        memorial service, or ceremony and that 
                        disturbs or tends to disturb the peace 
                        or good order of such funeral, memorial 
                        service, or ceremony; and
                          (II) with the intent of disturbing 
                        the peace or good order of such 
                        funeral, memorial service, or ceremony; 
                        or
                  (B)(i) is within 500 feet of the boundary of 
                such cemetery; and
                  (ii) includes any individual--
                          (I) willfully and without proper 
                        authorization impeding or tending to 
                        impede the access to or egress from 
                        such cemetery; and
                          (II) with the intent to impede the 
                        access to or egress from such cemetery.
    (b) Penalty.--Any person who violates subsection (a) shall 
be fined under title 18 or imprisoned for not more than 1 year, 
or both.
    (c) Civil Remedies.--(1) The district courts of the United 
States shall have jurisdiction--
          (A) to prevent and restrain violations of this 
        section; and
          (B) for the adjudication of any claims for relief 
        under this section.
    (2) The Attorney General of the United States may institute 
proceedings under this section.
    (3) Any person, including a surviving member of the 
deceased person's immediate family, who suffers injury as a 
result of conduct that violates this section may--
          (A) sue therefor in any appropriate United States 
        district court or in any court of competent 
        jurisdiction; and
          (B) recover damages as provided in subsection (d) and 
        the cost of the suit, including reasonable attorneys' 
        fees.
    (4) A final judgment or decree rendered in favor of the 
United States in any criminal proceeding brought by the United 
States under this section shall estop the defendant from 
denying the essential allegations of the criminal offense in 
any subsequent civil proceeding brought by a person or by the 
United States.
    (d) Actual and Statutory Damages.--(1) In addition to any 
penalty imposed under subsection (b), a violator of this 
section is liable in an action under subsection (c) for actual 
or statutory damages as provided in this subsection.
    (2) A person bringing an action under subsection (c)(3) may 
elect, at any time before final judgment is rendered, to 
recover the actual damages suffered by him or her as a result 
of the violation or, instead of actual damages, an award of 
statutory damages for each violation involved in the action.
    (3) In any action brought under subsection (c)(2), the 
Attorney General is entitled to recover an award of statutory 
damages for each violation involved in the action 
notwithstanding any recovery under subsection (c)(3).
    (4) A court may award, as the court considers just, 
statutory damages in a sum of not less than $25,000 or more 
than $50,000 per violation.
    (e) Rebuttable Presumption.--It shall be a rebuttable 
presumption that the violation of subsection (a) was committed 
willfully for purposes of determining relief under this section 
if the violator, or a person acting in concert with the 
violator, did not have reasonable grounds to believe, either 
from the attention or publicity sought by the violator or other 
circumstance, that the conduct of such violator or person would 
not--
          (1) disturb or tend to disturb the peace or good 
        order of such funeral, memorial service, or ceremony; 
        or
          (2) impede or tend to impede the access to or egress 
        from such funeral, memorial service, or ceremony.
    (f) Definitions.--In this section--
          (1) the term ``demonstration'' includes--
                  (A) any picketing or similar conduct;
                  (B) any oration, speech, use of sound 
                amplification equipment or device, or similar 
                conduct that is not part of a funeral, memorial 
                service, or ceremony;
                  (C) the display of any placard, banner, flag, 
                or similar device, unless such a display is 
                part of a funeral, memorial service, or 
                ceremony; and
                  (D) the distribution of any handbill, 
                pamphlet, leaflet, or other written or printed 
                matter other than a program distributed as part 
                of a funeral, memorial service, or ceremony; 
                and
          (2) the term ``immediate family'' means, with respect 
        to a person, the immediate family members of such 
        person, as such term is defined in section 115 of title 
        18.

           *       *       *       *       *       *       *


Part III. Readjustment and Related Benefits

           *       *       *       *       *       *       *


   Chapter 31. Training and Rehabilitation for Veterans with Service-
Connected Disabilities

           *       *       *       *       *       *       *


SEC. 3108. ALLOWANCES

    (a)(1) * * *
    (2)(A) In any case in which the Secretary determines, at 
the conclusion of such veteran's pursuit of a vocational 
rehabilitation program under this chapter, that such veteran 
has been rehabilitated to the point of employability, such 
veteran shall be paid a subsistence allowance, as prescribed in 
this section for full-time training for the type of program 
that the veteran was pursuing, for two months while 
satisfactorily following a program of employment services 
provided under section 3104(a)(5) of this title.
    (B) In any case in which the Secretary determines that a 
veteran described in subparagraph (A) has been displaced as the 
result of a natural or other disaster while being paid a 
subsistence allowance under that subparagraph, as determined by 
the Secretary, the Secretary may extend the payment of a 
subsistence allowance under such subparagraph for up to an 
additional two months while the veteran is satisfactorily 
following a program of employment services described in such 
subparagraph.

           *       *       *       *       *       *       *


SEC. 3120. PROGRAM OF INDEPENDENT LIVING SERVICES AND ASSISTANCE

           *       *       *       *       *       *       *


    (e)(1) Programs of independent living services and 
assistance shall be initiated for no more than 2,700 veterans 
in each fiscal year, and the first priority in the provision of 
such programs shall be afforded to veterans for whom the 
reasonable feasibility of achieving a vocational goal is 
precluded solely as a result of a service-connected disability.
    (2) The limitation in paragraph (1) shall not apply in any 
case in which the Secretary determines that a veteran described 
in subsection (b) has been displaced as the result of, or has 
otherwise been adversely affected in the areas covered by, a 
natural or other disaster, as determined by the Secretary.

           *       *       *       *       *       *       *


Chapter 36. Administration of Educational Benefits

           *       *       *       *       *       *       *


Subchapter II. Miscellaneous Provisions

           *       *       *       *       *       *       *


SEC. 3695. LIMITATION ON PERIOD OF ASSISTANCE UNDER TWO OR MORE 
                    PROGRAMS

    (a) * * *

           *       *       *       *       *       *       *

          (4) Chapters 30, 32, 33, 34, [35,] and 36.

           *       *       *       *       *       *       *

    (c) The aggregate period for which any person may receive 
assistance under chapter 35 of this title, on the one hand, and 
any of the provisions of law referred to in subsection (a), on 
the other hand, may not exceed 81 months (or the part-time 
equivalent thereof).

           *       *       *       *       *       *       *


Chapter 37. Housing and Small Business Loans

           *       *       *       *       *       *       *


Subchapter I. General

           *       *       *       *       *       *       *


SEC. 3703. BASIC PROVISIONS RELATING TO LOAN GUARANTY AND INSURANCE

           *       *       *       *       *       *       *


    (d)(1) * * *

           *       *       *       *       *       *       *

    [(3) Any real estate housing loan (other than for repairs, 
alterations, or improvements) shall be secured by a first lien 
on the realty. In determining whether a loan for the purchase 
or construction of a home is so secured, the Secretary may 
disregard a superior lien created by a duly recorded covenant 
running with the realty in favor of a private entity to secure 
an obligation to such entity for the homeowner's share of the 
costs of the management, operation, or maintenance of property, 
services or programs within and for the benefit of the 
development or community in which the veteran's realty is 
located, if the Secretary determines that the interests of the 
veteran borrower and of the Government will not be prejudiced 
by the operation of such covenant. In respect to any such 
superior lien to be created after June 6, 1969, the Secretary's 
determination must have been made prior to the recordation of 
the covenant.]
    (3)(A) Any real estate housing loan (other than for 
repairs, alterations, or improvements) shall be secured by a 
first lien on the realty. In determining whether a loan is so 
secured, the Secretary may either disregard or allow for 
subordination to a superior lien created by a duly recorded 
covenant running with the realty in favor of either of the 
following:
          (i) A public entity that has provided or will provide 
        assistance in response to a major disaster as 
        determined by the President under the Robert T. 
        Stafford Disaster Relief and Emergency Assistance Act 
        (42 U.S.C. 5121 et seq.).
          (ii) A private entity to secure an obligation to such 
        entity for the homeowner's share of the costs of the 
        management, operation, or maintenance of property, 
        services, or programs within and for the benefit of the 
        development or community in which the veteran's realty 
        is located, if the Secretary determines that the 
        interests of the veteran borrower and of the Government 
        will not be prejudiced by the operation of such 
        covenant.
    (B) With respect to any superior lien described in 
subparagraph (A) created after June 6, 1969, the Secretary's 
determination under clause (ii) of such subparagraph shall have 
been made prior to the recordation of the covenant.

           *       *       *       *       *       *       *


SEC. 3704. RESTRICTIONS ON LOANS

           *       *       *       *       *       *       *


    (c)(1) * * *
    [(2) In any case in which a veteran is in active duty 
status as a member of the Armed Forces and is unable to occupy 
a property because of such status, the occupancy requirements 
of--
          [(A) paragraph (1) of this subsection;
          [(B) paragraphs (1) through (5) and paragraph (7) of 
        section 3710(a) of this title;
          [(C) section 3712(a)(5)(A)(i) of this title; and
          [(D) section 3712(e)(5) of this title;
[shall be considered to be satisfied if the spouse of the 
veteran occupies the property as the spouse's home and the 
spouse makes the certification required by paragraph (1) of 
this subsection.]
    (2) In any case in which a veteran is in active-duty status 
as a member of the Armed Forces and is unable to occupy a 
property because of such status, the occupancy requirements of 
this chapter shall be considered to be satisfied if--
          (A) the spouse of the veteran occupies or intends to 
        occupy the property as a home and the spouse makes the 
        certification required by paragraph (1) of this 
        subsection; or
          (B) a dependent child of the veteran occupies or will 
        occupy the property as a home and the veteran's 
        attorney-in-fact or legal guardian of the dependent 
        child makes the certification required by paragraph (1) 
        of this subsection.

           *       *       *       *       *       *       *


Subchapter III. Administrative Provisions

           *       *       *       *       *       *       *


SEC. 3729. LOAN FEE

    (a) * * *
    (b) Determination of Fee.--
          (1) * * *
          (2) The loan fee table referred to in paragraph (1) 
        is as follows:

                             Loan Fee Table

                                                                Other
             Type of loan                Active   Reservist    obligor
                                          duty                 veteran

[(A)(i) Initial loan described in          2.00       2.75           NA
 section 3710(a) to purchase or
 construct a dwelling with 0-down, or
 any other initial loan described in
 section 3710(a) other than with 5-
 down or 10-down (closed before
 January 1, 2004)....................
[(A)(ii) Initial loan described in         2.20       2.40          NA]
 section 3710(a) to purchase or
 construct a dwelling with 0-down, or
 any other initial loan described in
 section 3710(a) other than with 5-
 down or 10-down (closed on or after
 January 1, 2004, and before October
 1, 2004)............................
(A)(i) [(iii)] Initial loan described      2.15       2.40           NA
 in section 3710(a) to purchase or
 construct a dwelling with 0-down, or
 any other initial loan described in
 section 3710(a) other than with 5-
 down or 10-down (closed on or after
 October 1, 2004, and before October
 1, 2011)............................
(A)(ii) Initial loan described in          1.50       1.75           NA
 section 3710(a) to purchase or
 construct a dwelling with 0-down, or
 any other initial loan described in
 section 3710(a) other than with 5-
 down or 10-down (closed on or after
 October 1, 2011, and before October
 1, 2012)............................
(A)(iii) [(iv)] Initial loan               1.40       2.65           NA
 described in section 3710(a) to
 purchase or construct a dwelling
 with 0-down, or any other initial
 loan described in section 3710(a)
 other than with 5-down or 10-down
 (closed on or after [October 1,
 2011] October 1, 2012)..............

               *      *      *      *      *      *      *


    (c) Waiver of Fee.--
          (1) * * *
          [(2) A veteran who is rated eligible to receive 
        compensation as a result of a pre-discharge disability 
        examination and rating shall be treated as receiving 
        compensation for purposes of this subsection as of the 
        date on which the veteran is rated eligible to receive 
        compensation as a result of the pre-discharge 
        disability examination and rating without regard to 
        whether an effective date of the award of compensation 
        is established as of that date.]
          (2)(A) A veteran described in subparagraph (B) shall 
        be treated as receiving compensation for purposes of 
        this subsection as of the date of the rating described 
        in such subparagraph without regard to whether an 
        effective date of the award of compensation is 
        established as of that date.
          (B) A veteran described in this subparagraph is a 
        veteran who is rated eligible to receive compensation--
                  (i) as the result of a pre-discharge 
                disability examination and rating; or
                  (ii) based on a pre-discharge review of 
                existing medical evidence (including service 
                medical and treatment records) that results in 
                the issuance of a memorandum rating.

           *       *       *       *       *       *       *


  Chapter 39. Automobiles and Adaptive Equipment for Certain Disabled 
Veterans and Members of the Armed Forces

           *       *       *       *       *       *       *


SEC. 3903. LIMITATIONS ON ASSISTANCE; SPECIAL TRAINING COURSES

    (a) [No] (1) Except as provided in paragraph (2), no 
eligible person shall be entitled to receive more than one 
automobile or other conveyance under the provisions of this 
chapter, and no payment shall be made under this chapter for 
the repair, maintenance, or replacement of an automobile or 
other conveyance.
    (2) The Secretary may provide or assist in providing an 
eligible person with a second automobile or other conveyance 
under this chapter if--
          (A) the Secretary receives satisfactory evidence that 
        the automobile or other conveyance previously purchased 
        with assistance under this chapter was destroyed--
                  (i) as a result of a natural or other 
                disaster, as determined by the Secretary; and
                  (ii) through no fault of the eligible person; 
                and
          (B) the eligible person does not otherwise receive 
        from a property insurer compensation for the loss.

           *       *       *       *       *       *       *


Part IV. General Administrative Provisions

           *       *       *       *       *       *       *


Chapter 51. Claims, Effective Dates, and Payments

           *       *       *       *       *       *       *


Subchapter I. Claims

           *       *       *       *       *       *       *


SEC. 5101. CLAIMS AND FORMS

    (a)(1) A specific [A specific] claim in the form prescribed 
by the Secretary (or jointly with the Commissioner of Social 
Security, as prescribed by section 5105 of this title) must be 
filed in order for benefits to be paid or furnished to any 
individual under the laws administered by the Secretary.
    (2) If an individual has not attained the age of 18 years, 
is mentally incompetent, or is physically unable to sign a 
form, a form filed under paragraph (1) for the individual may 
be signed by a court-appointed representative, a person who is 
responsible for the care of the individual, including a spouse 
or other relative, or an attorney in fact or agent authorized 
to act on behalf of the individual under a durable power of 
attorney. If the individual is in the care of an institution, 
the manager or principal officer of the institution may sign 
the form.

           *       *       *       *       *       *       *

    (c)(1) Any person who applies for, signs a form on behalf 
of an individual to apply for, or is in receipt of any 
compensation or pension benefit under laws administered by the 
Secretary shall, if requested by the Secretary, furnish the 
Secretary with the social security number of such person, or 
TIN in the case that the person is not an individual, and the 
social security number of any dependent or beneficiary on whose 
behalf, or based upon whom, such person applies for or is in 
receipt of such benefit. A person is not required to furnish 
the Secretary with a social security number for any person to 
whom a social security number has not been assigned.
    (2) The Secretary shall deny the application of or 
terminate the payment of compensation or pension to a person 
who fails to furnish the Secretary with a social security 
number or TIN required to be furnished pursuant to paragraph 
(1) of this subsection. The Secretary may thereafter reconsider 
the application or reinstate payment of compensation or 
pension, as the case may be, if such person furnishes the 
Secretary with such social security number or TIN.
    (3) * * *
    (d) In this section:
          (1) The term ``mentally incompetent'' with respect to 
        an individual means that the individual lacks the 
        mental capacity--
                  (A) to provide substantially accurate 
                information needed to complete a form; or
                  (B) to certify that the statements made on a 
                form are true and complete.
          (2) The term ``TIN'' has the meaning given the term 
        in section 7701(a)(41) of the Internal Revenue Code of 
        1986.

           *       *       *       *       *       *       *


SEC. 5105. JOINT APPLICATIONS FOR SOCIAL SECURITY AND DEPENDENCY AND 
                    INDEMNITY COMPENSATION

    (a) The Secretary and the Commissioner of Social Security 
[shall] may jointly prescribe forms for use by survivors of 
members and former members of the uniformed services in filing 
application for benefits under chapter 13 of this title and 
title II of the Social Security Act (42 U.S.C. 401 et seq.). 
[Each such form] Such forms shall request information 
sufficient to constitute an application for benefits under both 
chapter 13 of this title and title II of the Social Security 
Act (42 U.S.C. 401 et seq.).
    (b) When an application [on such a form] on any document 
indicating an intent to apply for survivor benefits is filed 
with either the Secretary or the Commissioner of Social 
Security, it shall be deemed to be an application for benefits 
under both chapter 13 of this title and title II of the Social 
Security Act (42 U.S.C. 401 et seq.). A copy of each such 
application filed with either the Secretary or the 
Commissioner, together with any additional information and 
supporting documents (or certifications thereof) which may have 
been received by the Secretary or the Commissioner with such 
application, and which may be needed by the other official in 
connection therewith, shall be transmitted by the Secretary or 
the Commissioner receiving the application to the other 
official. The preceding sentence shall not prevent the 
Secretary and the Commissioner of Social Security from 
requesting the applicant, or any other individual, to furnish 
such additional information as may be necessary for purposes of 
chapter 13 of this title and title II of the Social Security 
Act (42 U.S.C. 401 et seq.) respectively.

           *       *       *       *       *       *       *


                     Subchapter II. Effective Dates

SEC. 5110. EFFECTIVE DATES OF AWARDS

    (a) * * *
    (b)(1) * * *
    (2)(A) The effective date of an award of disability 
compensation to a veteran who submits an application therefor 
that sets forth a claim that is fully-developed (as prescribed 
by the Secretary for purposes of this paragraph) as of the date 
of submittal shall be fixed in accordance with the facts found, 
but shall not be earlier than the date that is one year before 
the date of receipt of the application.
    (B) Subparagraph (A) shall take effect on the date of the 
enactment of this paragraph and shall not apply with respect to 
claims filed after September 30, 2012.
    (3) [(2)] The effective date of an award of increased 
compensation shall be the earliest date as of which it is 
ascertainable that an increase in disability had occurred, if 
application is received within one year from such date.
    (4) [(3)](A) The effective date of an award of disability 
pension to a veteran described in subparagraph (B) of this 
paragraph shall be the date of application or the date on which 
the veteran became permanently and totally disabled, if the 
veteran applies for a retroactive award within one year from 
such date, whichever is to the advantage of the veteran.

           *       *       *       *       *       *       *


SEC. 5111. COMMENCEMENT OF PERIOD OF PAYMENT

           *       *       *       *       *       *       *


    (c)(1) This section shall [apply to payments made pursuant 
to section 5310 of this title only if the monthly amount of 
dependency and indemnity compensation or pension payable to the 
surviving spouse is greater than the amount of compensation or 
pension the veteran would have received, but for such veteran's 
death, for the month in which such veteran's death occurred] 
not apply to payments made pursuant to section 5310 of this 
title.

           *       *       *       *       *       *       *


Chapter 53. Special Provisions Relating to Benefits

           *       *       *       *       *       *       *


SEC. 5310. PAYMENT OF BENEFITS FOR MONTH OF DEATH

    [(a) If, in accordance with the provisions of section 
5110(d) of this title, a surviving spouse is entitled to death 
benefits under chapter 11, 13, or 15 of this title for the 
month in which a veteran's death occurs, the amount of such 
death benefits for that month shall be not less than the amount 
of benefits the veteran would have received under chapter 11 or 
15 of this title for that month but for the death of the 
veteran.
    [(b)(1) If the surviving spouse of a veteran who was in 
receipt of compensation or pension at the time of death is not 
entitled to death benefits under chapter 11, 13, or 15 of this 
title for the month in which the veteran's death occurs, that 
surviving spouse shall be entitled to a benefit for that month 
in the amount of benefits the veteran would have received under 
chapter 11 or 15 of this title for that month but for the death 
of the veteran.
    [(2) If (notwithstanding section 5112(b)(1) of this title) 
a check or other payment is issued to, and in the name of, the 
deceased veteran as a benefit payment under chapter 11 or 15 of 
this title for the month in which death occurs, that check or 
other payment (A) shall be treated for all purposes as being 
payable to the surviving spouse, and (B) if that check or other 
payment is negotiated or deposited, shall be considered to be 
the benefit to which the surviving spouse is entitled under 
paragraph (1). However, if such check or other payment is in an 
amount less than the amount of the benefit under paragraph (1), 
the unpaid amount shall be treated in the same manner as an 
accrued benefit under section 5121 of this title.]
    (a) In General.--(1) A surviving spouse of a veteran is 
entitled to a benefit for the month of the veteran's death if--
          (A) at the time of the veteran's death, the veteran 
        was receiving compensation or pension under chapter 11 
        or 15 of this title; or
          (B) the veteran is determined for purposes of section 
        5121 or 5121A of this title as having been entitled to 
        receive compensation or pension under chapter 11 or 15 
        of this title for the month of the veteran's death.
    (2) The amount of the benefit under paragraph (1) is the 
amount that the veteran would have received under chapter 11 or 
15 of this title, as the case may be, for the month of the 
veteran's death had the veteran not died.
    (b) Claims Pending Adjudication.--If a claim for 
entitlement to compensation or additional compensation under 
chapter 11 of this title or pension or additional pension under 
chapter 15 of this title is pending at the time of a veteran's 
death and the check or other payment issued to the veteran's 
surviving spouse under subsection (a) is less than the amount 
of the benefit the veteran would have been entitled to for the 
month of death pursuant to the adjudication of the pending 
claim, an amount equal to the difference between the amount to 
which the veteran would have been entitled to receive under 
chapter 11 or 15 of this title for the month of the veteran's 
death had the veteran not died and the amount of the check or 
other payment issued to the surviving spouse shall be treated 
in the same manner as an accrued benefit under section 5121 of 
this title.

           *       *       *       *       *       *       *


SEC. 5317. USE OF INCOME INFORMATION FROM OTHER AGENCIES: NOTICE AND 
                    VERIFICATION

           *       *       *       *       *       *       *


    (g) The authority of the Secretary to obtain information 
from the Secretary of the Treasury or the Commissioner of 
Social Security under section 6103(1)(7)(D)(viii) of the 
Internal Revenue Code of 1986 expires on [September 30, 2011] 
September 30, 2013.

           *       *       *       *       *       *       *


Chapter 57. Records and Investigations

           *       *       *       *       *       *       *


                         Subchapter I. Records

SEC. 5701. CONFIDENTIAL NATURE OF CLAIMS

           *       *       *       *       *       *       *


    (l) Under regulations the Secretary shall prescribe, the 
Secretary may disclose information about a veteran or the 
dependent of a veteran to a State controlled substance 
monitoring program, including a program approved by the 
Secretary of Health and Human Services under section 399O of 
the Public Health Service Act (42 U.S.C. 280g-3), to the extent 
necessary to prevent misuse and diversion of prescription 
medicines.

           *       *       *       *       *       *       *


Part V. Boards, Administrations, and Services

           *       *       *       *       *       *       *


Chapter 71. Board of Veterans' Appeals

           *       *       *       *       *       *       *


SEC. 7105. FILING OF NOTICE OF DISAGREEMENT AND APPEAL

           *       *       *       *       *       *       *


    (e)(1) If, either at the time or after the agency of 
original jurisdiction receives a substantive appeal, the 
claimant or the claimant's representative, if any, submits 
evidence to either the agency of original jurisdiction or the 
Board of Veterans' Appeals for consideration in connection with 
the issue or issues with which disagreement has been expressed, 
such evidence shall be subject to initial review by the Board 
unless the claimant or the claimant's representative, as the 
case may be, requests in writing that the agency of original 
jurisdiction initially review such evidence.
    (2) A request for review of evidence under paragraph (1) 
shall accompany the submittal of the evidence.

           *       *       *       *       *       *       *


 Chapter 73. Veterans Health Administration-Organization and Functions

SEC.

           *       *       *       *       *       *       *


          SUBCHAPTER II. GENERAL AUTHORITY AND ADMINISTRATION

7330A. EPILEPSY CENTERS OF EXCELLENCE.

7330B. CENTERS OF EXCELLENCE FOR RURAL HEALTH RESEARCH, EDUCATION, AND 
                    CLINICAL ACTIVITIES.

           *       *       *       *       *       *       *


Subchapter I. Organization

           *       *       *       *       *       *       *


SEC. 7308. OFFICE OF RURAL HEALTH

           *       *       *       *       *       *       *


    (d) Rural Health Resource Centers.--(1) There are in the 
Office veterans rural health resource centers that serve as 
satellite offices for the Office.
    (2) The veterans rural health resource centers have 
purposes as follows:
          (A) To improve the understanding of the Office of the 
        challenges faced by veterans living in rural areas.
          (B) To identify disparities in the availability of 
        health care to veterans living in rural areas.
          (C) To formulate practices or programs to enhance the 
        delivery of health care to veterans living in rural 
        areas.
          (D) To develop special practices and products for the 
        benefit of veterans living in rural areas and for 
        implementation of such practices and products in the 
        Department systemwide.

           *       *       *       *       *       *       *


Subchapter II. General Authority and Administration

           *       *       *       *       *       *       *


SEC. 7330A. EPILEPSY CENTERS OF EXCELLENCE

           *       *       *       *       *       *       *


SEC. 7330B. CENTERS OF EXCELLENCE FOR RURAL HEALTH RESEARCH, EDUCATION, 
                    AND CLINICAL ACTIVITIES.

    (a) Establishment.--The Secretary shall, through the 
Director of the Office of Rural Health, establish and operate 
centers of excellence for rural health research, education, and 
clinical activities.
    (b) Activities.--Each center established and operated under 
subsection (a) shall carry out one or more of the following:
          (1) Collaboration with the Office of Research and 
        Development of the Veterans Health Administration on 
        research relating to the furnishing of health services 
        in rural areas.
          (2) Development of specific models to be used by the 
        Department in furnishing health services to veterans in 
        rural areas.
          (3) Provision of education and training for health 
        care professionals of the Department on the furnishing 
        of health services to veterans in rural areas.
          (4) Development and implementation of innovative 
        clinical activities and systems of care for the 
        Department for the furnishing of health services to 
        veterans in rural areas.
    (c) Designation.--The Secretary may designate a rural 
health resource of the Office of Rural Health as a center of 
excellence for purposes of this section, including a rural 
health resource center described in section 7308(d) of this 
title, if such resource or center engages in one or more of the 
activities described in subsection (b).
    (d) Funding.--Activities of clinical and scientific 
investigation at each center operated under this section shall 
be eligible to compete for the award of funding from funds 
appropriated for the Medical and Prosthetics Research Account.

           *       *       *       *       *       *       *


Subchapter III. Protection of Patient Rights

           *       *       *       *       *       *       *


SEC. 7332. CONFIDENTIALITY OF CERTAIN MEDICAL RECORDS

           *       *       *       *       *       *       *


    (b)(1) * * *
    (2) * * *

           *       *       *       *       *       *       *

          (G) To a State controlled substance monitoring 
        program, including a program approved by the Secretary 
        of Health and Human Services under section 399O of the 
        Public Health Service Act (42 U.S.C. 280g-3), to the 
        extent necessary to prevent misuse and diversion of 
        prescription medicines.

           *       *       *       *       *       *       *


             Chapter 76. Health Professionals Educational 
Assistance Program

           *       *       *       *       *       *       *


Subchapter VI. Employee Incentive Scholarship Program

           *       *       *       *       *       *       *


SEC. 7675. BREACH OF AGREEMENT: LIABILITY

           *       *       *       *       *       *       *


    (b) Liability During Course of Education or Training.--
          (1) * * *

           *       *       *       *       *       *       *

                  [(E) In the case of a participant who is a 
                part-time student, the participant fails to 
                maintain employment, while enrolled in the 
                course of training being pursued by the 
                participant, as a Department employee.]
                  (E) In the case of a participant who is 
                employed as an employee of the Department while 
                enrolled in the course of training being 
                pursued by the participant, the participant 
                fails to maintain employment as a Department 
                employee during such course of training.

           *       *       *       *       *       *       *


Part VI. Acquisition and Disposition of Property

           *       *       *       *       *       *       *


   Chapter 81. Acquisition and Operation of Hospital and Domiciliary 
    Facilities; Procurement and Supply; Enhanced-Use Leases of Real 
Property

           *       *       *       *       *       *       *


Subchapter I. Acquisition and Operation of Medical Facilities

           *       *       *       *       *       *       *


SEC. 8104. CONGRESSIONAL APPROVAL OF CERTAIN MEDICAL FACILITY 
                    ACQUISITIONS

           *       *       *       *       *       *       *


    (d)(1) * * *
    (2)(A) * * *
    (B) * * *
    (C) The Secretary may not obligate an amount under 
subparagraph (A) to expand the purpose of a major medical 
facility project except pursuant to a provision of law enacted 
after the date on which the Secretary submits to the committees 
described in subparagraph (B) notice of the following:
          (i) The major medical facility project that is the 
        source of the bid savings.
          (ii) The major medical facility project for which the 
        Secretary intends to expand the purpose.
          (iii) A description of such expansion of purpose.
          (iv) The amounts the Secretary intends to obligate to 
        expand the purpose.

           *       *       *       *       *       *       *


Subchapter II. Procurement and Supply

           *       *       *       *       *       *       *


SEC. 8127. SMALL BUSINESS CONCERNS OWNED AND CONTROLLED BY VETERANS: 
                    CONTRACTING GOALS AND PREFERENCES

           *       *       *       *       *       *       *


    (g) Enforcement Penalties for Misrepresentation.--(1) Any 
business [Any business] concern that is determined by the 
Secretary to have deliberately misrepresented the status of 
that concern as a small business concern owned and controlled 
by veterans or as a small business concern owned and controlled 
by service-disabled veterans for purposes of this subsection 
shall be debarred from contracting with the Department for [a 
reasonable period of time, as determined by the Secretary] a 
period of not less than five years.
    (2) In the case of a debarment under paragraph (1), the 
Secretary shall commence debarment action against the business 
concern by not later than 30 days after determining that the 
concern misrepresented the status of the concern as described 
in paragraph (1) and shall complete debarment actions against 
such concern by not later than 90 days after such 
determination.
    (3) The debarment of a business concern under paragraph (1) 
includes the debarment of all principals in the business 
concern for a period of not less than five years.

           *       *       *       *       *       *       *


                    Servicemembers Civil Relief Act

                         (50 USCS Appx 533(b))

Title 50. War and National Defense

           *       *       *       *       *       *       *


 Title III. Rent, Installment Contracts, Mortgages, Liens, Assignment, 
Leases, Telephone Service Contracts

           *       *       *       *       *       *       *


SEC. 533. MORTGAGES AND TRUST DEEDS

           *       *       *       *       *       *       *


    (b) Stay of Proceedings and Adjustment of Obligation.--In 
an action filed during, or [within 9 months] within 12 months 
after, a servicemember's period of military service to enforce 
an obligation described in subsection (a), the court may after 
a hearing and on its own motion and shall upon application by a 
servicemember when the servicemember's ability to comply with 
the obligation is materially affected by military service--

           *       *       *       *       *       *       *

    (c) Sale or Foreclosure.--A sale, foreclosure, or seizure 
of property for a breach of an obligation described in 
subsection (a) shall not be valid if made during, or [within 9 
months] within 12 months after, the period of the 
servicemember's military service except--

           *       *       *       *       *       *       *


 Veterans Benefits, Health Care, and Information Technology Act of 2006

(Public Law 109-461)

           *       *       *       *       *       *       *


                    Title VIII. Construction Matters

Subtitle A. Construction and Lease Authorities

           *       *       *       *       *       *       *


SEC. 802. EXTENSION OF AUTHORIZATION FOR CERTAIN MAJOR MEDICAL FACILITY 
                    CONSTRUCTION PROJECTS PREVIOUSLY AUTHORIZED IN 
                    CONNECTION WITH CAPITAL ASSET REALIGNMENT 
                    INITIATIVE

           *       *       *       *       *       *       *


          (11) Construction of a new medical center facility in 
        the Orlando, Florida, area, including a Simulation, 
        Learning, Education, and Research Network Center, in an 
        amount not to exceed $377,700,000.

           *       *       *       *       *       *       *


SEC. 803. AUTHORIZATION OF FISCAL YEAR 2007 MAJOR MEDICAL FACILITY 
                    PROJECTS

           *       *       *       *       *       *       *


          (3) Construction of a new clinical addition and a 
        parking garage at the Department of Veterans Affairs 
        Medical Center, Fayetteville, Arkansas, in an amount 
        not to exceed [$56,163,000] $90,600,000.
          (4) * * *
          (5) Medical facility improvements and cemetery 
        expansion of Jefferson Barracks at the Department of 
        Veterans Affairs Medical Center, St. Louis, Missouri, 
        in an amount not to exceed [$69,053,000] $346,300,000.

           *       *       *       *       *       *       *


    Veterans' Mental Health and Other Care Improvements Act of 2008

(Public Law 110-387; 122 Stat. 4137)

           *       *       *       *       *       *       *


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

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

           *       *       *       *       *       *       *


          (3) Seismic corrections, Building 1, at the 
        Department of Veterans Affairs Medical Center, San 
        Juan, Puerto Rico, in an amount not to exceed 
        [$225,900,000] $277,000,000.

           *       *       *       *       *       *       *

  

                                  
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