    [United States Statutes at Large, Volume 124, 111th Congress, 2nd Session]
    [From the U.S. Government Publishing Office, www.gpo.gov]

    Public Law 111-163
    111th Congress

    An Act

    To amend title 38, United States Code, to provide assistance to
    caregivers of veterans, to improve the provision of health care to
    veterans, and for other purposes. <>

    Be it enacted by the Senate and House of Representatives of the
    United States of America in Congress assembled, <>
    SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) <>  Short Title.--This Act may be cited
    as the ``Caregivers and Veterans Omnibus Health Services Act of 2010''.

    (b) Table of Contents.--The table of contents for this Act is as
    follows:

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

    TITLE I--CAREGIVER SUPPORT

    Sec. 101. Assistance and support services for caregivers.
    Sec. 102. Medical care for family caregivers.
    Sec. 103. Counseling and mental health services for caregivers.
    Sec. 104. Lodging and subsistence for attendants.

    TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

    Sec. 201. Study of barriers for women veterans to health care from the
    Department of Veterans Affairs.
    Sec. 202. Training and certification for mental health care providers of
    the Department of Veterans Affairs on care for veterans
    suffering from sexual trauma and post-traumatic stress
    disorder.
    Sec. 203. Pilot program on counseling in retreat settings for women
    veterans newly separated from service in the Armed Forces.
    Sec. 204. Service on certain advisory committees of women recently
    separated from service in the Armed Forces.
    Sec. 205. Pilot program on assistance for child care for certain
    veterans receiving health care.
    Sec. 206. Care for newborn children of women veterans receiving
    maternity care.

    TITLE III--RURAL HEALTH IMPROVEMENTS

    Sec. 301. Improvements to the Education Debt Reduction Program.
    Sec. 302. Visual impairment and orientation and mobility professionals
    education assistance program.
    Sec. 303. Demonstration projects on alternatives for expanding care for
    veterans in rural areas.
    Sec. 304. Program on readjustment and mental health care services for
    veterans who served in Operation Enduring Freedom and
    Operation Iraqi Freedom.
    Sec. 305. Travel reimbursement for veterans receiving treatment at
    facilities of the Department of Veterans Affairs.
    Sec. 306. Pilot program on incentives for physicians who assume
    inpatient responsibilities at community hospitals in health
    professional shortage areas.
    Sec. 307. Grants for veterans service organizations for transportation
    of highly rural veterans.
    Sec. 308. Modification of eligibility for participation in pilot program
    of enhanced contract care authority for health care needs of
    certain veterans.

    [[Page 1131]]

    TITLE IV--MENTAL HEALTH CARE MATTERS

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

    TITLE V--OTHER HEALTH CARE MATTERS

    Sec. 501. Repeal of certain annual reporting requirements.
    Sec. 502. Submittal date of annual report on Gulf War research.
    Sec. 503. Payment for care furnished to CHAMPVA beneficiaries.
    Sec. 504. Disclosure of patient treatment information from medical
    records of patients lacking decisionmaking capacity.
    Sec. 505. Enhancement of quality management.
    Sec. 506. Pilot program on use of community-based organizations and
    local and State government entities to ensure that veterans
    receive care and benefits for which they are eligible.
    Sec. 507. Specialized residential care and rehabilitation for certain
    veterans.
    Sec. 508. Expanded study on the health impact of Project Shipboard
    Hazard and Defense.
    Sec. 509. Use of non-Department facilities for rehabilitation of
    individuals with traumatic brain injury.
    Sec. 510. Pilot program on provision of dental insurance plans to
    veterans and survivors and dependents of veterans.
    Sec. 511. Prohibition on collection of copayments from veterans who are
    catastrophically disabled.
    Sec. 512. Higher priority status for certain veterans who are medal of
    honor recipients.
    Sec. 513. Hospital care, medical services, and nursing home care for
    certain Vietnam-era veterans exposed to herbicide and
    veterans of the Persian Gulf War.
    Sec. 514. Establishment of Director of Physician Assistant Services in
    Veterans Health Administration.
    Sec. 515. Committee on Care of Veterans with Traumatic Brain Injury.
    Sec. 516. Increase in amount available to disabled veterans for
    improvements and structural alterations furnished as part of
    home health services.
    Sec. 517. Extension of statutorily defined copayments for certain
    veterans for hospital care and nursing home care.
    Sec. 518. Extension of authority to recover cost of certain care and
    services from disabled veterans with health-plan contracts.

    TITLE VI--DEPARTMENT PERSONNEL MATTERS

    Sec. 601. Enhancement of authorities for retention of medical
    professionals.
    Sec. 602. Limitations on overtime duty, weekend duty, and alternative
    work schedules for nurses.
    Sec. 603. Reauthorization of health professionals educational assistance
    scholarship program.
    Sec. 604. Loan repayment program for clinical researchers from
    disadvantaged backgrounds.

    TITLE VII--HOMELESS VETERANS MATTERS

    Sec. 701. Per diem grant payments to nonconforming entities.

    TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

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

    TITLE IX--CONSTRUCTION AND NAMING MATTERS

    Sec. 901. Authorization of medical facility projects.
    Sec. 902. Designation of Merril Lundman Department of Veterans Affairs
    Outpatient Clinic, Havre, Montana.
    Sec. 903. Designation of William C. Tallent Department of Veterans
    Affairs Outpatient Clinic, Knoxville, Tennessee.
    Sec. 904. Designation of Max J. Beilke Department of Veterans Affairs
    Outpatient Clinic, Alexandria, Minnesota.

    [[Page 1132]]

    TITLE X--OTHER MATTERS

    Sec. 1001. Expansion of authority for Department of Veterans Affairs
    police officers.
    Sec. 1002. Uniform allowance for Department of Veterans Affairs police
    officers.
    Sec. 1003. Submission of reports to Congress by Secretary of Veterans
    Affairs in electronic form.
    Sec. 1004. Determination of budgetary effects for purposes of compliance
    with Statutory Pay-As-You-Go Act of 2010.

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

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

    TITLE I--CAREGIVER SUPPORT

    SEC. 101. ASSISTANCE AND SUPPORT SERVICES FOR CAREGIVERS.

    (a) Assistance and Support Services.--
    (1) In general.--Subchapter II of chapter 17 is amended by
    adding at the end the following new section:
    ``Sec. 1720G. Assistance and support services for caregivers

    ``(a) Program of Comprehensive Assistance for Family Caregivers.--
    (1)(A) The Secretary shall establish a program of comprehensive
    assistance for family caregivers of eligible veterans.
    ``(B) <> The Secretary shall only provide
    support under the program required by subparagraph (A) to a family
    caregiver of an eligible veteran if the Secretary determines it is in
    the best interest of the eligible veteran to do so.

    ``(2) For purposes of this subsection, an eligible veteran is any
    individual who--
    ``(A) is a veteran or member of the Armed Forces undergoing
    medical discharge from the Armed Forces;
    ``(B) has a serious injury (including traumatic brain
    injury, psychological trauma, or other mental disorder) incurred
    or aggravated in the line of duty in the active military, naval,
    or air service on or after September 11, 2001; and
    ``(C) is in need of personal care services because of--
    ``(i) an inability to perform one or more activities
    of daily living;
    ``(ii) a need for supervision or protection based on
    symptoms or residuals of neurological or other
    impairment or injury; or
    ``(iii) such other matters as the Secretary
    considers appropriate.

    ``(3)(A) As part of the program required by paragraph (1), the
    Secretary shall provide to family caregivers of eligible veterans the
    following assistance:
    ``(i) To each family caregiver who is approved as a provider
    of personal care services for an eligible veteran under
    paragraph (6)--
    ``(I) such instruction, preparation, and training as
    the Secretary considers appropriate for the family
    caregiver to provide personal care services to the
    eligible veteran;
    ``(II) ongoing technical support consisting of
    information and assistance to address, in a timely
    manner, the

    [[Page 1133]]

    routine, emergency, and specialized caregiving needs of
    the family caregiver in providing personal care services
    to the eligible veteran;
    ``(III) counseling; and
    ``(IV) lodging and subsistence under section 111(e)
    of this title.
    ``(ii) To each family caregiver who is designated as the
    primary provider of personal care services for an eligible
    veteran under paragraph (7)--
    ``(I) the assistance described in clause (i);
    ``(II) such mental health services as the Secretary
    determines appropriate;
    ``(III) respite care of not less than 30 days
    annually, including 24-hour per day care of the veteran
    commensurate with the care provided by the family
    caregiver to permit extended respite;
    ``(IV) medical care under section 1781 of this
    title; and
    ``(V) a monthly personal caregiver stipend.

    ``(B) Respite care provided under subparagraph (A)(ii)(III) shall be
    medically and age-appropriate and include in-home care.
    ``(C)(i) <> The amount of the monthly
    personal caregiver stipend provided under subparagraph (A)(ii)(V) shall
    be determined in accordance with a schedule established by the Secretary
    that specifies stipends based upon the amount and degree of personal
    care services provided.

    ``(ii) The Secretary shall ensure, to the extent practicable, that
    the schedule required by clause (i) specifies that the amount of the
    monthly personal caregiver stipend provided to a primary provider of
    personal care services for the provision of personal care services to an
    eligible veteran is not less than the monthly amount a commercial home
    health care entity would pay an individual in the geographic area of the
    eligible veteran to provide equivalent personal care services to the
    eligible veteran.
    ``(iii) If personal care services are not available from a
    commercial home health entity in the geographic area of an eligible
    veteran, the amount of the monthly personal caregiver stipend payable
    under the schedule required by clause (i) with respect to the eligible
    veteran shall be determined by taking into consideration the costs of
    commercial providers of personal care services in providing personal
    care services in geographic areas other than the geographic area of the
    eligible veteran with similar costs of living.
    ``(4) <> An eligible veteran and a family member
    of the eligible veteran seeking to participate in the program required
    by paragraph (1) shall jointly submit to the Secretary an application
    therefor in such form and in such manner as the Secretary considers
    appropriate.

    ``(5) For each application submitted jointly by an eligible veteran
    and family member, the Secretary shall evaluate--
    ``(A) the eligible veteran--
    ``(i) to identify the personal care services
    required by the eligible veteran; and
    ``(ii) to determine whether such requirements could
    be significantly or substantially satisfied through the
    provision of personal care services from a family
    member; and
    ``(B) the family member to determine the amount of
    instruction, preparation, and training, if any, the family
    member

    [[Page 1134]]

    requires to provide the personal care services required by the
    eligible veteran--
    ``(i) as a provider of personal care services for
    the eligible veteran; and
    ``(ii) as the primary provider of personal care
    services for the eligible veteran.

    ``(6)(A) The Secretary shall provide each family member of an
    eligible veteran who makes a joint application under paragraph (4) the
    instruction, preparation, and training determined to be required by such
    family member under paragraph (5)(B).
    ``(B) Upon the successful completion by a family member of an
    eligible veteran of instruction, preparation, and training under
    subparagraph (A), the Secretary shall approve the family member as a
    provider of personal care services for the eligible veteran.
    ``(C) <> The Secretary shall, subject to
    regulations the Secretary shall prescribe, provide for necessary travel,
    lodging, and per diem expenses incurred by a family member of an
    eligible veteran in undergoing instruction, preparation, and training
    under subparagraph (A).

    ``(D) <> If the participation of a family member
    of an eligible veteran in instruction, preparation, and training under
    subparagraph (A) would interfere with the provision of personal care
    services to the eligible veteran, the Secretary shall, subject to
    regulations as the Secretary shall prescribe and in consultation with
    the veteran, provide respite care to the eligible veteran during the
    provision of such instruction, preparation, and training to the family
    member so that the family member can participate in such instruction,
    preparation, and training without interfering with the provision of such
    services to the eligible veteran.

    ``(7)(A) <> For each eligible veteran with at
    least one family member who is described by subparagraph (B), the
    Secretary shall designate one family member of such eligible veteran as
    the primary provider of personal care services for such eligible
    veteran.

    ``(B) A primary provider of personal care services designated for an
    eligible veteran under subparagraph (A) shall be selected from among
    family members of the eligible veteran who--
    ``(i) are approved under paragraph (6) as a provider of
    personal care services for the eligible veteran;
    ``(ii) <> elect to provide the
    personal care services to the eligible veteran that the
    Secretary determines the eligible veteran requires under
    paragraph (5)(A)(i);
    ``(iii) has the consent of the eligible veteran to be the
    primary provider of personal care services for the eligible
    veteran; and
    ``(iv) are considered by the Secretary as competent to be
    the primary provider of personal care services for the eligible
    veteran.

    ``(C) <> An eligible veteran receiving personal
    care services from a family member designated as the primary provider of
    personal care services for the eligible veteran under subparagraph (A)
    may, in accordance with procedures the Secretary shall establish for
    such purposes, revoke consent with respect to such family member under
    subparagraph (B)(iii).

    ``(D) If a family member designated as the primary provider of
    personal care services for an eligible veteran under subparagraph (A)
    subsequently fails to meet any requirement set forth in subparagraph
    (B), the Secretary--

    [[Page 1135]]

    ``(i) shall immediately revoke the family member's
    designation under subparagraph (A); and
    ``(ii) may designate, in consultation with the eligible
    veteran, a new primary provider of personal care services for
    the eligible veteran under such subparagraph.

    ``(E) The Secretary shall take such actions as may be necessary to
    ensure that the revocation of a designation under subparagraph (A) with
    respect to an eligible veteran does not interfere with the provision of
    personal care services required by the eligible veteran.
    ``(8) If an eligible veteran lacks the capacity to make a decision
    under this subsection, the Secretary may, in accordance with regulations
    and policies of the Department regarding appointment of guardians or the
    use of powers of attorney, appoint a surrogate for the eligible veteran
    who may make decisions and take action under this subsection on behalf
    of the eligible veteran.
    ``(9)(A) The Secretary shall monitor the well-being of each eligible
    veteran receiving personal care services under the program required by
    paragraph (1).
    ``(B) The Secretary shall document each finding the Secretary
    considers pertinent to the appropriate delivery of personal care
    services to an eligible veteran under the program.
    ``(C) <> The Secretary shall establish procedures
    to ensure appropriate follow-up regarding findings described in
    subparagraph (B). Such procedures may include the following:
    ``(i) Visiting an eligible veteran in the eligible veteran's
    home to review directly the quality of personal care services
    provided to the eligible veteran.
    ``(ii) Taking such corrective action with respect to the
    findings of any review of the quality of personal care services
    provided an eligible veteran as the Secretary considers
    appropriate, which may include--
    ``(I) providing additional training to a family
    caregiver; and
    ``(II) suspending or revoking the approval of a
    family caregiver under paragraph (6) or the designation
    of a family caregiver under paragraph (7).

    ``(10) The Secretary shall carry out outreach to inform eligible
    veterans and family members of eligible veterans of the program required
    by paragraph (1) and the benefits of participating in the program.
    ``(b) Program of General Caregiver Support Services.--(1) The
    Secretary shall establish a program of support services for caregivers
    of covered veterans who are enrolled in the health care system
    established under section 1705(a) of this title (including caregivers
    who do not reside with such veterans).
    ``(2) For purposes of this subsection, a covered veteran is any
    individual who needs personal care services because of--
    ``(A) an inability to perform one or more activities of
    daily living;
    ``(B) a need for supervision or protection based on symptoms
    or residuals of neurological or other impairment or injury; or
    ``(C) such other matters as the Secretary shall specify.

    ``(3)(A) The support services furnished to caregivers of covered
    veterans under the program required by paragraph (1) shall include the
    following:

    [[Page 1136]]

    ``(i) Services regarding the administering of personal care
    services, which, subject to subparagraph (B), shall include--
    ``(I) educational sessions made available both in
    person and on an Internet website;
    ``(II) use of telehealth and other available
    technologies; and
    ``(III) teaching techniques, strategies, and skills
    for caring for a disabled veteran;
    ``(ii) Counseling and other services under section 1782 of
    this title.
    ``(iii) Respite care under section 1720B of this title that
    is medically and age appropriate for the veteran (including 24-
    hour per day in-home care).
    ``(iv) Information concerning the supportive services
    available to caregivers under this subsection and other public,
    private, and nonprofit agencies that offer support to
    caregivers.

    ``(B) <> If the Secretary
    certifies to the Committees on Veterans' Affairs of the Senate and the
    House of Representatives that funding available for a fiscal year is
    insufficient to fund the provision of services specified in one or more
    subclauses of subparagraph (A)(i), the Secretary shall not be required
    under subparagraph (A) to provide the services so specified in the
    certification during the period beginning on the date that is 180 days
    after the date the certification is received by the Committees and
    ending on the last day of the fiscal year.

    ``(4) In providing information under paragraph (3)(A)(iv), the
    Secretary shall collaborate with the Assistant Secretary for Aging of
    the Department of Health and Human Services in order to provide
    caregivers access to aging and disability resource centers under the
    Administration on Aging of the Department of Health and Human Services.
    ``(5) In carrying out the program required by paragraph (1), the
    Secretary shall conduct outreach to inform covered veterans and
    caregivers of covered veterans about the program. The outreach shall
    include an emphasis on covered veterans and caregivers of covered
    veterans living in rural areas.
    ``(c) Construction.--(1) A decision by the Secretary under this
    section affecting the furnishing of assistance or support shall be
    considered a medical determination.
    ``(2) Nothing in this section shall be construed to create--
    ``(A) an employment relationship between the Secretary and
    an individual in receipt of assistance or support under this
    section; or
    ``(B) any entitlement to any assistance or support provided
    under this section.

    ``(d) Definitions.--In this section:
    ``(1) The term `caregiver', with respect to an eligible
    veteran under subsection (a) or a covered veteran under
    subsection (b), means an individual who provides personal care
    services to the veteran.
    ``(2) The term `family caregiver', with respect to an
    eligible veteran under subsection (a), means a family member who
    is a caregiver of the veteran.
    ``(3) The term `family member', with respect to an eligible
    veteran under subsection (a), means an individual who--
    ``(A) is a member of the family of the veteran,
    including--

    [[Page 1137]]

    ``(i) a parent;
    ``(ii) a spouse;
    ``(iii) a child;
    ``(iv) a step-family member; and
    ``(v) an extended family member; or
    ``(B) lives with the veteran but is not a member of
    the family of the veteran.
    ``(4) The term `personal care services', with respect to an
    eligible veteran under subsection (a) or a covered veteran under
    subsection (b), means services that provide the veteran the
    following:
    ``(A) Assistance with one or more independent
    activities of daily living.
    ``(B) Any other non-institutional extended care (as
    such term is used in section 1701(6)(E) of this title).

    ``(e) Authorization of Appropriations.--There are authorized to be
    appropriated to carry out the programs required by subsections (a) and
    (b)--
    ``(1) $60,000,000 for fiscal year 2010; and
    ``(2) $1,542,000,000 for the period of fiscal years 2011
    through 2015.''.
    (2) Clerical amendment.--The table of sections at the
    beginning of chapter 17 is amended by inserting after the item
    related to section 1720F the following new item:

    ``1720G. Assistance and support services for caregivers.''.

    (3) <> Effective date.--
    (A) In general.--The amendments made by this
    subsection shall take effect on the date that is 270
    days after the date of the enactment of this Act.
    (B) Implementation.--The Secretary of Veterans
    Affairs shall commence the programs required by
    subsections (a) and (b) of section 1720G of title 38,
    United States Code, as added by paragraph (1) of this
    subsection, on the date on which the amendments made by
    this subsection take effect.

    (b) Implementation Plan and Report.--
    (1) In general.--Not later than 180 days after the date of
    the enactment of this Act, the Secretary of Veterans Affairs
    shall--
    (A) develop a plan for the implementation of the
    program of comprehensive assistance for family
    caregivers required by section 1720G(a)(1) of title 38,
    United States Code, as added by subsection (a)(1) of
    this section; and
    (B) submit to the Committee on Veterans' Affairs of
    the Senate and the Committee on Veterans' Affairs of the
    House of Representatives a report on such plan.
    (2) Consultation.--In developing the plan required by
    paragraph (1)(A), the Secretary shall consult with the
    following:
    (A) Individuals described in section 1720G(a)(2) of
    title 38, United States Code, as added by subsection
    (a)(1) of this section.
    (B) Family members of such individuals who provide
    personal care services to such individuals.
    (C) The Secretary of Defense with respect to matters
    concerning personal care services for members of the
    Armed Forces undergoing medical discharge from the Armed

    [[Page 1138]]

    Forces who are eligible to benefit from personal care
    services furnished under the program of comprehensive
    assistance required by section 1720G(a)(1) of such
    title, as so added.
    (D) Veterans service organizations, as recognized by
    the Secretary for the representation of veterans under
    section 5902 of such title.
    (E) National organizations that specialize in the
    provision of assistance to individuals with the types of
    disabilities that family caregivers will encounter while
    providing personal care services under the program of
    comprehensive assistance required by section 1720G(a)(1)
    of such title, as so added.
    (F) National organizations that specialize in
    provision of assistance to family members of veterans
    who provide personal care services to such veterans.
    (G) Such other organizations with an interest in the
    provision of care to veterans and assistance to family
    caregivers as the Secretary considers appropriate.
    (3) Report contents.--The report required by paragraph
    (1)(B) shall contain the following:
    (A) The plan required by paragraph (1)(A).
    (B) A description of the individuals, caregivers,
    and organizations consulted by the Secretary of Veterans
    Affairs under paragraph (2).
    (C) A description of such consultations.
    (D) The recommendations of such individuals,
    caregivers, and organizations, if any, that were not
    adopted and incorporated into the plan required by
    paragraph (1)(A), and the reasons the Secretary did not
    adopt such recommendations.

    (c) <> Annual Evaluation Report.--
    (1) In general.--Not later than 2 years after the date
    described in subsection (a)(3)(A) and annually thereafter, the
    Secretary shall submit to the Committee on Veterans' Affairs of
    the Senate and the Committee on Veterans' Affairs of the House
    of Representatives a comprehensive report on the implementation
    of section 1720G of title 38, United States Code, as added by
    subsection (a)(1).
    (2) Contents.--The report required by paragraph (1) shall
    include the following:
    (A) With respect to the program of comprehensive
    assistance for family caregivers required by subsection
    (a)(1) of such section 1720G and the program of general
    caregiver support services required by subsection (b)(1)
    of such section--
    (i) the number of caregivers that received
    assistance under such programs;
    (ii) the cost to the Department of providing
    assistance under such programs;
    (iii) a description of the outcomes achieved
    by, and any measurable benefits of, carrying out
    such programs;
    (iv) an assessment of the effectiveness and
    the efficiency of the implementation of such
    programs; and
    (v) such recommendations, including
    recommendations for legislative or administrative
    action, as the

    [[Page 1139]]

    Secretary considers appropriate in light of
    carrying out such programs.
    (B) With respect to the program of comprehensive
    assistance for family caregivers required by such
    subsection (a)(1)--
    (i) a description of the outreach activities
    carried out by the Secretary under such program;
    and
    (ii) an assessment of the manner in which
    resources are expended by the Secretary under such
    program, particularly with respect to the
    provision of monthly personal caregiver stipends
    under paragraph (3)(A)(ii)(v) of such subsection
    (a).
    (C) With respect to the provision of general
    caregiver support services required by such subsection
    (b)(1)--
    (i) a summary of the support services made
    available under the program;
    (ii) the number of caregivers who received
    support services under the program;
    (iii) the cost to the Department of providing
    each support service provided under the program;
    and
    (iv) such other information as the Secretary
    considers appropriate.

    (d) Report on Expansion of Family Caregiver Assistance.--
    (1) In general.--Not later than 2 years after the date
    described in subsection (a)(3)(A), the Secretary shall submit to
    the Committee on Veterans' Affairs of the Senate and the
    Committee on Veterans' Affairs of the House of Representatives a
    report on the feasibility and advisability of expanding the
    provision of assistance under section 1720G(a) of title 38,
    United States Code, as added by subsection (a)(1), to family
    caregivers of veterans who have a serious injury incurred or
    aggravated in the line of duty in the active military, naval, or
    air service before September 11, 2001.
    (2) Recommendations.--The report required by paragraph (1)
    shall include such recommendations as the Secretary considers
    appropriate with respect to the expansion described in such
    paragraph.
    SEC. 102. MEDICAL CARE FOR FAMILY CAREGIVERS.

    Section 1781(a) is amended--
    (1) in paragraph (2), by striking ``and'' at the end;
    (2) in paragraph (3), by inserting ``and'' at the end; and
    (3) by inserting after paragraph (3), the following new
    paragraph:
    ``(4) an individual designated as a primary provider of
    personal care services under section 1720G(a)(7)(A) of this
    title who is not entitled to care or services under a health-
    plan contract (as defined in section 1725(f) of this title);''.
    SEC. 103. COUNSELING AND MENTAL HEALTH SERVICES FOR CAREGIVERS.

    (a) In General.--Section 1782(c) is amended--
    (1) in paragraph (1), by striking ``; or'' and inserting a
    semicolon;
    (2) by redesignating paragraph (2) as paragraph (3); and
    (3) by inserting after paragraph (1) the following new
    paragraph (2):

    [[Page 1140]]

    ``(2) a family caregiver of an eligible veteran or a
    caregiver of a covered veteran (as those terms are defined in
    section 1720G of this title); or''.

    (b) Conforming Amendment.--The section heading of section 1782 is
    amended by adding at the end, the following: ``and caregivers''.
    (c) Clerical Amendment.--The table of sections at the beginning of
    chapter 17 is amended by striking the item relating to section 1782 and
    inserting the following new item:

    ``1782. Counseling, training, and mental health services for immediate
    family members and caregivers.''.

    SEC. 104. LODGING AND SUBSISTENCE FOR ATTENDANTS.

    Section 111(e) is amended--
    (1) by striking ``When'' and inserting the following: ``(1)
    Except as provided in paragraph (2), when''; and
    (2) by adding at the end the following new paragraphs:

    ``(2)(A) Without regard to whether an eligible veteran entitled to
    mileage under this section for travel to a Department facility for the
    purpose of medical examination, treatment, or care requires an attendant
    in order to perform such travel, an attendant of such veteran described
    in subparagraph (B) may be allowed expenses of travel (including lodging
    and subsistence) upon the same basis as such veteran during--
    ``(i) the period of time in which such veteran is traveling
    to and from a Department facility for the purpose of medical
    examination, treatment, or care; and
    ``(ii) the duration of the medical examination, treatment,
    or care episode for such veteran.

    ``(B) An attendant of a veteran described in this subparagraph is a
    provider of personal care services for such veteran who is approved
    under paragraph (6) of section 1720G(a) of this title or designated
    under paragraph (7) of such section 1720G(a).
    ``(C) The Secretary may prescribe regulations to carry out this
    paragraph. Such regulations may include provisions--
    ``(i) to limit the number of attendants that may receive
    expenses of travel under this paragraph for a single medical
    examination, treatment, or care episode of an eligible veteran;
    and
    ``(ii) to require such attendants to use certain travel
    services.

    ``(D) In this subsection, the term `eligible veteran' has the
    meaning given that term in section 1720G(a)(2) of this title.''.

    TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

    SEC. 201. STUDY OF BARRIERS FOR WOMEN VETERANS TO HEALTH CARE FROM
    THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Study Required.--The Secretary of Veterans Affairs shall conduct
    a comprehensive study of the barriers to the provision of comprehensive
    health care by the Department of Veterans Affairs encountered by women
    who are veterans. In conducting the study, the Secretary shall--

    [[Page 1141]]

    (1) survey women veterans who seek or receive hospital care
    or medical services provided by the Department of Veterans
    Affairs as well as women veterans who do not seek or receive
    such care or services;
    (2) administer the survey to a representative sample of
    women veterans from each Veterans Integrated Service Network;
    and
    (3) ensure that the sample of women veterans surveyed is of
    sufficient size for the study results to be statistically
    significant and is a larger sample than that of the study
    referred to in subsection (b).

    (b) Use of Previous Study.--In conducting the study required by
    subsection (a), the Secretary shall build on the work of the study of
    the Department of Veterans Affairs titled ``National Survey of Women
    Veterans in Fiscal Year 2007-2008''.
    (c) Elements of Study.--In conducting the study required by
    subsection (a), the Secretary shall conduct research on the effects of
    the following on the women veterans surveyed in the study:
    (1) The perceived stigma associated with seeking mental
    health care services.
    (2) The effect of driving distance or availability of other
    forms of transportation to the nearest medical facility on
    access to care.
    (3) The availability of child care.
    (4) The acceptability of integrated primary care, women's
    health clinics, or both.
    (5) The comprehension of eligibility requirements for, and
    the scope of services available under, hospital care and medical
    services.
    (6) The perception of personal safety and comfort in
    inpatient, outpatient, and behavioral health facilities.
    (7) The gender sensitivity of health care providers and
    staff to issues that particularly affect women.
    (8) The effectiveness of outreach for health care services
    available to women veterans.
    (9) The location and operating hours of health care
    facilities that provide services to women veterans.
    (10) Such other significant barriers as the Secretary
    considers appropriate.

    (d) Discharge by Contract.--The Secretary shall enter into a
    contract with a qualified independent entity or organization to carry
    out the study and research required under this section.
    (e) Mandatory Review of Data by Certain Department Divisions.--
    (1) In general.--The Secretary shall ensure that the head of
    each division of the Department of Veterans Affairs specified in
    paragraph (2) reviews the results of the study conducted under
    this section. <> The head of each such
    division shall submit findings with respect to the study to the
    Under Secretary for Health and to other pertinent program
    offices within the Department of Veterans Affairs with
    responsibilities relating to health care services for women
    veterans.
    (2) Specified divisions.--The divisions of the Department of
    Veterans Affairs specified in this paragraph are the following:
    (A) The Center for Women Veterans established under
    section 318 of title 38, United States Code.

    [[Page 1142]]

    (B) The Advisory Committee on Women Veterans
    established under section 542 of such title.

    (f) Reports.--
    (1) Report on implementation.--Not later than 6 months after
    the date on which the Department of Veterans Affairs publishes a
    final report on the study titled ``National Survey of Women
    Veterans in Fiscal Year 2007-2008'', the Secretary shall submit
    to Congress a report on the status of the implementation of this
    section.
    (2) Report on study.--Not later than 30 months after the
    date on which the Department publishes such final report, the
    Secretary shall submit to Congress a report on the study
    required under this section. The report shall include
    recommendations for such administrative and legislative action
    as the Secretary considers appropriate. The report shall also
    include the findings of the head of each division of the
    Department specified under subsection (e)(2) and of the Under
    Secretary for Health.

    (g) Authorization of Appropriations.--There is authorized to be
    appropriated to the Secretary of Veterans Affairs $4,000,000 to carry
    out this section.
    SEC. 202. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE
    PROVIDERS OF THE DEPARTMENT OF VETERANS
    AFFAIRS ON CARE FOR VETERANS SUFFERING
    FROM SEXUAL TRAUMA AND POST-TRAUMATIC
    STRESS DISORDER.

    Section 1720D is amended--
    (1) by redesignating subsection (d) as subsection (f); and
    (2) by inserting after subsection (c) the following new
    subsections:

    ``(d)(1) The Secretary shall carry out a program to provide graduate
    medical education, training, certification, and continuing medical
    education for mental health professionals who provide counseling, care,
    and services under subsection (a).
    ``(2) In carrying out the program required by paragraph (1), the
    Secretary shall ensure that--
    ``(A) all mental health professionals described in such
    paragraph have been trained in a consistent manner; and
    ``(B) training described in such paragraph includes
    principles of evidence-based treatment and care for sexual
    trauma and post-traumatic stress disorder.

    ``(e) <> Each year, the Secretary shall
    submit to Congress an annual report on the counseling, care, and
    services provided to veterans pursuant to this section. Each report
    shall include data for the year covered by the report with respect to
    each of the following:
    ``(1) The number of mental health professionals, graduate
    medical education trainees, and primary care providers who have
    been certified under the program required by subsection (d) and
    the amount and nature of continuing medical education provided
    under such program to such professionals, trainees, and
    providers who are so certified.
    ``(2) The number of women veterans who received counseling
    and care and services under subsection (a) from professionals
    and providers who received training under subsection (d).

    [[Page 1143]]

    ``(3) The number of graduate medical education, training,
    certification, and continuing medical education courses provided
    by reason of subsection (d).
    ``(4) The number of trained full-time equivalent employees
    required in each facility of the Department to meet the needs of
    veterans requiring treatment and care for sexual trauma and
    post-traumatic stress disorder.
    ``(5) Such recommendations for improvements in the treatment
    of women veterans with sexual trauma and post-traumatic stress
    disorder as the Secretary considers appropriate.
    ``(6) Such other information as the Secretary considers
    appropriate.''.
    SEC. 203. <> PILOT PROGRAM ON COUNSELING
    IN RETREAT SETTINGS FOR WOMEN VETERANS
    NEWLY SEPARATED FROM SERVICE IN THE ARMED
    FORCES.

    (a) Pilot Program Required.--
    (1) In general. <> --Commencing not later
    than 180 days after the date of the enactment of this Act, the
    Secretary of Veterans Affairs shall carry out, through the
    Readjustment Counseling Service of the Veterans Health
    Administration, a pilot program to evaluate the feasibility and
    advisability of providing reintegration and readjustment
    services described in subsection (b) in group retreat settings
    to women veterans who are recently separated from service in the
    Armed Forces after a prolonged deployment.
    (2) Participation at election of veteran.--The participation
    of a veteran in the pilot program under this section shall be at
    the election of the veteran.

    (b) Covered Services.--The services provided to a woman veteran
    under the pilot program shall include the following:
    (1) Information on reintegration into the veteran's family,
    employment, and community.
    (2) Financial counseling.
    (3) Occupational counseling.
    (4) Information and counseling on stress reduction.
    (5) Information and counseling on conflict resolution.
    (6) Such other information and counseling as the Secretary
    considers appropriate to assist a woman veteran under the pilot
    program in reintegration into the veteran's family, employment,
    and community.

    (c) Locations.--The Secretary shall carry out the pilot program at
    not fewer than three locations selected by the Secretary for purposes of
    the pilot program.
    (d) Duration.--The pilot program shall be carried out during the 2-
    year period beginning on the date of the commencement of the pilot
    program.
    (e) Report.--Not later than 180 days after the completion of the
    pilot program, the Secretary shall submit to Congress a report on the
    pilot program. The report shall contain the findings and conclusions of
    the Secretary as a result of the pilot program, and shall include such
    recommendations for the continuation or expansion of the pilot program
    as the Secretary considers appropriate.
    (f) Authorization of Appropriations.--There is authorized to be
    appropriated to the Secretary of Veterans Affairs for each

    [[Page 1144]]

    of fiscal years 2010 and 2011, $2,000,000 to carry out the pilot
    program.
    SEC. 204. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN RECENTLY
    SEPARATED FROM SERVICE IN THE ARMED
    FORCES.

    (a) Advisory Committee on Women Veterans.--Section 542(a)(2)(A) is
    amended--
    (1) in clause (ii), by striking ``and'' at the end;
    (2) in clause (iii), by striking the period at the end and
    inserting ``; and''; and
    (3) by inserting after clause (iii) the following new
    clause:
    ``(iv) women veterans who are recently separated from
    service in the Armed Forces.''.

    (b) Advisory Committee on Minority Veterans.--Section 544(a)(2)(A)
    is amended--
    (1) in clause (iii), by striking ``and'' at the end;
    (2) in clause (iv), by striking the period at the end and
    inserting ``; and''; and
    (3) by inserting after clause (iv) the following new clause:
    ``(v) women veterans who are minority group members and are
    recently separated from service in the Armed Forces.''.

    (c) <> Applicability.--The amendments made
    by this section shall apply to appointments made on or after the date of
    the enactment of this Act.
    SEC. 205. <> PILOT PROGRAM ON ASSISTANCE
    FOR CHILD CARE FOR CERTAIN VETERANS
    RECEIVING HEALTH CARE.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall
    carry out a pilot program to assess the feasibility and advisability of
    providing, subject to subsection (b), assistance to qualified veterans
    described in subsection (c) to obtain child care so that such veterans
    can receive health care services described in subsection (c).
    (b) Limitation on Period of Payments.--Assistance may only be
    provided to a qualified veteran under the pilot program for receipt of
    child care during the period that the qualified veteran--
    (1) receives the types of health care services described in
    subsection (c) at a facility of the Department; and
    (2) requires travel to and return from such facility for the
    receipt of such health care services.

    (c) Qualified Veterans.--For purposes of this section, a qualified
    veteran is a veteran who is--
    (1) the primary caretaker of a child or children; and
    (2)(A) receiving from the Department--
    (i) regular mental health care services;
    (ii) intensive mental health care services; or
    (iii) such other intensive health care services that
    the Secretary determines that provision of assistance to
    the veteran to obtain child care would improve access to
    such health care services by the veteran; or
    (B) in need of regular or intensive mental health care
    services from the Department, and but for lack of child care
    services, would receive such health care services from the
    Department.

    (d) Locations.--The Secretary shall carry out the pilot program in
    no fewer than three Veterans Integrated Service Networks selected by the
    Secretary for purposes of the pilot program.

    [[Page 1145]]

    (e) Duration.--The pilot program shall be carried out during the 2-
    year period beginning on the date of the commencement of the pilot
    program.
    (f) Forms of Child Care Assistance.--
    (1) In general.--Child care assistance under this section
    may include the following:
    (A) Stipends for the payment of child care offered
    by licensed child care centers (either directly or
    through a voucher program) which shall be, to the extent
    practicable, modeled after the Department of Veterans
    Affairs Child Care Subsidy Program established pursuant
    to section 630 of the Treasury and General Government
    Appropriations Act, 2002 (Public Law 107-67; 115 Stat.
    552).
    (B) Direct provision of child care at an on-site
    facility of the Department of Veterans Affairs.
    (C) Payments to private child care agencies.
    (D) Collaboration with facilities or programs of
    other Federal departments or agencies.
    (E) Such other forms of assistance as the Secretary
    considers appropriate.
    (2) Amounts of stipends.--In the case that child care
    assistance under this section is provided as a stipend under
    paragraph (1)(A), such stipend shall cover the full cost of such
    child care.

    (g) Report.--Not later than 6 months after the completion of the
    pilot program, the Secretary shall submit to Congress a report on the
    pilot program. The report shall include the findings and conclusions of
    the Secretary as a result of the pilot program, and shall include such
    recommendations for the continuation or expansion of the pilot program
    as the Secretary considers appropriate.
    (h) Authorization of Appropriations.--There is authorized to be
    appropriated to the Secretary of Veterans Affairs to carry out the pilot
    program $1,500,000 for each of fiscal years 2010 and 2011.
    SEC. 206. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING
    MATERNITY CARE.

    (a) In General.--Subchapter VIII of chapter 17 is amended by adding
    at the end the following new section:
    ``Sec. 1786. Care for newborn children of women veterans receiving
    maternity care

    ``(a) In General.--The Secretary may furnish health care services
    described in subsection (b) to a newborn child of a woman veteran who is
    receiving maternity care furnished by the Department for not more than
    seven days after the birth of the child if the veteran delivered the
    child in--
    ``(1) a facility of the Department; or
    ``(2) another facility pursuant to a Department contract for
    services relating to such delivery.

    ``(b) Covered Health Care Services.--Health care services described
    in this subsection are all post-delivery care services, including
    routine care services, that a newborn child requires.''.

    [[Page 1146]]

    (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 17 is amended by inserting after the item relating to section
    1785 the following new item:

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

    TITLE III--RURAL HEALTH IMPROVEMENTS

    SEC. 301. IMPROVEMENTS TO THE EDUCATION DEBT REDUCTION PROGRAM.

    (a) Inclusion of Employee Retention as Purpose of Program.--Section
    7681(a)(2) is amended by inserting ``and retention'' after
    ``recruitment'' the first time it appears.
    (b) Expansion of Eligibility.--Section 7682 is amended--
    (1) in subsection (a)(1), by striking ``a recently
    appointed'' and inserting ``an''; and
    (2) by striking subsection (c).

    (c) Increase in Maximum Annual Amount of Payments.--Paragraph (1) of
    subsection (d) of section 7683 is amended--
    (1) by striking ``$44,000'' and inserting ``$60,000''; and
    (2) by striking ``$10,000'' and inserting ``$12,000''.

    (d) Exception to Limitation on Amount for Certain Participants.--
    Such subsection is further amended by adding at the end the following
    new paragraph:
    ``(3)(A) <> The Secretary may waive the
    limitations under paragraphs (1) and (2) in the case of a participant
    described in subparagraph (B). In the case of such a waiver, the total
    amount of education debt repayments payable to that participant is the
    total amount of the principal and the interest on the participant's
    loans referred to in subsection (a).

    ``(B) <> A participant described in this
    subparagraph is a participant in the Program who the Secretary
    determines serves in a position for which there is a shortage of
    qualified employees by reason of either the location or the requirements
    of the position.''.
    SEC. 302. VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY
    PROFESSIONALS EDUCATION ASSISTANCE
    PROGRAM.

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

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

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

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

    ``(a) Establishment.--Subject to the availability of appropriations,
    the Secretary shall establish and carry out a scholarship program to
    provide financial assistance in accordance with this chapter to
    individuals who--

    [[Page 1147]]

    ``(1) are accepted for enrollment or currently enrolled in a
    program of study leading to a degree or certificate in visual
    impairment or orientation and mobility, or a dual degree or
    certification in both such areas, at an accredited (as
    determined by the Secretary) educational institution that is in
    a State; and
    ``(2) <> enter into an agreement with the
    Secretary as described in section 7504 of this title.

    ``(b) Purpose.--The purpose of the scholarship program is to
    increase the supply of qualified blind rehabilitation specialists for
    the Department and the Nation.
    ``(c) Outreach.--The Secretary shall publicize the scholarship
    program to educational institutions throughout the United States, with
    an emphasis on disseminating information to such institutions with high
    numbers of Hispanic students and to Historically Black Colleges and
    Universities.
    ``Sec. 7502. Application and acceptance

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

    ``(b) <> Approval.--(1) Upon the Secretary's
    approval of an individual's participation in the scholarship program,
    the Secretary shall, in writing, promptly notify the individual of that
    acceptance.

    ``(2) An individual becomes a participant in the scholarship program
    upon such approval by the Secretary.
    ``Sec. 7503. Amount of assistance; duration

    ``(a) Amount of Assistance. <> --The amount of
    the financial assistance provided an individual under the scholarship
    program under this chapter shall be the amount determined by the
    Secretary as being necessary to pay the tuition and fees of the
    individual. In the case of an individual enrolled in a program of study
    leading to a dual degree or certification in both the areas of study
    described in section 7501(a)(1) of this title, the tuition and fees
    shall not exceed the amounts necessary for the minimum number of credit
    hours to achieve such dual degree or certification.

    ``(b) Relationship to Other Assistance.--Financial assistance may be
    provided to an individual under the scholarship program to supplement
    other educational assistance to the extent that the total amount of
    educational assistance received by the individual during an academic
    year does not exceed the total tuition and fees for such academic year.

    [[Page 1148]]

    ``(c) Maximum Amount of Assistance.--(1) The total amount of
    assistance provided under the scholarship program for an academic year
    to an individual who is a full-time student may not exceed $15,000.
    ``(2) In the case of an individual who is a part-time student, the
    total amount of assistance provided under the scholarship program shall
    bear the same ratio to the amount that would be paid under paragraph (1)
    if the participant were a full-time student in the program of study
    being pursued by the individual as the coursework carried by the
    individual to full-time coursework in that program of study.
    ``(3) The total amount of assistance provided to an individual under
    the scholarship program may not exceed $45,000.
    ``(d) Maximum Duration of Assistance.--Financial assistance may not
    be provided to an individual under the scholarship program for more than
    six academic years.
    ``Sec. 7504. Agreement

    ``An agreement between the Secretary and a participant in the
    scholarship program under this chapter shall be in writing, shall be
    signed by the participant, and shall include--
    ``(1) the Secretary's agreement to provide the participant
    with financial assistance as authorized under this chapter;
    ``(2) the participant's agreement--
    ``(A) to accept such financial assistance;
    ``(B) to maintain enrollment and attendance in the
    program of study described in section 7501(a)(1) of this
    title;
    ``(C) while enrolled in such program, to maintain an
    acceptable level of academic standing (as determined by
    the educational institution offering such program under
    regulations prescribed by the Secretary); and
    ``(D) after completion of the program, to serve as a
    full-time employee in the Department for a period of
    three years, to be served within the first six years
    after the participant has completed such program and
    received a degree or certificate described in section
    7501(a)(1) of this title; and
    ``(3) any other terms and conditions that the Secretary
    considers appropriate for carrying out this chapter.
    ``Sec. 7505. Repayment for failure to satisfy requirements of
    agreement

    ``(a) In General.--An individual who receives educational assistance
    under the scholarship program under this chapter shall repay to the
    Secretary an amount equal to the unearned portion of such assistance if
    the individual fails to satisfy the requirements of the agreement
    entered into under section 7504 of this title, except in circumstances
    authorized by the Secretary.
    ``(b) Amount of Repayment. <> --The
    Secretary shall establish, by regulations, procedures for determining
    the amount of the repayment required under this section and the
    circumstances under which an exception to the required repayment may be
    granted.

    ``(c) Waiver or Suspension of Compliance. <> --
    The Secretary shall prescribe regulations providing for the waiver or
    suspension of any obligation of an individual for service or payment
    under this chapter (or an agreement under this chapter) whenever--

    [[Page 1149]]

    ``(1) noncompliance by the individual is due to
    circumstances beyond the control of the individual; or
    ``(2) <> the Secretary determines that
    the waiver or suspension of compliance is in the best interest
    of the United States.

    ``(d) Obligation as Debt to United States.--An obligation to repay
    the Secretary under this section is, for all purposes, a debt owed the
    United States. A discharge in bankruptcy under title 11 does not
    discharge a person from such debt if the discharge order is entered less
    than five years after the date of the termination of the agreement or
    contract on which the debt is based.''.
    (b) Clerical Amendments.--The tables of chapters at the beginning of
    title 38, and of part V, are each amended by inserting after the item
    relating to chapter 74 the following new item:

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

    (c) Implementation. <> --The
    Secretary of Veterans Affairs shall implement chapter 75 of title 38,
    United States Code, as added by subsection (a), not later than 6 months
    after the date of the enactment of this Act.
    SEC. 303. <> DEMONSTRATION PROJECTS ON
    ALTERNATIVES FOR EXPANDING CARE FOR
    VETERANS IN RURAL AREAS.

    (a) In General.--The Secretary of Veterans Affairs may, through the
    Director of the Office of Rural Health, carry out demonstration projects
    to examine the feasibility and advisability of alternatives for
    expanding care for veterans in rural areas, which may include the
    following:
    (1) Establishing a partnership between the Department of
    Veterans Affairs and the Centers for Medicare and Medicaid
    Services of the Department of Health and Human Services to
    coordinate care for veterans in rural areas at critical access
    hospitals (as designated or certified under section 1820 of the
    Social Security Act (42 U.S.C. 1395i-4)).
    (2) Establishing a partnership between the Department of
    Veterans Affairs and the Department of Health and Human Services
    to coordinate care for veterans in rural areas at community
    health centers.
    (3) Expanding coordination between the Department of
    Veterans Affairs and the Indian Health Service to expand care
    for Indian veterans.

    (b) Geographic Distribution.--The Secretary shall ensure that the
    demonstration projects carried out under subsection (a) are located at
    facilities that are geographically distributed throughout the United
    States.
    (c) Report.--Not later than 2 years after the date of the enactment
    of this Act, the Secretary shall submit a report on the results of the
    demonstration projects carried out under subsection (a) to--
    (1) the Committee on Veterans' Affairs and the Committee on
    Appropriations of the Senate; and
    (2) the Committee on Veterans' Affairs and the Committee on
    Appropriations of the House of Representatives.

    (d) Authorization of Appropriations.--There is authorized to be
    appropriated to carry out this section $5,000,000 for fiscal year 2010
    and each fiscal year thereafter.

    [[Page 1150]]

    SEC. 304. <> PROGRAM ON READJUSTMENT AND
    MENTAL HEALTH CARE SERVICES FOR VETERANS
    WHO SERVED IN OPERATION ENDURING FREEDOM
    AND OPERATION IRAQI FREEDOM.

    (a) Program Required. <> --Not later than 180 days
    after the date of the enactment of this Act, the Secretary of Veterans
    Affairs shall establish a program to provide--
    (1) to veterans of Operation Enduring Freedom and Operation
    Iraqi Freedom, particularly veterans who served in such
    operations while in the National Guard and the Reserves--
    (A) peer outreach services;
    (B) peer support services;
    (C) readjustment counseling and services described
    in section 1712A of title 38, United States Code; and
    (D) mental health services; and
    (2) <> to members of the immediate
    family of veterans described in paragraph (1), during the 3-year
    period beginning on the date of the return of such veterans from
    deployment in Operation Enduring Freedom or Operation Iraqi
    Freedom, education, support, counseling, and mental health
    services to assist in--
    (A) the readjustment of such veterans to civilian
    life;
    (B) in the case such veterans have an injury or
    illness incurred during such deployment, the recovery of
    such veterans from such injury or illness; and
    (C) the readjustment of the family following the
    return of such veterans.

    (b) Contracts With Community Mental Health Centers and Other
    Qualified Entities. <> --In carrying out the
    program required by subsection (a), the Secretary may contract with
    community mental health centers and other qualified entities to provide
    the services required by such subsection only in areas the Secretary
    determines are not adequately served by other health care facilities or
    vet centers of the Department of Veterans Affairs. Such contracts shall
    require each contracting community health center or entity--
    (1) to the extent practicable, to use telehealth services
    for the delivery of services required by subsection (a);
    (2) to the extent practicable, to employ veterans trained
    under subsection (c) in the provision of services covered by
    that subsection;
    (3) to participate in the training program conducted in
    accordance with subsection (d);
    (4) to comply with applicable protocols of the Department
    before incurring any liability on behalf of the Department for
    the provision of services required by subsection (a);
    (5) for each veteran for whom a community mental health
    center or other qualified entity provides mental health services
    under such contract, to provide the Department with such
    clinical summary information as the Secretary shall require;
    (6) <> to submit annual reports to
    the Secretary containing, with respect to the program required
    by subsection (a) and for the last full calendar year ending
    before the submittal of such report--
    (A) the number of the veterans served, veterans
    diagnosed, and courses of treatment provided to veterans
    as part of the program required by subsection (a); and
    (B) demographic information for such services,
    diagnoses, and courses of treatment; and

    [[Page 1151]]

    (7) to meet such other requirements as the Secretary shall
    require.

    (c) Training of Veterans for Provision of Peer-outreach and Peer-
    support Services. <> --In carrying out the program
    required by subsection (a), the Secretary shall contract with a national
    not-for-profit mental health organization to carry out a national
    program of training for veterans described in subsection (a) to provide
    the services described in subparagraphs (A) and (B) of paragraph (1) of
    such subsection.

    (d) Training of Clinicians for Provision of Services.--The Secretary
    shall conduct a training program for clinicians of community mental
    health centers or entities that have contracts with the Secretary under
    subsection (b) to ensure that such clinicians can provide the services
    required by subsection (a) in a manner that--
    (1) recognizes factors that are unique to the experience of
    veterans who served on active duty in Operation Enduring Freedom
    or Operation Iraqi Freedom (including their combat and military
    training experiences); and
    (2) uses best practices and technologies.

    (e) Vet Center Defined.--In this section, the term ``vet center''
    means a center for readjustment counseling and related mental health
    services for veterans under section 1712A of title 38, United States
    Code.
    SEC. 305. TRAVEL REIMBURSEMENT FOR VETERANS RECEIVING TREATMENT AT
    FACILITIES OF THE DEPARTMENT OF VETERANS
    AFFAIRS.

    (a) Enhancement of Allowance Based Upon Mileage Traveled.--Section
    111 is amended--
    (1) in subsection (a), by striking ``traveled,'' and
    inserting ``(at a rate of 41.5 cents per mile),''; and
    (2) by amending subsection (g) to read as follows:

    ``(g)(1) <> Beginning one year after the date
    of the enactment of the Caregivers and Veterans Omnibus Health Services
    Act of 2010, the Secretary may adjust the mileage rate described in
    subsection (a) to be equal to the mileage reimbursement rate for the use
    of privately owned vehicles by Government employees on official business
    (when a Government vehicle is available), as prescribed by the
    Administrator of General Services under section 5707(b) of title 5.

    ``(2) <> If an adjustment in the mileage
    rate under paragraph (1) results in a lower mileage rate than the
    mileage rate otherwise specified in subsection (a), the Secretary shall,
    not later than 60 days before the date of the implementation of the
    mileage rate as so adjusted, submit to Congress a written report setting
    forth the adjustment in the mileage rate under this subsection, together
    with a justification for the decision to make the adjustment in the
    mileage rate under this subsection.''.

    (b) Coverage of Cost of Transportation by Air.--Subsection (a) of
    section 111, as amended by subsection (a)(1), is further amended by
    inserting after the first sentence the following new sentence: ``Actual
    necessary expense of travel includes the reasonable costs of airfare if
    travel by air is the only practical way to reach a Department
    facility.''.
    (c) Elimination of Limitation Based on Maximum Annual Rate of
    Pension.--Subsection (b)(1)(D)(i) of such section is

    [[Page 1152]]

    amended by inserting ``who is not traveling by air and'' before ``whose
    annual''.
    (d) Determination of Practicality.--Subsection (b) of such section
    is amended by adding at the end the following new paragraph:
    ``(4) In determining for purposes of subsection (a) whether travel
    by air is the only practical way for a veteran to reach a Department
    facility, the Secretary shall consider the medical condition of the
    veteran and any other impediments to the use of ground transportation by
    the veteran.''.
    (e) <> No Expansion of Eligibility for
    Beneficiary Travel.--The amendments made by subsections (b) and (d) of
    this section may not be construed as expanding or otherwise modifying
    eligibility for payments or allowances for beneficiary travel under
    section 111 of title 38, United States Code, as in effect on the day
    before the date of the enactment of this Act.

    (f) <> Clarification of Relation to Public
    Transportation in Veterans Health Administration
    Handbook. <> --Not later than 30 days after the date of
    the enactment of this Act, the Secretary of Veterans Affairs shall
    revise the Veterans Health Administration Handbook to clarify that an
    allowance for travel based on mileage paid under section 111(a) of title
    38, United States Code, may exceed the cost of such travel by public
    transportation regardless of medical necessity.
    SEC. 306. <> PILOT PROGRAM ON INCENTIVES
    FOR PHYSICIANS WHO ASSUME INPATIENT
    RESPONSIBILITIES AT COMMUNITY HOSPITALS IN
    HEALTH PROFESSIONAL SHORTAGE AREAS.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall
    carry out a pilot program to assess the feasability and advisability of
    each of the following:
    (1) The provision of financial incentives to eligible
    physicians who obtain and maintain inpatient privileges at
    community hospitals in health professional shortage areas in
    order to facilitate the provision by such physicians of primary
    care and mental health services to veterans at such hospitals.
    (2) The collection of payments from third-party providers
    for care provided by eligible physicians to nonveterans while
    discharging inpatient responsibilities at community hospitals in
    the course of exercising the privileges described in paragraph
    (1).

    (b) Eligible Physicians. <> --For purposes of
    this section, an eligible physician is a primary care or mental health
    physician employed by the Department of Veterans Affairs on a full-time
    basis.

    (c) Duration of Program.--The pilot program shall be carried out
    during the 3-year period beginning on the date of the commencement of
    the pilot program.
    (d) Locations.--
    (1) In general.--The pilot program shall be carried out at
    not less than five community hospitals in each of not less than
    two Veterans Integrated Services Networks. The hospitals shall
    be selected by the Secretary using the results of the survey
    required under subsection (e).
    (2) Qualifying community hospitals.--A community hospital
    may be selected by the Secretary as a location for the pilot
    program if--

    [[Page 1153]]

    (A) the hospital is located in a health professional
    shortage area; and
    (B) the number of eligible physicians willing to
    assume inpatient responsibilities at the hospital (as
    determined using the result of the survey) is sufficient
    for purposes of the pilot program.

    (e) Survey of Physician Interest in Participation.--
    (1) In general. <> --Not later than 120
    days after the date of the enactment of this Act, the Secretary
    shall conduct a survey of eligible physicians to determine the
    extent of the interest of such physicians in participating in
    the pilot program.
    (2) Elements.--The survey shall disclose the type, amount,
    and nature of the financial incentives to be provided under
    subsection (h) to physicians participating in the pilot program.

    (f) Physician Participation.--
    (1) In general.--The Secretary shall select physicians for
    participation in the pilot program from among eligible
    physicians who--
    (A) express interest in participating in the pilot
    program in the survey conducted under subsection (e);
    (B) are in good standing with the Department; and
    (C) primarily have clinical responsibilities with
    the Department.
    (2) Voluntary participation.--Participation in the pilot
    program shall be voluntary. Nothing in this section shall be
    construed to require a physician working for the Department to
    assume inpatient responsibilities at a community hospital unless
    otherwise required as a term or condition of employment with the
    Department.

    (g) Assumption of Inpatient Physician Responsibilities.--
    (1) In general.--Each eligible physician selected for
    participation in the pilot program shall assume and maintain
    inpatient responsibilities, including inpatient responsibilities
    with respect to nonveterans, at one or more community hospitals
    selected by the Secretary for participation in the pilot program
    under subsection (d).
    (2) Coverage under federal tort claims act.--If an eligible
    physician participating in the pilot program carries out on-call
    responsibilities at a community hospital where privileges to
    practice at such hospital are conditioned upon the provision of
    services to individuals who are not veterans while the physician
    is on call for such hospital, the provision of such services by
    the physician shall be considered an action within the scope of
    the physician's office or employment for purposes of chapter 171
    of title 28, United States Code (commonly referred to as the
    ``Federal Tort Claims Act'').

    (h) Compensation.--
    (1) In general.--The Secretary shall provide each eligible
    physician participating in the pilot program with such
    compensation (including pay and other appropriate compensation)
    as the Secretary considers appropriate to compensate such
    physician for the discharge of any inpatient responsibilities by
    such physician at a community hospital for which such physician
    would not otherwise be compensated by the Department as a full-
    time employee of the Department.
    (2) Written agreement.--The amount of any compensation to be
    provided a physician under the pilot program shall

    [[Page 1154]]

    be specified in a written agreement entered into by the
    Secretary and the physician for purposes of the pilot program.
    (3) Treatment of compensation. <> --The
    Secretary shall consult with the Director of the Office of
    Personnel Management on the inclusion of a provision in the
    written agreement required under paragraph (2) that describes
    the treatment under Federal law of any compensation provided a
    physician under the pilot program, including treatment for
    purposes of retirement under the civil service laws.

    (i) <> Collections From Third Parties.--In
    carrying out the pilot program for the purpose described in subsection
    (a)(2), the Secretary shall implement a variety and range of
    requirements and mechanisms for the collection from third-party payors
    of amounts to reimburse the Department for health care services provided
    to nonveterans under the pilot program by eligible physicians
    discharging inpatient responsibilities under the pilot program.

    (j) Report.--Not later than 1 year after the date of the enactment
    of this Act and annually thereafter, the Secretary shall submit to
    Congress a report on the pilot program, including the following:
    (1) The findings of the Secretary with respect to the pilot
    program.
    (2) The number of veterans and nonveterans provided
    inpatient care by physicians participating in the pilot program.
    (3) The amounts payable and collected under subsection (i).

    (k) Definitions.--In this section:
    (1) Health professional shortage area.--The term ``health
    professional shortage area'' has the meaning given the term in
    section 332(a) of the Public Health Service Act (42 U.S.C.
    254e(a)).
    (2) Inpatient responsibilities.--The term ``inpatient
    responsibilities'' means on-call responsibilities customarily
    required of a physician by a community hospital as a condition
    of granting privileges to the physician to practice in the
    hospital.
    SEC. 307. <> GRANTS FOR VETERANS SERVICE
    ORGANIZATIONS FOR TRANSPORTATION OF HIGHLY
    RURAL VETERANS.

    (a) Grants Authorized.--
    (1) In general.--The Secretary of Veterans Affairs shall
    establish a grant program to provide innovative transportation
    options to veterans in highly rural areas.
    (2) Eligible recipients.--The following may be awarded a
    grant under this section:
    (A) State veterans service agencies.
    (B) Veterans service organizations.
    (3) Use of funds.--A State veterans service agency or
    veterans service organization awarded a grant under this section
    may use the grant amount to--
    (A) assist veterans in highly rural areas to travel
    to Department of Veterans Affairs medical centers; and
    (B) otherwise assist in providing transportation in
    connection with the provision of medical care to
    veterans in highly rural areas.
    (4) Maximum amount.--The amount of a grant under this
    section may not exceed $50,000.

    [[Page 1155]]

    (5) No matching requirement.--The recipient of a grant under
    this section shall not be required to provide matching funds as
    a condition for receiving such grant.

    (b) Regulations.--The Secretary shall prescribe regulations for--
    (1) evaluating grant applications under this section; and
    (2) otherwise administering the program established by this
    section.

    (c) Definitions.--In this section:
    (1) Highly rural.--The term ``highly rural'', in the case of
    an area, means that the area consists of a county or counties
    having a population of less than seven persons per square mile.
    (2) Veterans service organization.--The term ``veterans
    service organization'' means any organization recognized by the
    Secretary of Veterans Affairs for the representation of veterans
    under section 5902 of title 38, United States Code.

    (d) Authorization of Appropriations.--There is authorized to be
    appropriated $3,000,000 for each of fiscal years 2010 through 2014 to
    carry out this section.
    SEC. 308. MODIFICATION OF ELIGIBILITY FOR PARTICIPATION IN PILOT
    PROGRAM OF ENHANCED CONTRACT CARE
    AUTHORITY FOR HEALTH CARE NEEDS OF CERTAIN
    VETERANS.

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

    [[Page 1156]]

    TITLE IV--MENTAL HEALTH CARE MATTERS

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

    (a) In General.--Any member of the Armed Forces, including a member
    of the National Guard or Reserve, who serves on active duty in the Armed
    Forces in Operation Enduring Freedom or Operation Iraqi Freedom is
    eligible for readjustment counseling and related mental health services
    under section 1712A of title 38, United States Code, through the
    Readjustment Counseling Service of the Veterans Health Administration.
    (b) No Requirement for Current Active Duty Service.--A member of the
    Armed Forces who meets the requirements for eligibility for counseling
    and services under subsection (a) is entitled to counseling and services
    under that subsection regardless of whether or not the member is
    currently on active duty in the Armed Forces at the time of receipt of
    counseling and services under that subsection.
    (c) Regulations.--The eligibility of members of the Armed Forces for
    counseling and services under subsection (a) shall be subject to such
    regulations as the Secretary of Defense and the Secretary of Veterans
    Affairs shall jointly prescribe for purposes of this section.
    (d) Subject to Availability of Appropriations.--The provision of
    counseling and services under subsection (a) shall be subject to the
    availability of appropriations for such purpose.
    SEC. 402. RESTORATION OF AUTHORITY OF READJUSTMENT COUNSELING
    SERVICE TO PROVIDE REFERRAL AND OTHER
    ASSISTANCE UPON REQUEST TO FORMER MEMBERS
    OF THE ARMED FORCES NOT AUTHORIZED
    COUNSELING.

    Section 1712A is amended--
    (1) by redesignating subsections (c) through (f) as
    subsections (d) through (g), respectively; and
    (2) by inserting after subsection (b) the following new
    subsection (c):

    ``(c) Upon receipt of a request for counseling under this section
    from any individual who has been discharged or released from active
    military, naval, or air service but who is not otherwise eligible for
    such counseling, the Secretary shall--
    ``(1) provide referral services to assist such individual,
    to the maximum extent practicable, in obtaining mental health
    care and services from sources outside the Department; and
    ``(2) if pertinent, advise such individual of such
    individual's rights to apply to the appropriate military, naval,
    or air service, and to the Department, for review of such
    individual's discharge or release from such service.''.
    SEC. 403. STUDY ON SUICIDES AMONG VETERANS.

    (a) Study Required.--The Secretary of Veterans Affairs shall conduct
    a study to determine the number of veterans who died by suicide between
    January 1, 1999, and the date of the enactment of this Act.

    [[Page 1157]]

    (b) Coordination.--In carrying out the study under subsection (a)
    the Secretary of Veterans Affairs shall coordinate with--
    (1) the Secretary of Defense;
    (2) veterans service organizations;
    (3) the Centers for Disease Control and Prevention; and
    (4) State public health offices and veterans agencies.

    (c) Report to Congress.--The Secretary of Veterans Affairs shall
    submit to the Committee on Veterans' Affairs of the Senate and the
    Committee on Veterans' Affairs of the House of Representatives a report
    on the study required under subsection (a) and the findings of the
    Secretary.
    (d) Veterans Service Organization Defined.--In this section, the
    term ``veterans service organization'' means any organization recognized
    by the Secretary for the representation of veterans under section 5902
    of title 38, United States Code.

    TITLE V--OTHER HEALTH CARE MATTERS

    SEC. 501. REPEAL OF CERTAIN ANNUAL REPORTING REQUIREMENTS.

    (a) Nurse Pay Report.--Section 7451 is amended--
    (1) by striking subsection (f); and
    (2) by redesignating subsection (g) as subsection (f).

    (b) Long-term Planning Report.--
    (1) In general.--Section 8107 is repealed.
    (2) Conforming amendment.--The table of sections at the
    beginning of chapter 81 is amended by striking the item relating
    to section 8107.
    SEC. 502. SUBMITTAL DATE OF ANNUAL REPORT ON GULF WAR RESEARCH.

    Section 707(c)(1) of the Persian Gulf War Veterans' Health Status
    Act (title VII of Public Law 102-585; 38 U.S.C. 527 note) is amended by
    striking ``Not later than March 1 of each year'' and inserting ``Not
    later than July 1, 2010, and July 1 of each of the five following
    years''.
    SEC. 503. PAYMENT FOR CARE FURNISHED TO CHAMPVA BENEFICIARIES.

    Section 1781 is amended by adding at the end the following new
    subsection:
    ``(e) Payment by the Secretary under this section on behalf of a
    covered beneficiary for medical care shall constitute payment in full
    and extinguish any liability on the part of the beneficiary for that
    care.''.
    SEC. 504. DISCLOSURE OF PATIENT TREATMENT INFORMATION FROM MEDICAL
    RECORDS OF PATIENTS LACKING DECISIONMAKING
    CAPACITY.

    Section 7332(b)(2) is amended by adding at the end the following new
    subparagraph:
    ``(F)(i) To a representative of a patient who lacks
    decision-making capacity, when a practitioner deems the content
    of the given record necessary for that representative to make an
    informed decision regarding the patient's treatment.

    [[Page 1158]]

    ``(ii) In this subparagraph, the term `representative' means
    an individual, organization, or other body authorized under
    section 7331 of this title and its implementing regulations to
    give informed consent on behalf of a patient who lacks decision-
    making capacity.''.
    SEC. 505. ENHANCEMENT OF QUALITY MANAGEMENT.

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

    ``(a) <> National Quality Management Officer.--
    (1) The Under Secretary for Health shall designate an official of the
    Veterans Health Administration to act as the principal quality
    management officer for the quality-assurance program required by section
    7311 of this title. The official so designated may be known as the
    `National Quality Management Officer of the Veterans Health
    Administration' (in this section referred to as the `National Quality
    Management Officer').

    ``(2) The National Quality Management Officer shall report directly
    to the Under Secretary for Health in the discharge of responsibilities
    and duties of the Officer under this section.
    ``(3) The National Quality Management Officer shall be the official
    within the Veterans Health Administration who is principally responsible
    for the quality-assurance program referred to in paragraph (1). In
    carrying out that responsibility, the Officer shall be responsible for
    the following:
    ``(A) Establishing and enforcing the requirements of the
    program referred to in paragraph (1).
    ``(B) Developing an aggregate quality metric from existing
    data sources, such as the Inpatient Evaluation Center of the
    Department, the National Surgical Quality Improvement Program,
    and the External Peer Review Program of the Veterans Health
    Administration, that could be used to assess reliably the
    quality of care provided at individual Department medical
    centers and associated community based outpatient clinics.
    ``(C) Ensuring that existing measures of quality, including
    measures from the Inpatient Evaluation Center, the National
    Surgical Quality Improvement Program, System-Wide Ongoing
    Assessment and Review reports of the Department, and Combined
    Assessment Program reviews of the Office of Inspector General of
    the Department, are monitored routinely and analyzed in a manner
    that ensures the timely detection of quality of care issues.
    ``(D) Encouraging research and development in the area of
    quality metrics for the purposes of improving how the Department
    measures quality in individual facilities.
    ``(E) Carrying out such other responsibilities and duties
    relating to quality management in the Veterans Health
    Administration as the Under Secretary for Health shall specify.

    ``(4) The requirements under paragraph (3) shall include
    requirements regarding the following:
    ``(A) A confidential system for the submittal of reports by
    Veterans Health Administration personnel regarding quality
    management at Department facilities.

    [[Page 1159]]

    ``(B) Mechanisms for the peer review of the actions of
    individuals appointed in the Veterans Health Administration in
    the position of physician.

    ``(b) <> Quality Management Officers for
    VISNs.--(1) The Regional Director of each Veterans Integrated Services
    Network shall appoint an official of the Network to act as the quality
    management officer of the Network.

    ``(2) The quality management officer for a Veterans Integrated
    Services Network shall report to the Regional Director of the Veterans
    Integrated Services Network, and to the National Quality Management
    Officer, regarding the discharge of the responsibilities and duties of
    the officer under this section.
    ``(3) The quality management officer for a Veterans Integrated
    Services Network shall--
    ``(A) direct the quality management office in the Network;
    and
    ``(B) coordinate, monitor, and oversee the quality
    management programs and activities of the Administration medical
    facilities in the Network in order to ensure the thorough and
    uniform discharge of quality management requirements under such
    programs and activities throughout such facilities.

    ``(c) <> Quality Management Officers for Medical
    Facilities.--(1) The director of each Veterans Health Administration
    medical facility shall appoint a quality management officer for that
    facility.

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

    ``7311A. Quality management officers.''.

    (b) Reports on Quality Concerns Under Quality-assurance Program.--
    Section 7311(b) is amended by adding at the end the following new
    paragraph:
    ``(4) As part of the quality-assurance program, the Under Secretary
    for Health shall establish mechanisms through which employees of
    Veterans Health Administration facilities may submit reports, on a
    confidential basis, on matters relating to quality of care in Veterans
    Health Administration facilities to the quality management officers of
    such facilities under section 7311A(c) of

    [[Page 1160]]

    this title. The mechanisms shall provide for the prompt and thorough
    review of any reports so submitted by the receiving officials.''.
    (c) Review of Current Health Care Quality Safeguards.--
    (1) In general.--The Secretary of Veterans Affairs shall
    conduct a comprehensive review of all current policies and
    protocols of the Department of Veterans Affairs for maintaining
    health care quality and patient safety at Department medical
    facilities. The review shall include a review and assessment of
    the National Surgical Quality Improvement Program, including an
    assessment of--
    (A) the efficacy of the quality indicators under the
    program;
    (B) the efficacy of the data collection methods
    under the program;
    (C) the efficacy of the frequency with which regular
    data analyses are performed under the program; and
    (D) the extent to which the resources allocated to
    the program are adequate to fulfill the stated function
    of the program.
    (2) Report.--Not later than 60 days after the date of the
    enactment of this Act, the Secretary shall submit to Congress a
    report on the review conducted under paragraph (1), including
    the findings of the Secretary as a result of the review and such
    recommendations as the Secretary considers appropriate in light
    of the review.
    SEC. 506. <> PILOT PROGRAM ON USE OF
    COMMUNITY-BASED ORGANIZATIONS AND LOCAL
    AND STATE GOVERNMENT ENTITIES TO ENSURE
    THAT VETERANS RECEIVE CARE AND BENEFITS
    FOR WHICH THEY ARE ELIGIBLE.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall
    carry out a pilot program to assess the feasibility and advisability of
    using community-based organizations and local and State government
    entities--
    (1) to increase the coordination of community, local, State,
    and Federal providers of health care and benefits for veterans
    to assist veterans who are transitioning from military service
    to civilian life in such transition;
    (2) to increase the availability of high quality medical and
    mental health services to veterans transitioning from military
    service to civilian life;
    (3) to provide assistance to families of veterans who are
    transitioning from military service to civilian life to help
    such families adjust to such transition; and
    (4) to provide outreach to veterans and their families to
    inform them about the availability of benefits and connect them
    with appropriate care and benefit programs.

    (b) Duration of Program.--The pilot program shall be carried out
    during the 2-year period beginning on the date that is 180 days after
    the date of the enactment of this Act.
    (c) Program Locations.--
    (1) In general.--The pilot program shall be carried out at
    five locations selected by the Secretary for purposes of the
    pilot program.
    (2) Considerations.--In selecting locations for the pilot
    program, the Secretary shall consider the advisability of
    selecting locations in--

    [[Page 1161]]

    (A) rural areas;
    (B) areas with populations that have a high
    proportion of minority group representation;
    (C) areas with populations that have a high
    proportion of individuals who have limited access to
    health care; and
    (D) areas that are not in close proximity to an
    active duty military installation.

    (d) Grants.--The Secretary shall carry out the pilot program through
    the award of grants to community-based organizations and local and State
    government entities.
    (e) Selection of Grant Recipients.--
    (1) In general.--A community-based organization or local or
    State government entity seeking a grant under the pilot program
    shall submit to the Secretary an application therefor in such
    form and in such manner as the Secretary considers appropriate.
    (2) Elements.--Each application submitted under paragraph
    (1) shall include the following:
    (A) A description of the consultations, if any, with
    the Department of Veterans Affairs in the development of
    the proposal under the application.
    (B) A plan to coordinate activities under the pilot
    program, to the greatest extent possible, with the
    local, State, and Federal providers of services for
    veterans to reduce duplication of services and to
    enhance the effect of such services.

    (f) Use of Grant Funds.--The Secretary shall prescribe appropriate
    uses of grant funds received under the pilot program.
    (g) Report on Program.--
    (1) In general.--Not later than 180 days after the
    completion of the pilot program, the Secretary shall submit to
    Congress a report on the pilot program.
    (2) Elements.--The report required by paragraph (1) shall
    include the following:
    (A) The findings and conclusions of the Secretary
    with respect to the pilot program.
    (B) An assessment of the benefits to veterans of the
    pilot program.
    (C) The recommendations of the Secretary as to the
    advisability of continuing the pilot program.
    SEC. 507. SPECIALIZED RESIDENTIAL CARE AND REHABILITATION FOR
    CERTAIN VETERANS.

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

    [[Page 1162]]

    SEC. 508. EXPANDED STUDY ON THE HEALTH IMPACT OF PROJECT SHIPBOARD
    HAZARD AND DEFENSE.

    (a) In General. <> --Not later than 90 days after
    the date of the enactment of this Act, the Secretary of Veterans Affairs
    shall enter into a contract with the Institute of Medicine of the
    National Academies to conduct an expanded study on the health impact of
    Project Shipboard Hazard and Defense (Project SHAD).

    (b) Covered Veterans.--The study required by subsection (a) shall
    include, to the extent practicable, all veterans who participated in
    Project Shipboard Hazard and Defense.
    (c) Use of Existing Studies.--The study required by subsection (a)
    may use results from the study covered in the report titled ``Long-Term
    Health Effects of Participation in Project SHAD'' of the Institute of
    Medicine of the National Academies.
    SEC. 509. USE OF NON-DEPARTMENT FACILITIES FOR REHABILITATION OF
    INDIVIDUALS WITH TRAUMATIC BRAIN INJURY.

    Section 1710E is amended--
    (1) by redesignating subsection (b) as subsection (c);
    (2) by inserting after subsection (a) the following new
    subsection (b):

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

    ``(d) Standards.--The Secretary may not provide treatment or
    services as described in subsection (a) at a non-Department facility
    under such subsection unless such facility maintains standards for the
    provision of such treatment or services established by an independent,
    peer-reviewed organization that accredits specialized rehabilitation
    programs for adults with traumatic brain injury.''.
    SEC. 510. <> PILOT PROGRAM ON PROVISION
    OF DENTAL INSURANCE PLANS TO VETERANS AND
    SURVIVORS AND DEPENDENTS OF VETERANS.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall
    carry out a pilot program to assess the feasibility and advisability of
    providing a dental insurance plan to veterans and survivors and
    dependents of veterans described in subsection (b).
    (b) Covered Veterans and Survivors and Dependents.--The veterans and
    survivors and dependents of veterans described in this subsection are as
    follows:
    (1) Any veteran who is enrolled in the system of annual
    patient enrollment under section 1705 of title 38, United States
    Code.
    (2) Any survivor or dependent of a veteran who is eligible
    for medical care under section 1781 of such title.

    [[Page 1163]]

    (c) Duration of Program.--The pilot program shall be carried out
    during the 3-year period beginning on the date that is 270 days after
    the date of the enactment of this Act.
    (d) Locations.--The pilot program shall be carried out in such
    Veterans Integrated Services Networks as the Secretary considers
    appropriate for purposes of the pilot program.
    (e) Administration.--The Secretary shall contract with a dental
    insurer to administer the dental insurance plan provided under the pilot
    program.
    (f) Benefits.--The dental insurance plan under the pilot program
    shall provide such benefits for dental care and treatment as the
    Secretary considers appropriate for the dental insurance plan, including
    diagnostic services, preventative services, endodontics and other
    restorative services, surgical services, and emergency services.
    (g) Enrollment.--
    (1) Voluntary.--Enrollment in the dental insurance plan
    under the pilot program shall be voluntary.
    (2) Minimum period.--Enrollment in the dental insurance plan
    shall be for such minimum period as the Secretary shall
    prescribe for purposes of this section.

    (h) Premiums.--
    (1) In general.--Premiums for coverage under the dental
    insurance plan under the pilot program shall be in such amount
    or amounts as the Secretary shall prescribe to cover all costs
    associated with the pilot program.
    (2) Annual adjustment.--The Secretary shall adjust the
    premiums payable under the pilot program for coverage under the
    dental insurance plan on an annual basis. Each individual
    covered by the dental insurance plan at the time of such an
    adjustment shall be notified of the amount and effective date of
    such adjustment.
    (3) Responsibility for payment.--Each individual covered by
    the dental insurance plan shall pay the entire premium for
    coverage under the dental insurance plan, in addition to the
    full cost of any copayments.

    (i) Voluntary Disenrollment.--
    (1) In general.--With respect to enrollment in the dental
    insurance plan under the pilot program, the Secretary shall--
    (A) <> permit the voluntary
    disenrollment of an individual in the dental insurance
    plan if the disenrollment occurs during the 30-day
    period beginning on the date of the enrollment of the
    individual in the dental insurance plan; and
    (B) permit the voluntary disenrollment of an
    individual in the dental insurance plan for such
    circumstances as the Secretary shall prescribe for
    purposes of this subsection, but only to the extent such
    disenrollment does not jeopardize the fiscal integrity
    of the dental insurance plan.
    (2) Allowable circumstances.--The circumstances prescribed
    under paragraph (1)(B) shall include the following:
    (A) If an individual enrolled in the dental
    insurance plan relocates to a location outside the
    jurisdiction of the dental insurance plan that prevents
    use of the benefits under the dental insurance plan.

    [[Page 1164]]

    (B) If an individual enrolled in the dental
    insurance plan is prevented by a serious medical
    condition from being able to obtain benefits under the
    dental insurance plan.
    (C) Such other circumstances as the Secretary shall
    prescribe for purposes of this subsection.
    (3) Establishment of procedures.--The Secretary shall
    establish procedures for determinations on the permissibility of
    voluntary disenrollments under paragraph (1)(B). Such procedures
    shall ensure timely determinations on the permissibility of such
    disenrollments.

    (j) Relationship to Dental Care Provided by Secretary.--Nothing in
    this section shall affect the responsibility of the Secretary to provide
    dental care under section 1712 of title 38, United States Code, and the
    participation of an individual in the dental insurance plan under the
    pilot program shall not affect the individual's entitlement to
    outpatient dental services and treatment, and related dental appliances,
    under that section.
    (k) Regulations.--The dental insurance plan under the pilot program
    shall be administered under such regulations as the Secretary shall
    prescribe.
    SEC. 511. PROHIBITION ON COLLECTION OF COPAYMENTS FROM VETERANS
    WHO ARE CATASTROPHICALLY DISABLED.

    (a) In General.--Subchapter III of chapter 17 is amended by adding
    at the end the following new section:
    ``Sec. 1730A. Prohibition on collection of copayments from
    catastrophically disabled veterans

    ``Notwithstanding subsections (f) and (g) of section 1710 and
    section 1722A(a) of this title or any other provision of law, the
    Secretary may not require a veteran who is catastrophically disabled, as
    defined by the Secretary, to make any copayment for the receipt of
    hospital care or medical services under the laws administered by the
    Secretary.''.
    (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 17 is amended by inserting after the item relating to section
    1730 the following new item:

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

    SEC. 512. HIGHER PRIORITY STATUS FOR CERTAIN VETERANS WHO ARE
    MEDAL OF HONOR RECIPIENTS.

    Section 1705(a)(3) is amended by inserting ``veterans who were
    awarded the medal of honor under section 3741, 6241, or 8741 of title 10
    or section 491 of title 14,'' after ``the Purple Heart,''.
    SEC. 513. HOSPITAL CARE, MEDICAL SERVICES, AND NURSING HOME CARE
    FOR CERTAIN VIETNAM-ERA VETERANS EXPOSED
    TO HERBICIDE AND VETERANS OF THE PERSIAN
    GULF WAR.

    Section 1710(e) is amended--
    (1) in paragraph (3)--
    (A) by striking ``subsection (a)(2)(F)--'' and all
    that follows through ``(C) in the case'' and inserting
    ``subsection (a)(2)(F) in the case''; and
    (B) by redesignating clauses (i) and (ii) of the
    former subparagraph (C) as subparagraphs (A) and (B) of
    such paragraph (3) and by realigning the margin of such
    new subparagraphs two ems to the left; and

    [[Page 1165]]

    (2) in paragraph (1)(C)--
    (A) by striking ``paragraphs (2) and (3)'' and
    inserting ``paragraph (2)''; and
    (B) by inserting after ``on active duty'' the
    following: ``between August 2, 1990, and November 11,
    1998,''.
    SEC. 514. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN ASSISTANT
    SERVICES IN VETERANS HEALTH
    ADMINISTRATION.

    (a) In General.--Section 7306(a) is amended by striking paragraph
    (9) and inserting the following new paragraph (9):
    ``(9) The Director of Physician Assistant Services, who
    shall--
    ``(A) serve in a full-time capacity at the Central
    Office of the Department;
    ``(B) be a qualified physician assistant; and
    ``(C) be responsible and report directly to the
    Chief Patient Care Services Officer of the Veterans
    Health Administration on all matters relating to the
    education and training, employment, appropriate use, and
    optimal participation of physician assistants within the
    programs and initiatives of the Administration.''.

    (b) <> Deadline for Implementation.--The
    Secretary of Veterans Affairs shall ensure that an individual is serving
    as the Director of Physician Assistant Services under paragraph (9) of
    section 7306(a) of title 38, United States Code, as amended by
    subsection (a), by not later than 120 days after the date of the
    enactment of this Act.
    SEC. 515. COMMITTEE ON CARE OF VETERANS WITH TRAUMATIC BRAIN
    INJURY.

    (a) Establishment of Committee.--Subchapter II of chapter 73 is
    amended by inserting after section 7321 the following new section:
    ``Sec. 7321A. Committee on Care of Veterans with Traumatic Brain
    Injury

    ``(a) Establishment.--The Secretary shall establish in the Veterans
    Health Administration a committee to be known as the `Committee on Care
    of Veterans with Traumatic Brain Injury'. The Under Secretary for Health
    shall appoint employees of the Department with expertise in the care of
    veterans with traumatic brain injury to serve on the committee.
    ``(b) Responsibilities of Committee.--The committee shall assess,
    and carry out a continuing assessment of, the capability of the Veterans
    Health Administration to meet effectively the treatment and
    rehabilitation needs of veterans with traumatic brain injury. In
    carrying out that responsibility, the committee shall--
    ``(1) evaluate the care provided to such veterans through
    the Veterans Health Administration;
    ``(2) identify systemwide problems in caring for such
    veterans in facilities of the Veterans Health Administration;
    ``(3) identify specific facilities within the Veterans
    Health Administration at which program enrichment is needed to
    improve treatment and rehabilitation of such veterans; and
    ``(4) identify model programs which the committee considers
    to have been successful in the treatment and rehabilitation of
    such veterans and which should be implemented more widely in or
    through facilities of the Veterans Health Administration.

    [[Page 1166]]

    ``(c) Advice and Recommendations.--The committee shall--
    ``(1) advise the Under Secretary regarding the development
    of policies for the care and rehabilitation of veterans with
    traumatic brain injury; and
    ``(2) make recommendations to the Under Secretary--
    ``(A) for improving programs of care of such
    veterans at specific facilities and throughout the
    Veterans Health Administration;
    ``(B) for establishing special programs of education
    and training relevant to the care of such veterans for
    employees of the Veterans Health Administration;
    ``(C) regarding research needs and priorities
    relevant to the care of such veterans; and
    ``(D) regarding the appropriate allocation of
    resources for all such activities.

    ``(d) Annual Report.--Not later than June 1, 2010, and each year
    thereafter, the Secretary shall submit to the Committee on Veterans'
    Affairs of the Senate and the Committee on Veterans' Affairs of the
    House of Representatives a report on the implementation of this section.
    Each such report shall include the following for the calendar year
    preceding the year in which the report is submitted:
    ``(1) A list of the members of the committee.
    ``(2) The assessment of the Under Secretary for Health,
    after review of the findings of the committee, regarding the
    capability of the Veterans Health Administration, on a
    systemwide and facility-by-facility basis, to meet effectively
    the treatment and rehabilitation needs of veterans with
    traumatic brain injury.
    ``(3) The plans of the committee for further assessments.
    ``(4) The findings and recommendations made by the committee
    to the Under Secretary for Health and the views of the Under
    Secretary on such findings and recommendations.
    ``(5) A description of the steps taken, plans made (and a
    timetable for the execution of such plans), and resources to be
    applied toward improving the capability of the Veterans Health
    Administration to meet effectively the treatment and
    rehabilitation needs of veterans with traumatic brain injury.''.

    (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 73 is amended by inserting after the item relating to section
    7321 the following new item:

    ``7321A. Committee on Care of Veterans with Traumatic Brain Injury.''.

    SEC. 516. INCREASE IN AMOUNT AVAILABLE TO DISABLED VETERANS FOR
    IMPROVEMENTS AND STRUCTURAL ALTERATIONS
    FURNISHED AS PART OF HOME HEALTH SERVICES.

    (a) Increase.--Section 1717(a)(2) is amended by striking
    subparagraphs (A) and (B) and inserting the following:
    ``(A) in the case of medical services furnished under
    section 1710(a)(1) of this title, or for a disability described
    in section 1710(a)(2)(C) of this title--
    ``(i) in the case of a veteran who first applies for
    benefits under this paragraph before the date of the
    Caregivers and Veterans Omnibus Health Services Act of
    2010, $4,100; or
    ``(ii) in the case of a veteran who first applies
    for benefits under this paragraph on or after the date
    of the

    [[Page 1167]]

    Caregivers and Veterans Omnibus Health Services Act of
    2010, $6,800; and
    ``(B) in the case of medical services furnished under any
    other provision of section 1710(a) of this title--
    ``(i) in the case of a veteran who first applies for
    benefits under this paragraph before the date of the
    Caregivers and Veterans Omnibus Health Services Act of
    2010, $1,200; or
    ``(ii) in the case of a veteran who first applies
    for benefits under this paragraph on or after the date
    of the Caregivers and Veterans Omnibus Health Services
    Act of 2010, $2,000.''.

    (b) <> Construction.--A veteran who
    exhausts such veteran's eligibility for benefits under section
    1717(a)(2) of such title before the date of the enactment of this Act,
    is not entitled to additional benefits under such section by reason of
    the amendments made by subsection (a).
    SEC. 517. EXTENSION OF STATUTORILY DEFINED COPAYMENTS FOR CERTAIN
    VETERANS FOR HOSPITAL CARE AND NURSING
    HOME CARE.

    Subparagraph (B) of section 1710(f)(2) is amended to read as
    follows:
    ``(B) before September 30, 2012, an amount equal to
    $10 for every day the veteran receives hospital care and
    $5 for every day the veteran receives nursing home
    care.''.
    SEC. 518. EXTENSION OF AUTHORITY TO RECOVER COST OF CERTAIN CARE
    AND SERVICES FROM DISABLED VETERANS WITH
    HEALTH-PLAN CONTRACTS.

    Subparagraph (E) of section 1729(a)(2) is amended to read as
    follows:
    ``(E) for which care and services are furnished
    before October 1, 2012, under this chapter to a veteran
    who--
    ``(i) has a service-connected disability; and
    ``(ii) is entitled to care (or payment of the
    expenses of care) under a health-plan contract.''.

    TITLE VI--DEPARTMENT PERSONNEL MATTERS

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

    (a) Secretarial Authority To Extend Title 38 Status to Additional
    Positions.--
    (1) In general.--Paragraph (3) of section 7401 is amended by
    striking ``and blind rehabilitation outpatient specialists.''
    and inserting the following: ``blind rehabilitation outpatient
    specialists, and such other classes of health care occupations
    as the Secretary considers necessary for the recruitment and
    retention needs of the Department subject to the following
    requirements:
    ``(A) Such other classes of health care
    occupations--
    ``(i) are not occupations relating to
    administrative, clerical, or physical plant
    maintenance and protective services;

    [[Page 1168]]

    ``(ii) that would otherwise receive basic pay
    in accordance with the General Schedule under
    section 5332 of title 5;
    ``(iii) provide, as determined by the
    Secretary, direct patient care services or
    services incident to direct patient services; and
    ``(iv) would not otherwise be available to
    provide medical care or treatment for veterans.
    ``(B) <> Not later
    than 45 days before the Secretary appoints any personnel
    for a class of health care occupations that is not
    specifically listed in this paragraph, the Secretary
    shall submit to the Committee on Veterans' Affairs of
    the Senate, the Committee on Veterans' Affairs of the
    House of Representatives, and the Office of Management
    and Budget notice of such appointment.
    ``(C) Before submitting notice under subparagraph
    (B), the Secretary shall solicit comments from any labor
    organization representing employees in such class and
    include such comments in such notice.''.
    (2) Appointment of nurse assistants.--Such paragraph is
    further amended by inserting ``nurse assistants,'' after
    ``licensed practical or vocational nurses,''.

    (b) Probationary Periods for Registered Nurses.--Section 7403(b) is
    amended--
    (1) in paragraph (1), by striking ``Appointments'' and
    inserting ``Except as otherwise provided in this subsection,
    appointments'';
    (2) by redesignating paragraph (2) as paragraph (4); and
    (3) by inserting after paragraph (1) the following new
    paragraphs:

    ``(2) With respect to the appointment of a registered nurse under
    this chapter, paragraph (1) shall apply with respect to such appointment
    regardless of whether such appointment is on a full-time basis or a
    part-time basis.
    ``(3) An appointment described in subsection (a) on a part-time
    basis of a person who has previously served on a full-time basis for the
    probationary period for the position concerned shall be without a
    probationary period.''.
    (c) Prohibition on Temporary Part-time Registered Nurse Appointments
    in Excess of 2 Years.--Section 7405 is amended by adding at the end the
    following new subsection:
    ``(g)(1) Except as provided in paragraph (3), employment of a
    registered nurse on a temporary part-time basis under subsection (a)(1)
    shall be for a probationary period of two years.
    ``(2) Except as provided in paragraph (3), upon completion by a
    registered nurse of the probationary period described in paragraph (1)--
    ``(A) the employment of such nurse shall--
    ``(i) no longer be considered temporary; and
    ``(ii) be considered an appointment described in
    section 7403(a) of this title; and
    ``(B) the nurse shall be considered to have served the
    probationary period required by section 7403(b).

    ``(3) This subsection shall not apply to appointments made on a term
    limited basis of less than or equal to three years of--

    [[Page 1169]]

    ``(A) nurses with a part-time appointment resulting from an
    academic affiliation or teaching position in a nursing academy
    of the Department;
    ``(B) nurses appointed as a result of a specific research
    proposal or grant; or
    ``(C) nurses who are not citizens of the United States and
    appointed under section 7407(a) of this title.''.

    (d) Rate of Basic Pay for Appointees to the Office of the Under
    Secretary for Health Set to Rate of Basic Pay for Senior Executive
    Service Positions.--
    (1) In general.--Section 7404(a) is amended--
    (A) by striking ``The annual'' and inserting ``(1)
    The annual'';
    (B) by striking ``The pay'' and inserting the
    following:

    ``(2) The pay'';
    (C) by striking ``under the preceding sentence'' and
    inserting ``under paragraph (1)''; and
    (D) by adding at the end the following new
    paragraph:

    ``(3)(A) The rate of basic pay for a position to which an Executive
    order applies under paragraph (1) and is not described by paragraph (2)
    shall be set in accordance with section 5382 of title 5 as if such
    position were a Senior Executive Service position (as such term is
    defined in section 3132(a) of title 5).
    ``(B) A rate of basic pay for a position may not be set under
    subparagraph (A) in excess of--
    ``(i) in the case the position is not described in clause
    (ii), the rate of basic pay payable for level III of the
    Executive Schedule; or
    ``(ii) in the case that the position is covered by a
    performance appraisal system that meets the certification
    criteria established by regulation under section 5307(d) of
    title 5, the rate of basic pay payable for level II of the
    Executive Schedule.

    ``(C) Notwithstanding the provisions of subsection (d) of section
    5307 of title 5, the Secretary may make any certification under that
    subsection instead of the Office of Personnel Management and without
    concurrence of the Office of Management and Budget.''.
    (2) <> Effective date.--The
    amendments made by paragraph (1) shall take effect on the first
    day of the first pay period beginning after the day that is 180
    days after the date of the enactment of this Act.

    (e) Special Incentive Pay for Department Pharmacist Executives.--
    Section 7410 is amended--
    (1) by striking ``The Secretary may'' and inserting the
    following:

    ``(a) In General.--The Secretary may''; and
    (2) by adding at the end the following new subsection:

    ``(b) Special Incentive Pay for Department Pharmacist Executives.--
    (1) In order to recruit and retain highly qualified Department
    pharmacist executives, the Secretary may authorize the Under Secretary
    for Health to pay special incentive pay of not more than $40,000 per
    year to an individual of the Veterans Health Administration who is a
    pharmacist executive.
    ``(2) In determining whether and how much special pay to provide to
    such individual, the Under Secretary shall consider the following:
    ``(A) The grade and step of the position of the individual.

    [[Page 1170]]

    ``(B) The scope and complexity of the position of the
    individual.
    ``(C) The personal qualifications of the individual.
    ``(D) The characteristics of the labor market concerned.
    ``(E) Such other factors as the Secretary considers
    appropriate.

    ``(3) Special incentive pay under paragraph (1) for an individual is
    in addition to all other pay (including basic pay) and allowances to
    which the individual is entitled.
    ``(4) Except as provided in paragraph (5), special incentive pay
    under paragraph (1) for an individual shall be considered basic pay for
    all purposes, including retirement benefits under chapters 83 and 84 of
    title 5, and other benefits.
    ``(5) Special incentive pay under paragraph (1) for an individual
    shall not be considered basic pay for purposes of adverse actions under
    subchapter V of this chapter.
    ``(6) Special incentive pay under paragraph (1) may not be awarded
    to an individual in an amount that would result in an aggregate amount
    of pay (including bonuses and awards) received by such individual in a
    year under this title that is greater than the annual pay of the
    President.''.
    (f) Pay for Physicians and Dentists.--
    (1) Non-foreign cost of living adjustment allowance.--
    Section 7431(b) is amended by adding at the end the following
    new paragraph:
    ``(5) The non-foreign cost of living adjustment allowance
    authorized under section 5941 of title 5 for physicians and
    dentists whose pay is set under this section shall be determined
    as a percentage of base pay only.''.
    (2) Market pay determinations for physicians and dentists in
    administrative or executive leadership positions.--Section
    7431(c)(4)(B)(i) is amended by adding at the end the following:
    ``The Secretary may exempt physicians and dentists occupying
    administrative or executive leadership positions from the
    requirements of the previous sentence.''.
    (3) Exception to prohibition on reduction of market pay.--
    Section 7431(c)(7) is amended by striking ``concerned.'' and
    inserting ``concerned, unless there is a change in board
    certification or reduction of privileges.''.

    (g) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) is amended
    by striking ``level V'' and inserting ``level IV''.
    (h) Exemption for Certified Registered Nurse Anesthetists From
    Limitation on Authorized Competitive Pay.--Section 7451(c)(2) is further
    amended by adding at the end the following new sentence: ``The maximum
    rate of basic pay for a grade for the position of certified registered
    nurse anesthetist pursuant to an adjustment under subsection (d) may
    exceed the maximum rate otherwise provided in the preceding sentence.''.
    (i) Increased Limitation on Special Pay for Nurse Executives.--
    Section 7452(g)(2) is amended by striking ``$25,000'' and inserting
    ``$100,000''.
    (j) Locality Pay Scale Computations.--
    (1) Education, training, and support for facility directors
    in wage surveys.--Section 7451(d)(3) is amended by adding at the
    end the following new subparagraph:

    ``(F) The Under Secretary for Health shall provide appropriate
    education, training, and support to directors of Department health

    [[Page 1171]]

    care facilities in the conduct and use of surveys, including the use of
    third-party surveys, under this paragraph.''.
    (2) Information on methodology used in wage surveys.--
    Section 7451(e)(4) is amended--
    (A) by redesignating subparagraph (D) as
    subparagraph (E); and
    (B) by inserting after subparagraph (C) the
    following new subparagraph (D):
    ``(D) In any case in which the director conducts such a wage
    survey during the period covered by the report and makes
    adjustment in rates of basic pay applicable to one or more
    covered positions at the facility, information on the
    methodology used in making such adjustment or adjustments.''.
    (3) Disclosure of information to persons in covered
    positions.--Section 7451(e), as amended by paragraph (2) of this
    subsection, is further amended by adding at the end the
    following new paragraph:

    ``(6)(A) <> Upon the request of an individual
    described in subparagraph (B) for a report provided under paragraph (4)
    with respect to a Department health-care facility, the Under Secretary
    for Health or the director of such facility shall provide to the
    individual the most current report for such facility provided under such
    paragraph.

    ``(B) An individual described in this subparagraph is--
    ``(i) an individual in a covered position at a Department
    health-care facility; or
    ``(ii) a representative of the labor organization
    representing that individual who is designated by that
    individual to make the request.''.

    (k) Eligibility of Part-Time Nurses for Additional Nurse Pay.--
    (1) In general.--Section 7453 is amended--
    (A) in subsection (a), by striking ``a nurse'' and
    inserting ``a full-time nurse or part-time nurse'';
    (B) in subsection (b)--
    (i) in the first sentence--
    (I) by striking ``on a tour of
    duty'';
    (II) by striking ``service on such
    tour'' and inserting ``such service'';
    and
    (III) by striking ``of such tour''
    and inserting ``of such service''; and
    (ii) in the second sentence, by striking ``of
    such tour'' and inserting ``of such service'';
    (C) in subsection (c)--
    (i) by striking ``on a tour of duty''; and
    (ii) by striking ``service on such tour'' and
    inserting ``such service''; and
    (D) in subsection (e)--
    (i) in paragraph (1), by striking ``eight
    hours in a day'' and inserting ``eight consecutive
    hours''; and
    (ii) in paragraph (5)(A), by striking ``tour
    of duty'' and inserting ``period of service''.
    (2) Exclusion of application of additional nurse pay
    provisions to certain additional employees.--Paragraph (3) of
    section 7454(b) is amended to read as follows:

    ``(3) <> Employees appointed under section 7408
    of this title performing service on a tour of duty, any part of which is
    within the period commencing at midnight Friday and ending at midnight

    [[Page 1172]]

    Sunday, shall receive additional pay in addition to the rate of basic
    pay provided such employees for each hour of service on such tour at a
    rate equal to 25 percent of such employee's hourly rate of basic pay.''.

    (l) Enhanced Authority To Increase Rates of Basic Pay To Obtain or
    Retain Services of Certain Persons.--Section 7455(c) is amended to read
    as follows:
    ``(c)(1) Subject to paragraph (2), the amount of any increase under
    subsection (a) in the minimum rate for any grade may not (except in the
    case of nurse anesthetists, licensed practical nurses, licensed
    vocational nurses, nursing positions otherwise covered by title 5,
    pharmacists, and licensed physical therapists) exceed the maximum rate
    of basic pay (excluding any locality-based comparability payment under
    section 5304 of title 5 or similar provision of law) for the grade or
    level by more than 30 percent.
    ``(2) No rate may be established under this section in excess of the
    rate of basic pay payable for level IV of the Executive Schedule.''.
    SEC. 602. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND
    ALTERNATIVE WORK SCHEDULES FOR NURSES.

    (a) Overtime Duty.--
    (1) In general.--Subchapter IV of chapter 74 is amended by
    adding at the end the following new section:
    ``Sec. 7459. Nursing staff: special rules for overtime duty

    ``(a) Limitation.--Except as provided in subsection (c), the
    Secretary may not require nursing staff to work more than 40 hours (or
    24 hours if such staff is covered under section 7456 of this title) in
    an administrative work week or more than eight consecutive hours (or 12
    hours if such staff is covered under section 7456 or 7456A of this
    title).
    ``(b) Voluntary Overtime.--(1) Nursing staff may on a voluntary
    basis elect to work hours otherwise prohibited by subsection (a).
    ``(2) The refusal of nursing staff to work hours prohibited by
    subsection (a) shall not be grounds--
    ``(A) to discriminate (within the meaning of section 704(a)
    of the Civil Rights Act of 1964 (42 U.S.C. 2000e-3(a))) against
    the staff;
    ``(B) to dismiss or discharge the staff; or
    ``(C) for any other adverse personnel action against the
    staff.

    ``(c) Overtime Under Emergency Circumstances.--(1) Subject to
    paragraph (2), the Secretary may require nursing staff to work hours
    otherwise prohibited by subsection (a) if--
    ``(A) the work is a consequence of an emergency that could
    not have been reasonably anticipated;
    ``(B) the emergency is non-recurring and is not caused by or
    aggravated by the inattention of the Secretary or lack of
    reasonable contingency planning by the Secretary;
    ``(C) the Secretary has exhausted all good faith, reasonable
    attempts to obtain voluntary workers;
    ``(D) the nurse staff have critical skills and expertise
    that are required for the work; and

    [[Page 1173]]

    ``(E) the work involves work for which the standard of care
    for a patient assignment requires continuity of care through
    completion of a case, treatment, or procedure.

    ``(2) Nursing staff may not be required to work hours under this
    subsection after the requirement for a direct role by the staff in
    responding to medical needs resulting from the emergency ends.
    ``(d) Nursing Staff Defined.--In this section, the term `nursing
    staff' includes the following:
    ``(1) A registered nurse.
    ``(2) A licensed practical or vocational nurse.
    ``(3) A nurse assistant appointed under this chapter or
    title 5.
    ``(4) Any other nurse position designated by the Secretary
    for purposes of this section.''.
    (2) Clerical amendment.--The table of sections at the
    beginning of chapter 74 is amended by inserting after the item
    relating to section 7458 the following new item:

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

    (b) Weekend Duty.--Section 7456 is amended--
    (1) by striking subsection (c); and
    (2) by redesignating subsection (d) as subsection (c).

    (c) Alternate Work Schedules.--
    (1) In general.--Section 7456A(b)(1)(A) is amended by
    striking ``three regularly scheduled'' and all that follows
    through the period at the end and inserting ``six regularly
    scheduled 12-hour tours of duty within a 14-day period shall be
    considered for all purposes to have worked a full 80-hour pay
    period.''.
    (2) Conforming amendments.--Section 7456A(b) is amended--
    (A) in the subsection heading, by striking ``36/40''
    and inserting ``72/80'';
    (B) in paragraph (2)(A), by striking ``40-hour basic
    work week'' and inserting ``80-hour pay period''; and
    (C) in paragraph (3), by striking ``regularly''.
    SEC. 603. REAUTHORIZATION OF HEALTH PROFESSIONALS EDUCATIONAL
    ASSISTANCE SCHOLARSHIP PROGRAM.

    (a) In General.--Section 7618 is amended by striking ``December 31,
    1998'' and inserting ``December 31, 2014''.
    (b) Expansion of Eligibility Requirements.--Section 7612(b)(2) is
    amended by striking ``(under section'' and all that follows through ``or
    vocational nurse.'' and inserting the following: ``as an appointee under
    paragraph (1) or (3) of section 7401 of this title.''.
    (c) Additional Program Requirements.--Subchapter II of chapter 76,
    as amended by subsections (a) and (b), is further amended--
    (1) by redesignating section 7618 as section 7619; and
    (2) by inserting after section 7617 the following new
    section:
    ``Sec. 7618. Additional program requirements

    ``(a) Program Modification.--Notwithstanding any provision of this
    subchapter, the Secretary shall carry out this subchapter after the date
    of the enactment of this section by modifying the Scholarship Program in
    such a manner that the program and hiring

    [[Page 1174]]

    processes are designed to fully employ Scholarship Program graduates as
    soon as possible, if not immediately, upon graduation and completion of
    necessary certifications, and to actively assist and monitor graduates
    to ensure certifications are obtained in a minimal amount of time
    following graduation.
    ``(b) Clinical Tours.--The Secretary shall require participants in
    the Scholarship Program to perform clinical tours in assignments or
    locations determined by the Secretary while the participants are
    enrolled in the course of education or training for which the
    scholarship is provided.
    ``(c) Mentors.--The Secretary shall ensure that at the commencement
    of the period of obligated service of a participant in the Scholarship
    Program, the participant is assigned to a mentor who is employed in the
    same facility where the participant performs such service.''.
    (d) Clerical Amendment.--The table of sections at the beginning of
    chapter 76 is amended by striking the item relating to section 7618 and
    inserting the following new items:

    ``7618. Additional program requirements.
    ``7619. Expiration of program.''.

    SEC. 604. <> LOAN REPAYMENT PROGRAM FOR
    CLINICAL RESEARCHERS FROM DISADVANTAGED
    BACKGROUNDS.

    (a) In General.--The Secretary of Veterans Affairs may, in
    consultation with the Secretary of Health and Human Services, use the
    authorities available in section 487E of the Public Health Service Act
    (42 U.S.C. 288-5) for the repayment of the principal and interest of
    educational loans of appropriately qualified health professionals who
    are from disadvantaged backgrounds in order to secure clinical research
    by such professionals for the Veterans Health Administration.
    (b) Limitations.--The exercise by the Secretary of Veterans Affairs
    of the authorities referred to in subsection (a) shall be subject to the
    conditions and limitations specified in paragraphs (2) and (3) of
    section 487E(a) of the Public Health Service Act (42 U.S.C. 288-5(a)(2)
    and (3)).
    (c) Funding.--Amounts for the repayment of principal and interest of
    educational loans under this section shall be derived from amounts
    available to the Secretary of Veterans Affairs for the Veterans Health
    Administration for Medical Services.

    TITLE VII--HOMELESS VETERANS MATTERS

    SEC. 701. PER DIEM GRANT PAYMENTS TO NONCONFORMING ENTITIES.

    Section 2012 is amended by adding at the end the following new
    subsection:
    ``(d) Per Diem Payments to Nonconforming Entities.--(1) The
    Secretary may make funds available for per diem payments under this
    section to the following grant recipients or eligible entities:
    ``(A) Grant recipients or eligible entities that--
    ``(i) meet each of the transitional and supportive
    services criteria prescribed by the Secretary pursuant
    to subsection (a)(1); and

    [[Page 1175]]

    ``(ii) furnish services to homeless individuals, of
    which less than 75 percent are veterans.
    ``(B) Grant recipients or eligible entities that--
    ``(i) meet at least one, but not all, of the
    transitional and supportive services criteria prescribed
    by the Secretary pursuant to subsection (a)(1); and
    ``(ii) furnish services to homeless individuals, of
    which not less than 75 percent are veterans.
    ``(C) Grant recipients or eligible entities that--
    ``(i) meet at least one, but not all, of the
    transitional and supportive services criteria prescribed
    by the Secretary pursuant to subsection (a)(1); and
    ``(ii) furnish services to homeless individuals, of
    which less than 75 percent are veterans.

    ``(2) Notwithstanding subsection (a)(2), in providing per diem
    payments under this subsection, the Secretary shall determine the rate
    of such per diem payments in accordance with the following order of
    priority:
    ``(A) Grant recipients or eligible entities described by
    paragraph (1)(A).
    ``(B) Grant recipients or eligible entities described by
    paragraph (1)(B).
    ``(C) Grant recipients or eligible entities described by
    paragraph (1)(C).

    ``(3) For purposes of this subsection, an eligible entity is a
    nonprofit entity and may be an entity that is ineligible to receive a
    grant under section 2011 of this title, but whom the Secretary
    determines carries out the purposes described in that section.''.

    TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

    SEC. 801. GENERAL AUTHORITIES ON ESTABLISHMENT OF CORPORATIONS.

    (a) Authorization of Multi-medical Center Research Corporations.--
    (1) In general.--Section 7361 is amended--
    (A) by redesignating subsection (b) as subsection
    (e); and
    (B) by inserting after subsection (a) the following
    new subsection (b):

    ``(b)(1) Subject to paragraph (2), a corporation established under
    this subchapter may facilitate the conduct of research, education, or
    both at more than one medical center. Such a corporation shall be known
    as a `multi-medical center research corporation'.
    ``(2) The board of directors of a multi-medical center research
    corporation under this subsection shall include the official at each
    Department medical center concerned who is, or who carries out the
    responsibilities of, the medical center director of such center as
    specified in section 7363(a)(1)(A)(i) of this title.
    ``(3) In facilitating the conduct of research, education, or both at
    more than one Department medical center under this subchapter, a multi-
    medical center research corporation may administer receipts and
    expenditures relating to such research, education, or both, as
    applicable, performed at the Department medical centers concerned.''.

    [[Page 1176]]

    (2) Expansion of existing corporations to multi-medical
    center research corporations.--Such section is further amended
    by adding at the end the following new subsection:

    ``(f) A corporation established under this subchapter may act as a
    multi-medical center research corporation under this subchapter in
    accordance with subsection (b) if--
    ``(1) the board of directors of the corporation approves a
    resolution permitting facilitation by the corporation of the
    conduct of research, education, or both at the other Department
    medical center or medical centers concerned; and
    ``(2) the Secretary approves the resolution of the
    corporation under paragraph (1).''.

    (b) Restatement and Modification of Authorities on Applicability of
    State Law.--
    (1) In general.--Section 7361 as amended by subsection (a)
    of this section, is further amended by inserting after
    subsection (b) the following new subsection (c):

    ``(c) Any corporation established under this subchapter shall be
    established in accordance with the nonprofit corporation laws of the
    State in which the applicable Department medical center is located and
    shall, to the extent not inconsistent with any Federal law, be subject
    to the laws of such State. In the case of any multi-medical center
    research corporation that facilitates the conduct of research,
    education, or both at Department medical centers located in different
    States, the corporation shall be established in accordance with the
    nonprofit corporation laws of the State in which one of such Department
    medical centers is located.''.
    (2) <> Conforming amendment.--Section 7365 is
    repealed.

    (c) Clarification of Status of Corporations.--Section 7361, as
    amended by this section, is further amended--
    (1) in subsection (a), by striking the second sentence; and
    (2) by inserting after subsection (c) the following new
    subsection (d):

    ``(d)(1) Except as otherwise provided in this subchapter or under
    regulations prescribed by the Secretary, any corporation established
    under this subchapter, and its officers, directors, and employees, shall
    be required to comply only with those Federal laws, regulations, and
    executive orders and directives that apply generally to private
    nonprofit corporations.
    ``(2) A corporation under this subchapter is not--
    ``(A) owned or controlled by the United States; or
    ``(B) an agency or instrumentality of the United States.''.

    (d) Reinstatement of Requirement for 501(c)(3) Status of
    Corporations.--Subsection (e) of section 7361, as redesignated by
    subsection (a)(1), is further amended by inserting ``section 501(c)(3)
    of'' after ``exempt from taxation under''.
    SEC. 802. CLARIFICATION OF PURPOSES OF CORPORATIONS.

    (a) Clarification of Purposes.--Subsection (a) of section 7362 is
    amended in the first sentence--
    (1) by striking ``Any corporation'' and all that follows
    through ``facilitate'' and inserting ``A corporation established
    under this subchapter shall be established to provide a flexible
    funding mechanism for the conduct of approved research and
    education at one or more Department medical centers and to
    facilitate functions related to the conduct of''; and

    [[Page 1177]]

    (2) by inserting before the period at the end the following:
    ``or centers''.

    (b) Modification of Defined Term Relating to Education and
    Training.--Subsection (b) of such section is amended in the matter
    preceding paragraph (1) by striking ``the term `education and
    training''' and inserting ``the term `education' includes education and
    training and''.
    (c) Repeal of Role of Corporations With Respect to Fellowships.--
    Paragraph (1) of subsection (b) of such section is amended by striking
    the flush matter following subparagraph (C).
    (d) Availability of Education for Families of Veteran Patients.--
    Paragraph (2) of subsection (b) of such section is amended by striking
    ``to patients and to the families'' and inserting ``and includes
    education and training for patients and families''.
    SEC. 803. MODIFICATION OF REQUIREMENTS FOR BOARDS OF DIRECTORS OF
    CORPORATIONS.

    (a) Requirements for Department Board Members.--Paragraph (1) of
    section 7363(a) is amended to read as follows:
    ``(1) with respect to the Department medical center--
    ``(A)(i) the director (or directors of each
    Department medical center, in the case of a multi-
    medical center research corporation);
    ``(ii) the chief of staff; and
    ``(iii) as appropriate for the activities of such
    corporation, the associate chief of staff for research
    and the associate chief of staff for education; or
    ``(B) in the case of a Department medical center at
    which one or more of the positions referred to in
    subparagraph (A) do not exist, the official or officials
    who are responsible for carrying out the
    responsibilities of such position or positions at the
    Department medical center; and''.

    (b) Requirements for Non-department Board Members.--Paragraph (2) of
    such section is amended--
    (1) by inserting ``not less than two'' before ``members'';
    and
    (2) by striking ``and who'' and all that follows through the
    period at the end and inserting ``and who have backgrounds, or
    business, legal, financial, medical, or scientific expertise, of
    benefit to the operations of the corporation.''.

    (c) Conflicts of Interest.--Subsection (c) of section 7363 is
    amended by striking ``, employed by, or have any other financial
    relationship with'' and inserting ``or employed by''.
    SEC. 804. CLARIFICATION OF POWERS OF CORPORATIONS.

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

    ``(a) In General.--(1) A corporation established under this
    subchapter may, solely to carry out the purposes of this subchapter--
    ``(A) accept, administer, retain, and spend funds derived
    from gifts, contributions, grants, fees, reimbursements, and
    bequests from individuals and public and private entities;
    ``(B) enter into contracts and agreements with individuals
    and public and private entities;

    [[Page 1178]]

    ``(C) subject to paragraph (2), set fees for education and
    training facilitated under section 7362 of this title, and
    receive, retain, administer, and spend funds in furtherance of
    such education and training;
    ``(D) reimburse amounts to the applicable appropriation
    account of the Department for the Office of General Counsel for
    any expenses of that Office in providing legal services
    attributable to research and education agreements under this
    subchapter; and
    ``(E) employ such employees as the corporation considers
    necessary for such purposes and fix the compensation of such
    employees.

    ``(2) Fees charged pursuant to paragraph (1)(C) for education and
    training described in that paragraph to individuals who are officers or
    employees of the Department may not be paid for by any funds
    appropriated to the Department.
    ``(3) Amounts reimbursed to the Office of General Counsel under
    paragraph (1)(D) shall be available for use by the Office of the General
    Counsel only for staff and training, and related travel, for the
    provision of legal services described in that paragraph and shall remain
    available for such use without fiscal year limitation.
    ``(b) Transfer and Administration of Funds.--(1) Except as provided
    in paragraph (2), any funds received by the Secretary for the conduct of
    research or education at a Department medical center or centers, other
    than funds appropriated to the Department, may be transferred to and
    administered by a corporation established under this subchapter for such
    purposes.
    ``(2) A Department medical center may reimburse the corporation for
    all or a portion of the pay, benefits, or both of an employee of the
    corporation who is assigned to the Department medical center if the
    assignment is carried out pursuant to subchapter VI of chapter 33 of
    title 5.
    ``(3) A Department medical center may retain and use funds provided
    to it by a corporation established under this subchapter. Such funds
    shall be credited to the applicable appropriation account of the
    Department and shall be available, without fiscal year limitation, for
    the purposes of that account.
    ``(c) Research Projects.--Except for reasonable and usual
    preliminary costs for project planning before its approval, a
    corporation established under this subchapter may not spend funds for a
    research project unless the project is approved in accordance with
    procedures prescribed by the Under Secretary for Health for research
    carried out with Department funds. Such procedures shall include a
    scientific review process.
    ``(d) Education Activities.--Except for reasonable and usual
    preliminary costs for activity planning before its approval, a
    corporation established under this subchapter may not spend funds for an
    education activity unless the activity is approved in accordance with
    procedures prescribed by the Under Secretary for Health.
    ``(e) Policies and Procedures.--The Under Secretary for Health may
    prescribe policies and procedures to guide the spending of funds by
    corporations established under this subchapter that are consistent with
    the purpose of such corporations as flexible funding mechanisms and with
    Federal and State laws and regulations, and executive orders, circulars,
    and directives that apply generally to the receipt and expenditure of
    funds by nonprofit

    [[Page 1179]]

    organizations exempt from taxation under section 501(c)(3) of the
    Internal Revenue Code of 1986.''.
    (b) Conforming Amendment.--Section 7362(a), as amended by section
    802(a)(1) of this Act, is further amended by striking the last sentence.
    SEC. 805. REDESIGNATION OF SECTION 7364A OF TITLE 38, UNITED
    STATES CODE.

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

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

    SEC. 806. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF CORPORATIONS.

    (a) Additional Information in Annual Reports.--Subsection (b) of
    section 7366 is amended to read as follows:
    ``(b)(1) Each corporation shall submit to the Secretary each year a
    report providing a detailed statement of the operations, activities, and
    accomplishments of the corporation during that year.
    ``(2)(A) A corporation with revenues in excess of $500,000 for any
    year shall obtain an audit of the corporation for that year.
    ``(B) A corporation with annual revenues between $100,000 and
    $500,000 shall obtain an audit of the corporation at least once every
    three years.
    ``(C) Any audit under this paragraph shall be performed by an
    independent auditor.
    ``(3) The corporation shall include in each report to the Secretary
    under paragraph (1) the following:
    ``(A) The most recent audit of the corporation under
    paragraph (2).
    ``(B) The most recent Internal Revenue Service Form 990
    `Return of Organization Exempt from Income Tax' or equivalent
    and the applicable schedules under such form.''.

    (b) Conflict of Interest Policies.--Subsection (c) of such section
    is amended to read as follows:
    ``(c) Each director, officer, and employee of a corporation
    established under this subchapter shall be subject to a conflict of
    interest policy adopted by that corporation.''.
    (c) Establishment of Appropriate Payee Reporting Threshold.--
    Subsection (d)(3)(C) of such section is amended by striking ``$35,000''
    and inserting ``$50,000''.

    TITLE IX--CONSTRUCTION AND NAMING MATTERS

    SEC. 901. AUTHORIZATION OF MEDICAL FACILITY PROJECTS.

    (a) Authorization of Fiscal Year 2010 Major Medical Facility
    Projects.--The Secretary of Veterans Affairs may carry out the following
    major medical facility projects in fiscal year 2010, with each project
    to be carried out in the amount specified for such project:

    [[Page 1180]]

    (1) Construction (including acquisition of land) for the
    realignment of services and closure projects at the Department
    of Veterans Affairs Medical Center in Livermore, California, in
    an amount not to exceed $55,430,000.
    (2) Construction (including acquisition of land) for a new
    medical facility at the Department of Veterans Affairs Medical
    Center in Louisville, Kentucky, in an amount not to exceed
    $75,000,000.
    (3) Construction (including acquisition of land) for a
    clinical expansion for a Mental Health Facility at the
    Department of Veterans Affairs Medical Center in Dallas, Texas,
    in an amount not to exceed $15,640,000.
    (4) Construction (including acquisition of land) for a
    replacement bed tower and clinical expansion at the Department
    of Veterans Affairs Medical Center in St. Louis, Missouri, in an
    amount not to exceed $43,340,000.

    (b) Extension of Authorization for Major Medical Facility
    Construction Projects Previously Authorized.--The Secretary of Veterans
    Affairs may carry out the following major medical facility projects in
    fiscal year 2010, as follows with each project to be carried out in the
    amount specified for such project:
    (1) Replacement of the existing Department of Veterans
    Affairs Medical Center in Denver, Colorado, in an amount not to
    exceed $800,000,000.
    (2) Construction of Outpatient and Inpatient Improvements in
    Bay Pines, Florida, in an amount not to exceed $194,400,000.

    (c) Authorization of Appropriations.--
    (1) Authorization of appropriations for construction.--There
    is authorized to be appropriated to the Secretary of Veterans
    Affairs for fiscal year 2010, or the year in which funds are
    appropriated, for the Construction, Major Projects account--
    (A) $189,410,000 for the projects authorized in
    subsection (a); and
    (B) $994,400,000 for the projects authorized in
    subsection (b).
    (2) Limitation.--The projects authorized in subsections (a)
    and (b) may only be carried out using--
    (A) funds appropriated for fiscal year 2010 pursuant
    to the authorization of appropriations in paragraph (1);
    (B) funds available for Construction, Major Projects
    for a fiscal year before fiscal year 2010 that remain
    available for obligation;
    (C) funds available for Construction, Major Projects
    for a fiscal year after fiscal year 2010 that remain
    available for obligation;
    (D) funds appropriated for Construction, Major
    Projects for fiscal year 2010 for a category of activity
    not specific to a project;
    (E) funds appropriated for Construction, Major
    Projects for a fiscal year before 2010 for a category of
    activity not specific to a project; and
    (F) funds appropriated for Construction, Major
    Projects for a fiscal year after 2010 for a category of
    activity not specific to a project.

    [[Page 1181]]

    SEC. 902. DESIGNATION OF MERRIL LUNDMAN DEPARTMENT OF VETERANS
    AFFAIRS OUTPATIENT CLINIC, HAVRE, MONTANA.

    (a) Designation.--The Department of Veterans Affairs outpatient
    clinic in Havre, Montana, shall after the date of the enactment of this
    Act be known and designated as the ``Merril Lundman Department of
    Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map,
    document, record, or other paper of the United States to the outpatient
    clinic referred to in subsection (a) shall be considered to be a
    reference to the Merril Lundman Department of Veterans Affairs
    Outpatient Clinic.
    SEC. 903. DESIGNATION OF WILLIAM C. TALLENT DEPARTMENT OF VETERANS
    AFFAIRS OUTPATIENT CLINIC, KNOXVILLE,
    TENNESSEE.

    (a) Designation.--The Department of Veterans Affairs Outpatient
    Clinic in Knoxville, Tennessee, shall after the date of the enactment of
    this Act be known and designated as the ``William C. Tallent Department
    of Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map,
    document, record, or other paper of the United States to the outpatient
    clinic referred to in subsection (a) shall be considered to be a
    reference to the William C. Tallent Department of Veterans Affairs
    Outpatient Clinic.
    SEC. 904. DESIGNATION OF MAX J. BEILKE DEPARTMENT OF VETERANS
    AFFAIRS OUTPATIENT CLINIC, ALEXANDRIA,
    MINNESOTA.

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

    TITLE X--OTHER MATTERS

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

    Section 902 is amended--
    (1) in subsection (a)--
    (A) by amending paragraph (1) to read as follows:

    ``(1) Employees of the Department who are Department police officers
    shall, with respect to acts occurring on Department property--
    ``(A) enforce Federal laws;
    ``(B) enforce the rules prescribed under section 901 of this
    title;
    ``(C) enforce traffic and motor vehicle laws of a State or
    local government (by issuance of a citation for violation of
    such laws) within the jurisdiction of which such Department
    property is located as authorized by an express grant of
    authority under applicable State or local law;

    [[Page 1182]]

    ``(D) carry the appropriate Department-issued weapons,
    including firearms, while off Department property in an official
    capacity or while in an official travel status;
    ``(E) conduct investigations, on and off Department
    property, of offenses that may have been committed on property
    under the original jurisdiction of Department, consistent with
    agreements or other consultation with affected Federal, State,
    or local law enforcement agencies; and
    ``(F) carry out, as needed and appropriate, the duties
    described in subparagraphs (A) through (E) when engaged in
    duties authorized by other Federal statutes.'';
    (B) by striking paragraph (2) and redesignating
    paragraph (3) as paragraph (2); and
    (C) in paragraph (2), as redesignated by
    subparagraph (B) of this paragraph, by inserting ``, and
    on any arrest warrant issued by competent judicial
    authority'' before the period; and
    (2) by amending subsection (c) to read as follows:

    ``(c) The powers granted to Department police officers designated
    under this section shall be exercised in accordance with guidelines
    approved by the Secretary and the Attorney General.''.
    SEC. 1002. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS AFFAIRS
    POLICE OFFICERS.

    Section 903 is amended--
    (1) by striking subsection (b) and inserting the following
    new subsection (b):

    ``(b)(1) The amount of the allowance that the Secretary may pay
    under this section is the lesser of--
    ``(A) the amount currently allowed as prescribed by the
    Office of Personnel Management; or
    ``(B) estimated costs or actual costs as determined by
    periodic surveys conducted by the Department.

    ``(2) During any fiscal year no officer shall receive more for the
    purchase of a uniform described in subsection (a) than the amount
    established under this subsection.''; and
    (2) by striking subsection (c) and inserting the following
    new subsection (c):

    ``(c) The allowance established under subsection (b) shall be paid
    at the beginning of a Department police officer's employment for those
    appointed on or after October 1, 2010. In the case of any other
    Department police officer, an allowance in the amount established under
    subsection (b) shall be paid upon the request of the officer.''.
    SEC. 1003. SUBMISSION OF REPORTS TO CONGRESS BY SECRETARY OF
    VETERANS AFFAIRS IN ELECTRONIC FORM.

    (a) In General.--Chapter 1 is amended by adding at the end the
    following new section:
    ``Sec. 118. Submission of reports to Congress in electronic form

    ``(a) In General.--Whenever the Secretary or any other official of
    the Department is required by law to submit to Congress (or any
    committee of either chamber of Congress) a report, the Secretary or
    other official shall submit to Congress (or such committee) a copy of
    the report in an electronic format.

    [[Page 1183]]

    ``(b) Treatment.--The submission of a copy of a report in accordance
    with this section shall be treated as meeting any requirement of law to
    submit such report to Congress (or any committee of either chamber of
    Congress).
    ``(c) Report Defined.--For purposes of this section, the term
    `report' includes any certification, notification, or other
    communication in writing.''.
    (b) Technical and Clerical Amendments.--The table of sections at the
    beginning of chapter 1 is amended--
    (1) by striking the item relating to section 117; and
    (2) by adding at the end the following new items:

    ``117. Advance appropriations for certain medical care accounts.
    ``118. Reports to Congress: submission in electronic form.''.

    SEC. 1004. DETERMINATION OF BUDGETARY EFFECTS FOR PURPOSES OF
    COMPLIANCE WITH STATUTORY PAY-AS-YOU-GO
    ACT OF 2010.

    <> The budgetary effects of this
    Act, for the purpose of complying with the Statutory Pay-As-You-Go Act
    of 2010, shall be determined by reference to the latest statement titled
    ``Budgetary Effects of PAYGO Legislation'' for this Act, submitted for
    printing in the Congressional Record by the Chairman of the House Budget
    Committee, provided that such statement has been submitted prior to the
    vote on passage.

    Approved May 5, 2010.

    LEGISLATIVE HISTORY--S. 1963:
    ---------------------------------------------------------------------------

    CONGRESSIONAL RECORD:
    Vol. 155 (2009):
    Nov. 19, considered and passed
    Senate.
    Vol. 156 (2010):
    Apr. 21, considered and passed
    House, amended.
    Apr. 22, Senate concurred in House
    amendment.
    DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2010):
    May 5, Presidential remarks.