A bill to amend title XVIII of the Social Security Act to expand the Medicare Rural Hospital Flexibility Program to increase the delivery of mental health services and other health services to veterans of Operation Enduring Freedom and Operation Iraqi Freedom and to other residents of rural areas, and for other purposes.

Summary: Relief for Rural Veterans in Crisis Act of 2008 - Amends title XVIII (Medicare) of the Social Security Act to: (1) authorize the Secretary of Health and Human Services to award grants to states for increasing the delivery of mental health services or other health care services deemed necessary to meet the needs of veterans of Operation Iraqi Freedom and Operation Enduring Freedom living in rural areas; and (2) extend the authorization for Medicare rural hospital flexibility program (FLEX) grants.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Relief for Rural Veterans in Crisis 
Act of 2008''.

SEC. 2. EXPANSION AND EXTENSION OF THE MEDICARE RURAL HOSPITAL 
              FLEXIBILITY PROGRAM.

    (a) In General.--Section 1820(g) of the Social Security Act (42 
U.S.C. 1395i-4(g)) is amended by adding at the end the following new 
paragraph:
            ``(6) Providing mental health services and other health 
        services to veterans and other residents of rural areas.--
                    ``(A) Grants to states.--The Secretary may award 
                grants to States that have submitted applications in 
                accordance with subparagraph (B) for increasing the 
                delivery of mental health services or other health care 
                services deemed necessary to meet the needs of veterans 
                of Operation Iraqi Freedom and Operation Enduring 
                Freedom living in rural areas (as defined for purposes 
                of section 1886(d) and including areas that are rural 
                census tracks, as defined by the Administrator of the 
                Health Resources and Services Administration), 
                including for the provision of crisis intervention 
                services and the detection of post-traumatic stress 
                disorder, traumatic brain injury, and other signature 
                injuries of veterans of Operation Iraqi Freedom and 
                Operation Enduring Freedom, and for referral of such 
                veterans to medical facilities operated by the 
                Department of Veterans Affairs, and for the delivery of 
                such services to other residents of such rural areas.
                    ``(B) Application.--
                            ``(i) In general.--An application is in 
                        accordance with this subparagraph if the State 
                        submits to the Secretary at such time and in 
                        such form as the Secretary may require an 
                        application containing the assurances described 
                        in subparagraphs (A)(ii) and (A)(iii) of 
                        subsection (b)(1).
                            ``(ii) Consideration of regional 
                        approaches, networks, or technology.--The 
                        Secretary may, as appropriate in awarding 
                        grants to States under subparagraph (A), 
                        consider whether the application submitted by a 
                        State under this subparagraph includes 1 or 
                        more proposals that utilize regional 
                        approaches, networks, health information 
                        technology, telehealth, or telemedicine to 
                        deliver services described in subparagraph (A) 
                        to individuals described in that subparagraph. 
                        For purposes of this clause, a network may, as 
                        the Secretary determines appropriate, include 
                        Federally qualified health centers, rural 
                        health clinics, home health agencies, community 
                        mental health clinics and other providers of 
                        mental health services, pharmacists, local 
                        government, and other providers deemed 
                        necessary to meet the needs of veterans.
                            ``(iii) Coordination at local level.--The 
                        Secretary shall require, as appropriate, a 
                        State to demonstrate consultation with the 
                        hospital association of such State, rural 
                        hospitals located in such State, providers of 
                        mental health services, or other appropriate 
                        stakeholders for the provision of services 
                        under a grant awarded under this paragraph.
                            ``(iv) Special consideration of certain 
                        applications.--In awarding grants to States 
                        under subparagraph (A), the Secretary shall 
                        give special consideration to applications 
                        submitted by States in which veterans make up a 
                        high percentage (as determined by the 
                        Secretary) of the total population of the 
                        State. Such consideration shall be given 
                        without regard to the number of veterans of 
                        Operation Iraqi Freedom and Operation Enduring 
                        Freedom living in the areas in which mental 
                        health services and other health care services 
                        would be delivered under the application.
                    ``(C) Coordination with va.--The Secretary shall, 
                as appropriate, consult with the Director of the Office 
                of Rural Health of the Department of Veterans Affairs 
                in awarding grants to States under subparagraph (A).
                    ``(D) Use of funds.--A State awarded a grant under 
                this paragraph may, as appropriate, use the funds to 
                reimburse providers of services described in 
                subparagraph (A) to individuals described in that 
                subparagraph.
                    ``(E) Limitation on use of grant funds for 
                administrative expenses.--A State awarded a grant under 
                this paragraph may not expend more than 15 percent of 
                the amount of the grant for administrative expenses.
                    ``(F) Final report.--Not later than 1 year after 
                the date on which the last grant is awarded to a State 
                under subparagraph (A), the Secretary shall submit a 
                report to Congress on the grants awarded under such 
                subparagraph. Such report shall include an assessment 
                of the impact of such grants on increasing the delivery 
                of mental health services and other health services to 
                veterans of the United States Armed Forces living in 
                rural areas (as so defined and including such areas 
                that are rural census tracks), with particular emphasis 
                on the impact of such grants on the delivery of such 
                services to veterans of Operation Enduring Freedom and 
                Operation Iraqi Freedom, and to other individuals 
                living in such rural areas.''.
    (b) Use of Funds for Federal Administrative Expenses.--Section 
1820(g)(5) of the Social Security Act (42 U.S.C. 1395i-4(g)(5)) is 
amended--
            (1) by striking ``beginning with fiscal year 2005'' and 
        inserting ``for each of fiscal years 2005 through 2008''; and
            (2) by inserting ``and, of the total amount appropriated 
        for grants under paragraphs (1), (2), and (6) for a fiscal year 
        (beginning with fiscal year 2009)'' after ``2005)''.
    (c) Extension of Authorization for FLEX Grants.--Section 1820(j) of 
the Social Security Act (42 U.S.C. 1395i-4(j)) is amended--
            (1) by striking ``and for'' and inserting ``for''; and
            (2) by inserting ``, for making grants to all States under 
        paragraphs (1) and (2) of subsection (g), $55,000,000 in each 
        of fiscal years 2009 and 2010, and for making grants to all 
        States under paragraph (6) of subsection (g), $50,000,000 in 
        each of fiscal years 2009 and 2010, to remain available until 
        expended'' before the period at the end.