19–010 

Calendar No. 188 

112TH CONGRESS REPORT " ! SENATE 1st Session 112–88 

VETERANS PROGRAMS IMPROVEMENT ACT OF 2011 

OCTOBER 11, 2011.—Ordered to be printed 

Mrs. MURRAY, from the Committee on Veterans’ Affairs, 

submitted the following 

R E P O R T 

[To accompany S. 914] 

The Committee on Veterans’ Affairs (hereinafter, ‘‘the Committee’’), to which was referred the bill (S. 914), to amend title 38, 

United States Code (hereinafter, ‘‘U.S.C.’’), to authorize the waiver 

of the collection of copayments for telehealth and telemedicine visits of veterans, and for other purposes, having considered the same, 

reports favorably thereon with an amendment in the nature of a 

substitute, and recommends that the bill, as amended, do pass. 

INTRODUCTION

On May 9, 2011, Senator Begich introduced S. 914, which would 

authorize the waiver of the collection of copayments for telehealth 

and telemedicine visits of veterans. Senators Grassley and Tester 

are original cosponsors. The bill was referred to the Committee. 

On February 3, 2011, Senator Cornyn introduced S. 269, which 

would designate the Department of Veterans Affairs (hereinafter, 

‘‘VA’’ or ‘‘the Department’’) medical center in Big Spring, Texas, as 

the ‘‘George H. O’Brien, Jr., Department of Veterans Affairs Medical Center.’’ Senator Hutchison is an original cosponsor. The bill 

was referred to the Committee. 

On February 14, 2011, Senator Mark Udall introduced S. 327, 

which would designate VA’s telehealth clinic in Craig, Colorado, as 

the ‘‘Major William Edward Adams Department of Veterans Affairs 

Clinic.’’ Senator Bennet is an original cosponsor. The bill was referred to the Committee. 

On February 17, 2011, Senator Klobuchar introduced S. 411, the 

proposed ‘‘Helping our Homeless Veterans Act of 2011.’’ S. 411 

would authorize VA to enter into agreements with States and nonprofit organizations to collaborate in the provision of case management services associated with certain supported housing programs 

for veterans. Senators Begich, Brown of Massachusetts, Casey, Cornyn, Inhofe, and Nelson of Florida are original cosponsors of the 

bill. Senators Blumenthal, Cantwell, Cardin, Coons, Durbin, Enzi, 

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Hagan, Merkley, Mikulski, Murkowski, Pryor, and Tester were 

later added as cosponsors of the bill. The bill was referred to the 

Committee. 

On March 1, 2011, Ranking Member Burr introduced S. 423, 

which would provide authority for a retroactive effective date for 

awards of disability compensation in connection with applications 

that are fully-developed at submittal. The bill was referred to the 

Committee. 

On March 3, 2011, Senator Whitehouse introduced S. 486, the 

proposed ‘‘Protecting Servicemembers from Mortgage Abuses Act of 

2011.’’ S. 486 would amend the Servicemembers Civil Relief Act 

(hereinafter, ‘‘SCRA’’) to enhance protections for members of the 

uniformed services related to mortgages, mortgage foreclosure, and 

eviction. Senators Merkley, Reed, Sanders, and Tester are original 

cosponsors of the bill. Senators Baucus, Blumenthal, Boxer, Durbin, Feinstein, Franken, Hagan, Lautenberg, Leahy, Mikulski, Nelson of Florida, and Pryor were later added as cosponsors of the bill. 

The bill was referred to the Committee. 

On March 9, 2011, Senator Webb introduced S. 536, which would 

provide that utilization of survivors’ and dependents’ educational 

assistance shall not be subject to the 48-month limitation on the 

aggregate amount of assistance utilizable under multiple veterans 

and related educational assistance programs. Senator Blumenthal 

was later added as a cosponsor of the bill. The bill was referred to 

the Committee. 

On March 29, 2011, Senator Baucus introduced S. 666, the proposed ‘‘Veterans Traumatic Brain Injury Care Improvement Act of 

2011.’’ S. 666 would require VA to report on the feasibility and advisability of establishing a Polytrauma Rehabilitation Center (hereinafter, ‘‘PRC’’) or Polytrauma Network Site (hereinafter, ‘‘PNS’’) in 

the northern Rockies or Dakotas. Senators Conrad, Johnson of 

South Dakota, and Tester are original cosponsors of the bill. Senator Cantwell was later added as a cosponsor of the bill. The bill 

was referred to the Committee. 

On March 31, 2011, Senator Tester introduced S. 696, which 

would treat the sites operated by the Department’s Readjustment 

Counseling Service (hereinafter, ‘‘Vet Centers’’) as VA facilities for 

purposes of payments or allowances for beneficiary travel to Department facilities. Senators Begich, Blumenthal, Johnson of South 

Dakota, Moran, and Wyden were later added as cosponsors of the 

bill. The bill was referred to the Committee. 

On March 31, 2011, Senator Warner introduced S. 698, which 

would codify the prohibition against the reservation of gravesites at 

Arlington National Cemetery (hereinafter, ‘‘ANC’’). The bill was referred to the Committee. 

On April 8, 2011, Senator Harkin introduced S. 769, the proposed ‘‘Veterans Equal Treatment for Service Dogs Act of 2011.’’ 

S. 769 would prevent the prohibition of the use of service dogs on 

VA property. Senator Isakson was an original cosponsor of the bill. 

Senators Begich, Hagan, Leahy, Murkowski, Pryor, Stabenow, and 

Wyden were later added as cosponsors of the bill. The bill was referred to the Committee. 

On April 13, 2011, Senator Snowe introduced S. 815, the proposed ‘‘Sanctity of Eternal Rest for Veterans Act of 2011.’’ S. 815 

would guarantee that military funerals are conducted with dignity 

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and respect. Senators Cardin, Coats, Conrad, Gillibrand, Hoeven, 

Hutchison, Johanns, Kirk, Pryor, Reid, Rockefeller, Rubio, and 

Shaheen are all original cosponsors of the bill. Senators Ayotte, 

Begich, Blunt, Boozman, Brown of Massachusetts, Cantwell, Collins, Coons, Cornyn, Enzi, Graham, Inhofe, Kerry, Lieberman, 

Manchin, McCaskill, Roberts, Stabenow, Webb, Whitehouse, and 

Wicker were later added as cosponsors of the bill. The bill was referred to the Committee. 

On May 3, 2011, Senator Akaka introduced S. 874, which would 

modify the provision of compensation and pension to surviving 

spouses of veterans in the months of death of the veterans and improve housing loan benefits for veterans. The bill was referred to 

the Committee. 

On May 10, 2011, Ranking Member Burr introduced S. 928, 

which would limit VA’s authority to use bid savings on major medical facility projects to expand or change the scope of a major medical facility project of the Department. The bill was referred to the 

Committee. 

On May 11, 2011, Senator Boozman introduced S. 957, the proposed ‘‘Veterans’ Traumatic Brain Injury Rehabilitative Services’ 

Improvements Act of 2011.’’ S. 957 would improve the provision of 

rehabilitation services for veterans with traumatic brain injury 

(hereinafter, ‘‘TBI’’). Senator Begich is an original cosponsor. Senator Johnson of South Dakota was later added as a cosponsor of 

the bill. The bill was referred to the Committee. 

On May 17, 2011, Senator Sanders introduced S. 1017, the proposed ‘‘Disabled Veteran Caregiver Housing Assistance Act of 

2011.’’ S. 1017 would increase assistance for disabled veterans who 

are temporarily residing in housing owned by a family member. 

The bill was referred to the Committee. 

On May 25, 2011, Senator Blumenthal introduced S. 1060, the 

proposed ‘‘Honoring All Veterans Act of 2011.’’ S. 1060 would improve education, employment, independent living services, and 

health care for veterans; improve assistance for homeless veterans; 

and improve the administration of VA. The bill was referred to the 

Committee. 

On May 26, 2011, Senator McConnell introduced S. 1089, the 

proposed ‘‘Veterans Health Care Improvement Act of 2011.’’ 

S. 1089 would provide for the introduction of pay-for-performance 

compensation mechanisms into VA contracts with communitybased outpatient clinics (hereinafter, ‘‘CBOCs’’) for the provision of 

health care services. The bill was referred to the Committee. 

On May 26, 2011, Senator Brown of Ohio introduced S. 1123, 

which would improve the provision of benefits and assistance to 

veterans affected by natural or other disasters. The bill was referred to the Committee. 

On May 26, 2011, Senator Conrad introduced S. 1124, the proposed ‘‘Veterans Telemedicine Act of 2011.’’ S. 1124 would improve 

the utilization of teleconsultation, teleretinal imaging, telemedicine, 

and telehealth coordination services for the provision of health care 

to veterans. The bill was referred to the Committee. 

On May 26, 2011, Senator Conrad introduced S. 1127, the proposed ‘‘Veterans Rural Health Improvement Act of 2011.’’ S. 1127 

would establish centers of excellence for rural health research, education, and clinical activities and recognize the rural health reVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00003 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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source centers in the Office of Rural Health (hereinafter, ‘‘ORH’’). 

The bill was referred to the Committee. 

On June 6, 2011, Senator Blumenthal introduced S. 1147, the 

proposed ‘‘Chiropractic Care Available to All Veterans Act of 2011.’’ 

S. 1147 would require the provision of chiropractic care and services to veterans at all VA medical centers and expand access to 

such care and services. Senators Grassley, Harkin, Moran, and 

Whitehouse are original cosponsors of the bill. Senators Murkowski 

and Tester were later added as cosponsors of the bill. The bill was 

referred to the Committee. 

On June 6, 2011, Committee Chairman Murray introduced 

S. 1148, the proposed ‘‘Veterans Programs Improvement Act of 

2011.’’ S. 1148 would improve the provision of assistance to homeless veterans and improve the regulation of fiduciaries who represent individuals for purposes of receiving benefits. The bill was 

referred to the Committee. 

On June 13, 2011, Senator Cantwell introduced S. 1184, which 

would revise the enforcement penalties for misrepresentation of a 

business concern as a small business concern owned and controlled 

by veterans or a small business concern owned and controlled by 

service-disabled veterans. The bill was referred to the Committee. 

On June 8, 2011, the Committee held a hearing on pending legislation. Testimony was offered by: Michael Cardarelli, Principal 

Deputy Under Secretary for Benefits, VA; Robert L. Jesse, MD, 

PhD, Principal Deputy Under Secretary for Health, VA; John 

McWilliam, Deputy Assistant Secretary, Veterans’ Employment 

and Training Service, Department of Labor (hereinafter, ‘‘DOL’’); 

Jeff Steele, Assistant Legislative Director, The American Legion; 

Joseph A. Violante, National Legislative Director, Disabled American Veterans; Raymond Kelley, Director, National Legislative 

Service, Veterans of Foreign Wars of the United States; Jerry 

Ensminger, MSgt USMC (Ret.); and J. David Cox, RN, National 

Secretary-Treasurer, American Federation of Government 

Employees. 

COMMITTEE MEETING

After carefully reviewing the testimony from the foregoing hearing, the Committee met in open session on June 29, 2011, to consider, among other legislation, an amended version of S. 914, consisting of provisions from S. 914 as introduced and provisions from 

the other legislation noted above. The Committee voted, without 

dissent, to report favorably S. 914 as amended. 

SUMMARY OF S. 914 AS REPORTED

S. 914, as reported (hereinafter, ‘‘the Committee bill’’), consists of 

54 sections, summarized below: 

Section 1 would provide a short title and table of contents. 

Section 2 provides that certain references within the bill are references to title 38, U.S.C. 

TITLE I—HEALTH CARE MATTERS

Section 101 would provide VA with the authority to waive collection of copayments for telehealth and telemedicine visits of veterans. 

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Section 102 would provide incentives for VA to further expand 

the use of teleconsultation, teleretinal imaging, and telemedicine. 

Section 103 would clarify that VA may make payments and allowances for beneficiary travel in connection with veterans receiving care from Vet Centers. 

Section 104 would require VA to allow the use of service dogs on 

VA property. 

Section 105 would require VA to add rehabilitative services to individualized care plans for veterans with TBI. 

Section 106 would require VA to establish centers of excellence 

for rural health research, education, and clinical activities and 

would recognize rural health resource centers in ORH. 

Section 107 would require VA to develop a policy to provide 

chiropractic services to veterans enrolled in VA health care system. 

Section 108 would provide reimbursement rates for ambulance 

services. 

Section 109 would provide for increased flexibility in establishing 

payment rates for nursing home care provided by State homes. 

Section 110 would allow VA to disclose certain information about 

a veteran to a State prescription monitoring program. 

Section 111 would require VA to develop a plan for improvements in recovery and collection of amounts for VA’s Medical Care 

Collections Fund (hereinafter, MCCF’’). 

TITLE II—HOMELESS VETERANS MATTERS

Section 201 would enhance VA’s comprehensive service programs. 

Section 202 would modify VA’s grant program for homeless veterans with special needs. 

Section 203 would modify the authority for provision of treatment and rehabilitation to certain veterans to include provision of 

treatment and rehabilitation to homeless veterans who are not seriously mentally ill. 

Section 204 would require VA to submit to Congress a plan to 

end veteran homelessness. 

Section 205 would extend certain authorities relating to homeless 

veterans. 

Section 206 would reauthorize appropriations for the Homeless 

Veterans Reintegration Program (hereinafter, ‘‘HVRP’’). 

Section 207 would reauthorize appropriations for financial assistance for supportive services for very low-income veteran families in 

permanent housing. 

Section 208 would reauthorize appropriations for a grant program for homeless veterans with special needs. 

Section 209 would encourage collaboration in the provision of 

case management services to homeless veterans in the supported 

housing program. 

TITLE III—HOUSING MATTERS

Section 301 would provide a short title. 

Section 302 would extend the period of protections for members 

of the uniformed services relating to mortgages, mortgage foreclosure, and eviction and require a report on those protections. 

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Section 303 would allow occupancy of property by a dependent 

child of a veteran to satisfy the occupancy requirement for VA 

housing loans. 

Section 304 would waive loan fees for individuals with disability 

ratings issued during pre-discharge programs. 

Section 305 would improve assistance for disabled veterans residing in housing owned by a family member. 

Section 306 would expand eligibility for specially adapted housing assistance for veterans with vision impairment. 

Section 307 would revise limitations on assistance furnished for 

acquisition and adaptation of housing for disabled veterans. 

TITLE IV—COMPENSATION AND PENSION

Section 401 would increase the rate of pension for disabled veterans married to another who both require regular aid and attendance (hereinafter, ‘‘A&A’’). 

Section 402 would provide authority for a retroactive effective 

date for awards of disability compensation in connection with applications that are fully developed at submittal. 

Section 403 would modify the month-of-death benefit for surviving spouses of veterans who die while entitled to compensation 

or pension. 

Section 404 would provide an automatic waiver of agency of 

original jurisdiction review of new evidence. 

TITLE V—MEMORIAL, BURIAL, AND CEMETERY MATTERS

Section 501 would prohibit certain disruptions of funerals of 

members or former members of the Armed Forces. 

Section 502 would codify the prohibition against reservation of 

gravesites at ANC. 

Section 503 would expand eligibility for presidential memorial 

certificates to persons who died in the active military, naval, or air 

service. 

TITLE VI—CONSTRUCTION MATTERS

Section 601 would authorize fiscal year (hereinafter, ‘‘FY’’) 2012 

major medical facility projects. 

Section 602 would modify authorization for certain major medical 

facility construction projects previously authorized. 

Section 603 would authorize FY 2012 major medical facility 

leases. 

Section 604 would authorize appropriations for construction and 

leases. 

Section 605 would limit the authority of VA to use bid savings 

on major medical facility projects to expand the purpose of major 

medical facility projects. 

Section 606 would designate the VA Medical Center in Big 

Spring, Texas, as the George H. O’Brien, Jr., Department of Veterans Affairs Medical Center. 

Section 607 would designate the telehealth clinic in Craig, Colorado, as the Major William Edward Adams Department of Veterans 

Affairs Clinic. 

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TITLE VII—OTHER ADMINISTRATIVE AND BENEFITS MATTERS

Section 701 would provide assistance to veterans affected by natural disasters. 

Section 702 would revise the limitation on the aggregate amount 

of educational assistance available to individuals who receive both 

survivors’ and dependents’ educational assistance and other veterans and related educational assistance. 

Section 703 would enhance VA enforcement penalties for misrepresentation of a business concern as a small business concern 

owned and controlled by veterans or as a small business concern 

owned and controlled by service-disabled veterans. 

Section 704 would provide authority for certain persons to sign 

claims filed with VA on behalf of claimants. 

Section 705 would improve the process for filing jointly for Social 

Security and dependency and indemnity compensation. 

Section 706 would provide parity between part-time and full-time 

students under VA employee incentive scholarship program. 

Section 707 would require a report on pay-for-performance compensation under health care services contracts. 

Section 708 would extend the authority to obtain information 

from the Secretary of Treasury and the Commissioner of Social Security for income verification purposes. 

Section 709 would extend the authority for a VA regional office 

in the Republic of the Philippines. 

Section 710 would require a report on establishment of a VA 

PRC or PNS in the northern Rockies or Dakotas. 

Section 711 would modify the loan guaranty fee for certain initial 

loans. 

BACKGROUND AND DISCUSSION

TITLE I—HEATH CARE MATTERS

Sec. 101. Authority to waive collection of copayments for telehealth 

and telemedicine visits of veterans. 

Section 101 of the Committee bill, which is derived from S. 914, 

as introduced, would provide VA with the authority to waive the 

collection of copayments from veterans for telehealth and telemedicine visits. 

Background. For purposes of providing greater access to care and 

reducing the amount of travel required for patients, especially in 

rural areas, VA delivers care through telehealth modalities such as 

telephone consultations, videoconferencing, and use of robotic technology. Telehealth visits can be made from patient homes or community-based outpatient clinics. 

In December 2008, a team led by Adam Darkins, MD, Chief Consultant, Care Coordination, in VA’s Office of Patient Care Services, 

published a study entitled, ‘‘Care Coordination/Home Telehealth: 

The Systematic Implementation of Health Informatics, Home Telehealth, and Disease Management to Support the Care of Veteran 

Patients with Chronic Conditions.’’ That study found that VA patients using home telehealth experienced a 19-percent reduction in 

hospital admissions and a 25-percent reduction in the number of 

days patients were required to be cared for in bed. The reduction 

in bed days of care has since declined by 30 percent for those utiVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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lizing home telehealth, according to routine outcomes data from 

VA’s Office of Telehealth Services from FY 2009 through FY 2010. 

Further, according to an October 2010 article, ‘‘Telehealth in the 

VA: Telehealth Continues to Make Its Mark,’’ by Dr. Darkins, patient satisfaction levels associated with home telehealth exceeded 

85 percent, and they exceeded 90 percent for use of store-and-forward technology. 

A RAND Corporation study, ‘‘Health Insurance and the Demand 

for Medical Care: Evidence from a Randomized Experiment,’’ found 

that copayment rates were highly influential in whether enrollees 

sought medical care. Under current law, section 1710 of title 38, 

U.S.C., VA charges full copayments for care delivered through telehealth technologies. Certain VA patients may be charged 15 dollars 

for primary care telehealth visits and 50 dollars for specialty care 

telehealth visits. 

In views submitted for the Committee’s June 8 hearing on pending legislation, VA agreed that, in the Department’s experience, copayments may have served as a disincentive for veterans to utilize 

this mode of treatment. VA further indicated that it is planning to 

waive copayments for veterans’ use of in-home video telehealth. 

Committee Bill. Section 101 of the Committee bill would amend 

subchapter III of chapter 17 of title 38, U.S.C., by adding a new 

section 1722B. The new section would authorize VA to waive collections of copayments from veterans for the utilization of telehealth 

or telemedicine. 

The Committee expects that, as indicated by the RAND study 

and VA data, waiving the collection of copayments from veterans 

for telehealth and telemedicine visits would increase utilization of 

telehealth and telemedicine services by veterans and would provide 

cost savings to the Department. 

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

Section 102 of the Committee bill, which is derived from S. 1124, 

would require VA to implement a program of teleconsultation for 

the assessment of mental health and TBI at facilities that are unable to provide such assessments without utilizing contract or feebasis care, require VA to implement incentives for Department 

medical centers to further expand use of telehealth technologies, 

assess the efficacy of such incentives, and offer telemedicine training for medical residents. 

Background. Telehealth is a form of clinical medicine where medical information is transferred via telephone, the Internet, or other 

networks for the purpose of monitoring health status, providing 

health education, consulting, and sometimes providing remote medical procedures or health examinations. Telehealth can take place 

in various situations—between providers and patients located in 

separate clinical settings, as well as with patients in their homes. 

Telehealth technology at veterans’ health care facilities allows patients in remote rural areas to consult with medical specialists 

through this technology. This option can provide such veterans 

with access to care without having to drive long distances to reach 

a specialist. 

Tele-mental health services refer to behavioral health services 

that are provided using communication technology. These services 

include clinical assessment, individual and group psychotherapy, 

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psycho-educational interventions, cognitive testing, and general 

psychiatry. The term tele-mental health describes a method of 

treatment in which a clinician uses various technologies to deliver 

mental health care to a patient who is at a different location. One 

major benefit of tele-mental health is that it eliminates travel that 

may be disruptive to or costly for the veteran. In addition, telemental health is a useful tool in correctional and forensic settings 

where it is difficult to transport the patient to a clinician. Telemental health also allows mental health care providers to consult 

with or supervise one another. 

According to Dr. Darkins, the benefits of telehealth to VA are improved access to specialty care, especially in rural areas, reductions 

in travel for patients and staff, better utilization of scarce health 

care resources, and improved coordination of care. 

Additionally, VA data released in December 2010 show that, of 

the Operation Enduring Freedom and Operation Iraqi Freedom 

(hereinafter, ‘‘OEF/OIF’’) veterans who have accessed VA health 

care services, 45,606 have been diagnosed with TBI-related conditions at VA medical facilities. With approximately 41 percent of enrolled veterans living in rural or highly rural areas, the Department faces a substantial need for increased telehealth and telemedicine in order to improve access to care. 

Committee Bill. Section 102 of the Committee bill would amend 

subchapter I of chapter 17 of title 38, U.S.C., by adding a new section 1709, which would require VA to provide mental health and 

TBI assessments through teleconsultation when necessary. Section 

102 of the Committee bill would further require VA to implement 

incentives for Department medical centers to further expand use of 

telehealth technologies, assess the efficacy of such incentives, and 

offer telemedicine training for medical residents. 

Subsection (a) of new section 1709 would require VA to carry out 

a teleconsultation program of remote mental health and TBI assessments in VA facilities that are unable to provide such assessments without utilizing contract or fee-basis care. New subsection 

(a) would also require VA to promulgate technical and clinical care 

standards for teleconsultation service in consultation with the appropriate professional societies. 

Section 102(b) of the Committee bill would require VA to offer 

opportunities for training in telemedicine to medical residents in 

facilities that have and utilize telemedicine, consistent with medical residency program standards established by the Accreditation 

Council for Graduate Medical Education. 

Section 102(c) of the Committee bill would require VA to modify 

the Veterans Equitable Resource Allocation (hereinafter, ‘‘VERA’’) 

system to include teleconsultation, teleretinal imaging, telemedicine, and telehealth coordination services. VA would also be required to assess, within one year of modifying the VERA system, 

the effect on the utilization of telehealth technologies and determine whether additional incentives are necessary to promote their 

utilization. VA would also be required to include telemedicine visits 

when calculating facility workload. 

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

Section 103 of the Committee bill, which is derived from S. 696, 

would clarify that VA is authorized to offer travel benefits to veterans receiving care at Vet Centers. It would provide for a one-year 

authorization of travel benefits to veterans receiving care at Vet 

Centers while VA completes a review of the feasibility and advisability of providing this benefit. 

Background. Vet Centers provide readjustment counseling and 

other needed services to combat veterans, to certain surviving family members of servicemembers who die in the line of duty, and to 

active duty servicemembers. Vet Centers provide these services at 

a cost savings to the Department. According to VA, it costs an average of $613 per veteran for treatment at a Vet Center, while it 

costs $4,129 per veteran for care at a VA medical center (hereinafter ‘‘VAMC’’). According to VA data published in April 2011, 300 

Vet Centers served 352,272 veterans from the first quarter of FY 

2002 through the first quarter of FY 2011. 

According to testimony submitted by the Department for the 

June 8 hearing on pending legislation, VA has begun a study to determine the potential efficacy and impacts of providing travel benefits to veterans who use Vet Centers. 

Committee Bill. Section 103 of the Committee bill would, in a 

freestanding provision, clarify that the Department is authorized to 

pay travel benefits to veterans receiving care at Vet Centers pursuant to existing authority under section 111(a) of title 38, U.S.C. It 

would also require VA to submit a report to Congress, no later than 

one year after the enactment of the Committee bill, on the feasibility and advisability of paying travel benefits to veterans receiving care at Vet Centers. Finally, this section of the Committee bill 

would authorize such sums as may be necessary to be appropriated 

for the Department to pay such expenses and allowances for the 

one-year period following the enactment of the Committee bill. 

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

Section 104 of the Committee bill, which is derived from S. 769, 

would require VA to admit service dogs into any Department 

owned or funded facility or property. 

Background. Section 1714(c) of title 38, U.S.C., authorizes VA to 

provide service dogs to veterans who are hearing impaired, veterans with spinal cord injury or dysfunction or other chronic impairment that substantially limits mobility, and veterans with 

mental illnesses, including post-traumatic stress disorder (hereinafter, ‘‘PTSD’’). 

On March 10, 2011, with the issuance of Veterans Health Administration (hereinafter, ‘‘VHA’’) Directive 2011–013, the Department 

authorized both veterans and members of the public with disabilities that require the assistance of a trained guide dog or trained 

service dog to enter VHA facilities and property accompanied by 

their trained guide dog or trained service dog, consistent with the 

same terms and conditions, and subject to the same regulations 

that govern the admission of members of the public to the property. 

According to the Department’s proposed rule, RIN 2900-AN51 

posted June 16, 2011, the Department will recognize dogs acquired 

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through organizations that provide service dogs and are accredited 

by Assistance Dogs International or International Guide Dog Federation and will only accept dogs trained by such accredited organizations for the service dog program. 

Committee Bill. Section 104 of the Committee bill would amend 

section 1714 of title 38, U.S.C., by adding a new subsection (e), 

which would require VA to grant full access to all service animals 

accompanying individuals at every VA facility according to the 

same regulations that govern the admission of the public to such 

facilities. The provision would apply not only to service dogs as provided for in section 1714(c) of title 38, U.S.C., but would also include trained service animals that accompany individuals with disabilities not specified by that subsection. Further, VA would be authorized to prohibit service animals from roaming or running free 

and to require the animals to wear harnesses or leashes and be 

under the control of an individual at all times while at a Department owned or funded facility. 

Sec. 105. Rehabilitative services for veterans with traumatic brain 

injury. 

Section 105 of the Committee bill, which is derived from S. 957, 

would amend section 1710C of title 38, U.S.C., by expanding individualized rehabilitation and reintegration plans required by such 

section to include services designed to maintain levels of functioning in care for veterans with TBI. 

Background. TBI has become a common injury of the conflicts in 

Iraq and Afghanistan. Because of advances in medicine, servicemembers who would not have been expected to survive catastrophic 

injuries in previous conflicts return home from combat in Iraq and 

Afghanistan with unprecedented severe and complex injuries. The 

Department indicated in December 2010 that 45,606 OEF/OIF veterans have accessed VA health care services and have been diagnosed with TBI-related conditions at VA medical facilities as of FY 

2010. According to the Defense and Veterans Brain Injury Center, 

between 2000 and the first quarter of 2011, 212,742 cases of TBI 

were diagnosed. Many of these servicemembers require rehabilitative programs ranging from total care for the most basic needs to 

semi-independent living support. 

In addition to medical care, veterans with TBI may require additional services such as life-skills coaching, supported employment, 

and community reintegration therapy. Yet these services are not 

sufficiently made available to veterans. In testimony before the 

Committee on June 8, 2011, Jeff Steele, Assistant Director of The 

American Legion’s National Legislative Commission, stated that 

the proposed section would ‘‘close gaps in both the duration and 

types of services provided to our wounded servicemembers who 

have sustained what are often profoundly debilitating traumatic 

brain injuries.’’ 

Committee Bill. Subsection (a) of section 105 of the Committee 

bill would amend section 1710C of title 38, U.S.C., by requiring VA 

to add rehabilitative services to the individualized rehabilitation 

and reintegration plans for care for veterans with TBI. 

Subsection (a) would further amend section 1710C of title 38, 

U.S.C., by adding a new subsection (h) that would define rehabilitative services as including the definition of such term as provided 

12 

for in section 1701 of title 38, U.S.C. (‘‘professional, counseling and 

guidance services and treatment programs as are necessary to restore, to the maximum extent possible, the physical, mental, and 

psychological functioning of an ill or disabled person’’), treatment 

and services to sustain functional gains, or other services that may 

maximize an individual’s independence. 

Subsection (b) of section 105 of the Committee bill would amend 

section 1710D(a) of title 38, U.S.C., by requiring VA to include rehabilitative services in the comprehensive program for long-term 

rehabilitation of individuals with TBI. 

Subsection (c) of section 105 of the Committee bill would amend 

section 1710E(a) of title 38, U.S.C., by including rehabilitative services in the categories of services VA is authorized to provide to individuals with TBI through cooperative agreements for use of nonDepartment rehabilitation facilities. 

Subsection (d) of section 105 of the Committee bill would make 

a technical amendment to section 1710C(c)(2)(S). 

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

and clinical activities. 

Section 106 of the Committee bill, which is derived from S. 1127, 

would require VA, acting through the Director of ORH, to establish 

and operate centers of excellence for rural health research, education, and clinical activities. 

Background. According to VA data, 3.3 million veterans, who represent approximately 41 percent of the total population enrolled in 

VA’s health care system, live in rural or highly rural areas. Insufficient access to care has been a particular problem for those in rural 

areas. A lack of providers, especially specialty care providers, long 

drive times, and other factors combine to present significant obstacles to accessing health care for rural veterans. Public Law 109– 

461, the Veterans Benefits, Health Care, and Information Technology Act of 2006, established ORH to address these issues. 

As part of the effort to improve care for rural veterans, in 2008, 

VA awarded a grant to the Fargo, North Dakota, VAMC and the 

Center for Rural Health at the University of North Dakota School 

of Medicine and Health Sciences to establish a multi-state Rural 

Health Resource Center. The Rural Health Resource Center is intended to help advance policies and strategies to improve access to 

care in rural areas. 

Committee Bill. Subsection (a) of section 106 of the Committee 

bill would amend subchapter II of chapter 73 of title 38, U.S.C., to 

create a new section 7330B. Subsection (a) of this new section 

would require VA, acting through the Director of ORH, to create 

centers of excellence for rural health, education, and clinical activities. Subsection (b) of new section 7330B would require these centers to perform one or more of the following functions: collaborate 

with the VHA Office of Research and Development (hereinafter, 

‘‘ORD’’) on rural health research; develop specific models for the 

Department to furnish care to rural veterans; develop innovative 

clinical activities and systems of care for rural veterans; and provide education and training on rural health issues for health care 

professionals. Subsection (c) of new section 7330B would authorize 

VA to designate an existing ORH rural health resource center as 

a center of excellence if it engages in one or more of the activities 

13 

described in new subsection (b). Subsection (d) of new section 

7330B would require that centers of excellence be eligible to compete for the awarding of funds from the Medical and Prosthetic Research Account. 

Subsection (b) of section 106 of the Committee bill would amend 

section 7308 of title 38, U.S.C., by adding a new subsection (d) to 

codify the existence and describe the purposes of rural health resource centers. Rural health resource centers would be required to 

improve the ORH’s understanding of challenges faced by rural veterans, identify disparities in the availability of health care to rural 

veterans, create programs to enhance the delivery of health care to 

rural veterans, and develop best practices and products for the Department to use in providing services to rural veterans. 

Subsection (c) of section 106 of the Committee bill would designate the VAMC in Fargo, North Dakota, as a center of excellence 

for rural health research, education, and clinical activities. 

Sec. 107. Provision of chiropractic services to veterans enrolled in 

health care system of Department of Veterans Affairs. 

Section 107 of the Committee bill, which is derived from S. 1147, 

would require VA to develop and implement a comprehensive policy 

on the provision of chiropractic services. 

Background. Pursuant to Public Law 107–135, the Department 

of Veterans Affairs Health Care Programs Enhancement Act of 

2001, VA carries out a program to provide chiropractic services to 

veterans through VAMCs and CBOCs. VA is required to designate 

at least one site in each Veterans Integrated Service Network 

(hereinafter, ‘‘VISN’’) to offer chiropractic services. As of June 2011, 

36 VAMCs and CBOCs provide chiropractic services. 

According to data published by the Department in April 2011, 

more than 54 percent of OEF/OIF veterans who sought health care 

from the Department over the period of the first quarter of FY 

2002 through the first quarter of FY 2011 were treated for musculoskeletal ailments. Chiropractic therapy can assist with some of 

these types of ailments and injuries. 

Committee Bill. Section 107 of the Committee bill would, in a 

freestanding provision, require VA to develop and implement a 

comprehensive policy on the provision of chiropractic services by 

June 1, 2012. 

Subsection (a) of section 107 of the Committee bill would require 

the scope of this policy to include: Department-wide protocols governing referrals and direct access to chiropractic services and governing the scope of practice of chiropractic providers; the definition 

of chiropractic services to be provided; the assurance of prompt and 

appropriate chiropractic services by VA when medically appropriate; Department programs of education and training of health 

care personnel on the benefits of chiropractic services; and Department programs of patient education for veterans suffering from 

back pain and related disorders. VA would also be required, in consultation with veterans service organizations (hereinafter, ‘‘VSOs’’) 

and other relevant organizations with expertise in chiropractic 

services, to develop and periodically revise such policy, in accordance with experience and evolving best practice guidelines. 

Subsection (b) of section 107 of the Committee bill would require 

VA to carry out the policy on chiropractic services at no less than 

14 

two locations in each VISN and in locations deemed appropriate 

with respect to demand for chiropractic services. 

Subsection (c) of section 107 of the Committee bill would require 

VA to submit a report on the implementation of the chiropractic 

services policy not later than 180 days after the completion and initial implementation of such policy, and on October 1 of every fiscal 

year thereafter until FY 2020, to the Committees on Veterans’ Affairs of the Senate and the House of Representatives. The report 

would be required to include a description of the policy, the performance measures used to determine the effectiveness of such policy, an assessment of the adequacy of VA chiropractic services 

based on patient surveys, an assessment of the training provided 

to VA health care personnel with respect to chiropractic services 

and appropriateness of referrals of patients for such services, an 

assessment of patient pain care education programs, and the number of episodes of chiropractic services provided, including through 

referrals to non-VA providers in the preceding fiscal year by facility. 

Sec. 108. Reimbursement rate for ambulance services. 

Section 108 of the Committee bill, which is derived from by-request legislation submitted by the Department, would authorize VA 

to pay the lesser of the actual amount charged by an ambulance 

provider or the applicable amount in the Medicare fee schedule for 

ambulance services, unless VA has entered into a contract for such 

transportation with the provider. 

Background. Under current law, section 111 of title 38, U.S.C., 

VA is authorized to reimburse certain veterans for their transportation by ambulance to and from VA medical facilities based on the 

‘‘actual necessary expense.’’ As a result, the Department pays significantly more than Medicare does for ambulance services. 

Committee Bill. Section 108 of the Committee bill would amend 

section 111(b)(3) of title 38, U.S.C., by adding a new subparagraph 

(C), which would authorize the Department to pay the lesser of the 

actual amount charged by the ambulance provider or the applicable 

amount in the Medicare fee schedule for ambulance services, unless 

VA has entered into a contract for such transportation with the 

provider. It is the Committee’s expectation that the Department 

would realize cost savings by utilizing the authority of this provision. 

Sec. 109. Increased flexibility in establishing payment rates for 

nursing home care provided by State homes. 

Section 109 of the Committee bill, which is derived from by-request legislation submitted by the Department, would modify the 

payment methodology for State veterans homes by requiring the 

Department to enter into contracts or agreements with State veterans homes for payment for nursing home care of veterans. 

Background. Public Law 109–461, the Veterans Benefits, Health 

Care, and Information Technology Act of 2006, provided for new 

payment mechanisms between VA and State veterans homes. 

When fully implemented with Department regulations in 2009, the 

legislation had the consequence of causing significantly lower total 

amounts to be paid to many State veterans homes providing skilled 

nursing care to veterans with service-connected disabilities. State 

15 

veterans homes are currently being paid less than what Medicare 

previously paid and less than the Department payment rate for 

providing the same care directly to the same veterans. As a result, 

many State veterans homes are not sufficiently compensated for 

their total cost of skilled nursing care for veterans with service-connected disabilities. 

The National Association of State Veterans Homes (hereinafter, 

‘‘NASVH’’), whose members operate 142 State veterans homes with 

over 29,000 beds in all 50 states and Puerto Rico, submitted a 

statement to the Committee on June 22, 2011. The NASVH statement asserts that, without the proposed section, current law will 

hinder the long-term care of veterans with service-connected disabilities, as well as endanger the financial welfare of many State 

veterans homes. Further, NASVH data show that State veterans 

homes provide long-term care for more than 50 percent of VA’s 

long-term care patients at a cost that is equal to approximately 12 

percent of VA’s long-term care budget. This is due to the fact that 

the cost of providing long-term care for a veteran at a State veterans home is, on average, less than half of the cost of providing 

care at a VA long-term care facility. 

In an explanatory analysis submitted by the Department to accompany its submission for its by-request legislation, VA states 

that it believes moving to a contract- or provider agreement-based 

model will afford the most flexibility and fairness in negotiations 

between VA and State veterans homes and will ensure that State 

veterans homes are paid adequately and according to the complexity and severity of each veteran’s condition. This approach 

would replace the current per diem grant payments for these veterans, which, according to VA, have been controversial since first 

implemented in 2009. 

Committee Bill. Section 109 of the Committee bill would amend 

section 1745(a) of title 38, U.S.C., by requiring VA to enter into 

contracts or provider agreements with State veterans homes for the 

purpose of providing nursing home care in these homes to veterans. 

Payment under the contract or provider agreement would be required to be based on a methodology developed in consultation with 

the State veterans home and to adequately reimburse the home for 

the care provided. This section would become effective on January 

1, 2012. 

Sec. 110. Access to State prescription monitoring programs. 

Section 110 of the Committee bill, which is derived from S. 1060 

and a similar provision that was submitted by the Department as 

a component of by-request legislation, would authorize VA, to the 

extent necessary to prevent misuse and diversion of prescription 

medicines, to disclose information about a veteran or the dependent 

of a veteran to a State controlled substance monitoring program. 

Background. Programs that permit sharing of prescription drug 

information with State prescription monitoring programs have been 

used to reduce abuse, misuse, or illegal diversion of controlled substances by patients seeing multiple providers or using multiple 

pharmacies. While there is no standardized structure in prescription monitoring programs, in general, such programs include an 

electronic database, operated by a State government entity, which 

allows medical providers, law enforcement personnel, pharmacists, 

16 

and other individuals who require access to such information for official purposes to access the database and contribute information to 

it. 

According to the White House Office of National Drug Control 

Policy (hereinafter, ‘‘ONDCP’’), one of the major ways to reduce 

prescription drug abuse is through monitoring. ONDCP is working 

to implement prescription drug monitoring programs in every State 

and enhance such programs to ensure they can share data between 

States and that they are used by health care providers. Prescription monitoring programs have been authorized by legislation in 48 

States, with 34 of these States maintaining operational programs. 

Committee Bill. Subsection (a) of section 110 of the Committee 

bill would amend section 5701 of title 38, U.S.C., by adding a new 

subsection (l) that would authorize VA, to the extent necessary to 

prevent misuse and diversion of prescription medicines, to disclose 

information from certain claims records about a veteran or a dependent of a veteran to a State controlled substance monitoring 

program. 

Subsection (b) of section 110 of the Committee bill would amend 

section 7332(b)(2) of title 38, U.S.C., by adding a new subparagraph 

(G), to authorize VA to share prescription drug data on controlled 

substances with State prescription monitoring programs. This subsection would authorize the Department, to the extent necessary to 

prevent misuse and diversion of prescription medicines, to disclose 

information from certain medical records about a veteran or a dependent of a veteran to a State controlled substance monitoring 

program. 

Sec. 111. Improvements for recovery and collection of amounts for 

Department of Veterans Affairs Medical Care Collections Fund. 

Section 111 of the Committee bill, which is an original provision, 

would require VA to develop and implement a better process and 

system of controls to ensure accurate and full collections by the VA 

health care system, pursuant to existing authorities for billing and 

collections. 

Background. VHA utilizes fee-basis care to augment availability 

of health care for services they are unable, or it would be inefficient, to provide using Department facilities and providers. 

According to a VA Office of Inspector General (hereinafter, 

‘‘OIG’’) report entitled, ‘‘Veterans Health Administration Audit of 

Medical Care Collection Fund Billings for Non-VA Care’’ published 

May 25, 2011, VHA failed to bill third-party insurers for 46 percent 

of billable fee care claims. OIG identified a lack of an effective procedure for identifying billable care as the prime reason for this 

shortcoming. 

In two of the VA medical facilities OIG reviewed, staff did not 

regularly review claims to identify billable fee care and, consequently, these locations did not identify 140, or 93 percent, of the 

150 billable fee claims OIG reviewed. 

VA is currently transitioning all medical center billing to regional centers known as Consolidated Patient Account Centers 

(hereinafter, ‘‘CPACs’’). According to OIG’s review, CPACs were no 

more successful in identifying billable fee claims than were medical 

facilities that have not yet begun to utilize a CPAC. 

17 

By creating effective processes and tools for identifying billable 

fee claims, OIG estimates that VHA could increase collections by 

approximately $110.4 million each year, or $552 million over the 

next five years. 

Committee Bill. Subsection (a) of section 111 of the Committee 

bill would, in a freestanding provision, require VA to develop and 

implement, within 180 days of enactment of the Committee bill, a 

plan to ensure the identification and collection of billable thirdparty revenue to be deposited in the MCCF. This provision would 

require the following elements to be included in the plan: an effective process to identify billable fee claims, effective and practicable 

policies and procedures to ensure billing and collection using current authorities, training of employees responsible for billing or collection of funds to enable them to comply with the provisions of 

this section, fee revenue goals for the Department, and an effective 

monitoring system to ensure the Department meets fee revenue 

goals and complies with such policies and procedures. 

Subsection (b) of section 111 of the Committee bill would require 

VA to monitor the billing and collection of funds from third parties 

for deposit into the MCCF. 

TITLE II—HOMELESS VETERANS MATTERS

Sec. 201. Enhancement of comprehensive service programs. 

Section 201 of the Committee bill, which is derived from S. 1148, 

would enhance VA’s homeless veterans’ comprehensive service programs by broadening the pool of potential applicants and making 

other changes designed to improve the overall program. 

Background. Public Law 102–590, the Homeless Veterans Comprehensive Service Programs Act of 1992, established VA’s Homeless Providers Grant and Per Diem Program (hereinafter, ‘‘GPD’’). 

The grant program was intended to assist public and nonprofit private entities with the costs associated with establishing new programs and service centers to furnish supportive services and housing for homeless veterans through grants that may be used to acquire, renovate, or alter facilities. The grant program also allows 

funds to be used to procure vans to conduct outreach to, or provide 

transportation for, homeless veterans. The per diem program was 

intended to provide per diem payments, or in-kind assistance in 

lieu of per diem payments, to assist eligible entities that established programs after November 10, 1992, with the daily costs associated with providing supportive services and housing for homeless 

veterans. 

Section 2011 of title 38, U.S.C., sets forth the authority, criteria, 

and requirements for VA’s grant program. The law requires VA to 

establish criteria and requirements for grants awarded under this 

section. Eligible entities for these grants are restricted to public or 

nonprofit private entities with the capacity to administer the grant 

effectively. An eligible entity must demonstrate that adequate financial support will be available to carry out the project for which 

the grant is sought consistent with the plans, specifications, and 

schedule submitted by the applicant. An eligible entity must also 

agree to meet, as well as have the capacity to meet, the applicable 

criteria and requirements established by VA. Currently, the specifications as to the kinds of projects for which the grants are availVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00017 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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able do not include new construction of facilities. In addition, the 

grants may not be used to support operational costs and the 

amount of the grant may not exceed 65 percent of the estimated 

cost of the project concerned. 

Section 2012 of title 38, U.S.C., sets forth the authority, criteria, 

and requirements for VA’s per diem program. The law requires VA 

to provide to recipients of grants under section 2011 of title 38 per 

diem payments for services furnished to any homeless veteran 

whom VA has referred to the grant recipient or for whom VA has 

authorized the provision of services. The per diem rate is defined 

as the estimated daily cost of care, not in excess of the per diem 

rate for VA’s State Home Per Diem Program. 

While GPD has proven to be a vital part of VA’s services for 

homeless veterans, funding challenges remain. VA’s Advisory Committee on Homeless Veterans (hereinafter, ‘‘ACHV’’), which provides advice and makes recommendations to the Department on 

the provision of benefits and services to homeless veterans, stated 

in its 2010 Annual Report that ‘‘the current system underfunds 

many providers, particularly those in high cost areas and those 

that offer intensive services to veterans with complex issues.’’ 

Challenges have also been identified regarding GPD’s payment 

process and reporting requirements. The National Coalition for 

Homeless Veterans (hereinafter, ‘‘NCHV’’) recommended that ‘‘[a] 

revised payment process would greatly benefit GPD grantees, the 

majority of which are modest community-based organizations.’’ According to the NCHV, grantees should be paid for the annual cost 

of providing services as opposed to a per diem rate. The NCHV argues that grantees should be allowed to draw from these funds in 

anticipation of contractual activities. Currently, grantees must pay 

for services they provide up front and are later reimbursed. 

Committee Bill. Section 201 of the Committee bill would amend 

subchapter II of chapter 20 of title 38, U.S.C., to make a number 

of improvements. It would amend section 2011(b)(1)(A), the provision that sets forth the criteria for grants, to include new construction of facilities as a type of program for which such grants could 

be awarded. It would amend section 2011(c), the provision that sets 

forth funding limitations on grantees, so as to specify that VA may 

not deny an application from an entity under this program solely 

on the basis that the entity proposes to use other funding sources, 

as long as such entity has a private nonprofit organization providing oversight and site control over the project. In connection 

with this change, the Committee bill would add a definition of a 

‘‘private nonprofit organization.’’ It is the Committee’s expectation 

that these changes will modernize GPD to allow for the utilization 

of innovative project funding strategies, including the use of lowincome housing tax credits and matching funds from other government sources to facilitate and hasten project development. 

With respect to the issue of the per diem payments, section 

201(b) of the Committee bill, in a freestanding provision, would require VA to study the method of compensating GPD community 

providers for their program expenses, including the adequacy of the 

reimbursement system, the adequacy of compensation in various 

geographic areas and for services of varying intensity levels, and 

the process by which grant recipients account for funds. 

19 

The Committee bill would require VA to report to Congress, 

within 1 year of this bill’s enactment, its findings with respect to 

the study undertaken and the procedures it has devised for more 

effective and efficient procedures for fiscal control and fund accounting by recipients of grants under sections 2011, 2012, and 

2061 of title 38. VA would also be required to report to Congress 

on a more effective and efficient method for adequately reimbursing recipients of grants under section 2011 of title 38. Finally, the 

report would include any recommendations by VA for revising the 

method used to compensate recipients of per diem grants under 

section 2012(a). 

This section of the Committee bill would ensure that VA will 

evaluate the effectiveness of its methods of payment and reimbursement and examine to whom reimbursements are made. Such 

a review is consistent with the Committee’s belief that the longterm success of GPD requires flexibility and improvement to the 

program. 

The Committee bill would amend section 2013 of title 38, U.S.C., 

by authorizing the following appropriations: (1) $150,000,000 for 

each of FYs 2007 through 2009; (2) $175,100,000 for FY 2010; (3) 

$217,700,000 for FY 2011; (4) $250,000,000 for FY 2012; and (5) 

$150,000,000 for FY 2013 and each fiscal year thereafter. 

The Committee has heard from providers who have the capacity 

to allow veterans to transition in place and believe that VA could 

achieve better results for more homeless veterans by increasing 

flexibility to fund this model. These providers are of the opinion 

that allowing veterans to transition in place by offering temporary 

rental assistance with case management may be less disruptive for 

some homeless veterans, allowing them to live in regular rental 

housing in the community while transitioning into self-sufficiency 

with the help of case management, employment programs, and 

other services. It is the Committee’s intent to increase flexibility in 

VA’s existing funding model to allow for more efficient delivery of 

transitional housing services to homeless veterans. 

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

special needs. 

Section 202 of the Committee bill, which is derived from S. 1148, 

would modify the grant program for homeless veterans with special 

needs. 

Background. Under section 2061 of title 38, U.S.C., VA operates 

a program of grants to encourage development of programs for 

homeless veterans with special needs. Section 2061(a) provides that 

these special needs grants may only be awarded to VA health care 

facilities and to providers receiving grant and per diem payments 

under VA’s GPD Program. Section 2061(b) defines homeless veterans with special needs as: (1) women, including women who have 

care of minor dependents; (2) frail elderly; (3) terminally ill; or (4) 

chronically mentally ill. 

The Committee has heard from organizations, such as the Vietnam Veterans of America, who are of the opinion that it is important to ensure that the program be expanded to include men who 

have care of minor dependents. 

Committee Bill. Subsection (a) of section 202 of the Committee 

bill would amend section 2061(a) of title 38, U.S.C., to expand the 

20 

pool of eligible providers who may receive VA grants for programs 

to assist homeless veterans with special needs to those entities eligible to receive grant and per diem payments, but who may not be 

doing so. Thus, these grants would no longer be limited to existing 

VA health care facilities and current grant and per diem providers, 

but will allow those eligible for but not in receipt of grant and per 

diem payments to apply to the grant program for homeless veterans with special needs. 

Subsection (b) of section 202 of the Committee bill would amend 

section 2061(b) of title 38 to expand the definition of homeless veterans with special needs to include veterans who have care of 

minor dependents, regardless of gender. 

Subsection (c) of section 202 of the Committee bill would amend 

section 2061 of title 38 to allow grantees to provide services directly 

to any dependent who is under the care of a homeless veteran with 

special needs while the veteran receives services from the grant recipient. 

Sec. 203. Modification of authority for provision of treatment and 

rehabilitation to certain veterans to include provision of treatment and rehabilitation to homeless veterans who are not seriously mentally ill. 

Section 203 of the Committee bill, which is derived from S. 1148, 

would expand VA’s authority to provide treatment and rehabilitation services to certain veterans who are homeless but not seriously 

mentally ill. 

Background. Section 2031 of title 38, U.S.C., authorizes VA to 

provide outreach services, care, treatment, rehabilitative services, 

and certain other assistance to veterans suffering from serious 

mental illness, including such veterans who are also homeless. A 

significant number of veterans are homeless for reasons other than 

mental illness. In February 2011, the Department of Housing and 

Urban Development (hereinafter, ‘‘HUD’’) and VA jointly released 

a report entitled, ‘‘Veterans Homelessness: A Supplemental Report 

to the 2009 Annual Homeless Assessment Report to Congress,’’ 

which cites several risk factors that can lead to homelessness 

among veterans, including but not limited to, age, race, psychiatric 

illness, economic status prior to entry in the military, combat exposure, wartime trauma, social isolation, pre-military traumas, unemployment, and poor health. 

Committee Bill. Section 203 of the Committee bill would amend 

section 2031(a) of title 38 to expand VA’s authority to provide outreach services, care, treatment, rehabilitative services, and certain 

other assistance to veterans suffering from serious mental illness 

and to veterans who are homeless. This section would allow VA to 

treat a homeless veteran under section 2031 even if that veteran 

does not suffer from a serious mental illness. The Committee believes that removing this unnecessary limitation will allow VA to 

better serve homeless veterans. 

Sec. 204. Plan to end veteran homelessness. 

Section 204, which is derived from S. 1148, would require VA to 

submit to Congress a comprehensive plan to end homelessness 

among veterans. 

21 

Background. Against a backdrop of an estimated 136,000 veterans who experienced homelessness in FY 2009, VA developed a 

‘‘Five Year Plan to End Homelessness Among Veterans’’ (hereinafter, ‘‘5-Year Plan’’). The six strategic pillars of the plan are: (1) 

outreach and education; (2) treatment; (3) prevention; (4) housing 

and supportive services; (5) income, employment, and benefits; and 

(6) community partnerships. While the plan lacked specific annual 

goals, timelines, and benchmarks, VA noted that performance 

metrics will include the number of veterans identified as homeless 

or at risk of being homeless and the number of these veterans who 

transition into stable housing situations, based on VA’s assistance. 

As a part of VA’s plan to end homelessness, each medical center 

has been charged with working with the community to create a 5- 

year plan to end veteran homelessness. The 2010 Annual Report of 

the ACHV noted that ‘‘there has been much made of local efforts 

however without a stronger national plan the effort may be 

unsustainable.’’ 

In 2010, VA participated in the Federal Strategic Plan to Prevent 

and End Homelessness. The plan is a roadmap for joint action by 

the 19-member United States Interagency Council on Homelessness, of which the Department is a member. It focuses on four key 

goals: (1) finish the job of ending chronic homelessness in 5 years; 

(2) prevent and end homelessness among veterans in 5 years; (3) 

prevent and end homelessness for families, youth, and children in 

10 years; and (4) set a path to ending all types of homelessness. 

Like the VA plan, this plan lacks specific annual goals, timelines, 

and benchmarks, but states that they will measure progress based 

on annual changes in the number of veterans experiencing 

homelessness. 

Committee Bill. Section 204 would, in a freestanding provision, 

build upon the existing 5-Year Plan and the Federal Strategic Plan 

to Prevent and End Homelessness by requiring VA to submit to 

Congress a comprehensive plan to end homelessness among veterans. The Committee believes that, in order to sustain efforts to 

end homelessness among veterans we must have strong leadership 

at the Federal level to guide strong collaborations at the local level. 

The plan required under this section would include an analysis 

of VA and Federal government programs designed to prevent 

homelessness among veterans and assist veterans who are homeless. The plan would also include an evaluation of whether and 

how coordination between VA and other Federal government departments and agencies would contribute to ending homelessness 

among veterans. The plan would include recommendations for improving VA and Federal government homelessness programs, enhancing coordination of such programs, and eliminating programs 

that are no longer effective. Recommendations for new programs to 

prevent and end homelessness among veterans, including the cost 

of such programs, would also be included. A timeline for implementing the plan, including milestones to track implementation 

and benchmarks to measure outcomes and effectiveness, would be 

required. Finally, the report would include consideration of the circumstances and requirements that are unique to veterans located 

in rural areas. 

While VA has made important and meaningful progress through 

its 5-Year Plan and through its participation in the Federal StraVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00021 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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tegic Plan to Prevent and End Homelessness, the Committee believes that a comprehensive plan is necessary for several reasons. 

It would ensure that VA performs a comprehensive analysis of the 

existing Federal government plans, programs and services designed 

to end veteran homelessness in order to avoid duplication of programs or services. VA would also be required to set forth measurable goals and benchmarks for its comprehensive plan and a 

timeline for implementation. It would also help ensure that VA 

programs and services for homeless veterans are implemented consistently nationwide. Finally, it would allow Congress to ensure 

that adequate resources can be provided in order to achieve this 

mutual goal. 

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

Section 205, which is derived from S. 1148, would extend VA’s 

authority for certain outreach, treatment, services, and programs to 

veterans with serious mental illnesses and to homeless veterans 

and their families. 

Background. While there is no exact measure of the number of 

homeless veterans, according to data from ‘‘Veteran Homelessness: 

A Supplemental Report to the 2009 Annual Homeless Assessment 

Report to Congress,’’ more than 136,000 people who spent at least 

one night in an emergency shelter or transitional housing program 

self-identified as a veteran in FY 2009. Numerous others are considered at risk of becoming homeless due to poverty, a lack of support from family and friends, and precarious living conditions in 

overcrowded or substandard housing. Congress has authorized several initiatives in an effort to provide VA with the tools it needs 

to address veteran homelessness. 

Section 2031 of title 38, U.S.C., authorizes VA to provide outreach services, care, treatment, rehabilitative services, and certain 

other assistance to veterans suffering from serious mental illness. 

The two main health care programs administered by VA pursuant 

to this section are the Health Care for Homeless Veterans (hereinafter, ‘‘HCHV’’) program and the Domiciliary Care for Homeless 

Veterans program. The authority under this section is set to expire 

on December 31, 2011. 

Section 2033 of title 38, U.S.C., directs VA, subject to the availability of appropriations, to operate a program to expand and improve its provision of benefits and services to homeless veterans. 

VA administers this program through its Community Resource and 

Referral Center (hereinafter, ‘‘CRRC’’) program. The authority for 

this program is scheduled to expire on December 31, 2011. 

Section 2041 of title 38, U.S.C., authorizes VA to enter into 

agreements with a nonprofit or government organization in order 

to assist homeless veterans and their families in acquiring shelter. 

Under this section, VA can provide assistance to community-based 

and governmental service-providers through the sale, lease, or donation of property acquired through default on a direct loan or loan 

guaranty. No agreements may be entered into after December 31, 

2011. 

Finally, section 2066 of title 38, U.S.C., establishes within VA 

the ACHV. Membership is comprised of a range of stakeholders, including formerly homeless veterans, VSOs, State veterans affairs 

23 

officials and experts on mental health and substance abuse. Under 

current law, the Committee shall cease to exist on December 30, 

2011. 

The authorities described in this section have been extended several times, most recently in 2006, pursuant to Public Law 109–461, 

the Veterans Benefits, Health Care, and Information Technology 

Act of 2006. 

Committee Bill. Section 205 of the Committee bill would extend 

the authorities of many of VA’s programs to address veteran homelessness. 

Section 205(a) would amend section 2031(b) of title 38 to extend 

the HCHV program and the Domiciliary Care for Homeless Veterans program through December 31, 2012. 

Section 205(b) of the Committee bill would amend section 2033(d) 

of title 38 to extend the CRRC program through December 31, 

2014. 

Section 205(c) of the Committee bill would amend section 2041(c) 

of title 38 to extend VA’s authority to sell, lease, or donate property 

to house homeless veterans through December 31, 2014. 

Section 205(d) of the Committee bill would amend section 2066(d) 

of title 38 to extend the ACHV through December 31, 2013. 

Sec. 206. Reauthorization of appropriations for homeless veterans 

reintegration program. 

Section 206 of the Committee bill, which is derived from S. 1148, 

would authorize for FY 2012 up to $50,000,000 to be appropriated 

for HVRP. 

Background. Section 2021 of title 38, U.S.C., authorizes the DOL 

to carry out HVRP, subject to the availability of appropriations. 

HVRP is a competitive grant program that awards funding to eligible applicants to provide employment assistance and case management to homeless veterans while linking them to supportive services available in the community. 

The program provides job placement, training, job development, 

career counseling, and resume preparation services they need in 

order to re-enter the labor force. Supportive services such as clothing, transportation assistance, and referral to housing, medical and 

substance abuse treatment resources are also provided to meet the 

needs of homeless veterans. 

Since its inception, HVRP has featured an outreach component 

using veterans who have experienced homelessness. In recent 

years, this successful technique was modified to allow the programs 

to utilize formerly homeless veterans in various other positions 

where there is direct client contact such as counseling, peer coaching, intake, and follow-up services. Section 2021 of title 38 authorizes up to $50,000,000 to be appropriated for each fiscal year, beginning in FY 2002 through FY 2011. 

Committee Bill. Section 206 of the Committee bill would amend 

section 2021(e)(1) of title 38, U.S.C., by authorizing up to 

$50,000,000 to be appropriated for HVRP in FY 2012. 

Reauthorization of appropriations for HVRP is necessary to substantively and materially reduce veteran homelessness and unemployment. The Committee believes that HVRP is an important component of the continuum of services available to homeless veterans, 

24 

providing the means by which a veteran can successfully transition 

from homelessness to self-reliance. 

Sec. 207. Reauthorization of appropriations for financial assistance 

for supportive services for very low-income veteran families in 

permanent housing. 

Section 207 of the Committee bill, which is derived from S. 1148, 

would authorize up to $100,000,000 to be appropriated for financial 

assistance and supportive services for very low-income veteran 

families in permanent housing in FY 2012. The section would also 

authorize up to $1,000,000 to be appropriated to provide technical 

assistance regarding the planning, development, and provision of 

supportive services in the same fiscal year. 

Background. Public Law 110–387, the Veterans’ Mental Health 

and Other Care Improvements Act of 2008, authorized the Department to develop the Supportive Services for Veteran Families Program (hereinafter, ‘‘SSVF’’). Under SSVF, VA is authorized to 

award grants to private nonprofit organizations and consumer cooperatives that provide supportive services to very low-income veteran families residing in or transitioning to permanent housing. 

Grantees provide a range of supportive services designed to promote housing stability to eligible very low-income veteran families. 

Such services include outreach services, case-management services, 

assistance obtaining benefits from VA and from other public agencies, health care services, daily living services, and other similar 

services. 

To receive supportive services under SSVF, a qualifying veteran 

family is defined as a single person or a family in which the head 

of household or the spouse of the head of household is a veteran. 

The veteran family’s household income cannot exceed 50 percent of 

area median income, as adjusted, and the veteran family must be 

residing in permanent housing; must be homeless and scheduled to 

re-enter a stable housing situation within 90 days; or must have 

exited permanent housing within the previous 90 days. 

Section 2044 of title 38 authorizes $15,000,000 to be appropriated for FY 2009 for financial assistance and support services 

through SSVF, $20,000,000 in FY 2010, and $25,000,000 in FY 

2011. Also, $1,000,000 is authorized for each of FY 2009 through 

2011 for technical assistance. Delays attributed to the federal regulatory process resulted in the reprogramming of funding for FY 

2009 and 2010. As a result, VA provided SSVF with $60,000,000 

of funding for FY 2011. According to VA, 400 grants were received 

for the most recent notice of funds availability in 2011. The 385 

grants that met the thresholds of the program requested over 

$238,000,000 in funding. 

Committee Bill. Section 207 of the Committee bill would amend 

section 2044(e) of title 38 by authorizing up to $100,000,000 to be 

appropriated for FY 2012 for financial assistance and support services through SSVF. Section 207 would also amend section 2044(e) 

by authorizing for FY 2012 $1,000,000 to be appropriated for technical assistance. Finally, section 207 would make a technical 

amendment to section 2044(e). 

25 

Sec. 208. Reauthorization of appropriations for grant program for 

homeless veterans with special needs. 

Section 208, which is derived from S. 1148, would authorize appropriations for the grant program for homeless veterans with special needs through FY 2013. 

Background. Originally authorized pursuant to section 5 of Public Law 107–95, the Homeless Veterans Comprehensive Assistance 

Act of 2001, section 2061 of title 38, U.S.C., directs VA to carry out 

a program to make grants to health care facilities of VA and to 

grant and per diem providers in order to encourage development by 

those facilities and providers of programs for homeless veterans 

with special needs. The section defines veterans with special needs 

as those veterans who are (1) women, including women who have 

care of minor dependents; (2) frail elderly; (3) terminally ill; or (4) 

chronically mentally ill. The grant program is designed to help provide more intensive services to homeless veterans who require services above and beyond those provided by the grant and per diem 

program authorized under section 2011 of title 38. For each fiscal 

year, beginning in FY 2007 through FY 2011, $5,000,000 is authorized to be appropriated for the purposes of the program under section 2061. 

Committee Bill. Section 208 of the Committee bill would amend 

section 2061(d)(1) of title 38, as redesignated by section 202 of the 

Committee bill, to authorize appropriations for this grant program 

through FY 2013 at $5,000,000 per fiscal year. 

Sec. 209. Collaboration in provision of case management services to 

homeless veterans in supported housing program. 

Section 209 of the Committee bill, which is derived from S. 411, 

would require VA to consider entering into contracts to provide 

case management services to eligible homeless veterans who participate in the Housing and Urban Development Veterans Affairs 

Supportive Housing (hereinafter, ‘‘HUD-VASH’’) program. 

Background. HUD-VASH is a cooperative partnership between 

HUD and VA that provides long-term case management, supportive services, and permanent housing support for eligible homeless veterans. The HUD-VASH program began in 1992 under a 

memorandum of agreement between the two departments. Congress codified the program in section 12 of Public Law 107–95, the 

Homeless Veterans Comprehensive Assistance Act of 2001, by adding a new paragraph (19) to section 8(o) of the United States Housing Act of 1937 (42 U.S.C. 1437f(o)). Public Law 107–95 also authorized HUD to allocate 500 additional HUD-VASH vouchers in 

each of FY 2003 through 2006. Public Law 109–461, the Veterans 

Benefits, Health Care, and Information Technology Act of 2006, authorized HUD to allocate 500 HUD-VASH vouchers in FY 2007 and 

to increase the amount in increments of 500 per fiscal year up to 

2,500 in FY 2011. 

The program is explicitly designed to provide permanent supportive housing to the most vulnerable homeless veterans by setting aside rental vouchers and providing intensive services. To be 

eligible, a veteran must be homeless, must be eligible for VA health 

care, and must need and participate in case management services 

in order to obtain and sustain permanent independent community 

housing. Eligible homeless veterans receive VA-provided case manVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00025 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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agement and supportive services to promote stability and recovery 

from physical and mental health, substance use, and functional 

concerns contributing to, or resulting from, homelessness. The program goals include promoting maximal veteran recovery and independence in order to enable the veteran and his or her family to 

sustain permanent housing in the community. The case manager 

and the veteran set goals related to housing, income, employment 

and treatment with the ultimate goal of having the veteran fully 

reintegrate back into the community. To achieve this goal, the case 

manager works on employment and educational goals with the veteran so that the veteran can be more self-sufficient. There is also 

an annual review by the Public Housing Authority (hereinafter, 

‘‘PHA’’) that evaluates income eligibility and, when the veteran exceeds income eligibility, both VA and local PHAs assist the veteran 

with transitioning to alternative and more independent living 

arrangements. 

Congress appropriated funding in fiscal years 2008, 2009, and 

2010 for a total of 30,000 new ‘‘Housing Choice’’ (section 8) vouchers for the HUD-VASH program. Congress also appropriated funding in FY 2011 for another 7,960 new vouchers to participating 

PHAs to assist with rent payment. According to an analysis of data 

by the National Alliance to End Homelessness, approximately 

63,000 veterans can be classified as chronically homeless. Given 

the limited number of vouchers, VA must continue efforts to target 

the most vulnerable veterans for participation in the program, as 

quickly as possible. While these efforts have been successful in 

many areas, there are still areas where the Department has trouble recruiting the appropriate number of case managers, where the 

Department has trouble identifying the appropriate veteran participants, where it takes substantially more time to house eligible veterans, or where there is an extreme lack of affordable housing 

options. 

In some areas, VA is beginning to utilize contract providers for 

case management. The Washington, DC, VAMC partnered with the 

District of Columbia Department of Human Services to run the 

VASH Plus program. Best practices identified through the program 

were the use of a vulnerability index to help identify and prioritize 

chronically homeless clients based on the risk of morbidity; the use 

of information technology solutions to streamline the information 

exchange between the client and the public agency; and collaboration with community partners to develop landlord relationships 

that helped identify housing, negotiate rental costs, and provide essentials for veterans moving into housing. Use of this model reduced the wait time from application to housing from an average 

of six months to an average of one month. 

Committee Bill. Section 209(a) of the Committee bill would, in a 

freestanding provision, require VA to consult with HUD and providers who participate in the local Continuum of Care (hereinafter, 

‘‘CoC’’) and consider entering into contracts or agreements to provide case management services to homeless veterans who are eligible to participate in the HUD-VASH program. The Committee 

notes that, since 2008, the Department has improved its ability to 

target HUD-VASH vouchers to those with the greatest need and 

move veterans into housing more quickly. However, the Committee 

believes that there is still room for improvement and the best pracVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00026 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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tices identified through the DC VASH Plus program could assist 

the Department in reaching the goal of ending veteran homelessness. 

The Committee recognizes that more veterans, and therefore 

more vouchers, are located in non-rural areas. However, the Committee notes that homeless veterans living at a greater distance 

from VAMCs still need services. VA needs to look for additional 

ways to extend its reach further into rural areas, to serve locations 

where chronically homeless veterans may be located in smaller 

numbers. The Committee is mindful that VASH Plus cannot and 

should not be done everywhere. However, the Committee is also 

aware of areas that might benefit from partnering with local providers to better serve chronically homeless veterans. Section 209(b) 

of the Committee bill defines this group as veterans who are eligible to receive a voucher and who are having trouble obtaining suitable housing, particularly those who do not live near VA facilities, 

those who live in areas with a shortage of low-income housing and 

need more intensive assistance than is usually provided, and those 

who reside in areas with significantly lower than average rates of 

obtaining suitable housing. 

The requirement to consider contracting for case management is 

intended to encourage VA to identify locations where contracting 

might allow the Department to better serve chronically homeless 

veterans. The Committee bill requires consultation with HUD and 

CoCs to help VA further strengthen relationships with community 

providers and identify suitable entities that have the capacity to 

serve this challenging population. The VASH Plus program has 

demonstrated the benefits of coordination with local providers. 

Therefore, even when the Department does not choose to contract 

out services to local providers, it should encourage VAMCs to 

strengthen its relationships and coordination with local homeless 

providers. 

Section 209(c) sets forth the parameters for entities that VA 

might contract with to include State or local government agencies, 

tribal organizations, or nonprofit agencies that agree to: provide 

case management services, maintain referral networks for additional entitlement and assistance programs, ensure the confidentiality of records, establish procedures for fiscal control and fund 

accounting, and submit information on their operations to VA annually. These agencies must also have demonstrated experience in 

identifying and serving homeless veterans, working collaboratively 

with HUD or VA, conducting outreach to and maintaining relationships with landlords, and mediating disputes between landlords 

and veterans. 

Section 209(d) requires VA to consult with HUD and the CoC 

while considering whether to enter into a contract or agreement 

with an organization. 

Section 209(e) would allow VA to provide training and technical 

assistance to any entities with which it collaborates to ensure compliance with program standards and the dissemination of best practice strategies, and the implementation of targeted treatment interventions through the ‘‘Housing First’’ model. It would also make 

available $500,000 per fiscal year from VA’s Medical Services account to carry out the technical assistance program. 

28 

Section 209(f) would require VA to produce an annual report on 

the consideration of potential collaborations and any collaboration 

that resulted. 

TITLE III—HOUSING MATTERS

Sec. 301. Short title. 

Section 301 of the Committee bill would provide a short title, the 

‘‘Andrew Connolly Veterans’ Housing Act,’’ for Title III of the Committee bill. 

Background. Andrew Connolly served in the United States Army 

National Guard from November 2000 to August 2007. During his 

service, he completed two tours, the first in Egypt and the second 

in Iraq. 

A year after Andrew’s tour in Iraq, he was diagnosed with cancer 

of the spine, a service-connected condition, which would soon lead 

to the loss of all function and feeling below the chest. At the same 

time, Andrew and his wife were caring for a newborn son with a 

neuromuscular disorder. This condition required his son to be on 

a ventilator and will confine his child to a wheelchair for the rest 

of his life. 

Andrew and his family were facing these challenges while living 

in a duplex built in the 1890’s, which was not accessible and severely limited his ability to accomplish simple tasks. Today, Andrew is in a new house, made possible with a grant from VA’s specially adapted housing program. This house was constructed specifically to allow Andrew to live as self-sufficiently as possible. 

At a May 3, 2011, hearing before the House Committee on Veterans’ Affairs’ Subcommittee on Economic Opportunity, Andrew 

Connolly described in detail how the adaptive housing assistance 

grant has allowed him to live more self-sufficiently: 

Today I am in my new house. Today I took a shower by 

myself in a 5′ x 5′ roll-in shower with handicapped controls. Today I cooked my own breakfast because I could 

reach all of the ingredients. Today I was able to watch my 

son Brody sleeping in his bedroom because I could roll 

through his doorway with my wheelchair. 

Committee Bill. Section 301 of the Committee bill would provide 

a short title, the ‘‘Andrew Connolly Veterans’ Housing Act,’’ for 

Title III of the Committee bill. The Committee believes Andrew 

Connolly’s story highlights the significant positive impact VA’s 

adaptive housing assistance programs can have on disabled veterans and their families. 

Sec. 302. Extended period of protections for members of uniformed 

services relating to mortgages, mortgage foreclosure, and eviction. 

Section 302 of the Committee bill, which is derived from S. 486, 

would extend from 9 months to 12 months after military service 

the period of protection against mortgage foreclosure and the period in which a court may stay a proceeding or adjust an obligation. 

It would also require the Comptroller General to report on certain 

foreclosure protections. 

Background. Congress has long recognized that the men and 

women of our military services should have civil legal protections 

29 

so they can devote their entire energy to the defense needs of the 

nation. 

The earliest recognition of the need to provide civil protections 

for servicemembers in the United States dates back to the ‘‘stay 

laws’’ promulgated by Louisiana during the War of 1812. Louisiana 

suspended all proceedings in civil cases for four months as the British were advancing on New Orleans. 

The development of the first modern version of the Soldiers’ and 

Sailors’ Civil Relief Act (hereinafter, ‘‘SSCRA’’) was outlined at a 

hearing on the Soldiers’ and Sailors’ Civil Relief Bill before the 

Senate Subcommittee of the Committee on the Judiciary in 1917. 

Following the decision of the United States to enter the war in Europe in 1917, the first modern version of the SSCRA was drafted 

under instructions from the Judge Advocate General of the Army 

in six weeks by Major John Wigmore, the eminent Dean of Northwestern University’s Law School, and others. In 1940, with the 

looming involvement of the United States in World War II, Congress again examined the needs of military personnel and reenacted the SSCRA almost verbatim. Both the SSCRA of 1918 and 

the SSCRA of 1940 provided legal protections to servicemembers in 

order to assist those who were struggling to meet financial and 

legal obligations while serving on active duty. 

In 2003, Public Law 108–189, the SCRA, clarified and strengthened many of the SSCRA protections afforded to servicemembers. 

Section 303(b) of the SCRA authorized a court to stay proceedings 

or adjust the obligation in the case of actions filed against servicemembers, during military service or within 90 days after a period 

of military service, to enforce a mortgage or trust deed entered into 

prior to service, if the servicemember’s ability to comply with the 

obligation had been materially affected by military service. Section 

303(c) of the SCRA protected servicemembers against mortgage 

foreclosure without a court order during service and for a period of 

90 days after a servicemember’s period of military service. 

Section 2203 of Public Law 110–289, the Housing and Economic 

Recovery Act of 2008, amended the SCRA, by extending from 90 

days to 9 months after military service the period of protection for 

servicemembers against mortgage foreclosure and the time period 

during which a court may stay proceedings or adjust obligations. 

These protections were scheduled to expire on December 31, 2010. 

Public Law 111–346, the Helping Heroes Keep Their Homes Act of 

2010, extended the enhanced protections through December 31, 

2012. 

Committee Bill. Section 302(a) of the Committee bill would 

amend section 303(b) of the SCRA, codified at 50 U.S.C. App. 

533(b), by extending from 9 months to 12 months after military 

service the period in which a court may stay proceedings or adjust 

an obligation, or to enforce an obligation on certain real or personal 

property owned by the servicemember. Section 302(b) of the Committee bill would amend section 303(c) of the SCRA, codified at 50 

U.S.C. App. 533(c), by extending from 9 months to 12 months after 

military service the period of protection for a servicemember 

against sale, foreclosure, or seizure of property. 

Section 302(c) of the Committee bill would require the Comptroller General to submit a report to Congress on the foreclosure 

protections of the SCRA. Specifically, the report would include an 

30 

assessment of the effects of these protections on the long-term financial well-being of servicemembers and their families; the number of servicemembers who faced foreclosure during a 90-, 270-, or 

365-day period following their completion of a period of military 

service; the number of servicemembers who applied for a stay or 

adjustment; an assessment of the effect of applying for a stay or 

adjustment on the financial well-being of the servicemembers; and 

an assessment of the Secretary of Defense’s partnerships with public and private-sector entities and recommendations on how the 

Secretary of Defense should modify such partnerships to improve 

financial education and counseling. 

The Committee believes that enhancing the foreclosure protections during these difficult economic times will help ensure the 

men and women of our military services have the civil legal protections necessary to ensure that they are able to devote their entire 

energy to the defense needs of the nation. 

Sec. 303. Occupancy of property by dependent child of veteran for 

purposes of meeting occupancy requirement for Department of 

Veterans Affairs housing loans. 

Section 303 of the Committee bill, which is derived from S. 874, 

would allow a veteran’s dependent child to satisfy the occupancy 

requirements necessary to qualify for a VA-backed home loan. 

Background. Current law, section 3704(c)(2) of title 38, U.S.C., 

states that, ‘‘[i]n any case in which a veteran is in active-duty status as a member of the Armed Forces and is unable to occupy a 

property because of such status, the occupancy requirements [for 

purposes of obtaining a VA-backed home loan] shall be considered 

to be satisfied if the spouse of the veteran occupies the property 

and the spouse makes the certification required by paragraph (1) 

of this subsection.’’ The structure of the American family often involves single parents. Under current law, a single veteran with a 

dependent child is disqualified from obtaining a VA-backed home 

loan if he or she is on active-duty status because he or she does 

not have a spouse to satisfy occupancy requirements. 

Committee Bill. Section 303 of the Committee bill would add to 

section 3704(c)(2) a provision allowing a veteran’s dependent child 

who occupies or will occupy the property as a home to satisfy the 

occupancy requirements for purposes of qualifying for a VA-backed 

home loan if the veteran’s attorney-in-fact or a legal guardian of 

the veteran’s dependent child makes the certification required by 

section 3704(c)(1) of title 38. 

The Committee believes this provision would allow single-parent 

veterans performing active-duty service to obtain a VA-guaranteed 

home loan in situations where a veteran’s dependent child will be 

occupying the home. The Committee also intends that this provision apply to situations where veterans, married to each other, are 

both deployed. 

Sec. 304. Waiver of loan fee for individuals with disability ratings 

issued during pre-discharge programs. 

Section 304 of the Committee bill, which is derived from S. 1148, 

would waive the housing loan fee for veterans rated eligible to receive compensation as the result of a pre-discharge review of existVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00030 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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ing medical evidence, such as service medical and treatment 

records. 

Background. Under current law, section 3729(c) of title 38, 

U.S.C., a housing loan fee may not be collected if a veteran is rated 

eligible to receive compensation as a result of a pre-discharge VA 

disability examination and rating. The time period between pre-discharge ratings and release from active-duty service can be quite 

long. During that time, many disabled servicemembers utilize their 

VA home loan benefit. Under current law, servicemembers who are 

rated eligible to receive compensation solely as the result of a predischarge review of existing medical evidence and not as the result 

of a VA examination are required to pay the housing loan fees until 

they have been discharged or released from active duty. 

Committee Bill. Section 304 of the Committee bill would amend 

section 3729(c) of title 38 by adding a provision that waives the collection of housing loan fees from a servicemember rated eligible to 

receive compensation based on a pre-discharge review of existing 

medical evidence that results in the issuance of a memorandum 

rating. 

The Committee believes this provision would ensure that all 

servicemembers eligible to receive compensation as the result of a 

pre-discharge program are eligible for the housing loan fee waiver, 

regardless of whether the eligibility was the result of an examination or a review of existing evidence. 

Sec. 305. Improvements to assistance for disabled veterans residing 

in housing owned by a family member. 

Section 305 of the Committee bill, which is derived from S. 1017, 

would increase the amount of assistance available to certain veterans with permanent and total service-connected disabilities to 

adapt a family member’s residence in which the veteran is residing 

temporarily. It would also provide for annual automatic adjustments of the amounts of assistance and extend VA’s authority to 

provide such assistance until December 31, 2021. 

Background. Public Law 109–233, the Veterans’ Housing Opportunity and Benefits Improvement Act of 2006, authorized VA to expand its previously existing adaptive housing assistance grants to 

include eligible individuals temporarily living in a home owned by 

a family member. These grants are known as Temporary Residence 

Adaptation (hereinafter, ‘‘TRA’’) grants. The benefit was extended 

to active duty servicemembers with the passage of Public Law 110– 

289, the Housing and Economic Recovery Act of 2008. 

Under current law, section 2102A of title 38, the TRA grant program allows veterans and servicemembers eligible under the Specially Adapted Housing (hereinafter, ‘‘SAH’’) and Special Housing 

Adaptation (hereinafter, ‘‘SHA’’) programs to use up to $14,000 and 

$2,000, respectively, to modify a family member’s home. The TRA 

grant program is scheduled to expire on December 31, 2011. 

Section 101 of Public Law 109–233 also required the Government 

Accountability Office (hereinafter, ‘‘GAO’’) to submit to Congress a 

report on VA’s implementation of the TRA grant program. The interim report, ‘‘Veterans Affairs: Implementation of Temporary Residence Adaptation Grants’’ (GAO–09–637R), and the final report, 

‘‘Opportunities Exist to Improve Potential Recipients’ Awareness of 

the Temporary Residence Adaptation Grant’’ (GAO–10–786) (hereVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00031 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
32 

inafter, ‘‘GAO Reports’’), both noted the limited participation in the 

TRA program. The interim report examined a number of reasons 

for the low usage and noted that veterans often chose to wait to 

take advantage of benefits to adapt their own home because the 

TRA grant counts against the overall amount available to an individual under the SAH or SHA grant program. One of the potential 

solutions GAO identified was increasing the maximum benefit 

available under SAH and SHA. 

Committee Bill. Section 305 of the Committee bill would amend 

section 2102A of title 38 by increasing the amount of assistance 

available for individuals with permanent and total service-connected disabilities that meet the criteria of section 2101(a)(2) of 

title 38 from $14,000 to $28,000. It would increase the amount of 

assistance available for individuals with permanent and total service-connected disabilities that meet the criteria of section 2101(b)(2) 

of title 38 from $2,000 to $5,000. 

It would add a new paragraph to section 2102A that would provide for automatic annual adjustments to the maximum grant 

amounts based on a cost-of-construction index already in effect for 

other SAH and SHA grants authorized under chapter 21 of title 38. 

Finally, the Committee bill would amend section 2102A of title 38 

by extending VA’s authority to provide assistance under the TRA 

grant program until December 31, 2021. 

The Committee believes that the enhancements made by section 

305 of the Committee bill to the TRA grant program will increase 

participation in the program. Further, the extension of authority 

for the TRA grant program provides individuals suffering from catastrophic injuries or illnesses with more flexibility during their convalescent period. 

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

Section 306 of the Committee bill, which is derived from S. 1017, 

would expand eligibility for VA’s adaptive housing assistance 

grants to veterans with a lesser degree of vision impairment than 

what is required under current law. 

Background. Under current law, section 2101(b) of title 38, 

U.S.C., a veteran with a permanent and total service-connected disability due to blindness in both eyes has to have visual acuity of 

5/200 or less in order to qualify for certain adaptive housing assistance grants. 

According to the National Eye Institute, visual acuity is defined 

as the eye’s ability to distinguish object details and shape with 

good contrast, using the smallest identifiable object that can be 

seen at a specified distance. It is measured by use of an eye chart 

and recorded as test distance/target size. Visual acuity of 5/200 

means that an individual must be 5 feet away from an eye chart 

to see a letter that an individual with normal vision could see from 

200 feet. 

While VA had used the 5/200 or less standard of visual acuity 

for blindness over the last several decades, a consensus definition 

of what constitutes ‘‘legal blindness’’ has emerged. 

This consensus definition, which is the statutory definition used 

for the Social Security disability insurance program and the Supplemental Security Income program and which is less stringent 

33 

than VA’s standard, encompasses individuals with lesser degrees of 

vision impairment. The American Medical Association has espoused this definition since 1934 and defines blindness as a ‘‘central visual acuity of 20/200 or less in the better eye with corrective 

glasses, or central visual acuity of more than 20/200 if there is a 

visual field defect in which the peripheral field is contracted to 

such an extent that the widest diameter of the visual field 

subtends an angular distance no greater than 20 degrees in the 

better eye.’’ 

In recognizing this consensus definition, Public Law 110–157, the 

Dr. James Allen Veteran Vision Equity Act of 2007, amended the 

criteria for receiving special monthly compensation to allow veterans who are very severely disabled as the result of blindness and 

other severe disabilities to be eligible to receive a higher rate of 

disability compensation if their visual acuity in both eyes is 20/200 

or less. 

Committee Bill. Section 306 of the Committee bill would amend 

section 2101(b) of title 38 by requiring central visual acuity of 20/ 

200 or less in the better eye with the use of a standard correcting 

lens. It also provides that an eye with a limitation in the fields of 

vision such that the widest diameter of the visual field subtends an 

angle no greater than 20 degrees shall be considered as having a 

central visual acuity of 20/200 or less. 

The Committee believes that this provision would bring the definition of blindness within chapter 21 of title 38 in line with consensus definitions and other disability rating provisions of title 38 

and that veterans who are so seriously disabled as to meet the visual acuity standard of 20/200 or less should be able to take advantage of VA’s adaptive housing assistance grants. 

Sec. 307. Revised limitations on assistance furnished for acquisition 

and adaptation of housing for disabled veterans. 

Section 307 of the Committee bill, which is derived from S. 1017, 

would exclude the TRA grant from counting towards the aggregate 

limitations on assistance for SAH and SHA grants. 

Background. Since 1948, VA has provided adaptive housing assistance grants to eligible individuals who have certain service-connected disabilities to construct an adapted home or modify an existing home to accommodate their disabilities. Today, VA provides 

adaptive housing assistance primarily through two programs—SAH 

and SHA. Both programs are codified under chapter 21 of title 38. 

The SAH grant program provides financial assistance to veterans 

and servicemembers who are entitled to compensation for permanent and total service-connected disability due to the loss or loss 

of use of multiple limbs, blindness and limb loss, or a severe burn 

injury. Eligible individuals may receive up to three SAH grants totaling no more than 50 percent of the cost of a specially adapted 

house, up to the aggregate maximum amount for fiscal year 2011 

of $63,780. This amount is adjusted annually based on a cost-ofconstruction index. Grants may be used to construct a house or remodel an existing house, or they may be applied against the unpaid 

principal mortgage balance of a specially adapted house. The SHA 

grant program—which is similar to SAH but is for individuals with 

slightly less serious disabilities—may be used for slightly different 

purposes and cannot exceed $12,756 during fiscal year 2011. This 

34 

amount is also adjusted annually based on a cost-of-construction 

index. 

P.L. 109–233, the Veterans’ Housing Opportunity and Benefits 

Improvement Act of 2006, authorized VA to expand its previously 

existing adaptive housing assistance grants to include eligible individuals temporarily living in a home owned by a family member. 

The TRA benefit, codified at section 2102A of title 38, U.S.C., allows veterans to apply for a grant to adapt the home of a family 

member with whom they are temporarily residing. The benefit was 

extended to active duty servicemembers with the passage of Public 

Law 110–289, the Housing and Economic Recovery Act of 2008. 

The TRA grant program enables veterans and servicemembers eligible under the SAH and SHA programs to use up to $14,000 and 

$2,000, respectively, to modify a family member’s home. 

Under current law, section 2102(d), each TRA grant counts as 

one of the three grants allowed under either SAH or SHA. TRA 

grants also count toward the maximum allowable fiscal year 2011 

amount of $63,780 under SAH and $12,756 under SHA. 

As described in section 309, GAO’s congressionally-mandated reports on the TRA grant program noted the limited participation in 

the TRA program. GAO found that one of the reasons for the low 

usage was that veterans often chose to wait to take advantage of 

benefits to adapt their own home because the TRA grant amount 

counts against the overall amount available to an individual under 

the SAH or SHA grant programs. One of the potential solutions 

GAO identified was no longer counting TRA grants against the 

maximum funds available under SAH and SHA. 

Committee Bill. Section 307 of the Committee bill would amend 

section 2102(d) of title 38 to exclude the TRA grant from the aggregate limitations on assistance furnished to an eligible veteran or 

servicemember pursuant to section 2102 of title 38. TRA grants 

would no longer be counted against the maximum funds available 

under SAH and SHA grants. 

The Committee believes this change would increase participation 

in the TRA grant program. 

TITLE IV—COMPENSATION AND PENSION MATTERS

Sec. 401. Increase in rate of pension for disabled veterans married 

to one another and both of whom require regular aid and 

attendance. 

Section 401 of the Committee bill, which is derived from S. 1060, 

would increase the benefit paid to married couples when both are 

veterans who qualify for A&A. 

Background. Veterans of a period of war who meet income, net 

worth, and other eligibility criteria are eligible to receive a pension 

based upon need. The amount of the pension also is based upon the 

number of dependents of the veteran. Additional benefits are paid 

if the veteran has a disability that results in housebound status or 

a need for A&A. In general, when a veteran is married to another 

veteran, the pension benefits paid are the same as for a veteran 

who is married to a non-veteran. However, in cases where one or 

both members of a veteran couple are housebound, the housebound 

veterans each receive an additional amount. If one member of the 

veteran couple is in need of A&A, that veteran receives an addiVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00034 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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tional amount. However, if both members need A&A, one member 

receives the full additional amount and the other receives a reduced amount. 

In 1998, section 8206 of Public Law 105–178, the Transportation 

Equity Act for the 21st Century, increased the benefit for a veteran 

who requires aid and attendance by $600 per year. Because of the 

way the bill was drafted, the benefit was increased for only one of 

the veterans in the rare case that a veteran is married to another 

veteran who requires A&A. The legislative history does not indicate 

any intent to treat these spouses differently. According to VA, there 

are fewer than 75 such cases. Therefore, under current law, a veteran who is married to another veteran and both qualify for A&A 

benefits, the benefit amount for one of the spouses is $825 per year 

lower than for the other spouse. 

Committee Bill. The Committee bill would increase the benefit 

paid to married couples where both members of the couple are veterans and both qualify for A&A by $825.00 per year. 

Sec. 402. Authority for retroactive effective date for awards of disability compensation in connection with applications that are 

fully-developed at submittal. 

Section 402 of the Committee bill, which is derived from S. 423, 

would allow up to a 1 year retroactive effective date for certain 

awards of disability compensation that are based on claims that 

are fully-developed when submitted to VA. 

Background. Under section 221 of Public Law 110–389, the Veterans’ Benefits Improvement Act of 2008, VA was required to conduct a pilot project to test ‘‘the feasibility and advisability of providing expeditious treatment of fully developed compensation or 

pension claims to ensure that such claims are adjudicated not later 

than 90 days after the date on which such claim is submitted as 

fully developed.’’ After carrying out that pilot at 10 VA regional offices, VA expanded the fully-developed claim process to all VA regional offices. At a July 14, 2010, hearing before the Committee, 

VA’s Acting Under Secretary for Benefits explained that, ‘‘if VA receives all of the available evidence when the claim is submitted, 

the remaining steps in the claims-decision process can be expedited 

without compromising quality.’’ 

However, under current law, there is a potential disincentive for 

veterans to file fully-developed claims. That is because, under section 5110(a) of title 38, U.S.C., the effective date of an award of disability compensation generally is the date on which VA received 

the application for those benefits. Although there are exceptions to 

that general rule, none of the exceptions would allow a retroactive 

effective date for veterans who file fully-developed claims. Accordingly, if a veteran takes time before filing a claim to gather the 

necessary information and evidence so as to ensure that the claim 

is fully-developed, the veteran could potentially lose out on benefits 

for the period between when the veteran began gathering the evidence and when he or she ultimately filed a fully-developed claim. 

Committee Bill. Section 402 of the Committee bill would amend 

section 5110 of title 38 to provide that the effective date of an 

award of disability compensation to a veteran who submitted a 

fully-developed claim would be based on the facts found but would 

not be earlier than 1 year before the date on which VA received the 

36 

veteran’s application. That change would take effect on the date of 

enactment and would not be applied to claims filed after September 

30, 2012. 

It is the Committee’s expectation that, by allowing an effective 

date up to 1 year earlier than the date on which a fully-developed 

claim is filed, more veterans will be encouraged to file fully-developed claims and in return receive faster decisions on their claims. 

Sec. 403. Modification of month of death for surviving spouses of 

veterans who die while entitled to compensation or pension. 

Section 403 of the Committee bill, which is derived from S. 874, 

would amend current law in order to clarify that a surviving 

spouse of a veteran who is receiving compensation or pension from 

VA is due the amount of benefits the veteran would have received 

for the entire month of the veteran’s death, regardless of whether 

the surviving spouse is otherwise entitled to survivor benefits. Also, 

if at the time of death the veteran had a claim pending for compensation or pension that was subsequently granted, the surviving 

spouse would be eligible for any benefits or additional benefits due 

as accrued benefits for the month of death. 

Background. VA has experienced considerable difficulty in administering month-of-death payments for surviving spouses because of the confusion in current law among various provisions and 

because certain automated procedures used by VA for termination 

and recovery of benefits paid to veterans for the month of their 

deaths are not consistent with current law. As a demonstration of 

the scope of this situation, Committee oversight led VA to pay over 

$65 million to survivors who had been wrongfully denied benefits 

to which they were entitled for the month of death. 

Under current law, veterans’ benefits for a specific month are 

paid in the month following the month to which they are attributable. No benefits are owed to a veteran for the month in which 

a veteran dies. For example, if a veteran is receiving VA compensation or pension for the month of January, the check or payment for 

January would be provided in February. If a veteran receiving such 

benefits dies in February, no benefits for the month of death would 

be payable to the veteran, meaning that no benefits would be provided in March. However, if the veteran had a surviving spouse, 

the month of death provision in current law, section 5310 of title 

38, provides that the amount of benefits that the veteran would 

have received for February had the veteran not died is payable to 

the surviving spouse. 

Section 5310 also provides that, if the benefit payable to a surviving spouse as death compensation, dependency and indemnity 

compensation (hereinafter, ‘‘DIC’’), or death pension is less than 

the amount that the veteran would have received for that month 

but for the veteran’s death, the greater benefit would be paid for 

the month of death. 

This latter provision has caused considerable confusion because 

it is not fully consistent with other provisions of current law concerning effective dates for survivor benefits. Under section 5110(d) 

of title 38, the effective date of an award of death compensation, 

DIC, or death pension for which application is received within 1 

year from the date of a veteran’s death is the first day of the month 

in which the death occurred. Thus, if the veteran dies in February, 

37 

the effective date of DIC or death pension would be February 1 if 

the surviving spouse applied for benefits within 1 year of the veteran’s death. If the application for survivor benefits is received 

after the 1-year period, the effective date is the date the application 

is received. 

Under section 5111(a) of title 38, payment of VA benefits, including survivor benefits, is not made for the month of the effective 

date of the benefit, but is paid for the first calendar month following the month in which the award became effective. For example, the first month for which benefits would be paid to the surviving spouse of a veteran dying in February, which would mean 

a February 1 effective date, would be the calendar month of March. 

As noted above, the check or payment for March would be issued 

at the beginning of April. Absent the month of death provision, the 

survivor would experience a gap in income with no benefit paid for 

either the deceased veteran or the surviving spouse in the month 

of March. 

Although section 5111(c)(1) of title 38 appears to provide an exception for month-of-death payments when the DIC or death pension for the month of death would be greater than the amount that 

would have been paid to the deceased veteran for that month had 

the veteran lived, the language of paragraph (1) of that section 

does not clearly authorize a payment with a different effective date 

or a different commencement date than provided by sections 5110 

or 5111(a). Because a surviving spouse eligible for benefits as the 

survivor of a veteran who died in February would not have those 

benefits commence until March and would receive the first DIC 

payment in April, it appears that there are no circumstances under 

which a surviving spouse could qualify for payments of both a 

month-of-death benefit for the month of February and a survivor 

benefit for the same month. 

VA has information concerning the identity and status of any 

spouse receiving benefits as a dependent on the veteran’s compensation or pension award, such as a veteran receiving additional 

compensation payable under section 1115 at the rate of 30 percent 

or higher or pension benefits for married veterans specified in section 1521. In cases involving such dependency relationships, VA 

has recently begun issuing month-of-death benefits to surviving 

spouses upon notification of the death of a veteran, whose surviving spouse was a dependent on the veteran’s compensation or 

pension award as of the date of death. In cases in which VA does 

not have information concerning the existence, identity, or status 

of a surviving spouse, VA is not able to comply with the requirement for a month-of-death payment without obtaining additional 

information. In such cases, VA is sending the veteran’s estate a notice that includes information concerning the month-of-death payment and advises the estate concerning the procedures necessary 

in order for a payment to be made. 

Committee Bill. Subsection (a) of section 403 of the Committee 

bill would amend subsection (a) and (b) of section 5310 of title 38 

to clarify that a payment for the month of a veteran’s death would 

be made to a surviving spouse of a veteran who, at the time of the 

veteran’s death, was receiving compensation or pension or to a surviving spouse of a veteran who is determined as having been entiVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00037 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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tled to receive compensation or pension for the month of the veteran’s death. 

Subsection (a) of section 403 of the Committee bill would further 

amend subsection (a) of section 5310 to specify that the amount of 

a payment for the month of a veteran’s death is the amount that 

the veteran would have received for that month if the veteran had 

not died and to specify that any benefits payable for the month of 

death for a veteran who was not receiving those benefits as of the 

date of death would be paid as accrued benefits. 

Subsection (a) of section 403 of the Committee bill would further 

amend subsection (b) of section 5310 of title 38 to clarify that, if 

a claim for entitlement to compensation or additional compensation 

under chapter 11 of title 38 or pension or additional pension under 

chapter 15 of title 38 was pending at the time of the veteran’s 

death and the pending claim was subsequently granted, any additional benefits for the month of death would be paid as accrued 

benefits under section 5121 of title 38. 

Subsection (b) of section 403 of the Committee bill would amend 

subsection (c) of section 5111 of title 38 to provide that month-ofdeath payments under section 5310 are exempt from the delayed 

commencement of benefits provision otherwise applicable under 

section 5111. 

Subsection (c) of section 403 of the Committee bill would provide 

that the changes made by that section would apply in cases of 

deaths that occur on or after the date of enactment of this legislation. 

The Committee expects that section 403 of the Committee bill, if 

enacted, will remove any confusion in current law and improve 

VA’s ability to pay a surviving spouse the benefits due for the 

month of a veteran’s death. 

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

of new evidence. 

Section 404 of the Committee bill, which is derived from S. 1148, 

would automatically waive the review of certain new evidence by 

the agency of original jurisdiction (hereinafter, ‘‘AOJ’’) so that certain new evidence submitted after the filing of a substantive appeal 

will be subject to initial review by the Board of Veterans’ Appeals 

(hereinafter, ‘‘Board’’), unless review by the AOJ is requested. 

Background. Current law precludes the Board’s initial consideration of evidence submitted in connection with a claim, unless the 

claimant waives the right to initial consideration by the AOJ. Evidence must first be considered by the AOJ in order to preserve a 

claimant’s statutory right under section 7104 of title 38 to one review on appeal. 

This requirement frequently delays the final adjudication of 

claims because claimants often submit additional evidence in support of their claims following the filing of a substantive appeal. 

Under current procedures, upon submission of this new evidence, 

the AOJ must review the new evidence and the claims file and prepare a new decisional document called the supplemental statement 

of the case (hereinafter, ‘‘SSOC’’). If the claimant submits additional evidence to the Board without waiving the right to initial 

AOJ consideration, the Board must remand the claim to the AOJ 

for initial consideration. This process can occur multiple times if 

39 

the veteran submits additional evidence after the AOJ issues the 

SSOC. 

Committee Bill. Section 404 of the Committee bill would amend 

section 7105 of title 38 by creating a new subsection, (e), to incorporate an automatic waiver of the right to initial consideration of 

certain evidence by the AOJ. The evidence subject to the waiver is 

evidence, in connection with the issue or issues with which disagreement has been expressed, submitted by the claimant, or his 

or her representative to the AOJ or the Board concurrently with or 

after the filing of a substantive appeal. Such evidence would be 

subject to initial consideration by the Board, unless the appellant 

or his or her representative requests in writing that the AOJ initially consider the evidence. The request would be required to be 

submitted with the evidence. These changes would take effect 180 

days after enactment and apply with respect to claims for which a 

substantive appeal is filed on or after that date. 

The Committee believes that the establishment of an automatic 

waiver would necessarily improve the timeliness of processing appeals. This automatic waiver would reduce the amount of time it 

takes the AOJ to certify an appeal to the Board and avoid timeconsuming remands for an initial review of new evidence. Further, 

the claimant’s right to initial consideration by the AOJ is also protected by permitting claimants to obtain initial consideration by 

the AOJ by requesting such review in writing. 

TITLE V—MEMORIAL, BURIAL, AND CEMETERY MATTERS

Sec. 501. Prohibition on disruptions of funerals of members or 

former members of the Armed Forces. 

Section 501 of the Committee bill, which is derived from S. 815, 

would increase the space and time restrictions and liability for 

those protesting at military funerals. 

Background. During the 109th Congress, two bills were passed 

to create limitations on protesting at military funerals. When introducing S. 4042, a bill to amend title 18, U.S.C., to prohibit disruptions of funerals of members or former members of the Armed 

Forces, which later became Public Law 109–464, Senator Durbin 

pointed out that in the 16 months leading up to the introduction 

of the bill, there had been 129 intentional disruptions of military 

funerals, underlining the necessity for protecting the sanctity of 

military funerals. 

The passage of Public Law 109–464 had been preceded by the 

passage of Public Law 109–228, the Respect for America’s Fallen 

Heroes Act. Although similar in nature and intent, these laws 

cover different jurisdictional areas and include differing definitions 

as to what constitutes prohibited behavior with respect to a military funeral. 

Specifically, Public Law 109–228 established a new section 2413 

in title 38, U.S.C., which prescribes specific limitations on demonstrations at cemeteries under the control of the National Cemetery Administration (hereinafter, ‘‘NCA’’) and ANC. Under section 

2413, a person may not demonstrate on the property of a cemetery 

under the control of NCA or ANC without prior authorization. Also, 

a person may not demonstrate during the period beginning 60 minutes before and ending 60 minutes after a funeral or memorial 

40 

service at these cemeteries if (1) the demonstration takes place 

within 150 feet of the road, pathway, or other egress or ingress 

point and includes ‘‘any individual willfully making or assisting in 

the making of any noise or diversion that disturbs or tends to disturb the peace or good order of the funeral’’, or (2) the demonstration is within 300 feet of the cemetery and impedes the access to 

or egress from the cemetery. Additionally, section 2413 specifically 

defines demonstrations to include activities such as picketing, amplified speech, or distributing leaflets. By doing so, the statute only 

precludes a narrow subset of speech and does not prohibit all 

speech in or around the cemetery. The penalty for violating this 

section is up to 1 year in prison and/or a fine, as set forth in section 

1387 of title 18, U.S.C. 

P.L. 109–464 established section 1388 of title 18, U.S.C. This law 

addresses disruptions at funerals of servicemembers or former 

servicemembers that take place in cemeteries other than NCA or 

part of ANC. The statute prohibits, within the period starting 60 

minutes before and ending 60 minutes after a military funeral, any 

activity that takes place within the boundary of the funeral location or is within 150 feet of the point of intersection between the 

boundary of the funeral location and the entrance or other ingress 

or egress point of the funeral location and ‘‘includes any individual 

willfully making or assisting in the making of any noise or diversion that is not part of such funeral and that disturbs or tends to 

disturb the peace or good order of such funeral with the intent of 

disturbing the peace or good order of that funeral.’’ Section 1388 

also prohibits any activity within the same timeframe that is within 300 feet of the boundary of the location of a funeral and ‘‘includes any individual willfully and without proper authorization 

impeding the access to or egress from such location with the intent 

to impede the access to or egress from such location.’’ Under section 

1388(b), the penalty for violating this section is up to 1 year in 

prison and/or a fine. 

In March 2011, the United States Supreme Court ruled in Snyder v. Phelps, 131 S. Ct. 1207 (2011), that the Free Speech Clause 

of the First Amendment protected the Westboro Baptist Church 

from state tort liability for intentional infliction of emotional distress and intrusion upon seclusion. Although the Court spoke to 

what constituted protected speech in the case, the Court made no 

ruling on the Constitutionality of buffer zones in the context of 

military funerals. However, the Supreme Court did note: ‘‘[E]ven 

protected speech is not equally permissible in all places and at all 

times * * *. Westboro’s choice of where and when to conduct its 

picketing is not beyond the Government’s regulatory reach—it is 

subject to reasonable time, place, or manner restrictions.’’ (Internal 

quotations and citations omitted.) 

Committee Bill. Section 501 of the Committee bill would amend 

section 1388 of title 18, U.S.C., to expand the prohibition against 

certain activities at any funeral of a member or former member of 

the Armed Forces, which does not take place at a cemetery under 

the control of NCA or ANC. 

Under the Committee bill, it would be unlawful for any person 

to engage in a prohibited activity during the period beginning 120 

minutes before and ending 120 minutes after a funeral of servicemembers or former members of the Armed Forces. Specifically, the 

41 

bill would prohibit an activity during that time by individuals within 300 feet of the intersection between the boundary of the property 

where the funeral takes place and a road or other route of ingress 

to or egress from the funeral location, if the activity includes any 

individual ‘‘willfully making or assisting in the making of any noise 

or diversion, that is not part of such funeral and that disturbs the 

peace and good order of such funeral, and with the intent of disturbing the peace and good order of such funeral.’’ It would also 

prohibit during that time activity within 500 feet of the boundary 

of the funeral location, if the activity includes an individual willfully and with intent impeding or tending to impede the access to 

or egress from the funeral location. 

The Committee bill would establish a prohibition, within section 

1388, for intentionally disturbing persons at the homes of surviving 

family members of the deceased servicemember or veteran. Specifically, it would be unlawful to engage in an activity during the period beginning 120 minutes before and ending 120 minutes after a 

military funeral, if the activity is on or near the boundary of the 

home of an immediate family member of the deceased person and 

the activity includes an individual willfully making a noise or diversion that disturbs or tends to disturb the peace of the individuals at that location and is intended to disturb that peace. The 

Committee believes it necessary to protect the sanctity of the 

homes of these grieving family members. This provision only precludes speech that disturbs and is directed at the family home, but 

does not prohibit other forms of protected speech within the surrounding area. In Frisby v. Schultz, 108 S. Ct. 2495 (1988), the Supreme Court acknowledged that people in their homes are captive 

audiences where, unlike in public, they cannot be expected to avoid 

speech which they may deem offensive. The Committee believes 

that the government has a significant interest in protecting servicemembers’ families while they are grieving in the sanctity of their 

own homes. Like the Court in Frisby, the Committee believes that 

homes—and in this case, the homes of grieving family members— 

are the last refuge for its occupants. 

Under the Committee bill, section 1388 would be further amended by adding subsections on civil remedies, actual and statutory 

damages, and a rebuttable presumption. Specifically, subsection 

1388(c) would provide that district courts of the United States 

would have jurisdiction to prevent and restrain violations of section 

1388 and to adjudicate claims for relief under that section. It would 

also authorize the Attorney General to institute legal proceedings 

with regard to violations of section 1388. Further, subsection 

1388(c) would provide that any person, including a surviving member of the deceased person’s immediate family, who suffers injury 

due to conduct prohibited by section 1388 may sue in United States 

district court or other courts of competent jurisdiction and may recover damages found in new subsection 1388(d), the cost of the 

suit, and reasonable attorneys’ fees. Finally, subsection 1388(c) 

would provide that a judgment in favor of the government in a 

criminal proceeding related to a violation of section 1388 would 

estop the defendant from denying the allegations with respect to 

that crime in a later civil proceeding. 

Further, section 1388 would be amended by the Committee bill 

by adding subsection 1388(d), which would provide that, in addition 

42 

to any criminal penalty, a violator of section 1388 would be liable 

in a civil proceeding for either actual or statutory damages. The 

person bringing forth the civil action may elect to recover either actual damages or statutory damages, which statutory damages 

would be set at a sum of not less than $25,000 or more than 

$50,000 per violation. Subsection 1388(d) would entitle the Attorney General to recover an award of statutory damages for each violation involved in the action notwithstanding those awarded to the 

immediate family of the deceased individual. 

The Committee bill would establish a new subsection 1388(e), 

which would set forth a rebuttable presumption that a violation of 

section 1388 was committed willfully for the purposes of relief 

under the section, if the violator or person acting in concert with 

the violator did not have reasonable grounds to believe, due to the 

attention or publicity sought or other circumstance, that the conduct would not disturb the peace or good order of the funeral, impede or tend to impede the access to or egress from the funeral, or 

disturb or tend to disturb the peace on or near the residence of any 

surviving member of the deceased individual’s family. 

Section 501 of the Committee bill would also amend section 2413 

of title 38, U.S.C., to expand the prohibition against certain demonstrations and disruptions at cemeteries under the control of NCA 

and ANC. The Committee bill would not affect the current prohibition, found in section 2413, against any person demonstrating on 

the property of a federally controlled cemetery without proper approval from the cemetery superintendent or director. However, 

under section 501, it would also be unlawful to engage in a demonstration in the period from 120 minutes prior to 120 minutes 

after a funeral or memorial service if: any part of the demonstration takes place within the boundary of the cemetery or takes place 

within 300 feet of the intersection between the boundary of the 

cemetery and the road or other route of ingress and egress from the 

cemetery; includes anyone willfully making or assisting in making 

any noise or diversion that is not part of the funeral; disturbs or 

tends to disturb the peace or good order of the funeral; and is intended to disturb the peace or good order of the funeral. It would 

also be unlawful to demonstrate within 500 feet of the boundary of 

the cemetery, if the demonstration includes anyone willfully and 

without proper authorization impeding or tending to impede the access to or the egress from the cemetery, with the intent to do so. 

The Committee bill would add subsection 2413(b), which would include the penalty for violating section 2413. The current penalties 

for a violation of section 2413 are found in section 1387 of title 18, 

U.S.C. The Committee bill would add subsection 2413(b) to clarify 

what the penalties are directly in title 38. 

The Committee bill would amend section 2413 of title 38, U.S.C., 

by adding subsections on civil remedies, actual and statutory damages, and a rebuttable presumption. Specifically, subsection 2413(c) 

would provide that district courts would have jurisdiction to prevent and restrain violations of section 2413 and to adjudicate 

claims for relief under that section. It would also authorize the Attorney General to institute legal proceedings with regard to violations of section 2413. Further, subsection 2413(c) would provide 

that any person, including a surviving member of the deceased person’s immediate family who suffers injury due to conduct prohibVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00042 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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ited by section 2413, may sue in district court or other courts of 

competent jurisdiction and may recover damages found in new subsection 2413(d), the cost of the suit, and reasonable attorneys’ fees. 

Finally subsection 2413(c) would provide that a judgment in favor 

of the government in a criminal proceeding related to a violation 

of section 2413 would estop the defendant from denying the allegations with respect to that crime in a later civil proceeding. 

The Committee bill includes a new subsection 2413(d), which 

would provide that, in addition to any criminal penalty, a violator 

of section 2413 would be liable in a civil proceeding for either actual or statutory damages. The person bringing forth the civil action may elect to recover either actual damages or statutory damages, which statutory damages would be set at a sum of not less 

than $25,000 or more than $50,000 per violation. Subsection 

2413(d) would entitle the Attorney General to recover an award of 

statutory damages for each violation involved in the action notwithstanding those awarded to the immediate family of the deceased 

individual. 

Additionally, new subsection 2413(e) would establish a rebuttable 

presumption that a violation of 2413(a) was committed willfully for 

the purposes of determining relief, if the violator or a person acting 

in concert with the violator did not have a reasonable expectation 

to believe, either from the publicity sought or other circumstance, 

that the conduct would not disturb or tend to disturb the peace and 

good order of the military funeral, or impede or tend to impede the 

access to or egress from the funeral. 

The Committee understands the critical importance of the First 

Amendment and, specifically, the rights found within the Free 

Speech Clause. However, the freedom of speech in the United 

States is not unlimited. The Supreme Court has ruled that the 

time, place, and manner of speech can be limited by the government if the restriction is content neutral, serves a significant government interest, is narrowly tailored to serve a significant government interest, and leaves ample alternative channels for communication. As discussed below, the Committee believes that the 

changes to section 1388 of title 18, U.S.C., and section 2413 of title 

38, U.S.C., meet this test and uphold the rights found within the 

Free Speech Clause, while at the same time protecting the sanctity 

and decorum of military funerals. 

The prohibitions in both sections are content neutral as they 

apply to all offenders, not a specific group or view point. The Committee believes that the restrictions in both sections are narrowly 

tailored to meet a significant government interest and thus would 

meet the thresholds outlined in previous Supreme Court cases. For 

example, section 1388 would only prohibit a very specific subset of 

speech: ‘‘making or assisting in making of any noise or 

diversion*** that is not part of such funeral and that disturbs 

or tends to disturb the peace or good order of such funeral.’’ Also, 

to be prohibited, that speech must take place at the cemetery or 

within 300 feet of the boundary of the cemetery and the intersection with a road or access point to the funeral location and there 

must be an intent to disturb the peace and good order of the funeral. In addition, those restrictions would apply only during the 

period starting 120 minutes before and ending 120 minutes after 

a military funeral. Individuals and/or groups would be free to utiVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00043 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
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lize their free speech rights outside of the 300 foot buffer or at a 

different time. The 300 foot buffer is designed to balance individual 

rights to protest, and at the same time protect families at a funeral 

who are captive for a set period of time while laying their military 

family members to rest. The Committee believes that the amended 

restrictions, which would be set forth by the Committee bill, are 

narrowly tailored so as to allow ample alternate channels for 

speech while protecting the sanctity and decorum of military 

funerals. 

Under sections 1388 and 2413, as would be amended by the 

Committee bill, it would be unlawful, during a limited period of 

time, for an individual to demonstrate or conduct activities within 

500 feet of the boundary of a cemetery where a military funeral is 

to be held, and to impede or tend to impede the access to or egress 

from the funeral with the intent of doing so. The government has 

a significant interest in allowing the free flow of people and vehicles into and out of the location of a military funeral. Family members of a deceased servicemember should be able to attend the funeral and should not be precluded from access to the funeral. The 

500 foot prohibition against impeding access does not restrict any 

more speech than is necessary to meet the government’s interest. 

The Constitution enumerates a number of powers explicitly given 

to Congress to exercise. These powers provided under the Constitution, article I, section 8, include the power to provide for the common defense, raise and support armies, provide and maintain a 

navy, make rules for government and regulation of the land and 

naval forces, and provide for organizing and governing such part of 

the militia as may be employed in the service of the United States. 

The Committee believes that by further protecting the sanctity and 

dignity of military funerals, Congress is utilizing its authority to 

make laws that are necessary and proper to exercise its enumerated powers as listed above. In order for Congress to meet its obligations in article I, section 8, the dignity of servicemembers, veterans, and their families must be protected by specifically allowing 

fallen servicemembers and veterans to be laid to rest in a dignified 

way. 

A number of states have passed laws with the intent of protecting the dignity of military funerals within their jurisdiction. 

These state laws vary in scope and have no uniform time, place, 

and manner restrictions. The Committee believes that protecting 

the sanctity of a military funeral is of high national importance, 

and all families of deceased servicemembers should have the same 

protection, regardless of where they choose to bury their loved 

ones. 

The Committee bill amends both sections 1388 and 2413 by allowing the Attorney General to institute proceedings due to violations of either section. The amended sections also make violating 

either section a civil offense, where a finding in favor of the plaintiff carries the award of actual or statutory damages. The Committee notes that it does not appear that the Federal government 

has been enforcing the statutes as they are currently constructed. 

By allowing for civil actions to be brought by other injured parties, 

setting forth damages, and authorizing the Attorney General to 

start proceedings, the Committee believes there will be a uniform 

45 

process for protecting the dignity of military funerals, both through 

governmental and non-governmental action. 

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

Section 502 of the Committee bill, which is derived from S. 698, 

would amend chapter 24 of title 38, U.S.C., by requiring that not 

more than one gravesite may be provided at ANC to an eligible veteran or member of the Armed Forces. The section would also prohibit the reservation of gravesites at ANC for individuals not yet 

deceased, and would require that the Army submit to Congress, 

within 180 days of the date of this section’s enactment, a report on 

reservations made for interment at ANC. 

Background. Army Regulation 290–5, Paragraph 4–14, states 

that ANC selection of specific gravesites or sections is not authorized. Despite a stated policy against preferential treatment and the 

reservation of gravesites, The Washington Post reported that in recent years ANC had repeatedly provided preferential treatment to 

VIPs by setting aside select and prestigious gravesites for their future use. The March 2011 article, titled ‘‘Arlington Cemetery Struggles with old reservations,’’ is excerpted in relevant part: 

Although [ANC] stopped formally taking reservations in 

1962, the practice of reserving choice grave sites continued, if unofficially, under Raymond J. Costanzo, who was 

superintendent from 1972 to 1990. [John C. Metzler, Jr.], 

his successor, who ran the cemetery until he was forced to 

retire last year, also apparently allowed people to pick 

areas of the cemetery where they wanted to be buried, 

Army officials said. 

The Army, which investigated the matter two decades 

ago and is looking into it again, has a list from 1990 with 

‘‘senior officials’’ who have plots that ‘‘were de facto reserved in violation of Army policy,’’ according to a memo 

obtained by The Post under the Freedom of Information 

Act. Some of these officials were driven around the cemetery by Costanzo, who told investigators that he had allowed them to pick their spots. 

‘‘I take the position that if there is anything I can do 

positively for a person, I will try to do that as long as it 

is not a serious violation of any rule, regulation, or law,’’ 

he told investigators at the time. 

Media reports regarding preferential treatment of and reservations for certain people, coupled with a 2010 investigation of ANC 

by the Army Inspector General, reflect a series of problems with 

the previous management of ANC. As ANC works to build accountability and transparency in its management and operations, the 

issue of gravesite reservations remains a paramount concern. 

Committee Bill. Section 502 would codify the Army regulations 

that ban reserving gravesites and would provide accountability and 

transparency. The section would amend chapter 24 of title 38, 

U.S.C., by requiring that not more than one gravesite at ANC be 

provided to eligible veterans or members of the Armed Forces, unless a waiver is made by the Secretary of the Army as considered 

46 

appropriate. This requirement would apply with respect to all interments at ANC after the date of the enactment of this section. 

Section 502 would also prohibit the reservation of gravesites at 

ANC for individuals not yet deceased. This prohibition would not 

apply with respect to the interment of an individual for whom a request for a reserved gravesite was approved by the Secretary of the 

Army before January 1, 1962—when ANC formally stopped accepting reservations. 

A reporting requirement would also be imposed by the section. 

Not later than 180 days after the enactment of this section, the 

Army would be required to submit to Congress a report on reservations made for interment at ANC. The report would describe the 

number of requests for reservations at ANC that were submitted 

to the Secretary of the Army before January 1, 1962. The report 

would also describe the number of gravesites at ANC that, on the 

day before the date of the enactment of this section, were reserved 

in response to such requests. The number of such gravesites that, 

on the day before the enactment of this section, were unoccupied 

would also be included in the report. Additionally, the report would 

list all reservations for gravesites at ANC that were extended by 

individuals responsible for the management of ANC in response to 

requests for such reservations made on or after January 1, 1962. 

Finally, the report would detail the measures that the Army is 

taking to improve the accountability and transparency of gravesite 

reservations at ANC and any recommendations for legislative action necessary to improve such accountability and transparency. 

The Committee believes that this section is necessary to ensure 

that qualified servicemembers and veterans are honored at ANC 

without regard to rank or status. In light of the extraordinary sacrifices made by America’s men and women in uniform, it is paramount that their burials at ANC occur with integrity, in a manner 

befitting such sacrifice, and in accordance with Army policy and 

regulation. 

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

service. 

Section 503 of the Committee bill, which is derived from S. 874, 

would expand eligibility for presidential memorial certificates to eligible friends and family of any servicemember who died in active 

military, naval or air service. 

Background. Under current law, section 112 of title 38, U.S.C., 

eligibility for presidential memorial certificates is limited to survivors of veterans who were discharged from service under honorable conditions. Under the statutory definition of ‘‘veteran,’’ for purposes of this section, an individual who died in active service, including an individual killed in action, technically is not a veteran 

because the individual was not ‘‘discharged’’ from service. Therefore, under current law, the survivors of such an individual are not 

eligible for a presidential memorial certificate for honoring the 

memory of the deceased individual. 

Committee Bill. Section 503 of the Committee bill would amend 

section 112 of title 38 by allowing VA to provide presidential memorial certificates to the next of kin, relatives, or friends of a 

servicemember who died in active military, naval, or air service. 

47 

TITLE VI—CONSTRUCTION MATTERS

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

projects. 

Section 601 of the Committee bill would authorize VA to carry 

out the construction of new major medical facility projects in FY 

2012 in Seattle, Washington, and in West Los Angeles, California. 

Background. Section 8104 of title 38, U.S.C., requires statutory 

authorization for all VA major medical facility construction projects 

prior to the appropriation or expenditure of funds. Two new 

projects warrant immediate FY 2012 authorization: Seattle, Washington, and West Los Angeles, California. 

The Seattle project will correct seismic deficiencies identified at 

Building 100, which contains both the Nursing Tower and Community Living Center (hereinafter, ‘‘CLC’’) at the Seattle Campus. According to the Department, over 90 percent of all patient activity 

at this facility goes through Building 100 on any given day. The 

nursing tower in Building 100 ranks eighth and the CLC in Building 100 ranks sixteenth among the buildings on the exceptionally 

high risk list of VA’s Seismic Inventory report. The Seattle project 

has already received $4,300,000 in budget authority to begin design. The total estimated cost associated with this project is 

$51,800,000. 

The West Los Angeles project would seismically retrofit and renovate twelve buildings to house research, mental health, and homeless veterans programs. These buildings are designated as exceptionally high risk on VA’s Seismic Inventory report and have a 

number of life safety and facility condition deficiencies. The West 

Los Angeles project has already received $15,500,000 in budget authority to begin design. The total estimated cost associated with 

this project is $346,900,000. For FY 2012, VA requested the authority to add Building 209 to the project and to obligate 

$20,000,000 of additional resources from prior year unobligated 

major construction funds to complete this renovation, for a total of 

$35,500,000. 

Committee Bill. Section 601 of the Committee bill would authorize appropriations of an amount not to exceed $51,800,000 to conduct seismic corrections for Building 100 at the VAMC in Seattle, 

Washington. It would also authorize appropriations of an amount 

not to exceed $35,500,000 to conduct seismic corrections and renovation of various buildings at the VAMC in West Los Angeles, 

California. 

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

Section 602 of the Committee bill would modify previously authorized major medical facility construction projects in Fayetteville, 

Arkansas; Orlando, Florida; Palo Alto, California; San Juan, Puerto 

Rico; and St. Louis, Missouri. 

Background. Section 8104 of title 38, U.S.C., requires authorization of any major medical facility construction project or lease. Section 8104(d)(2)(A) of title 38 requires that unobligated funds that 

are a direct result of bid savings from major medical facility construction projects may only be obligated for major medical facility 

projects authorized in the current or previous fiscal years. VA reVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00047 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
48 

quested that Congress modify previous authorizations for five 

major medical facility projects. 

Congress has authorized, through Public Law 109–461, the Veterans Benefits, Health Care, and Information Technology Act of 

2006, up to $56,163,000 to be appropriated to construct a clinical 

addition at the VAMC in Fayetteville, Arkansas, to address projected workload growth. $93,000,000 was appropriated but 

$2,400,000 was reprogrammed to the Filipino Equity Compensation 

Fund in 2010. Due to a favorable market, VA has realized 

$16,000,000 in savings on this project and has requested authorization to reinvest $13,500,000 to address parking shortages by constructing a 522-space parking garage. 

VA was authorized through Public Law 109–461, the Veterans 

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

fund an amount up to $377,700,000 for land acquisition and construction of a 134-bed new medical facility, a large medical clinic, 

a 120-bed community living center, a 60-bed domiciliary, and support services in Orlando, Florida. This authority was increased by 

Public Law 110–387, the Veterans’ Mental Health and Other Care 

Improvements Act of 2008, to up to $656,800,000. Congress appropriated $665,400,000. Due to a favorable market, VA has realized 

$111,243,000 in savings on this project and has requested authorization to reinvest $62,001,000 on energy projects and the creation 

of a Simulation, Learning, Education and Research Network Center. 

VA’s Palo Alto Health Care System was authorized to construct 

a replacement Ambulatory Care Center, a replacement PRC, a 

blind rehabilitation facility, a 600 stall parking structure, and a research facility. The project received a $194,877,000 appropriation 

and was one of several Level I PRCs authorized through Public 

Law 110–252, the Supplemental Appropriations Act, 2008. VA has 

requested that this project be authorized at the total estimated cost 

of $716,600,000 for completion. 

The project in San Juan seismically upgrades the main hospital 

building, provides asbestos abatement, provides fire sprinklers, and 

allows VA to sustain operations in the wake of a natural disaster, 

better fulfilling the Department’s role as the Coordinator of the 

Federal Response Plan in Puerto Rico. In addition, a new administrative building, parking structure, and outpatient clinic expansion 

will be built. Up to $225,900,000 was authorized to be appropriated 

through Public Law 110–387, the Veterans’ Mental Health and 

Other Care Improvements Act of 2008. VA has requested additional budget authority to complete the project, for a total estimated cost of $277,000,000. 

The Jefferson Barracks campus of the St. Louis VAMC was authorized to receive up to $69,053,000 through Public Law 109–461, 

to consolidate outpatient functions and relocate VA’s Employee 

Education system and the NCA administrative operations. This 

consolidation would involve the demolition of underutilized buildings that would provide about 30 acres of land for cemetery expansion. VA has requested that this project be authorized at the total 

estimated cost of $346,300,000 for completion. 

Committee Bill. Section 602(a) of the Committee bill would 

amend section 803(3) of Public Law 109–461 to authorize an 

amount not to exceed $90,600,000 and would authorize a change of 

49 

purpose, to include a parking garage in the major medical facility 

construction project at Fayetteville, Arkansas. 

Section 602(b) would amend section 802(11) of Public Law 109– 

461, as amended by section 702(b)(4) of Public Law 110–387, the 

Veterans’ Mental Health and Other Care Improvements Act of 

2008, to authorize a change of purpose, to include a Simulation, 

Learning, Education, and Research Network Center in the major 

medical facility construction project in Orlando, Florida. 

Section 602(c) would, in a freestanding provision, increase the 

authorized amount for the major medical facility construction 

project at Palo Alto, California, to $716,600,000. 

Section 602(d) would amend section 701(3) of Public Law 110– 

387, to increase the authorized amount for the major medical facility construction project in San Juan, Puerto Rico, to $277,000,000. 

Section 602(e) would amend section 803(5) of Public Law 109– 

461 to increase the authorized amount for the major medical facility improvements and cemetery construction project in St. Louis, 

Missouri, to $346,300,000. 

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

leases. 

Section 603 of the Committee bill would authorize eight leases 

for FY 2012: a CBOC in Columbus, Georgia; an outpatient clinic 

in Fort Wayne, Indiana; an outpatient clinic in Mobile, Alabama; 

an outpatient clinic in Rochester, New York; a CBOC in Salem, Oregon; an outpatient clinic in San Jose, California; an outpatient 

clinic in South Bend, Indiana; and a CBOC in Springfield, Missouri. 

Background. Section 8104 of title 38, U.S.C., requires authorization of any major medical facility construction project or lease. The 

Department has requested authorization for eight pending leases in 

order to improve health care. 

The Columbus, Georgia, replacement CBOC lease would consolidate two clinics whose leases have expired. This consolidation will 

allow patient and staff efficiencies as well as improve the patient 

continuum of care. 

The Department has indicated that the Ft. Wayne VAMC suffers 

from infrastructure deficiencies, space shortages, and patient privacy deficiencies. The Fort Wayne, Indiana, outpatient clinic lease 

would improve the quality of care delivered to veterans and allow 

the campus to decompress by housing mental health services, including substance abuse and PTSD care, in a new facility. 

The existing outpatient clinic in Mobile, Alabama, is housed in 

two floors of a functionally obsolete building in a neighborhood 

with rising crime rates. The clinic occupies 35,345 net usable 

square feet, but is overcrowded and cannot implement new programs due to a lack of space. The space cannot be reconfigured due 

to columns and load bearing walls. A more appropriately sized facility would allow VA to incorporate the services provided at the existing clinic, in addition to new services such as home-based primary care and the patient aligned care team model. 

The existing Rochester, New York, CBOC was determined to 

have a space and parking shortage, despite leasing a total of 41,190 

net usable square feet and 184 parking spaces. This deficiency limits the specialty services that can be provided at the clinic. A new 

50 

space would allow VA to serve area veterans through primary care, 

women’s health, an OEF/OIF clinic, mental health services, homeless outreach services, home-based primary care, specialty and ancillary services, research, residency programs, and space for Veterans Benefits Administration and VSO presence. 

The 10,000 net usable square foot Salem, Oregon, CBOC is too 

small to support projected workload growth. The size limits the 

services the clinic can offer to just primary and specialty care, mental health, and other ancillary services. A new lease would improve 

the delivery of health care in the South Cascades market by allowing the CBOC to also offer eye care, rehabilitation, audiology, and 

speech pathology. 

The existing lease on the San Jose, California, CBOC is set to 

expire in 2016, with no additional option years and no opportunity 

for renewal. The CBOC treats over 10,000 veterans annually. 

Maintaining access to health care is critical for these veterans. The 

new Outpatient Clinic lease will allow VA to provide a number of 

services, including primary care, mental health, audiology, podiatry, optometry, radiology, laboratory, pharmacy, and telehealth. 

VA provides limited outpatient services through a CBOC in 

South Bend, Indiana. The remaining need is met by contracting for 

care and housing VA mental health providers at a contract facility. 

For needs that cannot be met locally, veterans must travel approximately two hours to the Fort Wayne VAMC. A new outpatient clinic lease will increase the continuity of care in South Bend, decrease 

outsourcing costs, allow VA to expand the type of services it offers, 

and reduce the travel time for veterans in need of health care. 

The Gene Taylor Outpatient Clinic in Mt. Vernon, Missouri, currently leases space from the State of Missouri at the Missouri Rehabilitation Center. The State has elected to close the center and 

has offered to extend the lease for an additional surcharge of over 

$1,000,000 per year. The space is undersized and ill-equipped to 

handle demand in the area, necessitating that VA contract with 

community providers for laboratory and radiology services. Springfield, Missouri, is an area that has a high veteran population. Relocating and expanding the CBOC from Mt. Vernon to Springfield 

will improve veteran access, increase clinical capacity, and improve 

efficiency. 

Committee Bill. Section 603(1) of the Committee bill would authorize the lease of a CBOC in Columbus, Georgia. The replacement clinic will support the parent facility at the Central Alabama 

Veterans Health Care System through the acquisition of approximately 55,000 net usable square feet of clinical space. The Committee bill would fully authorize the lease in the amount of 

$5,335,000. 

Section 603(2) of the Committee bill would authorize the lease of 

an Outpatient Clinic in Fort Wayne, Indiana. The replacement clinic will support the parent facility of the VA Northern Indiana 

Health Care System through the acquisition of approximately 

27,000 net usable square feet of clinical space. The Committee bill 

would fully authorize the lease in the amount of $2,845,000. 

Section 603(3) of the Committee bill would authorize the lease of 

an Outpatient Clinic in Mobile, Alabama. The replacement clinic 

will support the parent facility of the VA Gulf Coast Veterans 

Health Care System in Biloxi, Mississippi, through the acquisition 

51 

of approximately 65,125 net usable square feet of clinical space. 

The Committee Bill would fully authorize the lease in the amount 

of $6,565,000. 

Section 603(4) of the Committee bill would authorize the lease of 

an Outpatient Clinic in Rochester, New York. The replacement 

clinic will support the parent facility of the Canandaigua VAMC in 

Canandaigua, New York, through the acquisition of approximately 

84,000 net usable square feet of clinical space and 672 parking 

spaces. The Committee bill would fully authorize the lease in the 

amount of $9,232,000. 

Section 603(5) of the Committee bill would authorize the lease of 

a CBOC in Salem, Oregon. The replacement clinic will support the 

parent facility of the Portland VAMC in Portland, Oregon, through 

the acquisition of approximately 26,000 net usable square feet of 

clinical space. The Committee bill would fully authorize the lease 

in the amount of $2,549,000. 

Section 603(6) of the Committee bill would authorize the lease of 

an Outpatient Clinic in San Jose, California, to replace the existing 

CBOC. The clinic will support the parent facility of the VA Palo 

Alto Health Care System in Palo Alto, California, through the acquisition of approximately 72,000 net usable square feet of clinical 

space and at least 576 parking spaces. The Committee bill would 

fully authorize the lease in the amount of $9,546,000. 

Section 603(7) of the Committee bill would authorize the lease of 

an Outpatient Clinic in South Bend, Indiana. The replacement clinic will support the parent facility of the VA Northern Indiana 

Health Care System in Fort Wayne, Indiana, through the acquisition of approximately 39,000 net usable square feet of clinical 

space. The Committee bill would fully authorize the lease in the 

amount of $6,731,000. 

Section 603(8) of the Committee bill would authorize the lease of 

a CBOC in Springfield, Missouri. The new clinic will support the 

parent facility of the Veterans Health Care System of the Ozarks 

in Fayetteville, Arkansas, through the acquisition of approximately 

68,000 net usable square feet of clinical space. The Committee bill 

would fully authorize the lease in the amount of $6,489,000. 

Sec. 604. Authorization of appropriations. 

Section 604 of the Committee bill would authorize appropriations 

for construction and leases. 

Background. Section 8104(a)(2) of title 38, U.S.C., prohibits the 

appropriation of funds for major medical facility construction 

projects or leases unless funds have been specifically authorized by 

law. 

Committee Bill. Section 604 of the Committee bill would, in a 

freestanding provision, authorize an appropriation for FY 2012, or 

the year in which funds are appropriated, of $937,370,000 from the 

Construction, Major Projects, account for projects authorized in sections 601 and 602 of the Committee bill. It would also authorize 

an appropriation for FY 2012, or the year in which funds are appropriated, of $49,292,000 from the Medical Facilities account for 

the leases authorized in section 603 of the Committee bill. 

52 

Sec. 605. Limitation on authority of VA to use bid savings on major 

medical facility projects to expand purpose of major medical facility projects. 

Section 605 of the Committee bill, which is derived from S. 928, 

would limit the authority of VA to use bid savings to expand the 

purpose of previously authorized major medical facility projects. 

Background. Due to a favorable bid environment, VA has realized savings on several major construction projects. Under current 

law, section 8104(d) of title 38, U.S.C., VA may only use those savings on previously authorized projects; however, VA may currently 

use bid savings to expand upon the original purpose of a previously 

authorized project. Through its Strategic Capital Investment Planning process, VA has identified and prioritized up to $65 billion in 

anticipated construction needs over the next 10 years. 

Committee Bill. Section 605 of the Committee bill would limit 

VA’s ability to use bid savings on major medical facilities to expand 

the purpose of a project. VA would be required to submit to the 

Committees on Veterans’ Affairs and the Committees on Appropriations of the Senate and the House of Representatives notice of the 

source of the bid savings; the major medical facility project with respect to which VA intends to expand the purpose; a description of 

such expansion; and the amounts VA intends to obligate for such 

expansion. 

VA would not be authorized to expand the purpose of a project 

without Congressional authorization enacted in law. It is the Committee’s intent that construction projects previously authorized, but 

not fully funded, be prioritized accordingly. 

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

Section 606 of the Committee bill, which is derived from S. 269, 

would designate the VAMC located in Big Spring, Texas, as the 

‘‘George H. O’Brien, Jr., Department of Veterans Affairs Medical 

Center.’’ 

Background. George H. O’Brien, Jr., served as a seaman in the 

United States Merchant Marines from December 1944 until May 

1946. In July 1946, while attending college at Texas Technical College, now known as Texas Tech University, he enlisted in the 

United States Marine Corps Reserve. After graduating from college 

in 1950, he was ordered to active duty and served in the Korean 

War until September 1952. He was awarded the Medal of Honor 

for his heroic actions during the Battle of the Hook on October 27, 

1952, as detailed in the citation accompanying his award. He also 

received the Purple Heart Medal with gold star in lieu of a second 

award, the Korean Service Medal with two bronze stars, and the 

United Nations Service Medal, among other military honors. After 

his active duty service, O’Brien began a career as a petroleum geologist in Texas, while serving on the Marine Corps Scholarship 

Foundation as well as in the Medal of Honor Society. O’Brien was 

also an active volunteer at the VAMC in Big Spring, Texas. 

The Committee’s Rules of Procedure (hereinafter, ‘‘Committee 

Rules’’) put forward the requirements for the naming of Department facilities. According to those rules, a facility may be named 

for an individual only if that individual is deceased, and was a veteran who was instrumental to the construction or operation of the 

53 

facility, received the Medal of Honor, or otherwise performed extraordinarily distinguished military service; was a member of Congress who was directly associated with such facility; an Administrator of Veterans Affairs, Secretary of Veterans Affairs, Secretary 

of Defense or of a branch of service, or a military or Federal civilian official of comparable rank; or the Chairman and Ranking 

Member agree the individual performed outstanding service for veterans. Further, each member of Congress representing the State in 

which the facility is located and the State chapter of each Congressionally-chartered VSO that has a national membership of at least 

500,000, must indicate in writing their support for the naming 

proposal. 

Committee Bill. Section 606 of the Committee bill would, in a 

freestanding provision, name the VAMC in Big Spring, Texas, the 

‘‘George H. O’Brien, Jr., Department of Veterans Affairs Medical 

Center.’’ 

Because all members of the Texas Congressional delegation have 

expressed their support for naming this facility in writing, and the 

Texas chapters of all VSOs with national memberships of at least 

500,000 individuals have endorsed this facility being named in 

honor of George H. O’Brien, Jr., this provision satisfies the Committee Rules regarding the naming of VA facilities. 

Sec. 607. Designation of Major William Edward Adams Department 

of Veterans Affairs Clinic. 

Section 607 of the Committee bill, which is derived from S. 327, 

would designate the VA telehealth clinic in Craig, Colorado, as the 

‘‘Major William Edward Adams Department of Veterans Affairs 

Clinic.’’ 

Background. Major Adams distinguished himself while serving as 

a U.S. Army helicopter pilot in Vietnam on May 25, 1971. Major 

Adams volunteered to fly a lightly armed helicopter in an attempt 

to evacuate three seriously wounded American soldiers from a 

small base that had come under attack. He made this decision with 

full knowledge that numerous anti-aircraft weapons were positioned around the base and that clear weather would make him 

visible to enemy gunners. As Major Adams approached the base, 

his aircraft came under heavy machine gun and rocket fire, but he 

continued his approach, simultaneously directing the attacks of 

supporting gunships while maintaining control of his own aircraft. 

He picked up the wounded soldiers, but his aircraft was then 

struck by enemy anti-aircraft fire and crashed, killing all aboard. 

In recognition of his heroism and sacrifice, Major Adams was posthumously awarded the Medal of Honor on August 8, 1974. 

The Committee Rules described in section 606 are also applicable 

to this section. 

Committee Bill. Section 607 of the Committee bill would name 

the VA telehealth clinic in Craig, Colorado, after Major William 

Edward Adams. 

Because all members of the Colorado Congressional delegation 

have expressed their support for naming this facility, in writing, 

and the Colorado chapters of all VSOs with national memberships 

of at least 500,000 individuals have endorsed this facility being 

named in honor of Major Adams, this provision satisfies the Committee Rules regarding the naming of VA facilities. 

54 

TITLE VII—OTHER ADMINISTRATIVE AND BENEFIT MATTERS

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

Section 701 of the Committee bill, which is derived from S. 1123, 

would provide certain types of assistance to eligible veterans affected by a natural or other disaster. 

Background. In the wake of Hurricane Katrina and other more 

recent natural disasters, Congress has renewed its focus on Federal 

disaster response activities and resources for individuals affected 

by such disasters. While laws such as Public Law 93–288, the Robert T. Stafford Disaster Relief and Emergency Assistance Act, provide Federal assistance to individuals and families affected by natural disasters, current law is not specifically tailored to the needs 

of veterans, particularly veterans with service-connected disabilities affected by such disasters. This means that under current law 

targeted assistance is unavailable to those veterans who are particularly vulnerable and most in need of assistance in the event of 

a natural disaster. 

For example, VA adaptive housing assistance grants are available to eligible individuals who have certain service-connected disabilities to construct an adapted home or to modify an existing 

home to accommodate their disabilities. However, limitations, such 

as caps on the total amount of assistance available under SAH or 

SHA grants may prevent a veteran from receiving additional assistance from VA to repair an adapted home damaged by a natural 

disaster. 

Similarly, under current law, section 3903 of title 38, U.S.C., if 

a veteran who has received a grant for the purchase of an automobile has that vehicle destroyed by a natural or other disaster, 

current statutory limitations would prevent VA from providing another grant to repair or replace the damaged vehicle. 

Committee Bill. Section 701 of the Committee bill would amend 

chapter 21 of title 38, U.S.C., by adding a new section which would 

provide assistance to a veteran whose home is destroyed or substantially damaged in a natural or other disaster and was previously adapted with assistance through the SAH or SHA grant 

program. Such assistance would not be subject to the limitations on 

assistance under section 2102. However, under this section, a grant 

award would not exceed the lesser of the reasonable cost of repairing or replacing the damaged or destroyed home in excess of the 

available insurance coverage on such home or the maximum grant 

amount to which the veteran would have been entitled under the 

SAH or SHA grant programs had the veteran not obtained the 

prior grant. 

Section 701 would amend section 3108 of title 38, U.S.C., by authorizing VA to extend the payment of a subsistence allowance to 

qualifying veterans participating in a rehabilitation program under 

chapter 31 of title 38. The extension would be authorized if the veteran has been displaced as a result of a natural or other disaster 

while being paid a subsistence allowance. If such circumstances are 

met, VA would be permitted to extend the payment of a subsistence 

allowance for up to an additional two months while the veteran is 

satisfactorily following a program of employment services. 

Section 701 would also amend section 3120 of title 38, U.S.C., by 

waiving the limitation on the number of veterans eligible to receive 

55 

programs of independent living services and assistance in any case 

in which VA determines that an eligible veteran has been displaced 

as the result of, or has otherwise been adversely affected in the 

areas covered by, a storm or other disaster. 

Section 701 would amend section 3703 of title 38, U.S.C., to allow 

VA to guarantee a loan regardless of whether such loan is subordinate to a superior lien created by a public entity that has provided, 

or will provide, assistance in response to a major disaster. 

Additionally, section 701 would amend section 3903, U.S.C., of 

title 38 by authorizing VA to provide or assist in providing an eligible person receiving assistance through the Automobile Assistance 

Program with a second automobile. This assistance would be permitted only if VA receives satisfactory evidence that the automobile, previously purchased with assistance through this program 

was destroyed as a result of a natural or other disaster, the eligible 

person bore no fault, and the person would not receive compensation for the loss from a property insurer. 

Finally, section 701 would require VA to submit an annual report 

to Congress detailing the assistance provided or action taken by VA 

during the last fiscal year pursuant to the authority of this section. 

Required report provisions would include: a description for each 

natural disaster for which assistance was provided, the number of 

cases or individuals in which or to whom VA provided assistance, 

and for each such case or individual, a description of the assistance 

provided. 

The Committee believes these provisions would provide VA with 

the targeted authority necessary to assist veterans, many who are 

particularly vulnerable and most in need of assistance, in the wake 

of a natural or other disaster. 

Sec. 702. Aggregate amount of educational assistance available to 

individuals who receive both survivors’ and dependents educational assistance and other veterans and related educational 

assistance. 

Section 702 of the Committee bill, which is derived from S. 536, 

would amend section 3695 of title 38 to modify the maximum number of months of educational assistance available to certain individuals. 

Background. Under chapter 35 of title 38, U.S.C., certain survivors and dependents of individuals who die or are disabled while 

on active duty are eligible for educational assistance benefits. Section 3511(a)(1) provides that each eligible person is entitled to the 

equivalent of 45 months of full-time benefits. 

P.L. 110–252, the Post-9/11 Veterans Educational Assistance Act 

of 2008, codified at chapter 33 of title 38, established a new program of educational assistance for individuals who served on active 

duty after September 11, 2001. This Act established a program of 

educational assistance in which individuals may earn up to a maximum of 36 months of full-time benefits. 

Further, under current law, section 3695 of title 38, an individual who is eligible for assistance under two or more specific educational programs may not receive in excess of the equivalent of 48 

months of full-time benefits. This means that an eligible survivor 

or dependent who is entitled to receive education benefits under 

the chapter 35 program and who uses all 45 months of those beneVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00055 Fmt 6659 Sfmt 6602 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
56 

fits to obtain a college education, and who subsequently decides to 

enter the military, would only be able to earn the equivalent of 

three months of benefits under Public Law 110–252. 

Committee Bill. Section 702 of the Committee bill would amend 

section 3695 of title 38, U.S.C., to provide that an individual entitled to benefits under chapter 35 will not be subject to the 48- 

month limitation. However, the maximum aggregate period of benefits an individual may receive under chapter 35 and certain other 

educational assistance programs listed at section 3695 of title 38 

would be capped at 81 months. 

Section 702 would also revive a period of entitlement to education benefits in situations where an individual’s entitlement to 

certain education benefits was reduced by the 48-month limitation. 

The maximum period of assistance for individuals with revived 

benefits would also be capped at 81 months. 

The Committee believes this change would allow individuals who 

use their survivors’ or dependents’ educational assistance benefits 

to also establish in their own right entitlement to the full range of 

benefits under Public Law 110–252. 

Sec. 703. Department of Veterans Affairs enforcement penalties for 

misrepresentation of a business concern as a small business 

concern owned and controlled by veterans or as a small business concern owned and controlled by service-disabled veterans. 

Section 703, which is derived from S. 1184 as introduced, would 

change the standard for enforcement of penalties for misrepresentation by businesses of their status as a small business concern 

owned and controlled by a veteran or service-disabled veteran and 

the period of time for any consequent debarment. 

Background. Misrepresentation by businesses of their status as 

a veteran-owned small business (hereinafter, ‘‘VOSB’’) or a servicedisabled veteran-owned small business (hereinafter, ‘‘SDVOSB’’) remains a serious and ongoing concern. VA has taken steps to ensure 

increased contracting opportunities for VOSBs and SDVOSBs are 

utilized by legitimate business concerns. VA has added to its acquisition regulations the misrepresentation of VOSB/SDVOSB status 

as a specific cause for debarment for a period of up to 5 years. Also, 

VA has instituted a separate and distinct Debarment Committee to 

review, examine, and refer those who misrepresent themselves to 

VA’s debarring official. 

Committee Bill. Section 703 would amend section 8127 of title 38 

by changing the standard for enforcement of penalties for misrepresentation by businesses of their status as a small business concern 

owned and controlled by a veteran or service-disabled veteran. 

Under this amendment, only those businesses determined by VA to 

have deliberately misrepresented their status would be liable for 

such misrepresentation. Section 703 would also require that those 

businesses liable for misrepresentation be debarred from contracting with VA for a period of not less than 5 years. The debarment of a business concern would include the debarment of all 

principals in the business concern for a period of not less than 5 

years. Finally, the section would require that commencement of a 

debarment action occur not later than 30 days after a determination by VA of deliberate misrepresentation and that the action be 

completed no later than 90 days after such determination. 

57 

While VA’s current measures reflect the Department’s commitment to an equitable debarment process, consistent with an appropriate level of due process, the Committee is aware that some misrepresentations of VSOB/SDVOSB status requirements may be the 

result of an innocent mistake. Given this, it is important that the 

standard for enforcement of penalties for misrepresentation account for such instances where the misrepresentation is inadvertent and not deliberate. 

To ensure equity and due process, it is also important that a 

minimum period of time for debarment, during which a business 

concern and its principals are prohibited from contracting with VA, 

be adopted and uniformly applied. 

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

Section 704 of the Committee bill, which is derived from S. 1148, 

would authorize certain individuals to sign claims filed with VA on 

behalf of claimants who are under age 18, are mentally incompetent, or are physically unable to sign a form. 

Background. Some claimants for VA benefits are so disabled as 

to be incapable of understanding the information on a benefits application form. Under current law, section 5101 of title 38, U.S.C., 

VA lacks specific authority to authorize a court-appointed representative or caregiver to sign an application form allowing the 

adjudication of the claim to proceed. However, the Social Security 

Administration (hereinafter, ‘‘SSA’’) has specific authority in section 404.612 of title 20 of the Code of Federal Regulations to permit 

certain individuals, such as court-appointed representatives, to sign 

a claim form on behalf of an individual unable to understand and 

sign a claim form. 

Committee Bill. Section 704 of the Committee bill would amend 

section 5101 of title 38 to modify the application process for claims 

filed with VA. This amendment would allow a court-appointed representative, a caregiver, an attorney-in-fact or an agent authorized 

to act on behalf of the claimant under a durable power of attorney 

to sign applications from individuals who are under 18 years of 

age, mentally incompetent, or physically unable to sign a form. If 

an individual is in the care of an institution, the manager or principal officer of the institution would be allowed to sign the form. 

These changes would apply with respect to claims filed on or after 

the date of enactment. 

This change will give VA the same authority that SSA has with 

respect to claimants who are unable to complete applications for 

benefits without requiring assistance. The Committee does not intend that this provision alter VA’s responsibility to evaluate and 

appoint a fiduciary in cases where the beneficiary is determined to 

be incompetent to manage his or her benefits. 

Sec. 705. Improvement of process for filing jointly for social security 

and dependency and indemnity compensation. 

Section 705 of the Committee bill, which is derived from S. 1148, 

would codify VA’s current practice of allowing any claim for survivor benefits filed with SSA to establish the effective date for DIC 

benefits. 

58 

Background. Under current law, section 5105 of title 38, VA and 

SSA are required to develop and use joint applications for survivors 

who apply for both DIC and Social Security survivor benefits. Section 5105 further provides that, if such a joint application form is 

filed with either VA or SSA, it will be deemed an application for 

both DIC and Social Security benefits. However, at present, SSA 

applications are primarily online and VA’s are paper-based. 

In a recent court case, Van Valkenburg v. Shinseki, 23 Vet. App. 

113 (2009), VA represented to the Court that ‘‘there has never been 

an individual ‘jointly prescribed form’ promulgated between VA and 

SSA,’’ and that ‘‘in practice, a claim for survivor’s benefits can be 

filed on any form, with either VA or SSA, when the applicant reflects an intent to seek such benefits.’’ The Court accepted VA’s 

representation that ‘‘any claim, sufficient to reflect an intent to 

apply for survivor’s benefits, that is filed with SSA will suffice to 

establish the effective date of DIC.’’ 

Committee Bill. Section 705 of the Committee bill would amend 

section 5105 of title 38 to permit—but not require—the development of a joint form for SSA and VA survivor benefits. This provision of the Committee bill would also amend section 5105 so that 

any form indicating an intent to apply for survivor benefits would 

be deemed an application for both DIC and Social Security benefits. 

This is intended to codify VA’s practice under which any indication 

of intent to apply for Social Security survivor benefits is also treated as an application for VA DIC benefits. 

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

Section 706 of the Committee bill, which is derived from by-request legislation submitted by the Department, would require that 

any employee of the Department participating in the Employee Incentive Scholarship Program (hereinafter, ‘‘EISP’’) be liable for the 

amount paid for a program should the employee fail to maintain 

VA employment during the program. 

Background. Section 7675 of title 38, U.S.C., limits liability for 

breach of the EISP agreement to part-time student participants. 

Currently, all other VA employee recruitment and retention incentive programs have a service obligation and liability component 

that affects both full-time and part-time employees. 

Committee Bill. Section 706 of the Committee bill would replace 

section 7675(b)(1)(E) of title 38, U.S.C., with a new subparagraph 

that would impose on full-time student participants in the EISP 

the same liability as is currently imposed on part-time students for 

breach of the EISP agreement if they leave VA employment prior 

to completion of their education program. 

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

care services contract. 

Section 707 of the Committee bill, which is derived from S. 1089, 

would require VA to submit to the Committees on Veterans’ Affairs 

of the Senate and the House of Representatives a report on the feasibility and advisability of implementing pay-for-performance 

mechanisms in VA health care contracts at community-based outpatient clinics. 

59 

Background. VA Directive 1663, issued in August 2006, allows 

VAMCs to purchase non-VA care from affiliated medical schools, 

groups, hospitals, and other providers, through contracts or fee-forservice care. These contracts are generally allowed if: a VA facility 

cannot provide a clinical service, the facility cannot recruit a needed clinician, it is not in VA’s best interest to provide such service, 

only a portion of a clinician’s time is needed, or it is cost-effective 

to share a service or space with another entity rather than to develop a capacity within VA. 

Throughout VHA, many CBOCs deliver health care on a contract 

basis. CBOCs typically are associated with VAMCs and refer patients to those facilities when needed. In FY 2010, VA operated 798 

CBOCs, 183 of which were operated by contract. 

The Independent Budget for FY 2012 (hereinafter, ‘‘IB’’) supports 

VA health care contracts when VA facilities are not capable of providing necessary care to veterans. The IB states, however, that VA 

does not track such care, its related costs, outcomes, or veteran satisfaction levels. 

Committee Bill. Section 707 of the Committee bill would, in a 

freestanding provision, require VA to submit a report on pay-forperformance compensation mechanisms, where providers are rewarded for meeting pre-established targets for delivery of health 

care services, in VA health care contracts at CBOCs. 

Subsection (a) of section 707 of the Committee bill would require 

VA to submit, within 180 days after enactment of the Committee 

bill, a report to the Committees on Veterans’ Affairs of the Senate 

and the House of Representatives, which would include information 

on VA’s use of pay-for-performance mechanisms in contracts for 

health care services at CBOCs. 

Subsection (b) of section 707 of the Committee bill would specify 

the required elements to be included in the report. Such requirements would include an assessment of the feasibility and advisability of using pay-for-performance compensation mechanisms in 

VA health care contracts with CBOCs; information on the number 

of CBOCs operating under pay-for-performance compensation 

mechanisms as of the date of enactment of the Committee bill; and 

the impact this mechanism has had in providing incentives to deliver high quality care and to better assure patient satisfaction. 

Subsection (c) of section 707 of the Committee bill would require 

VA to incorporate the views and experiences of representatives of 

at least two private health care systems that have utilized pay-forperformance compensation mechanisms in the operation of medical 

clinics, to determine if such mechanisms had an effect on the delivery of quality, timely medical care in the private sector. 

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

Section 708 of the Committee bill, which is derived from S. 1148, 

would extend for 2 years, until September 30, 2013, VA’s authority 

to obtain information from the Internal Revenue Service (hereinafter, ‘‘IRS’’) or the SSA for income verification purposes for needsbased benefits. 

Background. Under current law, certain benefit programs administered by VA, such as pensions for wartime veterans, are available 

60 

only to beneficiaries whose annual income is below a certain level. 

VA must have access to verifiable income information in order to 

ensure that those receiving benefits under its income-based programs are not earning a greater annual income than the law permits. 

Section 6103(l)(7)(D)(viii) of title 26, U.S.C., authorizes the release of certain income information by the IRS or the SSA to VA 

for the purposes of verifying the incomes of applicants for VA 

needs-based benefits. Section 5317(g) of title 38, U.S.C., provides 

VA with temporary authority to obtain and use this information. 

Under current law, this authority expires on September 30, 2011. 

Committee Bill. Section 708 of the Committee bill would amend 

subsection 5317(g) of title 38 to extend VA’s authority to obtain income information from the IRS or the SSA until September 30, 

2013. 

Sec. 709. Extension of authority for regional office of Department of 

Veterans Affairs in Republic of the Philippines. 

Section 709 of the Committee bill, which is derived from S. 1148, 

would extend until December 31, 2012, VA’s authority to operate 

a regional office in the Republic of the Philippines. 

Background. Filipino veterans who served under the command of 

the United States during World War II have been granted limited 

benefits. Section 315(b) of title 38, U.S.C., authorizes VA to maintain a regional office in the Republic of the Philippines until December 31, 2011, to administer these benefits. Congress has periodically extended this authority, most recently in Public Law 111– 

275, the Veterans’ Benefits Act of 2010. 

P.L. 111–275 also directed GAO to conduct a report on the regional office in the Republic of the Philippines. The report, which 

is due to the House and Senate Committees on Veterans’ Affairs 

and Appropriations no later than October 13, 2011, is required to 

contain a description of the activities of the regional office and an 

assessment of the costs and benefits of maintaining the regional office in the Republic of the Philippines. 

Committee Bill. Section 709 would authorize VA to maintain a 

regional office in the Republic of the Philippines until December 31, 

2012. 

Sec. 710. Report on establishment of a Polytrauma Rehabilitation 

Center or Polytrauma Network Site of the Department of Veterans Affairs in the northern Rockies or Dakotas. 

Section 710 of the Committee bill, which is derived from S. 666, 

would require VA to submit to Congress a report on the feasibility 

and advisability of establishing a VA PRC or PNS in the northern 

Rockies or Dakotas, not later than 180 days after the enactment 

of the Committee bill. 

Background. Polytrauma refers to the cumulative condition resulting from exposure to a single event which has caused multiple 

and complex injuries. Such injuries can impact the brain, limbs, 

spinal cord, and musculoskeletal system, and in turn, can adversely 

affect hearing, vision, and cognition. 

An April 2008 RAND Corporation study, ‘‘Invisible Wounds: 

Mental Health and Cognitive Care Needs of America’s Returning 

Veterans,’’ estimated that 320,000 veterans reported experiencing 

61 

TBI during deployment, from mild concussions to severe wounds. 

Of those who reported experiencing a probable TBI, 57 percent 

were never evaluated by a physician. Veterans with severe polytrauma who do not live in proximity to a polytrauma care facility 

face difficulties in receiving necessary treatment. 

The VA Polytrauma System of Care provides treatment to veterans with polytrauma through four PRCs, located in Palo Alto, 

Tampa, Richmond, and Minneapolis. These PRCs offer comprehensive inpatient and outpatient treatment. A fifth PRC is, as of the 

date of this report, being constructed at the VAMC in San Antonio, 

Texas. There are also 22 PNSs that provide a full range of comprehensive follow-on medical and rehabilitative services, both inpatient and outpatient. 

Committee Bill. Section 710 of the Committee bill would, in a 

freestanding provision, require the VA to conduct a study and report to Congress, not later than 180 days after enactment of the 

Committee bill, on the feasibility and advisability of establishing a 

PRC or PNS in the northern Rockies or Dakotas. This section 

would specify that the Fort Harrison VAMC be one of the sites 

evaluated for potential placement of a PRC or a PNS. 

The report would be required to include an assessment of the 

adequacy of existing services provided at Department facilities and 

the availability of the types of services that would otherwise be 

provided by a PRC or PNS. The report would also be required to 

include a comparative assessment of the effectiveness of TBI rehabilitation programs in urban versus rural settings, an assessment 

of whether the low cost of living in the region could reduce the financial burden on families of a veteran undergoing TBI care and 

thereby improve that care, and whether any stress caused by living 

in an urban area can impede therapies to prevent or remediate the 

development of secondary neurologic conditions related to TBI. The 

Department would be required to consult with State and local government entities in preparing this report. 

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

Section 711 of the Committee bill would modify VA’s authority 

to levy a loan guaranty fee for initial guaranteed housing loans. 

Background. Under VA’s home loan guaranty program, VA may 

guarantee a loan made to eligible servicemembers, veterans, reservists, and un-remarried surviving spouses for the purchase (or 

refinancing) of houses, condominiums, and manufactured homes. 

Section 3729(b)(2) of title 38, U.S.C., sets forth a loan fee table 

that lists funding fees, expressed as a percentage of the loan 

amount, for different types of loans. 

Committee Bill. Section 711 of the Committee bill would amend 

the fee schedule set forth in section 3729(b)(2) of title 38 by extending VA’s authority to collect certain fees and by adjusting the 

amount of the fees. Specifically, the section would strike clauses (i) 

and (ii), redesignate current clause (iii) as clause (i), and insert a 

new clause (ii), and redesignate current clause (iv) as (iii). New 

clause (iii) would additionally be amended by striking ‘‘October 1, 

2011’’ and inserting October 1, 2012. 

The practical effect of these changes would be to maintain the 

current home loan guaranty fees, 2.15 percent for active duty and 

2.4 percent for Reservists, until October 1, 2011. After that date, 

62 

and until October 1, 2012, the rates would be decreased to 1.5 percent for active duty and 1.75 percent for Reservists, rather than allowing them to decrease, according to current law, on October 1, 

2011 to 1.4 percent for active duty and 1.65 percent for Reservists, 

which would now be scheduled to occur on October 1, 2012. 

These amendments would take effect on the later of October 1, 

2011, and the date of the enactment of this section. 

COMMITTEE BILL COST ESTIMATE

In compliance with paragraph 11(a) of rule XXVI of the Standing 

Rules of the Senate, the Committee, based on information supplied 

by the Congressional Budget Office (hereinafter, ‘‘CBO’’), estimates 

that, on net, the Committee bill would decrease direct spending by 

$7 million over the 2012–2021 period. 

In addition, CBO estimates that implementing the Committee 

bill would have a discretionary cost of $1.3 billion over the 2012– 

2016 period, assuming appropriation of the specified and estimated 

amounts. The Committee bill contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform 

Act. The cost estimate provided by CBO, setting forth a detailed 

breakdown of costs, follows: 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, August 30, 2011. 

Hon. PATTY MURRAY, Chairman, 

Committee on Veterans’ Affairs, 

U.S. Senate, Washington, DC. 

DEAR MADAM CHAIRMAN: The Congressional Budget Office has 

prepared the enclosed cost estimate for S. 914, the Veterans Programs Improvement Act of 2011. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Ann E. Futrell. 

Sincerely, 

DOUGLAS W. ELMENDORF, 

Director. 

Enclosure. 

S. 914—Veterans Programs Improvement Act of 2011 

Summary: S. 914 would authorize the construction of several 

major medical facility projects, expand programs for homeless veterans and make other changes to health care, compensation, housing, education, and other programs offered by the Department of 

Veterans Affairs (VA). In total, CBO estimates that implementing 

the bill would have a discretionary cost of $1.3 billion over the 

2012–2016 period, assuming appropriation of the specified and estimated amounts. 

In addition, CBO estimates that enacting the bill would decrease 

direct spending by $7 million over the 2012–2021 period. Pay-asyou-go procedures apply because enacting the legislation would affect direct spending. Enacting S. 914 would not affect revenues. 

S. 914 contains no intergovernmental mandates as defined in the 

Unfunded Mandates Reform Act (UMRA). 

63 

S. 914 would impose a private-sector mandate, as defined in 

UMRA, on certain mortgage holders and other creditors. Based on 

information from industry sources, CBO expects that the cost of the 

mandate would fall below the annual threshold for private-sector 

mandates ($142 million in 2011, adjusted annually for inflation). 

Estimated cost to the Federal Government: The estimated budgetary impact of S. 914 is summarized in Table 1. The costs of this 

legislation fall within budget function 700 (veterans benefits and 

services). 

Table 1.—Estimated Budgetary Effects of S. 914, The Veterans Programs Improvement Act 

of 2011 

By fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2012–2016 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Estimated Authorization Level .................................................. 1,304 42 -5 -6 -7 1,328 

Estimated Outlays .................................................................... 347 344 313 215 77 1,296 

CHANGES IN DIRECT SPENDING a

Estimated Budget Authority ..................................................... -18 0 1 2 -1 -16 

Estimated Outlays .................................................................... -18 0 1 2 -1 -16 

a In addition to the changes in direct spending shown above, enacting S. 914 would have effects beyond 2016 (see Table 3). CBO esti- mates that over the 2012–2021 period, S. 914 would decrease net direct spending by $7million. 

Basis of estimate: For this estimate, CBO assumes the legislation 

will be enacted near the start of fiscal year 2012, that the necessary amounts will be appropriated each year, and that outlays 

will follow historical patterns for similar and existing programs. 

Spending subject to appropriation 

CBO estimates that implementing S. 914 would have a discre- tionary cost of $1.3 billion over the 2012–2016 period, assuming appropriation of the specified and estimated amounts (see Table 2). 

Most of the bill’s estimated costs stem from provisions that would 

authorize appropriations for medical construction projects. 

Medical Facilities. Title VI would authorize funding to construct, 

renovate, and lease several medical facilities. CBO estimates that 

implementing title VI would cost about $1 billion over the 2012– 

2016 period, assuming appropriation of the authorized and estimated amounts. 

Major Construction Projects. Section 602 would authorize the ap- propriation of $850 million to construct and modify medical facilities in Palo Alto, California; St. Louis, Missouri; and San Juan, 

Puerto Rico. CBO estimates that, if appropriated, those amounts 

would result in discretionary costs of $824 million over the 2012– 

2016 period. 

Table 2.—Estimated Changes in Spending Subject to Appropriation Under S. 914 

By fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2012–2016 

Medical Facilities 

Major Construction Projects 

Authorization Level .......................................................... 850 0 0 0 0 850 

Estimated Outlays ........................................................... 37 229 277 204 77 824 

Leases for Medical Facilities 

Estimated Authorization Level ......................................... 50 22 22 22 22 138 

Estimated Outlays ........................................................... 45 22 22 22 22 133 

64 

Table 2.—Estimated Changes in Spending Subject to Appropriation Under S. 914—Continued 

By fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2012–2016 

Seismic Corrections and Renovations 

Estimated Authorization Level ......................................... 68 0 0 0 0 68 

Estimated Outlays ........................................................... 3 18 22 16 6 65 

Subtotal, Medical Facilities 

Estimated Authorization Level ................................ 968 22 22 22 22 1,056 

Estimated Outlays .................................................. 85 269 321 242 105 1,022 

Health Care 

Reimbursement for Ambulance Services 

Estimated Authorization Level ......................................... -45 -48 -51 -53 -56 -253 

Estimated Outlays ........................................................... -41 -47 -50 -53 -55 -246 

Travel Reimbursements for Vet Centers 

Estimated Authorization Level ......................................... 7 14 14 15 15 65 

Estimated Outlays ........................................................... 6 13 14 15 15 63 

Telehealth and Telemedicine Programs 

Estimated Authorization Level ......................................... 2 3 4 6 8 23 

Estimated Outlays ........................................................... 2 3 4 6 8 23 

Chiropractic Care 

Estimated Authorization Level ......................................... 1 1 2 2 2 8 

Estimated Outlays ........................................................... 1 1 2 2 2 8 

Centers of Excellence for Rural Health 

Estimated Authorization Level ......................................... * 1 1 1 1 4 

Estimated Outlays ........................................................... * 1 1 1 1 4 

State Prescription Monitoring Programs 

Estimated Authorization Level ......................................... 1 * * * * 1 

Estimated Outlays ........................................................... 1 * * * * 1 

Subtotal, Health Care 

Estimated Authorization Level ................................ -34 -29 -30 -29 -30 -152 

Estimated Outlays .................................................. -31 -29 -29 -29 -29 -147 

Homeless Veterans 

Extension of Certain Authorities for Homeless Veterans 

Estimated Authorization Level ......................................... 107 37 * 0 0 144 

Estimated Outlays ........................................................... 96 43 4 0 0 143 

Supportive Services for Low-Income Families 

Authorization Level .......................................................... 101 0 0 0 0 101 

Estimated Outlays ........................................................... 91 9 * * 0 100 

Homeless Providers Grants and Per Diem Program 

Authorization Level .......................................................... 100 0 0 0 0 100 

Estimated Outlays ........................................................... 90 9 0 0 0 99 

Workforce Reintegration Program 

Authorization Level .......................................................... 50 0 0 0 0 50 

Estimated Outlays ........................................................... 4 31 14 1 0 50 

Homeless Veterans with Special Needs 

Authorization Level .......................................................... 5 5 0 0 0 10 

Estimated Outlays ........................................................... 5 5 * * * 10 

Case Management Services for HUD-VASH Program 

Estimated Authorization Level ......................................... 1 1 1 1 1 5 

Estimated Outlays ........................................................... 1 1 1 1 1 5 

Services for Homeless Veterans 

Estimated Authorization Level ......................................... 1 * 0 0 0 1 

Estimated Outlays ........................................................... 1 * * * * 1 

Subtotal, Homeless Veterans 

Estimated Authorization Level ................................ 365 43 1 1 1 411 

Estimated Outlays .................................................. 288 98 19 2 1 408 

Other Provisions 

VA Office in Philippines 

Estimated Authorization Level ......................................... 5 6 2 0 0 12 

Estimated Outlays ........................................................... 5 6 2 0 0 12 

Reports and Plans 

Estimated Authorization Level ......................................... * * * * * 1 

65 

Table 2.—Estimated Changes in Spending Subject to Appropriation Under S. 914—Continued 

By fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2012–2016 

Estimated Outlays ........................................................... * * * * * 1 

Subtotal, Other Provisions 

Estimated Authorization Level ................................ 5 6 2 0 0 13 

Estimated Outlays .................................................. 5 6 2 0 0 13 

Total Changes to Spending Subject to Appropriation 

Estimated Authorization Level ......................................... 1,304 42 -5 -6 -7 1,328 

Estimated Outlays ........................................................... 347 344 313 215 77 1,296 

Notes: VA = Department of Veterans Affairs; HUD-VASH = Housing and Urban Development-Department of Veterans Affairs Supported Hous- ing; * = less than $500,000. 

Leases for Medical Facilities. Section 603 would authorize the appropriation of $50 million for leasing eight medical facilities. Based 

on information from VA’s 2012 budget request, CBO expects that 

VA would enter into 20-year lease agreements for those facilities. 

CBO estimates that in addition to the specified amounts authorized 

to be appropriated in 2012, VA would incur additional costs of $22 

million a year starting in 2013. (Costs are higher in the first year 

than in other years because VA would pay up front for necessary 

improvements and upgrades.) CBO estimates that entering into 

those leases would cost $133 million over the 2012–2016 period, assuming appropriation of the authorized and estimated amounts. 

Seismic Corrections and Renovations. Section 601 would authorize the appropriation of $87 million for seismic corrections and renovations at facilities in Los Angeles and Seattle, Washington. 

Based on VA’s current estimated construction costs and the 

amounts that have already been appropriated for those projects, 

CBO estimates that VA would require additional funding of $68 

million in 2012. CBO estimates that implementing those projects 

would cost a total of $65 million over the 2012–2016 period, assuming appropriation of the estimated amounts. 

Health Care. Title I contains sections that would change reimbursements for certain VA health care services and related travel, 

as well as expand health care services. CBO estimates that implementing title I would reduce costs by a net of $147 million over the 

2012–2016 period, assuming appropriation of the authorized and 

estimated amounts. 

Reimbursement for Ambulance Services. Section 108 would allow 

VA to pay the provider of ambulance services the lesser of the actual charge or the amount determined by the Medicare fee schedule 

for ambulance services. Under current law, VA does not have a 

standard fee for ambulance services; rather they reimburse the 

transportation costs for certain veterans based upon the ‘‘actual 

necessary expense’’ as submitted by the provider. CBO expects that 

paying Medicare rates for ambulance services would lower such 

costs by roughly 20 percent (comparable to the difference between 

Medicare Part B physician payment rates and those of the private 

sector). On that basis, CBO estimates that using the Medicare fee 

schedule would reduce spending for ambulance services by $246 

million over the 2012–2016 period, assuming appropriations for 

such benefits continue. 

66 

Travel Reimbursements for Vet Centers. VA is required to reimburse the travel expenses of certain veterans seeking vocational rehabilitation, counseling, or treatment at a VA facility or other approved locations at a general rate of 41.5 cents per mile. According 

to the Veterans Health Administration, there are nearly 10 million 

claims made each year for travel reimbursement. 

Section 103 would require Vet Centers to be treated as VA facilities for the purpose of reimbursement for travel. Based on information from VA, CBO estimates that under the bill VA would approve 

between 280,000 and 300,000 new travel claims each year from Vet 

Center patients over the 2012–2016 period. Based on information 

from VA regarding recent travel claims, CBO estimates that VA 

would pay an average of $47 per claim in 2012, rising to $50 per 

claim in 2016. Assuming appropriation of the necessary amounts, 

a one-year phase-in period, and annual adjustments for inflation, 

CBO estimates that implementing this provision would cost $63 

million over the 2012–2016 period. 

Telehealth and Telemedicine Programs. Section 101 would prohibit the VA from charging copayments to veterans for any telehealth or telemedicine consultations. VA currently charges copayments of $15 for primary care visits and $50 for specialty care visits. Based on information from the department, CBO estimates that 

in 2012 VA will have a workload of over 67,000 such consultations 

for which it will receive $2 million in copayments. In recent years, 

those programs have experienced a 25 percent annual rate of 

growth in workload. Some of that growth represents new workload 

in terms of medical visits that would not have been made for reasons of distance or other difficulty in accessing VA care. The remainder of the growth is accounted for by veterans using telehealth 

and telemedicine in place of physical visits to a VA facility. CBO 

expects that eliminating the copayments for virtual visits would accelerate the shift from regular visits, which would continue to incur 

copayments. 

CBO estimates that implementing this provision would decrease 

collections by $2 million in 2012, growing to $8 million by 2016. 

Such collections are offsets to discretionary appropriations. As 

part of the annual appropriations process, the Congress gives VA 

authority to spend those collections. Therefore, maintaining the 

same level of health care services for veterans would necessitate 

additional funding each year to make up for the loss of copayments 

under this provision. Thus, CBO estimates that implementing this 

provision would cost $23 million over the 2012–2016 period, assuming appropriation of the necessary amounts. 

Chiropractic Care. Section 107 would require VA to provide comprehensive chiropractic services at two or more locations in each of 

the 21 Veterans Integrated Services Networks (VISNs), which are 

VA’s regional networks of medical facilities, and in other locations 

as the Secretary determines appropriate. Nine VISNs currently 

meet those requirements and the remaining 12 VISNs each provide 

care at one location. VA reports that the average salary for a chiropractor is roughly $115,000. After adjusting for inflation, CBO estimates that providing chiropractic care at one additional location in 

each of those 12 VISNs would cost $8 million over the 2012–2016 

period, assuming appropriation of the necessary amounts. 

67 

1Section 201 also would authorize the appropriation of an additional $68 million for fiscal 

year 2011. However, since CBO assumes this bill will be enacted near the start of 2012, the 

estimate does not include that funding. 

Centers of Excellence for Rural Health. Section 106 would require VA to establish centers of excellence for research, education, 

and clinical activities related to providing health care in rural 

areas. CBO assumes VA would use existing facilities, but would increase personnel. CBO estimates that establishing the centers of 

excellence would cost $4 million over the 2012–2016 period, assuming appropriation of the necessary amounts. 

State Prescription Monitoring Programs. Section 110 would allow 

VA to share information on prescription drug usage with state programs that seek to minimize misuse of prescription drugs. CBO estimates minimal costs to establish and maintain the necessary IT 

capabilities. CBO estimates that implementing this provision would 

cost $1 million over the 2012–2016 period, assuming the availability of appropriated funds. 

Homeless Veterans. Title II includes several provisions that 

would extend and expand programs providing assistance to homeless veterans. CBO estimates that implementing title VI would cost 

$408 million over the 2012–2016 period, assuming appropriation of 

the necessary amounts. 

Extension of Certain Authorities for Homeless Veterans. Section 

205 would extend, for various periods, the expiring authorities for 

several programs that provide services to homeless veterans. CBO 

estimates that extending such programs would cost $143 million 

over the 2012–2016 period, assuming appropriation of the necessary amounts. 

Supportive Services for Low-Income Families. Section 207 would 

extend through 2012 a VA program that provides grants to entities 

serving certain low-income families and authorize the appropriation of $101 million for that program in 2012. 

The program, which expires in 2011, provides grants to entities 

that help the families of low-income veterans that are homeless, 

making the transition to permanent housing, or already in permanent housing. Those entities provide a variety of services including 

outreach, case management, and assistance accessing VA or other 

public benefits. CBO estimates that implementing that provision 

would cost $100 million over the 2012–2016 period, assuming appropriation of the specified amount. 

Homeless Providers Grants and Per Diem (GPD) Program. Section 201 would increase the annual amounts authorized for the 

VA’s Homeless Providers Grant and Per Diem Program (GPD) from 

$150 million to $250 million in 2012.1 The GPD program provides 

capital grants for constructing, renovating, or acquiring buildings 

and per diem payments to fund operating costs. After factoring in 

historical spending patterns for this program, CBO estimates that 

implementing that provision would cost $99 million over the 2012– 

2016 period, assuming appropriation of the specified amount. 

Workforce Reintegration Program. Section 206 would authorize 

the appropriation of $50 million a year for 2012 for the homeless 

veteran reintegration program at VA. CBO estimates that implementing that provision would cost $50 million over the 2012–2016 

period, assuming appropriation of the specified amount. 

68 

Homeless Veterans with Special Needs. Section 208 would authorize the appropriation of $5 million a year for 2012 and 2013 to 

provide support to health care facilities and providers that offer 

services to homeless veterans who are: women, elderly, terminally 

ill, or chronically mentally ill. CBO estimates that implementing 

that provision would cost $10 million over the 2012–2016 period, 

assuming appropriation of the specified amounts. 

Case Management Services for Housing and Urban DevelopmentDepartment of Veterans Affairs Supported Housing (HUD-VASH) 

Program. Section 209 would authorize the VA to enter into contracts or agreements with other entities in the provision of case 

management services to certain homeless veterans in the HUDVASH program. This section also would provide training grants to 

collaborating entities. The HUD-VASH program is a collaboration 

between HUD and VA to provide permanent housing to homeless 

veterans and their families. Veterans enrolled in the HUD-VASH 

program receive case management and supportive services through 

VA. Based on information from VA, CBO expects that, under this 

provision, contract case managers would be added as necessary. 

CBO estimates that VA would add an additional 10 case managers 

on a part-time basis. CBO estimates that implementing this provision would cost $5 million over the 2012–2016 period, assuming the 

availability of appropriated funds. 

Services for Homeless Veterans. Section 203 would expand the 

provision of certain services provided to homeless veterans suffering from mental illness to include all homeless veterans. The underlying authority to provide those services is extended elsewhere 

in the bill through December 31, 2012. CBO expects that the primary effect of this provision would be to ensure that all homeless 

veterans are eligible for temporary housing. Based upon information from VA, CBO estimates that under this provision, placements 

into temporary housing would increase by nearly 10 percent, or 

about 1,500. On average, per diem costs are roughly $55 per day 

and the average length of stay is about 50 days. On that basis, 

CBO estimates that implementing section 203 would cost $1 million over the 2012–2013 period, assuming the availability of appropriated funds. 

Other Provisions. Several other provisions would increase discretionary costs. Implementing those requirements would, CBO estimates, have a total cost of $13 million over the 2012–2016 period, 

assuming appropriation of the necessary amounts. 

VA Office in Philippines. Section 709 would extend the authority 

to maintain a VA Office in the Philippines from December 31, 

2011, to December 31, 2013. Based on information from VA, the 

cost of maintaining that office is about $6 million a year; therefore, 

CBO estimates that implementing section 709 would cost $12 million over the 2012–2014 period, assuming appropriation of the necessary amounts. 

Reports and Plans. S. 914 would require several reports and 

plans to be completed by VA. CBO estimates that those provisions, 

collectively, would cost about $1 million over the 2012–2016 period, 

assuming availability of appropriated funds. 

69 

Direct spending 

S. 914 contains provisions that would both increase and decrease 

direct spending. CBO estimates that, on net, enacting S. 914 would 

decrease direct spending by $7 million over the 2012–2021 period 

(see Table 3). 

Extension of Income Verification. Section 708 would extend VA’s 

authority to verify income reported by recipients of VA pension 

benefits by allowing it to acquire information on income from the 

Internal Revenue Service (IRS). The authorization allowing the IRS 

to provide income information to VA was made permanent by Public Law 110–245, but the authorization allowing VA to acquire the 

information is scheduled to expire on September 30, 2011. Section 

708 would extend that authority through September 30, 2013. 

Over the last several years, VA saved, on average, $4 million 

each year in new pension benefit payments by using the IRS data 

to verify veterans’ incomes. CBO estimates that the incremental 

savings from utilizing the IRS data for income verification would 

be about $4 million in new savings each year. Those savings would 

compound, rising to about $8 million in 2013. After adjusting for 

cost-of-living increases and mortality rates, savings would decline 

starting in 2014 after the authority to use IRS data expires. CBO 

estimates that section 708 would reduce direct spending by $56 

million over the 2012–2021 period. 

Fees for Guaranteed Loans. Section 711 would increase the fees 

that VA charges for guaranteeing certain mortgages made to veterans. VA guarantees lenders a payment of up to 25 percent of the 

outstanding loan balance (subject to some limitations on the original loan amount) in the event that the veteran defaults. Such guarantees enable veterans to get better loan terms, for example, lower 

interest rates or smaller down payments. VA charges fees to some 

veterans for its guarantee to offset the costs of subsequent defaults. 

Under current law, veterans who get a mortgage with a VA guarantee and who don’t make a down payment are required to pay an 

up-front fee equal to 2.15 percent of the principal for loans taken 

in 2011. In 2012 and thereafter the fee for such loans declines to 

1.40 percent. Veterans of the reserve components pay an additional 

fee of 0.25 percent for loan guarantees. Fees for all veterans are 

higher if they have previously used the loan-guarantee benefit. 

Section 711 would increase the guarantee fee for loans with no 

down payment made in 2012 to 1.50 percent of the principal. Reserve veterans would continue to pay the additional 0.25 percent 

premium. In 2013 and thereafter, the fee would decline to 1.40 percent, consistent with current law. Raising the fee in 2012 would increase collections by VA, lowering the subsidy cost of the loan guarantees and reducing direct spending by $32 million in 2012, CBO 

estimates. 

Table 3.—Estimated Changes in Direct Spending Under S. 914 

Outlays by fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2012– 

2016 

2012– 

2021 

CHANGES IN DIRECT SPENDING 

Extension of Income Verification ....... -4 -8 -7 -6 -6 -6 -5 -5 -5 -4 -31 -56 

Fees for Guaranteed Loans ............... -32 0 0 0 0 0 0 0 0 0 -32 -32 

70 

Table 3.—Estimated Changes in Direct Spending Under S. 914—Continued 

Outlays by fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2012– 

2016 

2012– 

2021 

Survivors and Dependents Educational Benefits ........................... 1 2 2 2 2 2 3 3 3 4 9 24 

Retroactive Effective Date for Disability Compensation Claims ........ 15 0 0 0 0 0 0 0 0 0 15 15 

Assistance for Veterans Affected by 

Natural Disasters .......................... 1 1 1 1 1 1 1 1 1 1 5 10 

Specially Adapted Housing Assistance .............................................. 0 3 3 3 * * * * * * 9 10 

Occupancy of Housing by Dependent 

Children ......................................... * 1 1 1 1 1 1 1 1 1 4 9 

Waiver of Loan Fee ............................ * * * * * * 1 1 1 1 1 5 

Temporary Residence Adaptation 

Grants ........................................... 1 1 1 1 1 1 1 1 1 1 4 7 

Increased Pension for Married Veterans Requiring Aid and Attendance .............................................. * * * * * * * * * * * 1 

Total Changes -18 0 1 2 -1 -1 2 2 2 4 -16 -7 

Notes: Components may not sum to totals because of rounding; * = less than $500,000. 

Survivors and Dependents Educational Benefits. Spouses and 

children of certain deceased or totally disabled veterans are eligible 

for up to 45 months of veterans’ educational benefits. If the survivors and dependents are eligible for additional educational benefits because of their own military service or through the transfer 

of benefits, they are limited to a total of 48 months of benefits. Beginning October 1, 2011, section 702 would allow such survivors 

and dependents to use a maximum of 81 months of benefits. Based 

on information from VA and the Department of Defense, CBO estimates that approximately 130 survivors and dependents each year 

would use the additional benefits. If enacted, we estimate that section 702 would increase direct spending by $24 million over the 

2012–2021 period. 

Retroactive Effective Date for Disability Compensation Claims. 

Section 402 would allow VA to pay up to a year’s worth of retroactive payments to veterans who submit fully developed claims. 

This provision would expire on September 30, 2012. 

Based on information from VA, less than 1 percent of all disability claims are adjudicated as fully developed claims. Of the 

roughly 930,000 new claims that were adjudicated by VA in 2010, 

approximately 5,200 were processed and adjudicated as fully developed. Of those 5,200 claims, 83 percent were disability compensation claims that resulted in 1,300 accessions (24 percent) and 3,000 

(59 percent) reopened claims. CBO expects that a similar trend 

would continue for 2012. 

Under section 402, a veteran that submitted a fully developed 

claim would be eligible for one year’s worth of retroactive payments, should his or her claim be approved. Some veterans currently receive a retroactive benefit because they submitted an informal claim in advance of the fully developed claim. Those veterans receive payments for the period between the submission of 

the first and second applications. CBO estimates that about 25 percent of veterans submit informal claims ahead of their fully developed claim. Therefore, CBO estimates that about 970 new veterans 

71 

2 As the timing and magnitude of natural or other disasters cannot be forecast with certainty, 

the actual costs of providing assistance to veterans affected by natural or other disasters may 

differ significantly from the amounts contained in this estimate. 

and about 2,400 reopened cases would be eligible for a year’s worth 

of retroactive payments. 

Using information from VA, CBO estimates that in 2012, the average new veteran will enter the rolls with a 40 percent disability 

rating resulting in an annual payment of about $7,680. Veterans 

who reopened their cases and received an increase will be—on average—eligible for a 10 percent increase in their disability rating, 

resulting in a one-year retroactive payment of roughly $3,240. 

Therefore, CBO estimates that enacting section 402 would increase 

direct spending in 2012 by about $15 million. 

Assistance for Veterans Affected by Natural Disasters. Section 701 

would provide additional amounts of assistance to certain veterans 

with service-connected disabilities who are affected by natural disasters. That assistance includes: 

• Additional grants for certain veterans whose homes and automobiles that had been acquired or adapted using a grant from VA 

were destroyed or damaged in a natural or other disaster; 

• Additional payments of a subsistence allowance for certain veterans who were displaced because of a natural or other disaster; 

and 

• Additional services to achieve independence in daily living for 

those who were displaced because of a natural or other disaster. 

Based on information from VA, the Federal Emergency Management Agency, the Department of Transportation, the Insurance Information Institute, and the Insurance Services Office, CBO estimates that an average of about 600 veterans each year would qualify for the additional assistance offered under section 701. If enacted, that assistance is estimated to increase direct spending by 

about $10 million over the 2012–2021 period, CBO estimates.2

Specially Adapted Housing Assistance. Under current law, veterans who are entitled to compensation for permanent and total 

service-connected disability due to blindness in both eyes with visual acuity of at most 5/200 are also eligible to receive assistance 

to purchase, construct, or modify a home to meet their specific 

needs. Section 306 would reduce the required standard of visual 

acuity from 5/200 to 20/200. Based on information from VA, CBO 

estimates that under this provision about 1,200 previously ineligible veterans and 20 additional veterans each year would qualify 

for housing adaptation assistance and that, on average, each of 

those veterans would receive about $7,600 to meet their needs. If 

enacted, reducing the standard of visual acuity to 20/200 would increase direct spending by $10 million over the 2012–2021 period, 

CBO estimates. 

Occupancy of Housing by Dependent Children. To qualify for a 

home mortgage with a VA loan guarantee, a veteran must occupy 

the home as his or her primary dwelling. Section 303 would allow 

that requirement to be met by a dependent child of a veteran if the 

veteran’s active-duty status prevents him from residing in the 

house at the time the loan is issued. Based on information from 

VA, CBO expects that relaxing the occupancy requirement will result in a small increase in the number of loans that VA guarantees. 

72 

CBO estimates that enacting this provision would increase direct 

spending by $9 million over the 2012–2021 period. 

Waiver of Loan Fee. Veterans who receive compensation for service-related disabilities are exempt from the fee that most veterans 

pay to VA for guaranteeing a home mortgage loan. Veterans who 

have submitted a claim for disability compensation, but whose 

claims have not been adjudicated by VA must pay the fee if the 

loan closes before VA resolves the claim. Under section 304, veterans who have been assessed as eligible for disability compensation during an exam that took place prior to their discharge from 

military service or who have received a memorandum from VA indicating a preliminary disability rating also would be exempt from 

paying the loan fee. 

Veterans are only in such limbo status temporarily. Thus, the 

size of the veteran population who are awaiting adjudication of 

their claim is relatively stable, as those whose cases have been decided are replaced by new claimants. CBO expects that no more 

than 200 such veterans would apply for a VA-guaranteed loan in 

any year. Exempting those veterans from the loan fee would increase direct spending by $5 million over the 2012–2021 period, 

CBO estimates. 

Temporary Residence Adaptation (TRA) Grants. Under current 

law, veterans who are classified by VA as totally disabled and who 

have certain mobility limitations are entitled to receive housing 

grants of up to $12,756 or $63,780 (based on the severity of their 

disabilities) to be used to purchase, construct, or modify a home to 

meet their specific needs. Under a pilot program, qualifying veterans may use up to $14,000 from the larger grant or $2,000 from 

the smaller grant to adapt the home of a family member when the 

veteran resides with that family member temporarily. Any amount 

used to adapt the home of a family member reduces the amount 

that remains available to be used later for the veteran’s own home. 

This pilot program is scheduled to expire on December 31, 2011. 

Sections 305 and 307 would extend the pilot program through 

December 31, 2021, increase the maximum grant amounts to modify a relative’s home from $14,000 and $2,000 to $28,000 and 

$5,000, respectively, and no longer require that those amounts be 

subtracted from a veteran’s total grant amount. Based on recent 

rates of usage of TRA grants, CBO estimates that about 25 veterans would benefit from those combined provisions each year, with 

each veteran receiving about $27,000 in adaptive housing assistance to modify a family member’s home. If enacted, those provisions would increase direct spending by $7 million over the 2012– 

2021 period, CBO estimates. 

Increased Pension for Married Veterans Requiring Aid and Attendance (A&A). Section 401 would increase the annual pension 

payable to married veterans when both spouses require regular 

A&A. Under current law, when two married veterans are in need 

of regular A&A, they are eligible to receive an annual combined 

pension of $30,480. Section 20 would increase that combined annual payment amount to $31,305. 

There are currently about 75 married couples who are both receiving pensions and both in need of regular A&A. Based on information from VA, CBO estimates that the number of eligible couples 

will decline slightly over the next decade. Therefore, we estimate 

73 

that enacting section 401 would increase direct spending by about 

$1 million over the 2012–2021 period. 

Presidential Memorial Certificates. Section 503 would expand the 

VA’s Presidential Memorial Certificate program to include survivors of individuals who die while serving in the active military, 

naval, or air service. Through the Presidential Memorial Certificate 

program, a relative or friend can request a certificate signed by the 

President that expresses the country’s recognition of a veteran’s 

service. Eligibility for a certificate is currently limited to survivors 

of veterans who were honorably discharged from military service. 

Based on information from VA, CBO expects fewer than 100 additional requests would be made each year under this provision; 

therefore, CBO estimates section 503 would increase direct spending by less than $500,000 over the 2012–2021 period. Costs for the 

Presidential Memorial Certificates are paid out of the veterans’ 

burial account, which is a mandatory program. 

Extended Foreclosure Protection. Section 302 would prevent a 

lender from foreclosing on a servicemembers mortgage within 12 

months after they leave active duty. The Servicemembers Civil Relief Act provides such foreclosure protection for a nine-month period. Federal agencies such as VA and the Federal Housing Administration, which currently guarantee the mortgages of some servicemembers, are responsible for the payment of any interest that accrues between the period when the member stops paying the mortgage and the agency finally settles with the holder of the loan. 

Therefore, delaying certain foreclosures could result in additional 

costs to the federal government. Because of the small number of affected mortgages, and the relatively small increase in the forbearance period, CBO estimates that such costs would not be significant. 

Pay-As-You-Go Considerations: The Statutory Pay-As-You-Go Act 

of 2010 establishes budget-reporting and enforcement procedures 

for legislation affecting direct spending or revenues. S. 914 would 

modify several programs that provide benefits to veterans. The net 

changes in outlays that are subject to those pay-as-you-go procedures are shown in the following table. 

Table 4.—CBO Estimate of Pay-As-You-Go Effects for S. 914 as ordered reported by the 

Senate Committee on Veterans’ Affairs on June 29, 2011 

By fiscal year, in millions of dollars— 

2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2012– 

2016 

2012– 

2021 

NET INCREASE OR DECREASE (-) IN DIRECT SPENDING 

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

Estimated impact on state, local, and tribal governments: S. 914 

contains no intergovernmental mandates as defined in UMRA. 

States that provide nursing home care to eligible veterans would 

be required to comply with a new payment structure to receive federal reimbursement. Any costs to those governments would be incurred voluntarily as a condition of federal assistance. 

Estimated impact on the private sector: Section 302 would extend the expiration date by three months (from the original nine 

months) the time after a servicemember’s period of military service 

under which the member receives enhanced protection under the 

74 

Servicemembers Civil Relief Act relating to mortgages, mortgage 

foreclosures, and evictions. That action constitutes a mandate on 

mortgage holders. The cost of complying with the mandate would 

be the loss associated with delayed mortgage payments, delayed 

foreclosure, and interest-rate limitations. Based on historical separation rates, foreclosure rates, and mortgage-interest rates, CBO 

expects that the cost of the mandate would be small relative to the 

annual threshold for private-sector mandates ($142 million in 2011, 

adjusted annually for inflation). 

Previous CBO estimates: On May 16, 2011, CBO transmitted a 

cost estimate for H.R. 1407, the Veterans’ Compensation Cost-ofLiving Adjustment Act of 2011, as ordered reported by the House 

Committee on Veterans’ Affairs on May 12, 2011. Section 305 of 

S. 914 contains language similar to that in H.R. 1407. The difference in the estimated costs between the two provisions reflects 

different levels of assistance payable to qualifying veterans and different expiration dates. 

On May 16, 2011, CBO transmitted a cost estimate for H.R. 

1627, the Honoring American Veterans Act of 2011, as ordered reported by the House Committee on Veterans Affairs on May 12, 

2011. Section 502 of S. 914 contains language similar to section 3 

of H.R. 1627 and the corresponding estimates of costs are identical. 

Estimate prepared by: Federal Costs: Ann E. Futrell, Bill Ma, 

David Newman, and Dwayne Wright; Impact on State, Local, and 

Tribal Governments: Lisa Ramirez-Branum; Impact on the Private 

Sector: Elizabeth Bass. 

Estimate approved by: Peter H. Fontaine, Assistant Director for 

Budget Analysis. 

REGULATORY IMPACT STATEMENT

In compliance with paragraph 11(b) of rule XXVI of the Standing 

Rules of the Senate, the Committee has made an evaluation of the 

regulatory impact that would be incurred in carrying out S. 914. 

The Committee finds that S. 914 would not entail any regulation 

of individuals or businesses or result in any impact on the personal 

privacy of any individuals and that the paperwork resulting from 

enactment would be minimal. 

TABULATION OF VOTES CAST IN COMMITTEE

In compliance with paragraph 7 of rule XXVI of the Standing 

Rules of the Senate, the following is a tabulation of votes cast in 

person or by proxy by members of the Committee on Veterans’ Affairs at its June 29, 2011, meeting. The Committee voted, without 

dissent, to report S. 914 as amended to the Senate. 

AGENCY REPORT

On June 8, 2011, Robert L. Jesse, M.D., PhD., Principal Deputy 

Under Secretary for Health, Veterans Health Administration, Department of Veterans Affairs, appeared before the Committee and 

submitted testimony on various bills incorporated into the Committee bill. In addition, on June 28, 2011, VA provided views on 

various bills incorporated into the Committee bill. Excerpts from 

both the testimony and Department views are reprinted below: 

(75) 

STATEMENT OF ROBERT L. JESSE, M.D., PH.D., PRINCIPAL 

DEPUTY UNDER SECRETARY FOR HEALTH, VETERANS 

HEALTH ADMINISTRATION, U.S. DEPARTMENT OF VETERANS AFFAIRS 

Good Morning Chairman Murray, Ranking Member Burr and 

Members of the Committee: Thank you for inviting me here today 

to present the Administration’s views on several bills that would 

affect Department of Veterans Affairs (VA) benefits programs and 

services. Joining me today are Michael Cardarelli, Principal Deputy Under Secretary for Benefits, Richard Hipolit, Assistant General Counsel, and Walter A. Hall, Assistant General Counsel. We 

do not yet have cleared views on S. 411, S. 491, S. 873, S. 874, 

S. 914, S. 1017, S. 1060, S. 1089, S. 1104, S. 1123, S. 1124, and 

S. 1127 and the draft bill entitled ‘‘Veterans Programs Improvements Act of 2011.’’ Also, we do not have estimated costs associated 

with implementing S. 396, S. 666, S. 910, S. 935, and section 9 of 

S. 951. We will forward the views and estimated costs to you as 

soon as they are available. 

* * * * * * * 

S. 423, PROVIDING AUTHORITY FOR A RETROACTIVE EFFECTIVE DATE

FOR AWARDS OF DISABILITY COMPENSATION IN CONNECTION WITH

APPLICATIONS THAT ARE FULLY-DEVELOPED AT SUBMITTAL

S. 423 would amend 38 U.S.C. § 5110(b) to authorize a potentially retroactive award of disability compensation to a Veteran 

whose compensation application was fully developed as of the date 

submitted to VA. The effective date of a compensation award based 

on the submittal of a fully developed application would be ‘‘fixed in 

accordance with the facts found,’’ but could not be earlier than the 

date one year before the date the application was received by VA. 

The bill would allow VA to prescribe what constitutes a fully-developed claim for purposes of this provision. 

VA does not support this bill because it would result in the inequitable treatment of Veterans who cannot submit a ‘‘fully-developed’’ claim. Currently, section 5110 authorizes a retroactive compensation award in two instances, both based on the timing of the 

application. VA may award compensation retroactively if VA receives the application within one year from the date of a Veteran’s 

discharge or release from service or, in cases of increased compensation, if VA receives the application within one year of the 

date that an increase in disability is ascertainable. In either case, 

the timing of the application, and hence the eligibility for a retroactive award, is within a Veteran’s control. The retroactive award 

S. 423 would authorize, however, is based not on the timing of the 

application, but rather on the nature of the claim and the evidence 

needed to decide the claim, matters that are not within a Veteran’s 

76 

control. S. 423 would essentially penalize Veterans who cannot submit an application with the evidence necessary to decide the claim. 

The bill would result in retroactive compensation awards to Veterans whose claims involve simple factual issues or evidence within 

their possession or readily obtainable, but not to Veterans whose 

claims involve complex factual issues or evidentiary development, 

but are no less meritorious than the simple claims. 

In addition, S. 423 would likely result in litigation over whether 

a claim was fully developed when submitted because VA’s decision 

to obtain or request further evidence would preclude a retroactive 

award. 

Although VA does not support S. 423, it appreciates the attempt 

to create an incentive for Veterans to file fully developed claims. 

VA believes a more balanced approach would create that incentive. 

VA has implemented a Fully Developed Claim (FDC) Program at 

all regional offices as a result of the Veterans’ Benefits Improvement Act of 2008, Public Law 110–389, signed by the President on 

October 10, 2008. This law required VA to assess the feasibility 

and advisability of expeditiously adjudicating fully developed compensation or pension claims. Under the FDC program, a Veteran 

who submits a formal claim for benefits within one year from the 

date of VA’s acknowledgement of receipt of the Veteran’s informal 

claim may be awarded benefits effective from the date VA received 

the informal claim. Because the acknowledgement letter will include information about the evidence necessary to substantiate a 

claim for benefits, Veterans will be able to facilitate the processing 

of their claim by submitting evidence in conjunction with their formal claim. Thus, the timing of the application, not whether a fully 

developed claim is received, is determinative of whether retroactive 

benefits can be awarded. Further, this extra time allows any claimant the opportunity to assemble his or her claim package for submission, while still affording them the benefit of the FDC program 

and the potential of an earlier effective date. 

VA estimates that enactment would result in benefit costs of 

$54.9 million for fiscal year 2012, $315.7 million over five years, 

and $761.7 million over ten years. 

S. 486, PROTECTING SERVICEMEMBERS FROM MORTGAGE ABUSES

ACT OF 2011

S. 486 would extend the Servicemembers Civil Relief Act (SCRA) 

period of protections relating to real and personal property from 9 

months to 24 months. This bill would also change violations of 

SCRA from a misdemeanor to a felony and increase civilian penalty 

amounts. 

VA defers to the Departments of Defense and Justice regarding 

the merits of this bill. We are unable at this time to provide cost 

estimates associated with enactment of this bill, but will provide 

that information in writing for the record. 

* * * * * * * 

77 

S. 536, PROVIDE THAT UTILIZATION OF SURVIVORS’ AND DEPENDENTS’ 

EDUCATIONAL ASSISTANCE SHALL NOT BE SUBJECT TO THE 48- 

MONTH LIMITATION

S. 536 would amend section 3695(a)(4) of title 38, United States 

Code, to exempt individuals eligible for VA education benefits 

under the chapter 35 Survivors’ and Dependents’ Educational Assistance (DEA) program from the 48-month limitation on the use 

of educational assistance under multiple Veterans’ and related educational assistance programs. This amendment would allow an individual to receive up to 45 months of benefits under the DEA program and up to 48 months of benefits under other educational assistance programs administered by VA. The amendment would 

take effect on the date of enactment of S. 536. By its own terms, 

however, it would not revive any entitlement to educational assistance under chapter 35 or any other provision of law listed in section 3695(a) that terminated prior to that date. 

Under current law, section 3695(a) limits to 48 months the aggregate entitlement for any individual who receives educational assistance under two or more programs. This provision applies, in 

part, to the Montgomery GI Bill Active Duty (MGIB-AD/chapter 

30), the Vietnam Era Assistance Program (VEAP/chapter 32), the 

Post-9/11 GI Bill (chapter 33), the Survivors’ and Dependents’ Educational Assistance program (chapter 35), the Montgomery GI Bill 

Selected Reserve (MGIB-SR/chapter 1606), and the Reserve Educational Assistance Program (REAP/chapter 1607). 

Beginning on the date of enactment of this bill, as noted above, 

VA would not consider an individual’s chapter 35 entitlement when 

applying the 48-month limitation in section 3695(a). The amendment also would be applicable to those individuals who, as of the 

day before enactment, had not used a total of 48 months of benefits 

entitlement (regardless of whether the 48 months included receipt 

of chapter 35 benefits). Thus, those individuals with remaining entitlements under other educational assistance programs administered by VA on the bill’s date of enactment would have their entitlement to such programs determined without consideration of the 

benefits they used under chapter 35. 

VA does not have the specific data necessary to cost this proposal. While VA can determine the number of participants who 

used prior VA training and the amount of entitlement used in previous programs, we cannot extract the specific Survivors’ and Dependents’ Educational Assistance program population affected by 

this proposal. The system used to process chapter 35 claims stores 

and retrieves information for beneficiaries using the Veteran’s file 

number. Although information specific to the individual is stored in 

the record, the system uses the file number to search for multiple 

records. As a result, a query of the chapter 35 file numbers would 

provide information on Veterans rather than the beneficiaries of 

the Survivors’ and Dependents Educational Assistance program. 

Further, VA has no way of determining how many servicemembers 

elected not to participate in the MGIB-AD program because of prior 

chapter 35 benefits or how many individuals potentially eligible for 

the Post-9/11 GI Bill are or were eligible for chapter 35 benefits. 

78 

VA supports the intent of S. 536 and favors enactment of the bill, 

subject to Congress finding offsetting savings. While we are unable 

to extract a specific population and are unable to provide costs, we 

estimate that a student who used 45 months of benefits under the 

Survivors’ and Dependents’ Educational Assistance program would 

receive an additional $51,336 for a full 36 months of training under 

the Montgomery GI Bill—Active Duty program. Similarly, we estimate that a student in receipt of benefits at the 100 percent eligibility tier under the Post-9/11 GI Bill program would receive an additional $87,544 for 36 months of benefits. 

* * * * * * * 

S. 666, VETERANS TRAUMATIC BRAIN INJURY CARE IMPROVEMENT

ACT OF 2011

S. 666, the ‘‘Veterans Traumatic Brain Injury Care Improvement 

Act of 2011,’’ would require the Secretary to submit to Congress a 

report on the feasibility and advisability of establishing a Polytrauma Rehabilitation Center or Polytrauma Network Site for VA 

in the northern Rockies or the Dakotas. 

VA shares the concern for providing treatment facilities for polytrauma in this region. Consequently, in 2010, VA completed an assessment of need and determined that an enhanced Polytrauma 

Support Clinic Team with a strong telehealth component at the Ft. 

Harrison, Montana, VA facility would meet the needs and the 

workload volume of Veterans with mild to moderate Traumatic 

Brain Injury (TBI) residing in the catchment area of the Montana 

Healthcare System. It would also facilitate access to TBI rehabilitation care for other Veterans from the northern Rockies and the Dakotas through telehealth. VA has initiated hiring actions to fill additional positions needed to enhance the Polytrauma Support Clinic 

Team at Fort Harrison. We anticipate these positions will be in 

place by the end of 2011. However, establishment of a Polytrauma 

Rehabilitation Center or Polytrauma Network Site, which would 

focus on the treatment of moderate to severe TBI, is not feasible 

or advisable in this area based on the needs of the population 

served. Because of the action already being taken by VA, this bill 

is not necessary, and we thus cannot support it. 

The estimated cost of staffing the Polytrauma Support Clinic 

Team at Ft. Harrison would be $1.5 million in the first year, $6.2 

million for five years, and $13.0 million over ten years. We do not 

have estimated costs for implementing the bill but will provide 

them when they are available. 

Mr. Chairman, we would be pleased to provide the Committee 

with more detailed information about our findings and decisions regarding the northern Rockies and the Dakotas. 

S. 696, TREATMENT OF VET CENTERS AS DEPARTMENT OF VETERANS

AFFAIRS FACILITIES FOR PURPOSES OF PAYMENTS OR ALLOWANCES

FOR BENEFICIARY TRAVEL TO DEPARTMENT FACILITIES

S. 696 would require VA to make beneficiary travel payments to 

persons traveling to and from Vet Centers if those persons would 

otherwise be eligible for these payments under VA’s authority to 

pay beneficiary travel. VA is very interested in the possibility of exVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00078 Fmt 6604 Sfmt 6604 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
79 

panding this benefit to include travel to and from Vet Centers, but 

recommends that no action be taken on this bill at this time. In 

an effort to better assess the various factors potentially affecting 

implementation of such a travel benefit, VA began a 6-month analysis on May 1, 2011 at three Vet Centers to identify a model process for administering benefits. The analysis will: assess the likely 

utilization of the benefit; identify issues associated with administering this benefit; determine the potential impact this benefit 

would have on the Vet Center culture and Veterans’ privacy concerns; develop a model that can determine the upper and lower 

bounds for demand for this benefit; and create a behavioral model 

that can estimate potential changes in Veteran utilization of Vet 

Center services. 

This analysis will include focus groups of Veterans utilizing Vet 

Center services to assess various cultural variables, such as the effect this benefit might have on the Vet Center environment and 

services, as well as Veteran support for the implementation of this 

program. VA will also survey Veterans receiving Vet Center services to identify their interest, the average distance they travel to 

a Vet Center, and the number of visits they typically make each 

month. VA will also review data from the existing beneficiary travel program to estimate economic and behavioral impacts on utilization rates. VA believes this to be a prudent approach that will 

allow us to determine the likely impacts of such a change, prepare 

for any changes in demand for Vet Center services, and include a 

budget request sufficient to support these benefits or any other 

changes resulting from enactment. VA will provide an update to 

Congress at the end of this analysis with its results, conclusions 

and recommendations. 

Given available data, VA estimates the cost of S. 696 in fiscal 

year 2012 to be $3.7 million, $23.3 million over five years, and 

$63.2 million over ten years. VA notes these estimates may change 

based on the results of the aforementioned analysis, and VA will 

provide an updated cost estimate to the Committee when we have 

completed this analysis. 

S. 698, CODIFYING THE PROHIBITION AGAINST THE RESERVATION OF

GRAVESITES AT ARLINGTON NATIONAL CEMETERY

S. 698 would limit to one the number of gravesites at Arlington 

National Cemetery that may be provided to a Veteran or a Member 

of the Armed Forces who is eligible for interment at that cemetery 

and the Veteran’s or Member’s family members who are eligible for 

interment there. The bill would also prohibit pre-need reservations 

of gravesites at Arlington National Cemetery and would require 

the Secretary of the Army to submit to Congress a report on reservations made at Arlington National Cemetery. 

VA defers to DOD regarding S. 698 because the Secretary of the 

Army is responsible for the management and operation of Arlington 

National Cemetery. 

* * * * * * * 

80 

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

S. 769 would prohibit the Secretary from excluding from any VA 

facilities or property or any facilities or property that receive funding from VA, service dogs trained for use by Veterans enrolled in 

the VA health care system who were provided service dogs for reasons of hearing impairment, spinal cord injury or dysfunction or 

other chronic impairment that substantially limits mobility, and 

mental illness including Post Traumatic Stress Disorder. 

VA acknowledges that trained service dogs can have a significant 

role in maintaining functionality and promoting maximum independence of Veterans with disabilities. VA recognizes the need for 

Veterans with disabilities to be accompanied by their trained service dog on VA properties consistent with the same terms and conditions, and subject to the same regulations as generally govern the 

admission of members of the public to the property. However, 

S. 769 is unnecessary. Under existing statutory authority in 38 

U.S.C. 901, VA can implement national policy for all VA properties, 

and in fact did so for VHA facilities and property on March 10, 

2011 (VHA Directive 2011–2013), directing that both Veterans and 

members of the public with disabilities who require the assistance 

of a trained guide dog or trained service dog be authorized to enter 

VHA facilities and property accompanied by their trained guide dog 

or trained service dog consistent with the same terms and conditions, and subject to the same regulations that govern the admission of members of the public to the property. We would be glad 

to provide a copy of the Directive for the record. This Directive requires each Veterans Integrated Service Network (VISN) Director 

to ensure all VHA facilities have a written policy on access for 

guide and service dogs meeting the requirements of the national 

policy by June 30, 2011. In addition, VA intends to initiate rulemaking that will establish criteria for service dog access to all VA 

facilities and property in a manner consistent with the same terms 

and conditions, and subject to the same regulations as generally 

govern the admission of members of the public to the property 

while maintaining a safe environment for patients, employees, visitors, and the service dog. 

We note that VA’s new Directive is much broader in scope than 

S. 769 which would only apply to certain Veterans and not members of the public. In particular, it would only apply to that subset 

of Veterans who are enrolled in VA’s health care system and who 

were provided service dogs for reasons of hearing impairment, spinal cord injury or dysfunction or other chronic impairment that 

substantially limits mobility, and mental illness including Post 

Traumatic Stress Disorder pursuant to 38 U.S.C. 1714. VA’s policy 

allows not only all Veterans with a disability that requires the assistance of a trained guide dog or trained service dog, but also 

members of the public including Veterans’ families and friends 

with disabilities, to be accompanied by their trained guide dogs or 

trained service dogs in VHA facilities or properties. 

The bill also prohibits the Secretary from excluding service dogs 

from any facility or on any property that receives funding from the 

Secretary. Such a prohibition is unnecessary because it duplicates 

other statutes discussed below. 

81 

Any non-VA facilities and properties with which S. 769 is concerned that are also owned or controlled by the Federal Government must under current law at 40 U.S.C. § 3103, admit on the 

same terms and conditions, and subject to the same regulations, as 

generally govern the admission of the public to the property, specially trained and educated guide dogs or other service animals accompanying individuals with disabilities. Other non-VA properties 

not otherwise owned or controlled by the Federal Government, including but not limited to professional offices of health care providers, hospitals, and other service establishments, will almost certainly meet the definition of a place of public accommodation or 

public entity under the Americans with Disabilities Act of 1990 as 

prescribed in regulations at 28 CFR §§ 35.104 and 36.104, and 

therefore be required to modify their policies, practices, or procedures to permit the use of a service animal by an individual with 

a disability in accordance with 28 CFR §§ 35.136 and 36.302. We 

would note that VA facilities are not subject to the Americans with 

Disabilities Act of 1990, but are subject to the Rehabilitation Act. 

The Rehabilitation Act does not specifically address the issue of 

service dogs in buildings or on property owned or controlled by the 

Federal Government, but does prohibit discrimination against individuals with disabilities, including those who use service animals, 

in federally-funded or -conducted programs and activities. In addition, as explained above, there are other existing authorities that 

address the issue of bringing guide dogs and other service animals 

onto VA property. 

VA estimates that there would be no costs associated with implementing this bill. 

* * * * * * * 

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

THE SERVE ACT OF 2011

S. 815, the ‘‘Sanctity of Eternal Rest for Veterans Act of 2011’’ 

or the ‘‘SERVE Act of 2011,’’ would amend titles 18 and 38, United 

States Code, to guarantee that military funerals are conducted 

with dignity and respect. Section 2 of the bill would state the purpose of the bill, to provide necessary and proper support for the recruitment and retention of the U.S. Armed Forces and militia employed in the service of the United States by protecting the dignity 

of their members’ service and the privacy of persons attending 

their members’ funerals. It would also state Congress’ findings regarding the constitutional authority for the bill. Section 3 of the bill 

would amend title 18, United States Code, making it unlawful to 

engage in certain activities within a certain distance from, and during a certain period in relation to, any funeral of a member or 

former member of the Armed Forces not located at a cemetery 

under the control of the National Cemetery Administration (NCA) 

or a part of Arlington National Cemetery. It would provide for punishment by fine or imprisonment or both, give U.S. district courts 

jurisdiction to entertain suits for enjoining violations of the provision and complaints for damages resulting from conduct that violates the provision, authorize the Attorney General to institute proceedings, and authorize suits to recover damages. Although this 

82 

section of the bill is inapplicable to NCA cemeteries, VA supports 

its enactment because it would establish a unified approach to preserve the dignity of funeral services and reinforces the commitment 

to protect the privacy of attendees during their time of 

bereavement. 

Section 4 of the bill would make several changes to 38 U.S.C. 

§ 2413 to make it align with the title 18 provisions applicable to 

non-NCA cemeteries. Section 2413 currently prohibits certain demonstrations: (1) on the property of an NCA-controlled national cemetery or of Arlington National Cemetery without official approval; 

and (2) during a period beginning one hour before and ending one 

hour after a funeral, memorial service, or ceremony is held if any 

part of the demonstration takes place within a certain distance of 

such a cemetery, disturbs the peace, or impedes access to or egress 

from such a cemetery. The effect of the amendment is to expand 

the time period during which demonstrations are prohibited to 

begin two hours before and end two hours after a funeral, and increase the distance restriction for demonstrations from 150 feet to 

300 feet of the cemetery or a road, pathway, or other route of ingress or egress from the cemetery. It would increase protections 

against willful conduct which causes or assists in making noise or 

diversion that disturbs the funeral or memorial service, or unauthorized conduct that impedes the access to or egress from the cemetery by the funeral procession by increasing the boundary limits 

for engaging in such prohibited conduct from 300 feet to within 500 

feet of the cemetery where the funeral is held. The bill provides for 

punishment by fine or imprisonment or both, gives U.S. district 

courts jurisdiction to entertain suits for enjoining violations of the 

provision and complaints for damages resulting from conduct that 

violates the provision, authorizes the Attorney General to institute 

proceedings, and authorizes suits to recover damages. The bill also 

contains a clerical amendment to revise the heading for section 

2413. 

VA supports section 4 of this bill to ensure the privacy and protection of grieving families during funeral, memorial and ceremonial services meant to honor these fallen heroes who, through their 

service, paid the ultimate price. If enacted, S. 815 would have no 

monetary impact on NCA’s current practice of coordinating with 

local law enforcement and community supporters. 

* * * * * * * 

S. 928, LIMITING THE AUTHORITY OF THE SECRETARY OF VETERANS

AFFAIRS TO USE BID SAVINGS ON MAJOR MEDICAL FACILITY

PROJECTS OF THE DEPARTMENT OF VETERANS AFFAIRS TO EXPAND

OR CHANGE THE SCOPE OF A MAJOR MEDICAL FACILITY PROJECT

OF THE DEPARTMENT

S. 928 would amend title 38, Section 8104(d)(2) of the United 

States Code, to limit the authority of the Secretary of VA to use 

bid savings on major medical facility projects of the Department, 

to expand or change the scope of a major medical facility project 

of the Department, and for other purposes. The Secretary would be 

required to submit a notice to the Committees identifying the 

major medical facility project that is the source of the bid savings, 

83 

the major medical facility project to be expanded or changed in 

scope, describe the expansion or change in scope, and identify the 

amounts intended to be obligated for the expansion or change in 

scope. The Secretary would then be required to wait until legislation is enacted before making a contract obligation. However, 

ample congressional notification requirements for changes or expansions in scope are already in place. VA thus opposes this legislation as unnecessary. 

* * * * * * * 

S. 957, VETERANS’ TRAUMATIC BRAIN INJURY REHABILITATIVE

SERVICES IMPROVEMENTS ACT OF 2011

In 2008, Congress established several programs targeted at the 

comprehensive rehabilitation of Veterans and members of the 

Armed Services receiving VA care and services for Traumatic Brain 

Injuries (TBI). In general, S. 957 seeks to improve those programs 

(established by 38 U.S.C. §§ 1710C-E) by requiring rehabilitative 

services, as defined by the bill and discussed below, to be an integral component of those on-going programs. With two exceptions, 

we have no objection to S. 957. 

Currently, the provisions of 38 U.S.C. § 1710C set forth the requirements for an individualized rehabilitation and reintegration 

plan that must be developed for each Veteran or member of the 

Armed Forces receiving VA inpatient or outpatient rehabilitative 

hospital care or medical services for a TBI. VA Handbook 1172.04, 

Physical Medicine and Rehabilitation Individualized Rehabilitation 

and Community Reintegration Care Plan, implements section 

1710C. 

Section 2(a) of S. 957 would amend some of the mandated requirements in section 1710C. Specifically, it would clarify that the 

goal of each individualized plan is to maximize the individual’s 

independence and quality of life. It would also require, as part of 

a plan’s stated rehabilitative objectives, the sustaining of improvements made in the areas of physical, cognitive, and vocational functioning. Section 2(a) of the bill would further require that each 

such plan include rehabilitation objectives for improving and sustaining improvements in the individual’s behavioral functioning as 

well as mental health. 

These amendments would not alter VA’s policy or operations in 

any significant way, as VA’s primary aim for Veterans with serious 

or severe injuries has always been, and continues to be, maximizing their independence, health, and quality of life. It is out of 

these concerns that VA has developed robust rehabilitation therapy 

programs to help them learn or re-learn skills and develop resources for sustaining gains made in their rehabilitation. 

Section 2(a) of the bill would require the individual plans to include access, as warranted, to all appropriate rehabilitative services of the TBI continuum of care. The law now requires these 

plans to provide access, as warranted, to rehabilitative components 

of the TBI continuum of care (which includes, as appropriate, access to long-term care services). 

Current law also requires that each individualized plan include 

a description of the specific ‘‘rehabilitation treatments and other 

84 

services’’ needed to achieve the patient’s rehabilitation and reintegration goals. Section 2(a) of the bill would replace all references to ‘‘treatments’’ in the affected provision with ‘‘services.’’ 

This would ostensibly broaden the scope of rehabilitative benefits 

available to these patients beyond what is deemed to be treatment 

per se. 

It would also add to each plan the specific objective of improving 

(and sustaining improvements in) the patient’s behavioral functioning. That addition, together with the existing rehabilitation objective to improve a patient’s cognitive functioning, would effectively encompass all relevant mental health issues related to TBI. 

For that reason, we believe the bill’s other amendment to separately include a rehabilitation objective for improving ‘‘mental 

health’’ would create confusion or redundancy. We thus recommend 

that language be deleted. 

Most notably, section 2(a) of S. 957 would establish a new definition of the term ‘‘rehabilitative services,’’ for purposes of all of VA’s 

specially targeted, statutory programs for TBI-patients (i.e., 38 

U.S.C. §§ 1710C–E). Such services would include not only those 

that fall under the current statutory definition found in 38 U.S.C. 

1701 but also ‘‘services (which may be of ongoing duration) to sustain, and prevent loss of, functional gains that have been achieved.’’ 

Plus, they would include ‘‘any other services or supports that may 

contribute to maximizing an individual’s independence and quality 

of life.’’ This last definition is overly broad and could be read to include services or items well beyond the field of health care. It is 

also unworkable. What maximizes an individual’s ‘‘quality of life’’ 

is highly subjective, and, as such, the term defies consistent interpretation and application. Quite simply, we believe enactment of 

that last provision of the proposed new definition would conflict 

with, and exceed, our primary statutory mission, which is to provide medical and hospital care. It should therefore be deleted, leaving only the first two prongs of the definition. 

Next, as briefly alluded to above, the individualized rehabilitation and reintegration plans required by section 1710C must include access, where appropriate, to long-term care services. The eligibility and other requirements of VA’s mandated comprehensive 

program of long-term care for the rehabilitation of post-acute TBI 

are found in 38 U.S.C. § 1710D. Section 2(b) of S. 957 would require 

the Secretary to include rehabilitative services (as that term would 

be defined by Sec. 2(a) of the bill) in the comprehensive program. 

It would also eliminate the word ‘‘treatment’’ in the description of 

the interdisciplinary teams to be used in carrying out that program. We have no objection to this proposed revision. 

Last, Congress authorized VA, under specified circumstances, to 

furnish hospital care and medical services required by an individualized rehabilitation and reintegration plan through a cooperative 

agreement. (A cooperative agreement may be entered only with an 

appropriate public or private entity that has established long-term 

neurobehavioral rehabilitation and recovery programs.) This authority is found at 38 U.S.C. 1710E. Section 2(c) of S. 957 would 

add ‘‘rehabilitative services’’ (again as defined by Sec. 2(a) of the 

bill) to the types of services that may be provided under those 

agreements. We have no objection to this proposed revision. 

85 

Section 2(d) of S. 957 is merely a technical amendment to correct 

a typographical error in section 1710C(c)(2)(S) of title 38, United 

States Code. We would also like to point out another technical 

issue. Current law permits inclusion of ‘‘educational therapists’’ 

among the TBI-experts responsible for conducting a comprehensive 

assessment of each patient. (It is this assessment which serves as 

the basis for the individualized plans discussed above.) This categorization of professionals is no longer used in the field of medical 

rehabilitation. 

Aside from the two (substantive) modifications discussed above 

(deleting the phrase ‘‘any other services or supports that may contribute to maximizing an individual’s independence and quality of 

life’’ from the new definition of the term ‘‘rehabilitative services,’’ 

and deleting the bill’s amendment to separately include a rehabilitation objective for improving ‘‘mental health’’), we have no objection to S. 957, and no new costs would be associated with its enactment. 

S. 1148, THE VETERANS PROGRAMS IMPROVEMENT ACT OF 2011

On June 6, Chairman Murray introduced S. 1148, the Veterans 

Programs Improvement Act of 2011. We note that the bill carries 

many provisions proposed by the Administration, in its draft Veterans Benefits Improvement Act of 2011, transmitted to the Senate 

on May 19, 2011. We have not had the opportunity to review the 

bill closely regarding its technical aspects, but we offer here our 

support of the general intent of those provisions, and VA’s appreciation for your including them for consideration. We believe they 

are very worthy of the Committee’s endorsement. We also look forward to reviewing the other titles of the bill which address VA’s 

programs to combat homelessness as well as VBA’s fiduciary program. 

This concludes my prepared statement. Madam Chairman, we 

would be pleased to respond to whatever questions you may have. 

86 

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88 

89 

90 

91 

THE SECRETARY OF VETERANS AFFAIRS, 

Washington, DC, June 28, 2011. 

Hon. PATTY MURRAY, 

Chairman, 

Committee on Veterans’ Affairs, 

U.S. Senate, Washington, DC. 

DEAR MADAM CHAIRMAN: The agenda for the Senate Committee 

on Veterans Affairs’ June 8, 2011, legislative hearing included a 

number of bills that the Department of Veterans Affairs was unable to address in our testimony. We are aware of the Committee’s 

interest in receiving our views on those bills in advance of the June 

29 mark-up. By this letter, we are providing our views and cost estimates on S. 411, S. 491, S. 914, S. 1017, sections 202 and 305 of 

S. 1060, S. 1104, S. 1127, and titles I and III of S. 1148. We will 

provide views on the remaining bills in a separate letter. 

This Office of Management and Budget advises that there is no 

objection to the submission of this letter from the standpoint of the 

Administration. 

We appreciate this opportunity to comment on this legislation 

and look forward to working with you and the other Committee 

Members on these important legislative issues. 

Sincerely, 

ERIC K. SHINSEKI

Enclosure. 

92 

ENCLOSURE

VA VIEWS

S. 411 ‘‘HELPING OUR HOMELESS VETERANS ACT OF 2011’’ 

S. 411 would authorize VA to enter into agreements with certain 

entities to collaborate in the provision of case management services 

as part of the HUD-Veterans Affairs Supportive Housing (HUDVASH) program. In addition, S. 411 would require the Department 

of Veterans Affairs (VA), in consultation with the Department of 

Housing and Urban Development (HUD), to ensure that the distribution of vouchers to Veterans under the HUD-VASH program 

meets the needs of Veterans in rural areas and underserved Veterans in metropolitan areas or on Indian lands. This bill would expand VA’s existing authority to provide case management services 

and collaborate with other entities. VA supports this bill, although 

we do have one technical comment and a suggestion for improving 

this bill. 

S. 411 specifically authorizes VA to enter into these agreements 

with tribal organizations. However, tribal lands do not have public 

housing agencies and because public housing agencies are the sole 

mechanism for issuing section 8 Housing Choice Vouchers to Veterans, S. 411 would not expand the HUD-VASH program to Veterans living on Indian lands. We note that there are other HUD 

programs available to Veterans on Indian lands. 

In order to maximize care coordination and to implement and 

sustain a shared case management model that supports permanent 

housing, VA proposes including a provision in S. 411 to authorize 

VA to provide Technical Assistance (TA) to community partners. 

TA would focus on compliance with documentation and program 

evaluation standards, implementing best practices strategies to coordinate with VA treatment, and other supportive services that 

promote rapid access and sustainment of permanent supportive 

housing. TA would also support site visits for monitoring and promoting the coordination and creation of shared learning communities, as well as the development of webinars that teach shared 

best practices. TA would encourage a ‘‘Housing First’’ treatment 

intervention for homeless Veterans by targeting the chronic homeless and the most vulnerable Veterans. Money management and 

addressing unmet health care needs of homeless Veterans are other 

essential components that TA would further enhance. Through 

these efforts, VA will continue to work with local public housing 

agencies and support interventions with homeless Veterans in crisis by utilizing motivational interviewing to promote treatment. 

VA estimates that there would be no costs associated with implementing S. 411. If S. 411 is amended to include a provision authorizing VA to provide technical assistance, VA anticipates the cost associated with this bill would be $300,000 in fiscal year (FY) 2012 

and $750,000 over the next three fiscal years. VA only anticipates 

the need for additional funds for technical assistance for the first 

three fiscal years. After that, VA believes the costs could be rolled 

into the homeless program’s operating budget. 

* * * * * * * 

93 

S. 914 TO AUTHORIZE WAIVER OF COPAYMENTS FOR

TELEHEALTH AND TELEMEDICINE

S. 914 would add a new section to title 38, U.S.C., that would authorize VA to waive copayment requirements for Veterans’ telehealth and telemedicine visits. VA opposes this legislation because 

it would create an inequity in billing practices for services provided 

to Veterans. We believe it would be inappropriate to waive copayments for Veterans who receive telehealth services at a VA facility 

while Veterans who see their VA provider in person in the same 

facility would be charged a copayment. 

Under existing authority, no Veteran is charged a copayment for 

telephone calls, since in many cases they are used simply as a 

means to check on the progress of a Veteran, not to deliver care. 

VA believes the use of video consultation into the home is analogous to that of a telephone call and that copayments for clinical 

video telehealth services provided directly into a patient’s home 

should be considered for exclusion from copayments. VA plans 

under its existing authority (38 U.S.C. 1710(g)) to exempt copayments for video consultations when the Veteran is located at his or 

her home. 

Recent VA experience demonstrates that copayments for hometelehealth may have resulted in a reduced use of this intervention. 

To ensure convenient and cost effective care to populations of patients who will otherwise delay care and incur larger costs from 

emergency room visits and hospital admissions, VA will take the 

appropriate action to exempt copayments for in-home video telehealth care for Veterans. Because VA already has the authority to 

waive or modify the imposition of copayments for such care, legislation is not required. 

If copayments are not collected for all telehealth or telemedicine 

services, VA estimates a revenue loss of $2.2 million in FY 2012, 

$18.0 million over 5 years, and $72.9 million over 10 years. 

S. 1017 ‘‘DISABLED VETERAN CAREGIVER HOUSING ASSISTANCE

ACT OF 2011’’ 

S. 1017 would increase the amount of Specially Adapted Housing 

(SAH) assistance available to disabled Veterans who reside temporarily in housing owned by family members, and would also expand 

SAH eligibility for the visually impaired. Provided Congress identifies appropriate and acceptable offsetting PAYGO cost savings, VA 

supports this legislation. 

Section 2 of the bill would amend 38 U.S.C. 2102A, SAH assistance for disabled Veterans and Servicemembers who reside temporarily in housing owned by a family member. In general, subsection 

(a) would increase, from $14,000 to $28,000, the amount of assistance available for individuals eligible for SAH grants under section 

2101(a), and would increase the amount from $2,000 to $5,000 for 

individuals eligible for SAH grants under section 2101(b). Subsection (b) would eliminate the December 31, 2011, termination 

date currently in effect, and make such assistance permanent. Subsection (c) would tie the newly increased amounts to the same costof-construction index as that authorized for grants made pursuant 

94 

to sections 2101(a) and 2101(b), meaning that the grants would adjust upwards with the costs of inflation. 

We note that both this section and sections 303 and 304 of 

S. 1148 would make similar improvements to section 2102A. The 

relevant sections of S. 1148 would extend the authority of assistance for individuals residing temporarily in housing owned by a 

family member through 2021 and would implement a cost-of-construction index. These provisions are substantively the same as 

sections 306 and 307 of VA’s draft bill, the ‘‘Veterans Benefits Programs Improvement Act of 2011.’’ VA supports both of these 

provisions. 

Section 3 would amend 38 U.S.C. 2101(b) to expand SAH eligibility for the visually impaired. Under current law, an individual 

is not eligible for what is commonly called a ‘‘2101(b) grant’’ unless 

his or her visual acuity is 5/200 or less, an exceptionally stringent 

standard in comparison to other areas of law. Many grant applicants who are considered legally blind by other commonly-held 

standards are ineligible for 2101(b) grants because their visual impairments, though profound, are not severe enough to meet the 

standard set under current law. For example, under the Social Security Administration’s eligibility standards for supplemental security income (SSI), individuals are considered legally blind with visual acuity of 20/200 or less, or a peripheral field of vision of 20 degrees or less. Additionally, VA’s Servicemembers’ Group Life Insurance Traumatic Injury Protection Program’s eligibility standard related to visual acuity is ‘‘20/200 or less.’’ However, since the standard for ‘‘blindness’’ for the 2101(b) grant is ‘‘5/200 visual acuity or 

less,’’ a Veteran or Servicemember who is legally blind for purposes 

of SSI or VA life insurance would not be eligible for a 2101(b) 

grant. 

By establishing a qualifying degree of blindness at visual acuity 

of 20/200 best-corrected visual acuity or less, or as a field of vision 

subtending an angle of 20 degrees or less, the bill would bring the 

SAH requirements in line with more commonly recognized standards. It would also make the 2101(b) grant available to a wider 

range of Veterans and Servicemembers, including those who use rehabilitative low-vision adaptive medical devices. 

Section 4 of S. 1017 would no longer count grants authorized 

under 38 U.S.C. 2102A (commonly referred to as ‘‘TRA grants’’) 

against the aggregate dollar amount of SAH assistance available to 

eligible individuals. Under current law, an eligible individual may 

receive up to three grants of SAH assistance totaling in aggregate 

not more than $63,780 for a 2101(a) grant or $12,756 in the case 

of a 2101(b) grant. If an individual receives a TRA grant, the 

amount is subtracted from the total amount of assistance available, 

leaving him or her with fewer funds for future adaptations to a 

permanent residence. 

If section 4 were enacted, a veteran who had previously adapted 

a family member’s residence using a TRA grant would be able to 

adapt his or her own permanent residence as if the TRA grant 

funds had not been used. Although the TRA grant would still count 

as one of the three allowable uses, it would not reduce the amount 

of assistance available for a grant authorized under section 2101(a) 

or 2101(b). 

95 

VA estimates benefits costs of enactment to be $3.4 million in the 

first year, $13.0 million over five years, and $20.6 million over ten 

years. VA does not identify any increase in General Operating Expense (GOE) cost associated with these provisions. 

S. 1060 ‘‘HONORING ALL VETERANS ACT OF 2011’’ 

Section 202 

Section 202 would dramatically change VA’s Grant and Per Diem 

(GPD) program, which has been a key factor in reducing Veteran 

homelessness. The GPD Program is designed to support transitional housing for Veterans. VA generally supports the spirit of the 

section, but is apprehensive that this legislation will result in policy problems and lead to significantly higher costs. 

Currently, payments to eligible programs receiving grants to provide services to homeless Veterans are made on a per diem basis. 

Section 202(a)(2)(A) would eliminate all references to ‘‘per diem’’ in 

38 U.S.C. 2012 and change the basis of grants from the ‘‘daily cost 

of care’’ to the ‘‘annual cost of furnishing services.’’ It would also 

remove the prohibition on VA providing a rate in excess of the rate 

authorized for State domiciliaries and grant the Secretary the discretion to set a maximum amount payable to grant recipients. 

Section 202(a)(2)(B) would direct the Secretary to adjust the rate 

of payment to reflect anticipated changes in the cost of furnishing 

services and take into account the cost of services in different geographic areas. Section 202(a)(2)(C) would remove the requirement 

that the Secretary consider other available sources of funding and 

would leave it to his or her discretion. Section 202(a)(2)(E) would 

require the Secretary to make quarterly payments based on the estimated annual basis and would require recipients to declare the 

actual amount paid by quarter for services and repay any outstanding balances if the amount spent by the recipient is less than 

the estimated quarterly disbursement. Similarly, if recipients 

spend more than the estimated amount, determined on a quarterly 

basis, the Secretary would be required to make an additional payment equal to that sum. It would limit payment to recipients to the 

amount of the annual payment as determined by the Secretary. 

Section 202(a)(3) would allow grant recipients to use VA grants to 

match other payments or grants from other providers. Finally, section 202(a)(4) would repeal a ‘‘grandfather’’ provision extending the 

time period for certain grantees to satisfy applicable requirements 

of the Life Safety Code of the National Fire Protection Association, 

as this provision expired in December 2006. 

Although VA is not opposed to the concept of making its per 

diem authorities more flexible to better reflect the actual cost of 

providing services, especially in different geographic regions, VA is 

currently evaluating the impact of shifting from the ‘‘per diem’’ or 

‘‘daily cost of care’’ approach to an ‘‘annual cost of furnishing services’’ paid and reconciled on a quarterly basis. Though this change 

may offer VA’s partners needed capital and funds at the beginning 

of the fiscal year to support their work, it would require significantly more detailed auditing as well as increased direct oversight 

by VA. Furthermore, the requirement in section 202(a)(2)(E), to 

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counting of unpaid balances and/or over-billings; however, this approach would impose significant administrative burdens, requiring 

VA to monitor and process GPD provider accounts nationwide. VA 

would welcome the opportunity to discuss these issues with Congress but asks that section 202 be deferred until VA can fully 

evaluate its impact. 

VA does not oppose removing the existing rate cap pursuant to 

section 202(a)(2)(B). Currently, the statute limits VA’s GPD per 

diem payments to the rate for state domiciliary care. The difference 

between what VA pays and the actual cost of expenditures is absorbed by the provider. Allowing the Secretary to establish the 

basis and the formula for payment based on cost and geographic 

location would increase the sustainability of community-based providers and promote increased and more comprehensive services for 

Veterans. 

Although section 202 would no longer require the Secretary to 

consider the availability of other sources of income for grant recipients, the Secretary would in all likelihood consider the availability 

of other funds when evaluating a grant application. GPD Program 

Office experience has shown that the availability of other sources 

of income is often an indicator of a viable GPD project. 

VA supports the authorization in section 202(a)(2)(D) for VA 

operational payments to be used in conjunction with grants from 

other federal programs. The purpose of the payment contained in 

38 U.S.C. 2012 is to pay for operational costs for a specific program 

operation. VA estimates the cost of this section to be $450.0 million in the 

first year, $2.8 billion over 5 years and $6.9 billion over 10 years. 

Section 305 

Section 305 would authorize VA to disclose information about 

Veterans and their dependents to State prescription monitoring 

programs to the extent necessary to prevent misuse and diversion 

of prescription medications. VA supports section 305 of this bill. It 

would enhance the ability of VA clinicians to provide treatment to 

VA beneficiaries by improving the visibility of both VA and non-VA 

prescriptions for controlled substance medications. VA estimates 

the cost associated with implementing this section would be 

$361,501 in FY 2012, $1.3 million over 5 years, and $2.4 million 

over 10 years. 

* * * * * * * 

S. 1127 CENTERS OF EXCELLENCE FOR RURAL HEALTH RESEARCH, 

EDUCATION, AND CLINICAL ACTIVITIES

Section 2(a) of S. 1127 would require the Secretary to establish 

and operate at least one and not more than five centers of excellence for rural health research, education, and clinical activities 

through the Director of the Office of Rural Health. These centers 

would be geographically dispersed and would be established to: 1) 

conduct research on the furnishing of health services in rural 

areas; 2) develop specific models to be used by the Department in 

furnishing health services to Veterans in rural areas; 3) provide 

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ment on the furnishing of health services to Veterans in rural 

areas; and 4) develop and implement innovative clinical activities 

and systems of care for the Department for the furnishing of health 

services to Veterans in rural areas. The activities of clinical and 

scientific investigation at each center would receive priority in the 

award of VA funds for medical and prosthetics research to the extent that these funds are awarded to projects for research in the 

care of rural Veterans. Section 2(c) would also recognize that there 

are Veterans rural health resource centers which serve as satellite 

offices of the Office of Rural Health. 

VA supports section 2(c), but opposes section 2(a). The Office of 

Rural Health (ORH) currently supports rural program resource 

centers and implements research initiatives that are largely duplicative of the activities proposed for the Centers of Excellence. Specifically, ORH currently funds three Veterans Rural Health Resource Centers (VRHRC). These Centers function as field-based 

clinical laboratories for demonstration projects. A number of these 

projects are focused on developing models of care, as well as the 

implementation of innovative clinical practices and systems of care. 

VRHRC staff members also serve as rural health experts for the 

field. They provide training and education to VA and non-VA service providers caring for rural Veterans. ORH also supports VISN 

Rural Consultants (VRCs). In each VISN, there is a VRC who 

serves as the primary interface between ORH and VISN rural activities. The VRCs work closely with internal and external stakeholders to introduce, implement, and evaluate ORH-funded 

projects. The VRCs are also instrumental in conducting outreach to 

develop strong partnerships with community members, state agencies, rural health providers, and special interest groups. Since 

being established, ORH has funded well over 500 projects across 

the VA health care system. These projects cover a wide range of 

areas, including education, home based primary care, long-term 

care, mental health, case management, telehealth, primary care, 

and specialty care. 

ORH is funded by Medical Services appropriations, which cannot 

be used to conduct research. Rather ORH supports demonstration 

and pilot projects. ORH has established partnerships within VA, 

namely VA Health Services Research & Development (HSR&D), to 

conduct relevant rural health research. 

ORH has already committed considerable resources to implementing and evaluating models of care in rural areas, developing 

and providing education to rural providers, and developing innovative clinical activities and systems of care. Although ORH does not 

conduct research, collaborations with HSR&D have allowed for 

ORH to be involved in rural health research activities. Furthermore, HSR&D currently has a very extensive rural health portfolio 

including studies on access, health disparities, and developing new 

models of care appropriate for rural areas. The research findings 

are then shared with ORH and are used to form rural health policies and programs. Funding the proposed Centers of Excellence 

would be duplicative of activities that are already being addressed. 

If this bill provision is passed, it would be more cost effective to 

add this function in our existing VRHRCs rather than to establish 

three new Centers of Excellence. 

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VA estimates the cost of adding a research component to each of 

the three existing VRHRCs to be $3 million dollars per year. However, VA estimates the cost of establishing three new independent 

and separate Centers of Excellence to be $7.5 million dollars per 

year. 

S. 1148 ‘‘VETERANS PROGRAMS IMPROVEMENT ACT OF 2011’’ 

TITLE I—HOMELESS VETERANS MATTERS

Section 101 

Section 101(a) would amend 38 U.S.C. 2011(a) by expanding the 

kinds of projects for which grants are available to include the new 

construction of facilities. Section 101(a)(3)(A) would also amend section 2011(c) to prohibit the Secretary from denying a grant application based only on the fact that an entity proposes to use funding 

from other private or public sources, as long as a private nonprofit 

organization will provide oversight and site control for the project. 

Section 101(a)(3)(B) would also define the term private non-profit 

organization to include a for profit limited partnership or limited 

liability corporation whose managing or general partner is a nonprofit as defined under this section. 

Section 101(b) would also require the Secretary to conduct a 

study of the method used to make per diem payments under 38 

U.S.C. 2012 and develop an improved method for reimbursing 

grants under section 2011. The Secretary would be required to submit a report of the findings within a year after enactment of this 

bill. 

Last, section 101(c) would amend 38 U.S.C. 2013 to increase the 

amount authorized to be appropriated to $250,000,000 for FY 2012 

and each fiscal year thereafter. 

VA does not support the provisions of section 101(a)(3)(B) and 

has concerns about section 101(c), but supports section 101(b). Section 101(a)(3)(B) would amend the definition of private nonprofit 

organization, to include a private nonprofit organization ‘‘that has 

received, or has temporary clearance to receive, tax-exempt status 

under*** section 501(c) of the Internal Revenue Code of 

1986 * * *’’ as well as allow additional entities to become eligible 

for grants under the Grant and Per Diem (GPD) Program. 

VA believes that the ‘‘temporary clearance’’ proposed in this subsection does not adequately ensure the capability of the grant applicant to administer federal funds. This change would void the 

reason for the final determination by the Internal Revenue Service 

(IRS) as to organizational suitability for nonprofit status, increasing the risk that unsuitable grant applicants would apply for GPD 

projects. Furthermore, the ‘‘temporary clearance’’ provision is not 

needed because the IRS can expedite applications for tax-exempt 

status. 

Additionally, VA does not believe section 501(c)(2) entities should 

be included in the definition of a private nonprofit organization. In 

general, section 501(c)(2) provides a tax-free means of managing 

and protecting real estate and other assets. Inclusion of a section 

501(c)(2) organization in the definition of a ‘‘nonprofit organization’’ 

does not seem necessary. 

99 

VA also finds the inclusion of sections 101(a)(3)(B)(ii) and 

101(a)(3)(B)(iii) unnecessary and potentially burdensome. Under 

the present statute, 38 U.S.C. 2011, eligible applicants include nonprofit organizations, state or local government agencies, or Indian 

tribal governments. Additionally, IRS rules allow under the definition of organization, limited liability corporations to apply for section 501(c)(3) status. Consequently there is no need to specifically 

include limited liability companies in the statutory definition of a 

‘‘nonprofit organization.’’ 

VA has no objection to the section 101(b)’s requirement to conduct a study and develop a payment method under 38 U.S.C. 2011 

and 2012; however, VA proposes that Congress grant VA more 

than one year to conduct the study and provide the report to Congress. Based on past program office experience, it is generally not 

feasible to analyze findings, implement changes, draft findings, and 

report to Congress within one year after the date of the enactment. 

VA estimates the study proposed in section 101(b) would cost approximately $300,000. 

VA supports in principle raising the authorized appropriation 

amounts in section 101(c) but has concerns about the proposed annual appropriation level. VA estimates that the proposed maximum 

annual authorization level of $250 million would be inadequate for 

this important program after fiscal year 2015. We recommend that 

a specific authorization funding level be dropped from the statute. 

VA estimates that there would be no additional costs associated 

with this provision as the budget through FY 2013 includes the 

program. 

Section 102 

Section 102 would amend 38 U.S.C. 2061 by expanding eligibility 

for the grant program to entities eligible for grants and per diem 

payments under sections 2011 and 2012 of title 38. It would also 

broaden the definition of homeless Veterans with special needs to 

include any Veteran who cares for minor dependents, not just 

women. Last, this section would allow recipients of grants under 

section 2061 to use grant amounts to provide services directly to 

a dependent of a homeless Veteran if the Veteran is receiving services from the recipient. 

In principle, VA supports section 102 and agrees that modifications are needed to fully realize the potential of special needs 

grants through the GPD Program. Specifically, VA has no objection 

to the inclusion of subparts (a), (b), and (c) in section 102. However, 

VA believes the modifications as written are insufficient to adequately meet the needs of the special needs population presently 

served by the GPD Program. 

VA respectfully suggests that the Committee consider the language in sections 303 to 305 of VA’s draft bill, the ‘‘Veterans 

Health Care Act of 2011,’’ which was transmitted to Congress on 

June 7, 2011, relating to GPD special needs grants. These provisions would amend 38 U.S.C. 2061 and also create a new section 

for establishment of per diem programs for homeless Veterans with 

special needs. VA considers the language in Title III, sections 303– 

305 of VA’s draft bill an effective way to meet the needs of the special needs population served by GPD Program grants. 

100 

We will provide costs associated with implementing this section 

as soon as they are available. If section 102 is amended to contain 

the proposed special needs amendments in sections 303 through 

305 of VA’s draft bill, the costs would be $15.2 million in FY 2012, 

$79.9 million over 5 years, and $217.7 million over 10 years. 

Section 103 

Section 103 would amend 38 U.S.C. 2031(a) by authorizing VA 

to provide services listed in section 2031 to homeless Veterans, regardless of whether such Veterans suffer from serious mental illness (SMI). VA fully supports the draft bill language in section 103. 

In the drive to end homelessness among Veterans, VA recognizes 

the need to provide homeless Veterans with emergency housing, 

case management services, and outreach services. Consequently, 

VA fully supports removing the requirement in 38 U.S.C. 2031 that 

a Veteran must have a co-occurring SMI before receiving Health 

Care for Homeless Veterans (HCHV) program services. 

While co-occurring disorders such as SMI have traditionally been 

the markers of homelessness among Veterans and have been well 

documented in relevant research, conditioning the provision of 

services on the existence of SMI unnecessarily limits the scope of 

services to thoroughly address the condition of homelessness. 

HCHV program field experience has shown that there are many 

Veterans who are homeless for reasons other than mental healthrelated issues. Therefore, expanding the scope of 38 U.S.C. 2031 

would allow VA to better reach and serve Homeless Veterans. 

VA estimates the cost of this section to be $3.5 million in the 

first year, $19.1 million over 5 years and $42.1 million over 10 

years. 

Section 104 

Section 104 of S. 1148 would require VA to submit to Congress 

a comprehensive plan to end homelessness among Veterans. VA 

does not support this provision because VA has already formulated 

and is presently implementing a comprehensive strategic plan to 

end Veteran homelessness. VA’s Plan to End Homelessness Among 

Veterans Initiative is built upon six strategies: Outreach/Education, Treatment, Prevention, Housing/Supportive Services, Income/Employment/Benefits and Community Partnerships. These 

six strategies encompass a wide continuum of interventions and 

services to prevent and end homelessness among Veterans. Homeless Veterans will benefit from the expansion of existing program 

capacity and treatment services, as well as the implementation of 

new programs focused on homelessness prevention and increased 

access to permanent housing with supportive services. Although 

the provision of safe housing is fundamental, programming will include mental health stabilization, substance use disorder treatment 

services, enhancement of independent living skills; vocational and 

employment services, and assistance with permanent housing 

searches and placement. VA does not anticipate any additional 

costs associated with implementing section 104. 

101 

Section 105 

VA fully supports section 105(a) that would extend authority for 

the Health Care for Homeless Veterans (HCHV) Program through 

December 31, 2014. The HCHV Program, as authorized by 38 

U.S.C. 2031, allows VA to provision care and services to homeless 

Veterans suffering from serious mental illness (SMI). Specifically, 

the HCHV Program provides emergency housing, outreach services, 

and case management services. This authority has been extended 

several times since November 21, 1997. The most recent extension 

of this authority was from December 31, 2006 through December 31, 2011. 

As an essential component of VA’s Plan to End Homelessness 

Among Veterans, VA fully supports any effort to extend this important authority. 

VA also supports section 105(b) that would amend 38 U.S.C. 

2033 to extend by an additional three years until December 31, 

2014, VA’s authority to expand and improve benefits to homeless 

Veterans. Section 2033 authorizes VA, subject to appropriations, to 

operate a program to expand and improve the provision of benefits 

and services to homeless Veterans. The program includes establishing sites under VA jurisdiction to be centers for the provision 

of comprehensive services to homeless Veterans (also known as 

Community Resource and Referral Centers (CRRCs)). This authority has been extended several times since November 21, 1997. The 

most recent extension of this authority was from December 31, 

2006 through December 31, 2011. CRRCs are an important component of VA’s Plan to End Homelessness Among Veterans, and VA 

fully supports any effort to extend this authority. 

VA estimates there would be no additional costs associated with 

these provisions. 

Subsection (c) of section 105 would extend through December 31, 

2014, the Secretary’s authority to enter into agreements with nonprofit organizations for the purpose of selling, leasing, or donating 

homes acquired through the guaranteed loan program. VA supports 

this provision. Under current law, 38 U.S.C. 2041, this authority 

is set to expire on December 31, 2011. The proposed extension 

would allow VA to continue using homes acquired through the 

guaranteed loan program to help provide shelter to homeless 

Veterans. 

VA estimates that enactment of section 105(c) will result in no 

additional costs. 

Section 105(d) would amend 38 U.S.C. 2066 to extend Congressional authority to continue the Advisory Committee for Homeless 

Veterans for an additional two years until December 30, 2013. This 

Committee was Congressionally-mandated by Public Law 107–95. 

The mission of the Committee is to provide advice and make recommendations to the Secretary on issues affecting homeless Veterans and determine if VA and other programs and services are 

meeting the needs of homeless Veterans. VA has implemented 

many of the Committee’s recommendations through policy and regulatory changes to enhance access and services for homeless Veterans. 

The costs associated with the Advisory Committee were $114,000 

in FY 2010 and we estimate an increase in 3 to 5 percent in the 

102 

additional two years of operation for hotel room, air travel, and 

meeting space. 

Section 106 

VA supports section 106 which would re-authorize appropriations 

for the Department of Labor’s (DOL) Homeless Veterans Reintegration Program (HVRP) for fiscal years 2012 and 2013. HVRP is a 

grant program intended to assist homeless Veterans rejoin the 

workforce. Grantees provide homeless Veterans with job training 

and employment placement assistance, as well as related supportive services such as transitional housing, transportation and 

referral to treatment services. In Fiscal Year 2011, DOL used 

HVRP funds to restart its Incarcerated Veterans Transition Program (IVTP), under which grantees provide HVRP services to Veterans reentering their communities from prison or jail. HVRP 

grantees conduct regular outreach to identify homeless Veterans, 

and often refer them to VA for health care. Veterans ineligible for 

services from the Veterans Health Administration may often be 

able to access needed services through HVRP. The HVRP program, 

especially the IVTP component, is therefore an extremely valuable, 

complementary resource for VHA Justice Program’s staff. Reauthorization will contribute to achieving VA’s Plan to End Homelessness Among Veterans. 

Reauthorization would be cost-neutral for VA. VHA Justice Programs staff coordinate with HVRP grantees and serve the Veterans 

they refer to VA, but these staff are funded under separate 

authority. 

Section 107 

Section 107 would amend 38 U.S.C. 2044(e) to extend VA’s authority to provide financial assistance to entities approved to provide and coordinate the provision of supportive services for very 

low-income Veteran families occupying permanent housing to fiscal 

year 2012. Section 107 would also make available $100 million 

from the amounts appropriated to the Department of Medical Services to carry out section 2044. Last, this provision makes a technical amendment to correct a grammatical error in subsection 

2044(e). 

Although VA fully supports the reauthorization of appropriations 

for the Supportive Services for Veteran Families (SSVF) Program 

under section 107, VA respectfully suggests that the Committee 

consider the language in section 306 of VA’s draft bill, the ‘‘Veterans Health Care Act of 2011,’’ which was transmitted to Congress 

on June 7, 2011. Section 306 would extend Congressional authority 

to continue the SSVF Program permanently. Additionally, beginning in fiscal year 2014, VA would be authorized to fund the program with the amounts deemed necessary. This modification would 

give VA maximum flexibility to redirect resources to prevention efforts as the VA’s Plan to End Homelessness Among Veterans reduces the overall number of homeless Veterans. 

The current statute authorizes funding for the SSVF Program 

through the end of fiscal year 2011. However, at the current level 

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wide, leaving significant areas of the country, both urban and 

rural, without services. 

The SSVF Program is the only VA homeless program that is national in scope that can provide direct services to both Veterans 

and their family members. Recent Community Homelessness Assessment, Local Education and Networking Groups (CHALENG) 

reports indicate that homeless and formerly homeless Veterans 

consider family concerns as their highest unmet need. Additionally, 

homeless prevention is one of the key strategies in eliminating Veteran homelessness. Currently, approximately 1.3 million Veterans 

live in poverty. Estimates from the 2009 Annual Homelessness Assessment Report (AHAR) indicate that ten percent of all Veterans 

in poverty will become homeless at some point during the year. 

Prevention services are critical to reducing this incidence of homelessness. Continued authorization of the SSVF Program would 

allow VA to serve over 20,000 Veteran families in FY 2012. As the 

SSVF Program is one of the cornerstones of VA’s Plan to End 

Homelessness Among Veterans and the Federal Strategic Plan to 

Prevent and End All Homelessness, its reauthorization at levels 

that allow for national access is critical to the success of both 

efforts. 

The cost of the SSVF program is contained in the current VHA 

Homeless Veteran program budgets so there are no additional cost 

associated with this section. 

Section 108 

Pursuant to 38 U.S.C. 2061, VA makes grants for homeless Veterans with special needs to VA health care facilities and GPD providers. The ‘‘grants’’ to GPD providers are in the form of supplemental per diem payments for additional operating expenses not 

covered by per diem payments under the GPD program. The section 2061 grant authority expires on September 30, 2011. 

Section 108 which would amend 38 U.S.C. 2061 to extend by an 

additional 2 years, until December 31, 2013, VA’s authority to offer 

grants to health care facilities and grant and per diem providers 

for the development of programs for homeless Veterans with special needs. Veterans with special needs are those who are: women, 

including women who have care of minor dependents; frail, elderly; 

terminally ill; or chronically mentally ill. 

VA supports section 108, however respectfully requests that the 

Committee consider adopting the language found in section 303 of 

VA’s draft bill, the ‘‘Veterans Health Care Act of 2011,’’ which was 

transmitted to Congress on June 7, 2011, which would grant permanent authority to offer capital grants for homeless Veterans 

with special needs. 

VA estimates the costs associated with this section to be $5 million for the first fiscal year and $10 million over two years. 

TITLE III—OTHER ADMINISTRATIVE AND BENEFITS MATTERS

Section 301 

Section 301 would amend 38 U.S.C. 3704(c) to allow a Veteran’s 

dependent child to satisfy the occupancy requirements of VA home 

loans. Currently, only a Veteran or a Veteran’s spouse may satisfy 

104 

the requirement, which means that a single parent on active duty 

may be prevented from obtaining a VA-guaranteed loan. The proposed change would make it easier for those serving in the Armed 

Forces to use their VA home loan benefits. 

VA supports section 301, noting it is identical to section 3 of 

S. 874 and substantively the same as section 301 of VA’s draft bill, 

the ‘‘Veterans Benefits Programs Improvement Act of 2011,’’ which 

was transmitted to Congress on May 19, 2011. 

VA estimates that enactment of this provision would result in ad- ditional loan subsidy costs of $370 thousand the first year, $3.9 

million over the first five years and $10.8 million over ten years. 

Section 302 

Section 302 would amend 38 U.S.C. 3729(c) to allow an individual to receive a fee waiver if, during a pre-discharge program, 

he or she receives a disability rating for purposes of VA compensation based on existing medical evidence, such as service medical 

and treatment records. VA supports this provision, noting that it 

is substantively the same as section 304 of VA’s draft bill, the ‘‘Veterans Benefits programs Improvement Act of 2011,’’ which was 

transmitted to Congress on May 19, 2011. Under current law, the 

loan fee may be waived if the Veteran receives a pre-discharge rating based on a VA examination and rating. This provision would 

extend the waiver to individuals rated eligible for VA compensation 

based on existing evidence. 

VA estimates that there would be no additional costs associated 

with implementing section 302. 

Section 303 

Section 303 would amend 38 U.S.C. 2102A(e) by extending, 

through December 31, 2021, the Secretary’s authority to provide 

Specially Adapted Housing assistance to eligible individuals residing temporarily with family members. VA supports this provision, 

noting that it is substantively the same as section 306 of VA’s draft 

bill, the ‘‘Veterans Benefits Programs Improvement Act of 2011.’’ 

Under current law, the authority is set to expire on December 31, 

2011. 

VA estimates that there would be no additional costs associated 

with implementing section 303. 

Section 304 

Section 304 would amend 38 U.S.C. 2102A(b) to provide that 

amounts of assistance payable under that section to certain individuals who reside temporarily in housing owed by family members be 

adjusted on an annual basis based on a cost-of-construction index 

already in effect for other Specially Adapted Housing grants authorized under chapter 21 of title 38, United States Code. The proposal is substantively the same as section 307 of VA’s draft bill, the 

‘‘Veterans Benefits Programs Improvement Act of 2011.’’ VA supports this provision to ensure that seriously disabled Veterans temporarily living with family members may have continued access to 

residences that suit the Veterans’ day to day needs. 

VA estimates that there would be no additional costs associated 

with implementing section 304. 

105 

Section 305 

Section 305 of S. 1148 would extend eligibility for Presidential 

memorial certificates to the survivors of any Servicemember who 

died in active military, naval or air service. An alternate version 

of this provision was introduced in S. 874, and section 305 is identical to a provision the Secretary proposed on May 19, 2011. VA 

strongly supports enactment of this provision. 

Under current law, eligibility for a Presidential memorial certificate is limited to survivors of Veterans who were discharged under 

honorable conditions. Under the statutory definition of ‘‘Veteran’’ 

generally applicable to title 38, United States Code, an individual 

who died in active service, including an individual killed in action, 

technically is not a ‘‘Veteran’’ because the individual was not ‘‘discharged or released’’ from service. Therefore, under current law, 

the survivors of such an individual are not eligible for a Presidential memorial certificate to honor the memory of the individual. 

Section 305 would authorize VA to provide a Presidential memorial 

certificate to the next of kin, relatives, or friends of such individuals, who have made the supreme sacrifice for our country, and express our country’s grateful recognition of the individual’s service 

in the Armed Forces. We estimate that this eligibility expansion 

would result in discretionary costs of $8,924 the first year, $44,436 

over five years, and $88,416 over ten years. 

Section 306 

Section 306 would amend 38 U.S.C. 7105 to incorporate an automatic waiver of the right to initial consideration of certain evidence 

by the agency of original jurisdiction (AOJ). The evidence that 

would be subject to the waiver is evidence that the claimant or his 

or her representative submits to VA concurrently with or after filing the substantive appeal. Such evidence would be subject to initial consideration by the Board of Veterans’ Appeals unless the appellant or his or her representative requests in writing that the 

AOJ initially consider the evidence. Such request would be required to be submitted with the evidence. The amendment made 

under this provision would become effective 180 days after enactment of this provision. Section 306 is very similar to section 204 

of VA’s draft bill, the ‘‘Veterans Benefits Programs Improvement 

Act of 2011,’’ which was transmitted to Congress on May 19, 2011. 

VA strongly supports its enactment. 

Current law precludes the Board’s initial consideration of evidence submitted in connection with a claim, unless the claimant 

waives the right to initial consideration by the AOJ. Evidence must 

first be considered by the AOJ in order to preserve a claimant’s 

statutory right under 38 U.S.C. 7104 to one review on appeal, 

which the Board provides on behalf of the Secretary. The requirement that the AOJ initially consider all evidence, unless the claimant waives the right, frequently delays the final adjudication of 

claims because claimants often submit additional evidence after 

perfecting their appeals to the Board by filing a substantive appeal. 

Under current procedures, each time a claimant, after filing a substantive appeal, submits more evidence without waiving the right 

to initial AOJ consideration, the AOJ must review the evidence 

submitted and issue a supplemental statement of the case that adVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00105 Fmt 6604 Sfmt 6601 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
106 

dresses it. If a claimant submits relevant evidence to the Board 

without waiving the right to initial AOJ consideration, the Board 

must remand the claim to the AOJ for initial consideration and 

preparation of a supplemental statement of the case. The effect of 

the bill would not be to deprive claimants of the right to initial consideration by the AOJ. It would permit claimants to obtain initial 

consideration by the AOJ by requesting such review in writing. 

The establishment of an automatic waiver would necessarily improve the timeliness of processing appeals as a whole. Because the 

Board bases its decisions on a de novo review of all the evidence 

of record, many more appeals could be more quickly transferred to 

the Board following the receipt of a substantive appeal. AOJs 

would spend less time responding to appellants who submit additional evidence following the filing of a substantive appeal, and the 

Board would avoid time-consuming remands in cases when the appellant submits evidence directly to the Board. By presuming a 

waiver of AOJ review of new evidence, the Board would be able to 

adjudicate claims without the delay of a remand, thereby getting 

final decisions to Veterans more quickly and reducing the increased 

appellate workload caused by the reworking of remanded claims. 

We anticipate that enactment of section 306 would have no 

measurable monetary costs or savings. The potential benefits that 

would result from enactment of the proposal include expedited adjudication of claims on appeal and a reduction in the time spent 

processing appeals, both at AOJs and the Board, allowing more 

time for deciding new claims. 

Section 307 

Section 307 would permit VA to continue to use income information from other agencies in making certain benefits determinations 

by extending the sunset provision for using income data from the 

Internal Revenue Service (IRS) and the Social Security Administration (SSA) from September 30, 2011, to September 30, 2016, and 

extending the sunset provision for using income data from the U.S. 

Department of Health and Human Services (HHS) from September 30, 2011, to September 30, 2021. VA supports this provision, noting that it is substantively the same as sections 502 and 

503 of VA’s draft bill, the ‘‘Veterans Benefits Programs Improvement Act of 2011.’’ VA estimates that enactment of section 307 

would result in a net savings of $159 million over 5 years with respect to the IRS/SSA extension and a net savings of $13 million 

over 10 years with respect to the HHS extension. 

Section 308 

Section 308 would permit the VA Regional Office in Manila, Philippines, to maintain its operations until December 31, 2012. Section 504 of VA’s draft bill, the ‘‘Veterans Benefits Programs Improvement Act of 2011,’’ which was transmitted to Congress on 

May 19, 2011, proposed extending to December 31, 2016, the authority to maintain a regional office in the Philippines. Although 

section 308 would provide a shorter extension, VA nevertheless 

supports enactment. It is more cost effective to maintain the facility in Manila than it would be to transfer its functions and hire 

equivalent numbers of employees to perform those functions on the 

107 

U.S. mainland. In addition, VA’s presence in Manila significantly 

enhances the ability to manage potential fraud. For these reasons, 

there is no increased cost associated with this provision. 

* * * * * * * 

On June 8, 2011, John McWilliam, Deputy Assistant Secretary, 

Veterans’ Employment and Training Service, Department of Labor, 

appeared before the Committee and submitted testimony on 

S. 1060, among other issues. Excerpts from this statement are reprinted below: 

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STATEMENT OF JOHN MCWILLIAM, DEPUTY ASSISTANT 

SECRETARY, VETERANS’ EMPLOYMENT AND TRAINING 

SERVICE, U.S. DEPARTMENT OF LABOR 

Chairman Murray, Ranking Member Burr, and distinguished 

Members of the Committee, I am pleased to appear before you 

today to discuss legislation pending in this Committee aimed at 

helping our returning Servicemembers transition back to civilian 

life. 

The Veterans’ Employment and Training Service (VETS) proudly 

serves Veterans and transitioning Servicemembers by providing resources and expertise to assist and prepare them to obtain meaningful careers, maximize their employment opportunities and protect their employment rights. 

Secretary Solis has been an incredible source of guidance and 

support, and has made Veterans and VETS one of her top priorities. Our programs are an integral part of Secretary Solis’s vision 

of ‘‘Good Jobs for Everyone’’ and her unwavering commitment to 

help Veterans and their families get into the middle class and 

maintain stability. We strive to achieve this vision through four 

main programs: 

• Jobs for Veterans State Grants; • Transition Assistance Program Employment Workshops; • Homeless Veterans’ Reintegration Programs; and • Uniformed Services Employment and Reemployment Rights 

Act. 

Your letter of invitation seeks input on a significant number of 

bills at this hearing, and you ask VETS to specifically provide 

input on S. 951, the ‘‘Hiring Heroes Act of 2011.’’ We have done so 

in subsequent portions of this testimony, in addition to providing 

comments on the proposed ‘‘Honoring All Veterans Act of 2011,’’ 

which would require the Department of Labor (DOL), through the 

Assistant Secretary of the Office of Disability Employment Policy 

(ODEP), to initiate a program providing technical assistance to employers of Veterans who have a Traumatic Brain Injury or Post 

Traumatic Stress Disorder. 

As the remaining pieces of proposed legislation being addressed 

at this hearing fall under the purview of other departments, VETS 

defers to those departments and I will restrict my testimony to the 

appropriate sections of S. 951, and the ‘‘Honoring All Veterans Act 

of 2011’’ that have a direct impact on DOL and the Veterans’ Employment and Training Service. 

In addition to the invitation for today’s hearing, VETS has received a follow-up request to comment on Senator Casey’s proposed 

‘‘Veteran Transition Assistance Program Audit Act of 2011.’’ Due to 

time constraints, VETS was unable to conduct a thorough review 

in time for today’s hearing, but we look forward to providing our 

comments for the record and continuing to work with Senator 

109 

Casey and this entire Committee to ensure that our Servicemembers receive the best assistance possible as they transition 

back to civilian life. 

* * * * * * * 

DRAFT BILL: ‘‘HONORING ALL VETERANS ACT OF 2011’’ 

The stated purpose of this bill is to: ‘‘improve education, employment, independent living services, and health care for veterans, to 

improve assistance for homeless veterans, and to improve the administration of the Department of Veterans Affairs, and for other 

purposes.’’ Accordingly, we defer to VA and DOD for most of the 

sections of the bill. 

Section 105: This section would require the Secretary of Labor, 

through the Assistant Secretary for the Office of Disability Employment Policy, to initiate a program to provide technical assistance 

to prospective employers, employers of covered Veterans and entities in the workforce system to assist Veterans who have Traumatic Brain Injury or Post Traumatic Stress Disorder in the area 

of employment. 

DOL believes that this section is unnecessary. ODEP, in cooperation with VETS, created the America’s Heroes at Work (AHAW) 

program in 2008 to fulfill this need. We are currently in the process of transitioning the leadership and funding for this program to 

our office, and propose to work with the Committee to determine 

if AHAW needs further enhancements. 

CONCLUSION

We are reminded everyday of the tremendous sacrifices made by 

our Veterans, Servicemembers and their families. Secretary Solis 

and the Veterans’ Employment and Training Service believe that 

America must honor those sacrifices by providing the Nation’s 

bravest with the best possible programs and services that we have 

to offer. We look forward to continuing our work with this Committee to do just that. 

I again thank this Committee for your commitment to our Nation’s Veterans and for the opportunity to testify before you. We 

would be happy to work with your staffs to provide technical assistance on any of these or future bills, and I would be happy to respond to any questions. 

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

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STATEMENT OF THE U.S. DEPARTMENT OF DEFENSE 

Chairman Murray, Ranking Member Burr, and Members of this 

distinguished Committee thank you for extending the invitation to 

the Department of Defense to address pending legislation that 

would significantly affect our Servicemembers: S. 277, the proposed 

‘‘Caring for Camp Lejeune Veterans Act of 2011;’’ S. 486, the proposed ‘‘Protecting Servicemembers from Mortgage Abuses Act of 

2011;’’ S. 491, the proposed ‘‘Honor America’s Guard-Reserve Retirees Act of 2011;’’ S. 698, the proposed bill to amend title 38, United 

States Code, to codify the prohibition against the reservation of 

gravesites at Arlington National Cemetery, and for other purposes; 

S. 951, the proposed ‘‘Hiring Heroes Act of 2011.’’ 

* * * * * * * 

The Department supports the proposed bill S. 486 as drafted, 

with one caveat: the mortgage protections of section 533 should 

only be extended to 12 months rather than to the proposed 24 

months. 

* * * * * * * 

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

* * * * * * * 

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

any specific concerns. 

SUMMARY OF THE DEPARTMENT’S VIEWS ON PENDING LEGISLATION

* * * * * * * 

S. 486

The Department of Defense (DOD) supports the proposed bill 

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

proposed 24 months. 

Although DOD hesitates to recommend against any protection 

extended to Servicemembers, we believe that a three-month extension more fairly balances the equities of all parties, including the 

lending industry, and would help ensure that no backlash against 

the Servicemember—perhaps in the form of decreased credit opportunities—is ever considered. 

An extension to 12 months would align the foreclosure protections of section 533 with the current 12-month interest rate cap of 

section 527 (for pre-service mortgage obligations). This would help 

reduce confusion over the current, unevenly-extended protections. 

* * * * * * * 

111 

S. 698

S. 698 would amend title 38, United States Code, to codify the 

prohibition against the reservation of gravesites at Arlington National Cemetery. As drafted, S. 698 would prohibit more than one 

gravesite per eligible veteran and would also prohibit gravesite reservations prior to the time of need with an exception for written 

‘‘requests’’ for a reserved gravesite made prior to January 1, 1962 

regardless of current eligibility requirements. Current Army regulations establish a ‘‘one-gravesite-per-family’’ policy. This rule has 

been in effect since 1961. One important element of Army policy is 

that the Army may allow exceptions to the ‘‘one-gravesite-per-family’’ policy when strict adherence to the policy is not feasible. This 

policy is set forth at 32 CFR § 553.18(a) and Army Regulation 290– 

5 § 2–5(a). S. 698, as drafted, does not, but in the Department’s 

view should, provide the Secretary of the Army with the requisite 

authority to make an appropriately justified exception to the ‘‘onegravesite-per-family’’ policy. The Department recommends modifying S. 698 accordingly. 

Similarly, the Army currently prohibits reserving gravesites prior 

to time of need and does not honor gravesite reservations unless 

(1) the reservation was made in writing before the ‘‘one-gravesiteper-family’’ policy was established, (2) an eligible person was interred before the one-gravesite-per-family policy was established, 

and (3) the person holding the reservation for the adjacent gravesite is eligible for interment at Arlington National Cemetery under 

current Army eligibility rules. This policy is set forth at 32 CFR 

§ 553.18 and Army Regulation 290–5 § 2–5. This exception to the 

prohibition on reservations is necessary because prior to the ‘‘onegravesite-per-family’’ policy, individuals were not interred at depths 

that would accommodate two or three subsequent burials in the 

same gravesite like they are today. 

As drafted, proposed section 2410A(b) in S. 698 reflects the 

Army’s current policy prohibiting reservations. Section 1(c)(2) of 

S. 698, however, creates an exception to the prohibition on reservations for those who have a ‘‘written request for a reserved gravesite 

[that] was submitted to the Secretary of the Army before January 1, 1962.’’ This exception would alter current Army policy by allowing reservations for those with only a reservation request rather 

than an approved reservation before 1962. The requirement for a 

valid reservation, not just a request, is necessary to implement 

S. 698. The Department has no objection to the reporting requirement contained in section 1(d) of S. 698. 

* * * * * * * 

On June 8, 2011, Mercedes Marquez, Assistant Secretary for 

Community Planning and Development, Department of Housing 

and Urban Development, submitted testimony on S. 411. This 

statement is reprinted below: 

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

S. 411, HELPING OUR HOMELESS VETERANS ACT OF 2011

Chairman Murray, Ranking Member Burr, Distinguished Members of the Senate Committee on Veterans’ Affairs, I am pleased to 

be able to submit this testimony on behalf of the U.S. Department 

of Housing and Urban Development (HUD) regarding S. 411, Helping our Homeless Veterans Act of 2011. 

BACKGROUND

This bill proposes two amendments to U.S. Code Title 38: Inserting section 2045, allowing the VA to ‘‘enter into agreements with 

eligible entities to collaborate in the provision of case management 

services’’ as part of the HUD-VA Supportive Housing (HUD-VASH) 

program; and section 2046, which calls for ‘‘the distribution of rental vouchers to veterans in rural areas and underserved veterans in 

metropolitan areas or on Indian lands in each region of the United 

States.’’ 

HUD and the Administration share the goal of this legislation to 

better meet the needs of homeless veterans. One year ago this 

month, the President released Opening Doors: The Federal Strategic Plan to Prevent and End Homelessness, which calls for ending veteran homelessness by 2015, and includes strategies to help 

achieve the goal. HUD is working closely with the Department of 

Veterans Affairs to ensure our programs are coordinated to effectively and efficiently meet the needs of homeless veterans. One of 

the key successes, to date, is the HUD-VASH program. This program combines rental assistance provided by HUD with services 

and health care provided by VA. By jointly working to improve the 

program, the ability to more swiftly identify and house homeless 

veterans has been greatly enhanced. 

GEOGRAPHIC DISTRIBUTION

S. 411 seeks to ensure that resources are provided to homeless 

veterans who reside in rural communities—some of whom may be 

in areas that are long distances from VA medical centers. The current allocation methodology uses relative need and performance to 

distribute vouchers, and provides vouchers to many rural areas 

that demonstrate relative need via data provided to HUD and VA. 

While HUD agrees that there should be geographic diversity in the 

distribution of vouchers, it should be noted HUD and VA data show 

that the most significant need remains in urban centers. On the 

other hand, the Administration is committed to addressing veterans’ homelessness wherever it exists, and a more efficient way to 

113 

meet rural veterans’ needs may be through HUD’s Continuum of 

Care programs. As part of the Administration’s funding request for 

the new Homeless Emergency and Rapid Transition to Housing 

(HEARTH) Act, HUD included in its FY 2012 budget funding to 

implement the Rural Housing Stability Assistance Program 

(RHSP). This would provide assistance in rural areas to individuals 

and families (including veterans) who are homeless, in imminent 

danger of losing housing, or in worst case housing situations. The 

HEARTH Act also authorizes the new Emergency Solutions Grant 

(ESG) program, which provides funding for homelessness prevention, shelter, and rapid re-housing services. HUD looks forward to 

working with the Committee and our Administration partners to 

determine the most effective ways of addressing homelessness 

among veterans in urban and rural areas. 

CONTRACTING

One component of the bill that we believe could have a significant positive impact on assisting homeless veterans involves the 

provision of services through VA contracts with local non-profits 

and other agencies to provide case management and to connect to 

HUD housing resources. As demonstrated by the success of the 

HUD-VA—U.S. Interagency Council on Homelessness (USICH) 

Washington, DC. Pilot Initiative, contracting and collaborating 

with local providers can greatly enhance the provision of needed 

services in some communities. Through a joint effort between 

Washington, DC’s Department of Human Services and the D.C. 

Housing Authority, the eligibility process was streamlined and as 

a result, vouchers were allocated at a substantially faster pace and 

clients with vouchers were quickly housed. These very positive, initial results from the first pilot suggest that this model should be 

looked at further in other communities that the Departments deem 

appropriate. 

TARGETING

We have learned through our HUD-VASH efforts in recent years 

that a key to success in ending veteran homelessness is effective 

targeting. Therefore we have concerns about the potential impact 

of this bill on those targeting efforts. While the title of the bill indicates that the targeted population will be homeless veterans, the 

text of the bill in a number of cases uses the term ‘‘underserved 

veterans,’’ suggesting that the program could be modified to serve 

more than veterans who are homeless. The current HUD-VASH assistance is designed to house the neediest veterans, many of whom 

are chronically homeless. We would argue in favor of keeping that 

targeting to this population as a priority at this time. 

CASE MANAGEMENT

The bill includes a broad definition of case management services, 

which could complicate the efforts of HUD, the VA, and organizations that would be contracted to provide needed services to homeless veterans. For example, the bill includes activities such as rental assistance, legal assistance, and mental health or substance 

abuse counseling as part of case management. HUD looks forward 

114 

to working with the Committee and VA to clarify the definition of 

case management in the legislation in order to help improve coordination and efficiency, as well as oversight. 

TRIBAL LANDS

HUD recognizes the need for improved housing and services for 

veterans on Tribal Lands, and we are eager to explore options for 

helping to achieve this goal. While persons living in tribal areas 

are individually eligible for HUD-VASH, under current law the 

tribal areas themselves are not eligible for any Housing Choice 

Voucher (HCV) program (including HUD-VASH), or for McKinneyVento Act/homeless programs. However, it should be noted that the 

Native American Housing Assistance and Self-Determination Act 

(NAHASDA) authorizes assistance to Indian Tribes or their Tribally Designated Housing Entities (TDHE) through the Indian 

Housing Block Grant (IHBG). IHBG can be used to develop rental 

assistance programs similar to HCV. We believe it is important to 

take into account these mechanisms for providing services to veterans on Tribal Lands as part of the effort to consider what 

changes to the existing system make sense. And, again, we look 

forward to discussing these matters with Members of the Committee. 

CONCLUSION

The HUD-VASH model has served as a vital tool for ending veteran homelessness, and HUD is encouraged that Senator Klobuchar and the Committee continue to seek ways to improve the 

program. HUD looks forward to working with the Committee to 

further discuss how the intent of the S. 411’s provisions can best 

be realized. 

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CHANGES IN EXISTING LAW

In compliance with paragraph 12 of Rule XXVI of the Standing 

Rules of the Senate, changes in existing law made by the bill, as 

reported, are shown as follows (existing law proposed to be omitted 

is enclosed in black brackets, new matter is printed in italic, existing law in which no change is proposed is shown in roman). 

Title 18. Crimes and Criminal Procedure 

* * * * * * * 

Part I. Crimes 

* * * * * * * 

Chapter 67. Military and Navy 

* * * * * * * 

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

ø(a) PROHIBITION.—For any funeral of a member or former member of the Armed Forces that is not located at a cemetery under 

the control of the National Cemetery Administration or part of Arlington National Cemetery, it shall be unlawful for any person to 

engage in an activity during the period beginning 60 minutes before and ending 60 minutes after such funeral, any part of which 

activity— 

ø(1) (A) takes place within the boundaries of the location of 

such funeral or takes place within 150 feet of the point of the 

intersection between— 

ø(i) the boundary of the location of such funeral; and 

ø(ii) a road, pathway, or other route of ingress to or 

egress from the location of such funeral; and 

ø(B) includes any individual willfully making or assisting in 

the making of any noise or diversion that is not part of such 

funeral and that disturbs or tends to disturb the peace or good 

order of such funeral with the intent of disturbing the peace 

or good order of that funeral; or 

ø(2)(A) is within 300 feet of the boundary of the location of 

such funeral; and 

ø(B) includes any individual willfully and without proper authorization impeding the access to or egress from such location 

with the intent to impede the access to or egress from such location. 

ø(b) PENALTY.—Any person who violates subsection (a) shall be 

fined under this title, imprisoned for not more than 1 year, or both. 

ø(c) DEFINITIONS.—In this section: 

116 

ø(1) The term ‘‘Armed Forces’’ has the meaning given the 

term in section 101 of title 10. 

ø(2) The term ‘‘funeral of a member or former member of the 

Armed Forces’’ means any ceremony or memorial service held 

in connection with the burial or cremation of a member or 

former member of the Armed Forces. 

ø(3) The term ‘‘boundary of the location’’, with respect to a 

funeral of a member or former member of the Armed Forces, 

means— 

ø(A) in the case of a funeral of a member or former 

member of the Armed Forces that is held at a cemetery, 

the property line of the cemetery; 

ø(B) in the case of a funeral of a member or former 

member of the Armed Forces that is held at a mortuary, 

the property line of the mortuary; 

ø(C) in the case of a funeral of a member or former 

member of the Armed Forces that is held at a house of 

worship, the property line of the house of worship; and 

ø(D) in the case of a funeral of a member or former 

member of the Armed Forces that is held at any other kind 

of location, the reasonable property line of that location.¿ 

(a) PROHIBITION.—For any funeral of a member or former member 

of the Armed Forces that is not located at a cemetery under the control of the National Cemetery Administration or part of Arlington 

National Cemetery, it shall be unlawful for any person to engage in 

an activity during the period beginning 120 minutes before and ending 120 minutes after such funeral, any part of which activity— 

(1)(A) takes place within the boundaries of the location of 

such funeral or takes place within 300 feet of the point of the 

intersection between— 

(i) the boundary of the location of such funeral; and 

(ii) a road, pathway, or other route of ingress to or egress 

from the location of such funeral; and 

(B) includes any individual willfully making or assisting in 

the making of any noise or diversion— 

(i) that is not part of such funeral and that disturbs or 

tends to disturb the peace or good order of such funeral; 

and 

(ii) with the intent of disturbing the peace or good order 

of such funeral; 

(2)(A) is within 500 feet of the boundary of the location of 

such funeral; and 

(B) includes any individual— 

(i) willfully and without proper authorization impeding 

or tending to impede the access to or egress from such location; and 

(ii) with the intent to impede the access to or egress from 

such location; or 

(3) is on or near the boundary of the residence, home, or 

domicile of any surviving member of the deceased person’s immediate family and includes any individual willfully making or 

assisting in the making of any noise or diversion— 

(A) that disturbs or tends to disturb the peace of the persons located at such location; and 

117 

(B) with the intent of disturbing such peace. 

(b) PENALTY.—Any person who violates subsection (a) shall be 

fined under this title or imprisoned for not more than 1 year, or 

both. 

(c) CIVIL REMEDIES.— 

(1) DISTRICT COURTS.—The district courts of the United 

States shall have jurisdiction— 

(A) to prevent and restrain violations of this section; and 

(B) for the adjudication of any claims for relief under 

this section. 

(2) ATTORNEY GENERAL.—The Attorney General may institute 

proceedings under this section. 

(3) CLAIMS.—Any person, including a surviving member of 

the deceased person’s immediate family, who suffers injury as 

a result of conduct that violates this section may— 

(A) sue therefor in any appropriate United States district 

court or in any court of competent jurisdiction; and 

(B) recover damages as provided in subsection (d) and 

the cost of the suit, including reasonable attorneys’ fees. 

(4) ESTOPPEL.—A final judgment or decree rendered in favor 

of the United States in any criminal proceeding brought by the 

United States under this section shall estop the defendant from 

denying the essential allegations of the criminal offense in any 

subsequent civil proceeding brought by a person or by the 

United States. 

(d) ACTUAL AND STATUTORY DAMAGES.— 

(1) IN GENERAL.—In addition to any penalty imposed under 

subsection (b), a violator of this section is liable in an action 

under subsection (c) for actual or statutory damages as provided in this subsection. 

(2) ACTIONS BY PRIVATE PERSONS.—A person bringing an action under subsection (c)(3) may elect, at any time before final 

judgment is rendered, to recover the actual damages suffered by 

him or her as a result of the violation or, instead of actual damages, an award of statutory damages for each violation involved 

in the action. 

(3) ACTIONS BY ATTORNEY GENERAL.—In any action under 

subsection (c)(2), the Attorney General is entitled to recover an 

award of statutory damages for each violation involved in the 

action notwithstanding any recovery under subsection (c)(3). 

(4) STATUTORY DAMAGES.—A court may award, as the court 

considers just, statutory damages in a sum of not less than 

$25,000 or more than $50,000 per violation. 

(e) REBUTTABLE PRESUMPTION.—It shall be a rebuttable presumption that the violation was committed willfully for purposes of determining relief under this section if the violator, or a person acting 

in concert with the violator, did not have reasonable grounds to believe, either from the attention or publicity sought by the violator or 

other circumstance, that the conduct of such violator or person 

would not disturb or tend to disturb the peace or good order of such 

funeral, impede or tend to impede the access to or egress from such 

funeral, or disturb or tend to disturb the peace of any surviving 

member of the deceased person’s immediate family who may be 

118 

found on or near the residence, home, or domicile of the deceased 

person’s immediate family on the date of the service or ceremony. 

(f) DEFINITIONS.—In this section— 

(1) the term ‘‘Armed Forces’’ has the meaning given the term 

in section 101 of title 10 and includes members and former 

members of the National Guard who were employed in the service of the United States; and 

(2) the term ‘‘immediate family’’ means, with respect to a person, the immediate family members of such person, as such 

term is defined in section 115 of this title. 

* * * * * * * 

Title 38. Veterans’ Benefits 

* * * * * * * 

Part I. General Provisions 

* * * * * * * 

Chapter 1. General 

* * * * * * * 

SEC. 111. PAYMENTS OR ALLOWANCES FOR BENEFICIARY TRAVEL 

* * * * * * * 

(b)(1) * * * 

* * * * * * * 

(3)(A) * * * 

* * * * * * * 

(C) In the case of transportation of a person under subparagraph 

(B) by ambulance, the Secretary may pay the provider of the transportation the lesser of the actual charge for the transportation or the 

amount determined by the fee schedule established under section 

1834(l) of the Social Security Act (42 U.S.C. 1395m(l)) unless the 

Secretary has entered into a contract for that transportation with 

the provider. 

* * * * * * * 

SEC. 112. PRESIDENTIAL MEMORIAL CERTIFICATE PROGRAM 

(a) At the request of the President the Secretary may conduct a 

program for honoring the memory of deceased veterans, discharged 

under honorable conditions, and persons who died in the active 

military, naval, or air service, by preparing and sending to eligible 

recipients a certificate bearing the signature of the President and 

expressing the country’s grateful recognition of the øveteran’s¿ deceased individual’s service in the Armed Forces. The award of a 

certificate to one eligible recipient will not preclude authorization 

of another certificate if a request is received from some other eligible recipient. 

* * * * * * * 

119 

Chapter 3. Department of Veterans Affairs 

* * * * * * * 

SEC. 315. REGIONAL OFFICES 

(a) * * * 

(b) The Secretary may maintain a regional office in the Republic 

of the Philippines until øDecember 31, 2011¿ December 31, 2012. 

* * * * * * * 

Part II. General Benefits 

* * * * * * * 

Chapter 15. Pension for Non-Service-Connected Disability 

or Death or for Service 

* * * * * * * 

Subchapter II. Veterans’ Pensions 

* * * * * * * 

NON-SERVICE-CONNECTED DISABILITY PENSION 

SEC. 1521. VETERANS OF A PERIOD OF WAR. 

* * * * * * * 

(f)(1) * * * 

(2) If either such veteran is in need of regular aid and attendance, the annual rate provided by paragraph (1) of this subsection 

shall be $23,396. If both such veterans are in need of regular aid 

and attendance, such rate shall be ø$30,480¿ $31,305. 

* * * * * * * 

Chapter 17. Hospital, Nursing Home, Domiciliary, and 

Medical Care 

Sec. 

SUBCHAPTER I. GENERAL 

* * * * * * * 

1708. Temporary lodging. 

1709. Teleconsultation. 

* * * * * * * 

SUBCHAPTER III. MISCELLANEOUS PROVISIONS RELATING TO HOSPITAL AND NURSING HOME 

CARE AND MEDICAL TREATMENT OF VETERANS 

1721. Power to make rules and regulations. 

* * * * * * * 

1722A. Copayment for medications. 

1722B. Copayments: waiver of collection of copayments for telehealth and telemedicine visits of veterans. 

* * * * * * * 

120 

Subchapter I. General 

* * * * * * * 

SEC. 1708. TEMPORARY LODGING 

* * * * * * * 

SEC. 1709. TELECONSULTATION 

(a) TELECONSULTATION.—(1) The Secretary shall carry out a program of teleconsultation for the provision of remote mental health 

and traumatic brain injury assessments in facilities of the Department that are not otherwise able to provide such assessments without contracting with third party providers or reimbursing providers 

through a fee basis system. 

(2) The Secretary shall, in consultation with appropriate professional societies, promulgate technical and clinical care standards 

for the use of teleconsultation services within facilities of the Department. 

(b) TELECONSULTATION DEFINED.—In this section, the term ‘‘teleconsultation’’ means the use by a health care specialist of telecommunications to assist another health care provider in rendering 

a diagnosis or treatment. 

* * * * * * * 

Subchapter II. Hospital, Nursing Home, or Domiciliary Care 

and Medical Treatment 

* * * * * * * 

SEC. 1710C. TRAUMATIC BRAIN INJURY: PLANS FOR REHABILITATION 

AND REINTEGRATION INTO THE COMMUNITY 

(a) * * * 

(1) develop an individualized plan for the rehabilitation and 

reintegration of the individual into the community with the 

goal of maximizing the individual’s independence; and 

* * * * * * * 

(b) * * * 

(1) Rehabilitation objectives for improving (and sustaining 

improvement in) the physical, cognitive, behavioral, and vocational functioning of the individual with the goal of maximizing 

the independence and reintegration of such individual into the 

community. 

(2) Access, as warranted, to all appropriate rehabilitative 

services and rehabilitative components of the traumatic brain 

injury continuum of care, and where appropriate, to long-term 

care services. 

(3) A description of specific rehabilitative øtreatments¿ services and other services to achieve the objectives described in 

paragraph (1), which shall set forth the type, frequency, duration, and location of such øtreatments and¿ services. 

* * * * * * * 

(c) COMPREHENSIVE ASSESSMENT.— (1) * * * 

(2) * * * 

121 

(A) A neurologist. 

* * * * * * * 

(S) An øopthamologist¿ ophthalmologist. 

* * * * * * * 

(h) REHABILITATIVE SERVICES DEFINED.—For purposes of this section, and sections 1710D and 1710E of this title, the term ‘‘rehabilitative services’’ includes— 

(1) rehabilitative services, as such term is defined in section 

1701 of this title; 

(2) treatment and services (which may be of ongoing duration) to sustain, and prevent loss of, functional gains that have 

been achieved; and 

(3) any other rehabilitative services or supports that may contribute to maximizing an individual’s independence. 

SEC. 1710D. TRAUMATIC BRAIN INJURY: COMPREHENSIVE PROGRAM 

FOR LONG-TERM REHABILITATION 

(a) COMPREHENSIVE PROGRAM.—In developing plans for the rehabilitation and reintegration of individuals with traumatic brain injury under section 1710C of this title, the Secretary shall develop 

and carry out a comprehensive program of long-term care and rehabilitative services (as defined in section 1710C of this title) for 

postacute traumatic brain injury rehabilitation that includes residential, community, and home-based components utilizing interdisciplinary øtreatment¿ teams. 

* * * * * * * 

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

FACILITIES FOR REHABILITATION 

(a) COOPERATIVE AGREEMENTS.—The Secretary, in implementing 

and carrying out a plan developed under section 1710C of this title, 

may provide hospital care and medical services, including rehabilitative services (as defined in section 1710C of this title), through cooperative agreements with appropriate public or private entities 

that have established long-term neurobehavioral rehabilitation and 

recovery programs. 

* * * * * * * 

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

* * * * * * * 

(e)(1) Subject to paragraph (3), the Secretary shall admit service 

animals described in paragraph (2) to any building or property of 

the Department on the same terms and conditions, and subject to 

the same regulations, as otherwise generally govern the admission 

of the public to such buildings or properties. 

(2) The service animals described in this paragraph are service 

dogs provided under subsection (c) and other guide dogs or service 

animals that accompany individuals with disabilities and that are 

especially trained and educated to accompany such individuals. 

(3) The Secretary may prohibit service animals described in paragraph (2) from running free in or roaming buildings or properties 

described in paragraph (1) and may require such service animals 

to adorn guiding harnesses or leashes and be under the control of 

122 

an individual at all times while in such buildings or on such properties. 

* * * * * * * 

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

Veterans 

* * * * * * * 

SEC. 1722A. COPAYMENT FOR MEDICATIONS 

* * * * * * * 

SEC. 1722B. COPAYMENTS: WAIVER OF COLLECTION OF COPAYMENTS 

FOR TELEHEALTH AND TELEMEDICINE VISITS OF VETERANS 

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

laws administered by the Secretary. 

* * * * * * * 

Subchapter V. Payments to State Homes 

* * * * * * * 

SEC. 1745. NURSING HOME CARE AND MEDICATIONS FOR VETERANS 

WITH SERVICE-CONNECTED DISABILITIES 

(a)(1) øThe Secretary shall pay each State home for nursing 

home care at the rate determined under paragraph (2)¿ The Secretary shall enter into a contract (or agreement under section 

1720(c)(1) of this title) with each State home for payment by the Secretary for nursing home care provided in the home, in any case in 

which such care is provided to any veteran as follows: 

* * * * * * * 

ø(2) The rate determined under this paragraph with respect to 

a State home is the lesser of— 

ø(A) the applicable or prevailing rate payable in the geographic area in which the State home is located, as determined 

by the Secretary, for nursing home care furnished in a non-Department nursing home (as that term is defined in section 

1720(e)(2) of this title); or 

ø(B) a rate not to exceed the daily cost of care, as determined 

by the Secretary, following a report to the Secretary by the director of the State home.¿ 

(2) Payment under each contract (or agreement) between the Secretary and a State home under paragraph (1) shall be based on a 

methodology, developed by the Secretary in consultation with the 

State home, to adequately reimburse the State home for the care 

provided by the State home under the contract (or agreement). 

* * * * * * * 

Chapter 20. Benefits For Homeless Veterans 

* * * * * * * 

123 

Subchapter II. Comprehensive Service Programs 

SEC. 2011. GRANTS 

* * * * * * * 

(b) * * * 

(1) * * * 

(A) øexpansion, remodeling, or alteration of existing 

buildings, or acquisition of facilities,¿ new construction of 

facilities, expansion, remodeling, or alteration of existing 

facilities, or acquisition of facilities for use as service centers, transitional housing, or other facilities to serve homeless veterans; and 

* * * * * * * 

(c) FUNDING LIMITATIONS.—øA grant¿ (1) A grant under this section may not be used to support operational costs. øThe amount¿ 

(2) The amount of a grant under this section may not exceed 65 

percent of the estimated cost of the project concerned. 

(3)(A) The Secretary may not deny an application from an entity 

that seeks a grant under this section to carry out a project described 

in subsection (b)(1)(A) solely on the basis that the entity proposes to 

use funding from other private or public sources, if the entity demonstrates that a private nonprofit organization will provide oversight and site control for the project. 

(B) In this paragraph, the term ‘‘private nonprofit organization’’ 

means the following: 

(i) An incorporated private institution, organization, or foundation— 

(I) that has received, or has temporary clearance to receive, tax-exempt status under paragraph (2), (3), or (19) of 

section 501(c) of the Internal Revenue Code of 1986; 

(II) for which no part of the net earnings of the institution, organization, or foundation inures to the benefit of 

any member, founder, or contributor of the institution, organization, or foundation; and 

(III) that the Secretary determines is financially responsible. 

(ii) A for-profit limited partnership or limited liability company, the sole general partner or manager of which is an organization that is described by subclauses (I) through (III) of 

clause (i). 

(iii) A corporation wholly owned and controlled by an organization that is described by subclauses (I) through (III) of 

clause (i). 

* * * * * * * 

SEC. 2013. AUTHORIZATION OF APPROPRIATIONS 

There is authorized to be appropriated to carry out this 

øsubchapter $150,000,000 for fiscal year 2007 and each fiscal year 

thereafter.¿ subchapter amounts as follows: 

(1) $150,000,000 for each of fiscal years 2007 through 2009. 

(2) $175,100,000 for fiscal year 2010. 

(3) $217,700,000 for fiscal year 2011. 

(4) $250,000,000 for fiscal year 2012. 

124 

(5) $150,000,000 for fiscal year 2013 and each fiscal year 

thereafter. 

Subchapter III. Training and Outreach 

SEC. 2021. HOMELESS VETERANS REINTEGRATION PROGRAMS 

* * * * * * * 

(e) * * * 

(1) * * * 

* * * * * * * 

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

* * * * * * * 

Subchapter IV. Treatment and Rehabilitation for Seriously 

Mentally Ill and Homeless Veterans 

SEC. 2031. GENERAL TREATMENT 

(a) In providing care and services under section 1710 of this title 

to veterans suffering from serious mental illnessø, including¿ and 

to veterans who are homeless, the Secretary may provide (directly 

or in conjunction with a governmental or other entity)— 

* * * * * * * 

(b) The authority of the Secretary under subsection (a) expires on 

øDecember 31, 2011¿ December 31, 2012. 

* * * * * * * 

SEC. 2033. ADDITIONAL SERVICES AT CERTAIN LOCATIONS 

* * * * * * * 

(d) The program under this section shall terminate on øDecember 

31, 2011¿ December 31, 2014. 

* * * * * * * 

Subchapter V. Housing Assistance 

SEC. 2041. HOUSING ASSISTANCE FOR HOMELESS VETERANS 

* * * * * * * 

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

* * * * * * * 

SEC. 2044. FINANCIAL ASSISTANCE FOR SUPPORTIVE SERVICES FOR 

VERY LOW-INCOME VETERAN FAMILIES IN PERMANENT 

HOUSING 

* * * * * * * 

(e) FUNDING.— 

(1) From amounts appropriated to the Department for Medical Services, there shall be available to øcarry out subsection 

(a), (b), and (c)¿ carry out subsections (a), (b), and (c) amounts 

as follows: 

(A) $15,000,000 for fiscal year 2009. 

(B) $20,000,000 for fiscal year 2010. 

(C) $25,000,000 for fiscal year 2011. 

125 

(D) $100,000,000 for fiscal year 2012. 

(2) * * * 

(3) There is authorized to be appropriated $1,000,000 for 

each of the fiscal years 2009 through ø2011¿ 2012 to carry out 

the provisions of subsection (d). 

* * * * * * * 

Subchapter VII. Other Provisions 

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

(a) ESTABLISHMENT.—The Secretary shall carry out a program to 

make grants to health care facilities of the Department and øto 

grant and per diem providers¿ to entities eligible for grants and per 

diem payments under sections 2011 and 2012 of this title in order 

to encourage development øby those facilities and providers¿ by 

those facilities and entities of programs for homeless veterans with 

special needs. 

(b) HOMELESS VETERANS WITH SPECIAL NEEDS.—For purposes of 

this section, homeless veterans with special needs include homeless 

veterans who are— 

(1) womenø, including women who have care of minor dependents¿; 

(2) frail elderly; 

(3) terminally ill; øor¿ 

(4) chronically mentally illø.¿; or 

(5) individuals who have care of minor dependents. 

(c) Provision of Services to Dependents.—A recipient of a grant 

under subsection (a) may use amounts under the grant to provide 

services directly to a dependent of a homeless veteran with special 

needs who is under the care of such homeless veteran while such 

homeless veteran receives services from the grant recipient under 

this section. 

(d) ø(c)¿ FUNDING.— (1) From amounts appropriated to the Department for ‘‘Medical Services’’ for each of fiscal years 2007 through ø2011¿ 

2013, $5,000,000 shall be available for each such fiscal year for 

the purposes of the program under this section. 

* * * * * * * 

SEC. 2066. ADVISORY COMMITTEE ON HOMELESS VETERANS 

* * * * * * * 

(d) TERMINATION.—The Committee shall cease to exist 

øDecember 31, 2011¿ December 31, 2013. 

* * * * * * * 

Chapter 21. Specially Adapted Housing for Disabled 

Veterans 

Sec. 

2101. Acquisition and adaptation of housing: eligible veterans. 

* * * * * * * 

126 

2108. Specially adapted housing assistive technology grant program. 

2109. Specially adapted housing destroyed or damaged by natural disasters. 

SEC. 2101. ACQUISITION AND ADAPTATION OF HOUSING: ELIGIBLE 

VETERANS 

* * * * * * * 

(b) ADAPTATIONS TO RESIDENCE OF VETERAN. (1) * * * 

ø(2) A veteran is described in this paragraph if the veteran 

is entitled to compensation under chapter 11 of this title for a 

permanent and total service-connected disability that meets 

any of the following criteria: 

ø(A) The disability is due to blindness in both eyes with 

5/200 visual acuity or less. 

ø(B) The disability includes the anatomical loss or loss 

of use of both hands. 

ø(C) The disability is due to a severe burn injury (as so 

determined).¿ 

(2) A veteran is described in this paragraph if the veteran is 

entitled to compensation under chapter 11 of this title for a 

service-connected disability that meets any of the following criteria: 

(A) The disability is due to blindness in both eyes, having 

central visual acuity of 20/200 or less in the better eye with 

the use of a standard correcting lens. For the purposes of 

this subparagraph, an eye with a limitation in the fields of 

vision such that the widest diameter of the visual field 

subtends an angle no greater than 20 degrees shall be considered as having a central visual acuity of 20/200 or less. 

(B) A permanent and total disability that includes the 

anatomical loss or loss of use of both hands. 

(C) A permanent and total disability that is due to a severe burn injury (as so determined). 

* * * * * * * 

SEC. 2102. LIMITATIONS ON ASSISTANCE FURNISHED 

* * * * * * * 

(d)(1) The aggregate amount of assistance available to an individual øunder sections 2101(a) and 2102A¿ under section 2101(a) 

of this title shall be limited to $60,000. 

(2) The aggregate amount of assistance available to an individual 

øunder sections 2101(b) and 2102A¿ under section 2101(b) of this 

title shall be limited to $12,000. 

* * * * * * * 

SEC. 2102A. ASSISTANCE FOR INDIVIDUALS RESIDING TEMPORARILY 

IN HOUSING OWNED BY A FAMILY MEMBER 

* * * * * * * 

(b) AMOUNT OF ASSISTANCE.—(1) The assistance authorized 

under subsection (a) may not exceed— 

(A) ø(1)¿ ø$14,000¿ $28,000, in the case of an individual described in section 2101(a)(2) of this title; or 

(B) ø(2)¿ ø$2,000¿ $5,000, in the case of an individual described in section 2101(b)(2) of this title. 

127 

(2) Effective on October 1 of each year (beginning in 2012), the 

Secretary shall use the same percentage calculated pursuant to section 2102(e) of this title to increase the amounts described in paragraph (1) of this subsection. 

* * * * * * * 

(e) TERMINATION.—No assistance may be provided under this section after øDecember 31, 2011¿ December 31, 2021. 

* * * * * * * 

SEC. 2108. SPECIALLY ADAPTED HOUSING ASSISTIVE TECHNOLOGY 

GRANT PROGRAM. 

* * * * * * * 

SEC. 2109. SPECIALLY ADAPTED HOUSING DESTROYED OR DAMAGED 

BY NATURAL DISASTERS 

(a) IN GENERAL.—Notwithstanding the provisions of section 2102 

of this title, the Secretary may award a grant to a veteran whose 

home was previously adapted with assistance of a grant under this 

chapter in the event the adapted home which was being used and 

occupied by the veteran was destroyed or substantially damaged in 

a natural or other disaster, as determined by the Secretary. 

(b) USE OF FUNDS.—A grant awarded under subsection (a) shall 

be available to acquire a suitable housing unit with special fixtures 

or moveable facilities made necessary by the veteran’s disability, 

and necessary land therefor. 

(c) LIMITATIONS.—The amount of the grant awarded under subsection (a) may not exceed the lesser of— 

(1) the reasonable cost, as determined by the Secretary, of repairing or replacing the damaged or destroyed home in excess 

of the available insurance coverage on such home; or 

(2) the maximum grant amount to which the veteran would 

have been entitled under subsection (a) or (b) of section 2102 of 

this title had the veteran not obtained the prior grant. 

* * * * * * * 

Chapter 24. National Cemeteries and Memorials 

Sec. 

2400. Establishment of National Cemetery Administration; composition of Administration. 

* * * * * * * 

2410. Burial of cremated remains in Arlington National Cemetery. 

2410A. Arlington National Cemetery: other administrative matters. 

* * * * * * * 

2413. Prohibition on certain demonstrations and disruptions at cemeteries under 

control of the National Cemetery Administration and at Arlington National Cemetery. 

* * * * * * * 

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

(a) ONE GRAVESITE.—(1) Not more than one gravesite may be provided at Arlington National Cemetery to a veteran or member of the 

128 

Armed Forces who is eligible for interment or inurnment at such 

cemetery. 

(2) The Secretary of the Army may waive the prohibition in paragraph (1) as the Secretary of the Army considers appropriate. 

(b) PROHIBITION AGAINST RESERVATION OF GRAVESITES.—A 

gravesite at Arlington National Cemetery may not be reserved for an 

individual before the death of such individual. 

* * * * * * * 

øSEC. 2413. PROHIBITION ON CERTAIN DEMONSTRATIONS AT CEMETERIES UNDER CONTROL OF THE NATIONAL CEMETERY 

ADMINISTRATION AND AT ARLINGTON NATIONAL CEMETERY 

ø(a) PROHIBITION.—No person may carry out— 

ø(1) a demonstration on the property of a cemetery under the 

control of the National Cemetery Administration or on the 

property of Arlington National Cemetery unless the demonstration has been approved by the cemetery superintendent 

or the director of the property on which the cemetery is located; or 

ø(2) with respect to such a cemetery, a demonstration during 

the period beginning 60 minutes before and ending 60 minutes 

after a funeral, memorial service, or ceremony is held, any part 

of which demonstration— 

ø(A)(i) takes place within 150 feet of a road, pathway, or 

other route of ingress to or egress from such cemetery 

property; and 

ø(ii) includes, as part of such demonstration, any individual willfully making or assisting in the making of any 

noise or diversion that disturbs or tends to disturb the 

peace or good order of the funeral, memorial service, or 

ceremony; or 

ø(B) is within 300 feet of such cemetery and impedes the 

access to or egress from such cemetery. 

ø(b) DEMONSTRATION.—For purposes of this section, the term 

‘‘demonstration’’ includes the following: 

ø(1) Any picketing or similar conduct. 

ø(2) Any oration, speech, use of sound amplification equipment or device, or similar conduct that is not part of a funeral, 

memorial service, or ceremony. 

ø(3) The display of any placard, banner, flag, or similar device, unless such a display is part of a funeral, memorial service, or ceremony. 

ø(4) The distribution of any handbill, pamphlet, leaflet, or 

other written or printed matter other than a program distributed as part of a funeral, memorial service, or ceremony.¿ 

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

NATIONAL CEMETERY 

(a) PROHIBITION.—It shall be unlawful for any person— 

(1) to carry out a demonstration on the property of a cemetery 

under the control of the National Cemetery Administration or 

on the property of Arlington National Cemetery unless the demVerDate Nov 24 2008 16:05 Oct 17, 2011 Jkt 000000 PO 00000 Frm 00128 Fmt 6604 Sfmt 6603 H:\REPORTS AND CORDONS\S. 914 - 112TH 1ST\S914RPT.TXT SVETS PsN: PAULIN
129 

onstration has been approved by the cemetery superintendent or 

the director of the property on which the cemetery is located; or 

(2) with respect to such a cemetery, to engage in a demonstration during the period beginning 120 minutes before and ending 120 minutes after a funeral, memorial service, or ceremony 

is held, any part of which demonstration— 

(A)(i) takes place within the boundaries of such cemetery 

or takes place within 300 feet of the point of the intersection 

between— 

(I) the boundary of such cemetery; and 

(II) a road, pathway, or other route of ingress to or 

egress from such cemetery; and 

(ii) includes any individual willfully making or assisting 

in the making of any noise or diversion— 

(I) that is not part of such funeral, memorial service, 

or ceremony and that disturbs or tends to disturb the 

peace or good order of such funeral, memorial service, 

or ceremony; and 

(II) with the intent of disturbing the peace or good 

order of such funeral, memorial service, or ceremony; 

or 

(B)(i) is within 500 feet of the boundary of such cemetery; 

and 

(ii) includes any individual— 

(I) willfully and without proper authorization impeding or tending to impede the access to or egress from 

such cemetery; and 

(II) with the intent to impede the access to or egress 

from such cemetery. 

(b) PENALTY.—Any person who violates subsection (a) shall be 

fined under title 18 or imprisoned for not more than 1 year, or both. 

(c) CIVIL REMEDIES.—(1) The district courts of the United States 

shall have jurisdiction— 

(A) to prevent and restrain violations of this section; and 

(B) for the adjudication of any claims for relief under this 

section. 

(2) The Attorney General of the United States may institute proceedings under this section. 

(3) Any person, including a surviving member of the deceased person’s immediate family, who suffers injury as a result of conduct 

that violates this section may— 

(A) sue therefor in any appropriate United States district 

court or in any court of competent jurisdiction; and 

(B) recover damages as provided in subsection (d) and the 

cost of the suit, including reasonable attorneys’ fees. 

(4) A final judgment or decree rendered in favor of the United 

States in any criminal proceeding brought by the United States 

under this section shall estop the defendant from denying the essential allegations of the criminal offense in any subsequent civil proceeding brought by a person or by the United States. 

(d) ACTUAL AND STATUTORY DAMAGES.—(1) In addition to any 

penalty imposed under subsection (b), a violator of this section is 

liable in an action under subsection (c) for actual or statutory damages as provided in this subsection. 

130 

(2) A person bringing an action under subsection (c)(3) may elect, 

at any time before final judgment is rendered, to recover the actual 

damages suffered by him or her as a result of the violation or, instead of actual damages, an award of statutory damages for each 

violation involved in the action. 

(3) In any action brought under subsection (c)(2), the Attorney 

General is entitled to recover an award of statutory damages for 

each violation involved in the action notwithstanding any recovery 

under subsection (c)(3). 

(4) A court may award, as the court considers just, statutory dam- ages in a sum of not less than $25,000 or more than $50,000 per 

violation. 

(e) REBUTTABLE PRESUMPTION.—It shall be a rebuttable presumption that the violation of subsection (a) was committed willfully for 

purposes of determining relief under this section if the violator, or 

a person acting in concert with the violator, did not have reasonable 

grounds to believe, either from the attention or publicity sought by 

the violator or other circumstance, that the conduct of such violator 

or person would not— 

(1) disturb or tend to disturb the peace or good order of such 

funeral, memorial service, or ceremony; or 

(2) impede or tend to impede the access to or egress from such 

funeral, memorial service, or ceremony. 

(f) DEFINITIONS.—In this section— 

(1) the term ‘‘demonstration’’ includes— 

(A) any picketing or similar conduct; 

(B) any oration, speech, use of sound amplification equipment or device, or similar conduct that is not part of a funeral, memorial service, or ceremony; 

(C) the display of any placard, banner, flag, or similar 

device, unless such a display is part of a funeral, memorial 

service, or ceremony; and 

(D) the distribution of any handbill, pamphlet, leaflet, or 

other written or printed matter other than a program distributed as part of a funeral, memorial service, or ceremony; and 

(2) the term ‘‘immediate family’’ means, with respect to a person, the immediate family members of such person, as such 

term is defined in section 115 of title 18. 

* * * * * * * 

Part III. Readjustment and Related Benefits 

* * * * * * * 

Chapter 31. Training and Rehabilitation for Veterans with 

Service-Connected Disabilities 

* * * * * * * 

SEC. 3108. ALLOWANCES 

(a)(1) * * * 

(2)(A) In any case in which the Secretary determines, at the conclusion of such veteran’s pursuit of a vocational rehabilitation program under this chapter, that such veteran has been rehabilitated 

131 

to the point of employability, such veteran shall be paid a subsistence allowance, as prescribed in this section for full-time training 

for the type of program that the veteran was pursuing, for two 

months while satisfactorily following a program of employment 

services provided under section 3104(a)(5) of this title. 

(B) In any case in which the Secretary determines that a veteran 

described in subparagraph (A) has been displaced as the result of 

a natural or other disaster while being paid a subsistence allowance 

under that subparagraph, as determined by the Secretary, the Secretary may extend the payment of a subsistence allowance under 

such subparagraph for up to an additional two months while the 

veteran is satisfactorily following a program of employment services 

described in such subparagraph. 

* * * * * * * 

SEC. 3120. PROGRAM OF INDEPENDENT LIVING SERVICES AND ASSISTANCE 

* * * * * * * 

(e)(1) Programs of independent living services and assistance 

shall be initiated for no more than 2,700 veterans in each fiscal 

year, and the first priority in the provision of such programs shall 

be afforded to veterans for whom the reasonable feasibility of 

achieving a vocational goal is precluded solely as a result of a service-connected disability. 

(2) The limitation in paragraph (1) shall not apply in any case 

in which the Secretary determines that a veteran described in subsection (b) has been displaced as the result of, or has otherwise been 

adversely affected in the areas covered by, a natural or other disaster, as determined by the Secretary. 

* * * * * * * 

Chapter 36. Administration of Educational Benefits 

* * * * * * * 

Subchapter II. Miscellaneous Provisions 

* * * * * * * 

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

MORE PROGRAMS 

(a) * * * 

* * * * * * * 

(4) Chapters 30, 32, 33, 34, ø35,¿ and 36. 

* * * * * * * 

(c) The aggregate period for which any person may receive assistance under chapter 35 of this title, on the one hand, and any of the 

provisions of law referred to in subsection (a), on the other hand, 

may not exceed 81 months (or the part-time equivalent thereof). 

* * * * * * * 

Chapter 37. Housing and Small Business Loans 

* * * * * * * 

132 

Subchapter I. General 

* * * * * * * 

SEC. 3703. BASIC PROVISIONS RELATING TO LOAN GUARANTY AND 

INSURANCE 

* * * * * * * 

(d)(1) * * * 

* * * * * * * 

ø(3) Any real estate housing loan (other than for repairs, alterations, or improvements) shall be secured by a first lien on the realty. In determining whether a loan for the purchase or construction of a home is so secured, the Secretary may disregard a superior lien created by a duly recorded covenant running with the realty in favor of a private entity to secure an obligation to such entity 

for the homeowner’s share of the costs of the management, operation, or maintenance of property, services or programs within and 

for the benefit of the development or community in which the veteran’s realty is located, if the Secretary determines that the interests of the veteran borrower and of the Government will not be 

prejudiced by the operation of such covenant. In respect to any 

such superior lien to be created after June 6, 1969, the Secretary’s 

determination must have been made prior to the recordation of the 

covenant.¿ 

(3)(A) Any real estate housing loan (other than for repairs, alterations, or improvements) shall be secured by a first lien on the realty. In determining whether a loan is so secured, the Secretary may 

either disregard or allow for subordination to a superior lien created by a duly recorded covenant running with the realty in favor 

of either of the following: 

(i) A public entity that has provided or will provide assistance in response to a major disaster as determined by the President under the Robert T. Stafford Disaster Relief and Emergency Assistance Act (42 U.S.C. 5121 et seq.). 

(ii) A private entity to secure an obligation to such entity for 

the homeowner’s share of the costs of the management, operation, or maintenance of property, services, or programs within 

and for the benefit of the development or community in which 

the veteran’s realty is located, if the Secretary determines that 

the interests of the veteran borrower and of the Government will 

not be prejudiced by the operation of such covenant. 

(B) With respect to any superior lien described in subparagraph 

(A) created after June 6, 1969, the Secretary’s determination under 

clause (ii) of such subparagraph shall have been made prior to the 

recordation of the covenant. 

* * * * * * * 

SEC. 3704. RESTRICTIONS ON LOANS 

* * * * * * * 

(c)(1) * * * 

ø(2) In any case in which a veteran is in active duty status as 

a member of the Armed Forces and is unable to occupy a property 

because of such status, the occupancy requirements of— 

ø(A) paragraph (1) of this subsection; 

133 

ø(B) paragraphs (1) through (5) and paragraph (7) of section 

3710(a) of this title; 

ø(C) section 3712(a)(5)(A)(i) of this title; and 

ø(D) section 3712(e)(5) of this title; 

øshall be considered to be satisfied if the spouse of the veteran occupies the property as the spouse’s home and the spouse makes the 

certification required by paragraph (1) of this subsection.¿ 

(2) In any case in which a veteran is in active-duty status as a 

member of the Armed Forces and is unable to occupy a property because of such status, the occupancy requirements of this chapter 

shall be considered to be satisfied if— 

(A) the spouse of the veteran occupies or intends to occupy the 

property as a home and the spouse makes the certification required by paragraph (1) of this subsection; or 

(B) a dependent child of the veteran occupies or will occupy 

the property as a home and the veteran’s attorney-in-fact or 

legal guardian of the dependent child makes the certification required by paragraph (1) of this subsection. 

* * * * * * * 

Subchapter III. Administrative Provisions 

* * * * * * * 

SEC. 3729. LOAN FEE 

(a) * * * 

(b) DETERMINATION OF FEE.— 

(1) * * * 

(2) The loan fee table referred to in paragraph (1) is as follows: 

Loan Fee Table 

Type of loan Active 

duty Reservist 

Other 

obligor 

veteran 

ø(A)(i) Initial loan described in section 3710(a) to purchase or 

construct a dwelling with 0-down, or any other initial loan 

described in section 3710(a) other than with 5-down or 10- 

down (closed before January 1, 2004) ...................................... 2.00 2.75 NA 

ø(A)(ii) Initial loan described in section 3710(a) to purchase or 

construct a dwelling with 0-down, or any other initial loan 

described in section 3710(a) other than with 5-down or 10- 

down (closed on or after January 1, 2004, and before October 1, 2004) ................................................................................ 2.20 2.40 NA¿ 

(A)(i) ø(iii)¿ Initial loan described in section 3710(a) to purchase or construct a dwelling with 0-down, or any other initial loan described in section 3710(a) other than with 5- 

down or 10-down (closed on or after October 1, 2004, and 

before October 1, 2011) ............................................................. 2.15 2.40 NA 

(A)(ii) Initial loan described in section 3710(a) to purchase or 

construct a dwelling with 0-down, or any other initial loan 

described in section 3710(a) other than with 5-down or 10- 

down (closed on or after October 1, 2011, and before October 

1, 2012) ....................................................................................... 1.50 1.75 NA 

(A)(iii) ø(iv)¿ Initial loan described in section 3710(a) to purchase or construct a dwelling with 0-down, or any other initial loan described in section 3710(a) other than with 5- 

down or 10-down (closed on or after øOctober 1, 2011¿ October 1, 2012) ................................................................................. 1.40 2.65 NA 

* * * * * * * 

134 

(c) WAIVER OF FEE.— 

(1) * * * 

ø(2) A veteran who is rated eligible to receive compensation 

as a result of a pre-discharge disability examination and rating 

shall be treated as receiving compensation for purposes of this 

subsection as of the date on which the veteran is rated eligible 

to receive compensation as a result of the pre-discharge disability examination and rating without regard to whether an 

effective date of the award of compensation is established as of 

that date.¿ 

(2)(A) A veteran described in subparagraph (B) shall be treated as receiving compensation for purposes of this subsection as 

of the date of the rating described in such subparagraph without regard to whether an effective date of the award of compensation is established as of that date. 

(B) A veteran described in this subparagraph is a veteran 

who is rated eligible to receive compensation— 

(i) as the result of a pre-discharge disability examination 

and rating; or 

(ii) based on a pre-discharge review of existing medical 

evidence (including service medical and treatment records) 

that results in the issuance of a memorandum rating. 

* * * * * * * 

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

* * * * * * * 

SEC. 3903. LIMITATIONS ON ASSISTANCE; SPECIAL TRAINING 

COURSES 

(a) øNo¿ (1) Except as provided in paragraph (2), no eligible person shall be entitled to receive more than one automobile or other 

conveyance under the provisions of this chapter, and no payment 

shall be made under this chapter for the repair, maintenance, or 

replacement of an automobile or other conveyance. 

(2) The Secretary may provide or assist in providing an eligible 

person with a second automobile or other conveyance under this 

chapter if— 

(A) the Secretary receives satisfactory evidence that the automobile or other conveyance previously purchased with assistance under this chapter was destroyed— 

(i) as a result of a natural or other disaster, as determined by the Secretary; and 

(ii) through no fault of the eligible person; and 

(B) the eligible person does not otherwise receive from a property insurer compensation for the loss. 

* * * * * * * 

Part IV. General Administrative Provisions 

* * * * * * * 

135 

Chapter 51. Claims, Effective Dates, and Payments 

* * * * * * * 

Subchapter I. Claims 

* * * * * * * 

SEC. 5101. CLAIMS AND FORMS 

(a)(1) A specific øA specific¿ claim in the form prescribed by the 

Secretary (or jointly with the Commissioner of Social Security, as 

prescribed by section 5105 of this title) must be filed in order for 

benefits to be paid or furnished to any individual under the laws 

administered by the Secretary. 

(2) If an individual has not attained the age of 18 years, is mentally incompetent, or is physically unable to sign a form, a form 

filed under paragraph (1) for the individual may be signed by a 

court-appointed representative, a person who is responsible for the 

care of the individual, including a spouse or other relative, or an 

attorney in fact or agent authorized to act on behalf of the individual under a durable power of attorney. If the individual is in the 

care of an institution, the manager or principal officer of the institution may sign the form. 

* * * * * * * 

(c)(1) Any person who applies for, signs a form on behalf of an 

individual to apply for, or is in receipt of any compensation or pension benefit under laws administered by the Secretary shall, if requested by the Secretary, furnish the Secretary with the social security number of such person, or TIN in the case that the person 

is not an individual, and the social security number of any dependent or beneficiary on whose behalf, or based upon whom, such person applies for or is in receipt of such benefit. A person is not required to furnish the Secretary with a social security number for 

any person to whom a social security number has not been 

assigned. 

(2) The Secretary shall deny the application of or terminate the 

payment of compensation or pension to a person who fails to furnish the Secretary with a social security number or TIN required 

to be furnished pursuant to paragraph (1) of this subsection. The 

Secretary may thereafter reconsider the application or reinstate 

payment of compensation or pension, as the case may be, if such 

person furnishes the Secretary with such social security number or 

TIN. 

(3) * * * 

(d) In this section: 

(1) The term ‘‘mentally incompetent’’ with respect to an individual means that the individual lacks the mental capacity— 

(A) to provide substantially accurate information needed 

to complete a form; or 

(B) to certify that the statements made on a form are true 

and complete. 

(2) The term ‘‘TIN’’ has the meaning given the term in section 

7701(a)(41) of the Internal Revenue Code of 1986. 

* * * * * * * 

136 

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

(a) The Secretary and the Commissioner of Social Security 

øshall¿ may jointly prescribe forms for use by survivors of members 

and former members of the uniformed services in filing application 

for benefits under chapter 13 of this title and title II of the Social 

Security Act (42 U.S.C. 401 et seq.). øEach such form¿ Such forms 

shall request information sufficient to constitute an application for 

benefits under both chapter 13 of this title and title II of the Social 

Security Act (42 U.S.C. 401 et seq.). 

(b) When an application øon such a form¿ on any document indicating an intent to apply for survivor benefits is filed with either 

the Secretary or the Commissioner of Social Security, it shall be 

deemed to be an application for benefits under both chapter 13 of 

this title and title II of the Social Security Act (42 U.S.C. 401 et 

seq.). A copy of each such application filed with either the Secretary or the Commissioner, together with any additional information and supporting documents (or certifications thereof) which 

may have been received by the Secretary or the Commissioner with 

such application, and which may be needed by the other official in 

connection therewith, shall be transmitted by the Secretary or the 

Commissioner receiving the application to the other official. The 

preceding sentence shall not prevent the Secretary and the Commissioner of Social Security from requesting the applicant, or any 

other individual, to furnish such additional information as may be 

necessary for purposes of chapter 13 of this title and title II of the 

Social Security Act (42 U.S.C. 401 et seq.) respectively. 

* * * * * * * 

Subchapter II. Effective Dates 

SEC. 5110. EFFECTIVE DATES OF AWARDS 

(a) * * * 

(b)(1) * * * 

(2)(A) The effective date of an award of disability compensation 

to a veteran who submits an application therefor that sets forth a 

claim that is fully-developed (as prescribed by the Secretary for purposes of this paragraph) as of the date of submittal shall be fixed 

in accordance with the facts found, but shall not be earlier than the 

date that is one year before the date of receipt of the application. 

(B) Subparagraph (A) shall take effect on the date of the enactment of this paragraph and shall not apply with respect to claims 

filed after September 30, 2012. 

(3) ø(2)¿ The effective date of an award of increased compensation shall be the earliest date as of which it is ascertainable that 

an increase in disability had occurred, if application is received 

within one year from such date. 

(4) ø(3)¿(A) The effective date of an award of disability pension 

to a veteran described in subparagraph (B) of this paragraph shall 

be the date of application or the date on which the veteran became 

permanently and totally disabled, if the veteran applies for a retroactive award within one year from such date, whichever is to the 

advantage of the veteran. 

* * * * * * * 

137 

SEC. 5111. COMMENCEMENT OF PERIOD OF PAYMENT 

* * * * * * * 

(c)(1) This section shall øapply to payments made pursuant to 

section 5310 of this title only if the monthly amount of dependency 

and indemnity compensation or pension payable to the surviving 

spouse is greater than the amount of compensation or pension the 

veteran would have received, but for such veteran’s death, for the 

month in which such veteran’s death occurred¿ not apply to payments made pursuant to section 5310 of this title. 

* * * * * * * 

Chapter 53. Special Provisions Relating to Benefits 

* * * * * * * 

SEC. 5310. PAYMENT OF BENEFITS FOR MONTH OF DEATH 

ø(a) If, in accordance with the provisions of section 5110(d) of 

this title, a surviving spouse is entitled to death benefits under 

chapter 11, 13, or 15 of this title for the month in which a veteran’s 

death occurs, the amount of such death benefits for that month 

shall be not less than the amount of benefits the veteran would 

have received under chapter 11 or 15 of this title for that month 

but for the death of the veteran. 

ø(b)(1) If the surviving spouse of a veteran who was in receipt 

of compensation or pension at the time of death is not entitled to 

death benefits under chapter 11, 13, or 15 of this title for the 

month in which the veteran’s death occurs, that surviving spouse 

shall be entitled to a benefit for that month in the amount of benefits the veteran would have received under chapter 11 or 15 of this 

title for that month but for the death of the veteran. 

ø(2) If (notwithstanding section 5112(b)(1) of this title) a check 

or other payment is issued to, and in the name of, the deceased 

veteran as a benefit payment under chapter 11 or 15 of this title 

for the month in which death occurs, that check or other payment 

(A) shall be treated for all purposes as being payable to the surviving spouse, and (B) if that check or other payment is negotiated 

or deposited, shall be considered to be the benefit to which the surviving spouse is entitled under paragraph (1). However, if such 

check or other payment is in an amount less than the amount of 

the benefit under paragraph (1), the unpaid amount shall be treated in the same manner as an accrued benefit under section 5121 

of this title.¿ 

(a) IN GENERAL.—(1) A surviving spouse of a veteran is entitled 

to a benefit for the month of the veteran’s death if— 

(A) at the time of the veteran’s death, the veteran was receiving compensation or pension under chapter 11 or 15 of this 

title; or 

(B) the veteran is determined for purposes of section 5121 or 

5121A of this title as having been entitled to receive compensation or pension under chapter 11 or 15 of this title for the 

month of the veteran’s death. 

(2) The amount of the benefit under paragraph (1) is the amount 

that the veteran would have received under chapter 11 or 15 of this 

138 

title, as the case may be, for the month of the veteran’s death had 

the veteran not died. 

(b) CLAIMS PENDING ADJUDICATION.—If a claim for entitlement to 

compensation or additional compensation under chapter 11 of this 

title or pension or additional pension under chapter 15 of this title 

is pending at the time of a veteran’s death and the check or other 

payment issued to the veteran’s surviving spouse under subsection 

(a) is less than the amount of the benefit the veteran would have 

been entitled to for the month of death pursuant to the adjudication 

of the pending claim, an amount equal to the difference between the 

amount to which the veteran would have been entitled to receive 

under chapter 11 or 15 of this title for the month of the veteran’s 

death had the veteran not died and the amount of the check or other 

payment issued to the surviving spouse shall be treated in the same 

manner as an accrued benefit under section 5121 of this title. 

* * * * * * * 

SEC. 5317. USE OF INCOME INFORMATION FROM OTHER AGENCIES: 

NOTICE AND VERIFICATION 

* * * * * * * 

(g) The authority of the Secretary to obtain information from the 

Secretary of the Treasury or the Commissioner of Social Security 

under section 6103(1)(7)(D)(viii) of the Internal Revenue Code of 

1986 expires on øSeptember 30, 2011¿ September 30, 2013. 

* * * * * * * 

Chapter 57. Records and Investigations 

* * * * * * * 

Subchapter I. Records 

SEC. 5701. CONFIDENTIAL NATURE OF CLAIMS 

* * * * * * * 

(l) Under regulations the Secretary shall prescribe, the Secretary 

may disclose information about a veteran or the dependent of a veteran to a State controlled substance monitoring program, including 

a program approved by the Secretary of Health and Human Services under section 399O of the Public Health Service Act (42 U.S.C. 

280g–3), to the extent necessary to prevent misuse and diversion of 

prescription medicines. 

* * * * * * * 

Part V. Boards, Administrations, and Services 

* * * * * * * 

Chapter 71. Board of Veterans’ Appeals 

* * * * * * * 

SEC. 7105. FILING OF NOTICE OF DISAGREEMENT AND APPEAL 

* * * * * * * 

139 

(e)(1) If, either at the time or after the agency of original jurisdiction receives a substantive appeal, the claimant or the claimant’s 

representative, if any, submits evidence to either the agency of original jurisdiction or the Board of Veterans’ Appeals for consideration 

in connection with the issue or issues with which disagreement has 

been expressed, such evidence shall be subject to initial review by 

the Board unless the claimant or the claimant’s representative, as 

the case may be, requests in writing that the agency of original jurisdiction initially review such evidence. 

(2) A request for review of evidence under paragraph (1) shall accompany the submittal of the evidence. 

* * * * * * * 

Chapter 73. Veterans Health Administration-Organization 

and Functions 

Sec. 

* * * * * * * 

SUBCHAPTER II. GENERAL AUTHORITY AND ADMINISTRATION 

7330A. Epilepsy centers of excellence. 

7330B. Centers of excellence for rural health research, education, and clinical 

activities. 

* * * * * * * 

Subchapter I. Organization 

* * * * * * * 

SEC. 7308. OFFICE OF RURAL HEALTH 

* * * * * * * 

(d) RURAL HEALTH RESOURCE CENTERS.—(1) There are in the Office veterans rural health resource centers that serve as satellite offices for the Office. 

(2) The veterans rural health resource centers have purposes as 

follows: 

(A) To improve the understanding of the Office of the challenges faced by veterans living in rural areas. 

(B) To identify disparities in the availability of health care to 

veterans living in rural areas. 

(C) To formulate practices or programs to enhance the delivery of health care to veterans living in rural areas. 

(D) To develop special practices and products for the benefit 

of veterans living in rural areas and for implementation of such 

practices and products in the Department systemwide. 

* * * * * * * 

Subchapter II. General Authority and Administration 

* * * * * * * 

SEC. 7330A. EPILEPSY CENTERS OF EXCELLENCE 

* * * * * * * 

140 

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

(a) ESTABLISHMENT.—The Secretary shall, through the Director of 

the Office of Rural Health, establish and operate centers of excellence for rural health research, education, and clinical activities. 

(b) ACTIVITIES.—Each center established and operated under subsection (a) shall carry out one or more of the following: 

(1) Collaboration with the Office of Research and Development of the Veterans Health Administration on research relating to the furnishing of health services in rural areas. 

(2) Development of specific models to be used by the Department in furnishing health services to veterans in rural areas. 

(3) Provision of education and training for health care professionals of the Department on the furnishing of health services 

to veterans in rural areas. 

(4) Development and implementation of innovative clinical 

activities and systems of care for the Department for the furnishing of health services to veterans in rural areas. 

(c) DESIGNATION.—The Secretary may designate a rural health resource of the Office of Rural Health as a center of excellence for purposes of this section, including a rural health resource center described in section 7308(d) of this title, if such resource or center engages in one or more of the activities described in subsection (b). 

(d) FUNDING.—Activities of clinical and scientific investigation at 

each center operated under this section shall be eligible to compete 

for the award of funding from funds appropriated for the Medical 

and Prosthetics Research Account. 

* * * * * * * 

Subchapter III. Protection of Patient Rights 

* * * * * * * 

SEC. 7332. CONFIDENTIALITY OF CERTAIN MEDICAL RECORDS 

* * * * * * * 

(b)(1) * * * 

(2) * * * 

* * * * * * * 

(G) To a State controlled substance monitoring program, including a program approved by the Secretary of Health and 

Human Services under section 399O of the Public Health Service Act (42 U.S.C. 280g–3), to the extent necessary to prevent 

misuse and diversion of prescription medicines. 

* * * * * * * 

Chapter 76. Health Professionals Educational 

Assistance Program 

* * * * * * * 

Subchapter VI. Employee Incentive Scholarship Program 

* * * * * * * 

141 

SEC. 7675. BREACH OF AGREEMENT: LIABILITY 

* * * * * * * 

(b) LIABILITY DURING COURSE OF EDUCATION OR TRAINING.— 

(1) * * * 

* * * * * * * 

ø(E) In the case of a participant who is a part-time student, the participant fails to maintain employment, while 

enrolled in the course of training being pursued by the 

participant, as a Department employee.¿ 

(E) In the case of a participant who is employed as an 

employee of the Department while enrolled in the course of 

training being pursued by the participant, the participant 

fails to maintain employment as a Department employee 

during such course of training. 

* * * * * * * 

Part VI. Acquisition and Disposition of Property 

* * * * * * * 

Chapter 81. Acquisition and Operation of Hospital and 

Domiciliary Facilities; Procurement and Supply; Enhanced-Use Leases of Real Property 

* * * * * * * 

Subchapter I. Acquisition and Operation of Medical 

Facilities 

* * * * * * * 

SEC. 8104. CONGRESSIONAL APPROVAL OF CERTAIN MEDICAL FACILITY ACQUISITIONS 

* * * * * * * 

(d)(1) * * * 

(2)(A) * * * 

(B) * * * 

(C) The Secretary may not obligate an amount under subparagraph (A) to expand the purpose of a major medical facility project 

except pursuant to a provision of law enacted after the date on 

which the Secretary submits to the committees described in subparagraph (B) notice of the following: 

(i) The major medical facility project that is the source of the 

bid savings. 

(ii) The major medical facility project for which the Secretary 

intends to expand the purpose. 

(iii) A description of such expansion of purpose. 

(iv) The amounts the Secretary intends to obligate to expand 

the purpose. 

* * * * * * * 

Subchapter II. Procurement and Supply 

* * * * * * * 

142 

SEC. 8127. SMALL BUSINESS CONCERNS OWNED AND CONTROLLED BY 

VETERANS: CONTRACTING GOALS AND PREFERENCES 

* * * * * * * 

(g) ENFORCEMENT PENALTIES FOR MISREPRESENTATION.—(1) Any 

business øAny business¿ concern that is determined by the Secretary to have deliberately misrepresented the status of that concern as a small business concern owned and controlled by veterans 

or as a small business concern owned and controlled by service-disabled veterans for purposes of this subsection shall be debarred 

from contracting with the Department for øa reasonable period of 

time, as determined by the Secretary¿ a period of not less than five 

years. 

(2) In the case of a debarment under paragraph (1), the Secretary 

shall commence debarment action against the business concern by 

not later than 30 days after determining that the concern misrepresented the status of the concern as described in paragraph (1) and 

shall complete debarment actions against such concern by not later 

than 90 days after such determination. 

(3) The debarment of a business concern under paragraph (1) includes the debarment of all principals in the business concern for 

a period of not less than five years. 

* * * * * * * 

Servicemembers Civil Relief Act 

(50 USCS Appx §533(b)) 

Title 50. War and National Defense 

* * * * * * * 

Title III. Rent, Installment Contracts, Mortgages, 

Liens, Assignment, Leases, Telephone Service 

Contracts 

* * * * * * * 

SEC. 533. MORTGAGES AND TRUST DEEDS 

* * * * * * * 

(b) STAY OF PROCEEDINGS AND ADJUSTMENT OF OBLIGATION.—In 

an action filed during, or øwithin 9 months¿ within 12 months 

after, a servicemember’s period of military service to enforce an obligation described in subsection (a), the court may after a hearing 

and on its own motion and shall upon application by a servicemember when the servicemember’s ability to comply with the obligation is materially affected by military service— 

* * * * * * * 

(c) SALE OR FORECLOSURE.—A sale, foreclosure, or seizure of 

property for a breach of an obligation described in subsection (a) 

shall not be valid if made during, or øwithin 9 months¿ within 12 

143 

months after, the period of the servicemember’s military service 

except— 

* * * * * * * 

Veterans Benefits, Health Care, and 

Information Technology Act of 2006 

(Public Law 109–461) 

* * * * * * * 

Title VIII. Construction Matters 

Subtitle A. Construction and Lease Authorities 

* * * * * * * 

SEC. 802. EXTENSION OF AUTHORIZATION FOR CERTAIN MAJOR MEDICAL FACILITY CONSTRUCTION PROJECTS PREVIOUSLY 

AUTHORIZED IN CONNECTION WITH CAPITAL ASSET REALIGNMENT INITIATIVE 

* * * * * * * 

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

* * * * * * * 

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

* * * * * * * 

(3) Construction of a new clinical addition and a parking garage at the Department of Veterans Affairs Medical Center, 

Fayetteville, Arkansas, in an amount not to exceed 

ø$56,163,000¿ $90,600,000. 

(4) * * * 

(5) Medical facility improvements and cemetery expansion of 

Jefferson Barracks at the Department of Veterans Affairs Medical Center, St. Louis, Missouri, in an amount not to exceed 

ø$69,053,000¿ $346,300,000. 

* * * * * * * 

Veterans’ Mental Health and Other Care 

Improvements Act of 2008 

(Public Law 110–387; 122 Stat. 4137) 

* * * * * * * 

144 

Title VII. Authorization of Medical Facility 

Projects and Major Medical Facility Leases 

SEC. 701. AUTHORIZATION FOR FISCAL YEAR 2009 MAJOR MEDICAL 

FACILITY PROJECTS. 

* * * * * * * 

(3) Seismic corrections, Building 1, at the Department of Veterans Affairs Medical Center, San Juan, Puerto Rico, in an 

amount not to exceed ø$225,900,000¿ $277,000,000. 

* * * * * * * 

Æ