PUBLIC LAW 110–387—OCT. 10, 2008 

VETERANS’ MENTAL HEALTH AND OTHER 

CARE IMPROVEMENTS ACT OF 2008 


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122 STAT. 4110 PUBLIC LAW 110–387—OCT. 10, 2008 

Public Law 110–387 

110th Congress 

An Act 

To improve the treatment and services provided by the Department of Veterans 

Affairs to veterans with post-traumatic stress disorder and substance use disorders, 

and for other purposes. 

Be it enacted by the Senate and House of Representatives of 

the United States of America in Congress assembled, 

SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

(a) SHORT TITLE.—This Act may be cited as the ‘‘Veterans’ 

Mental Health and Other Care Improvements Act of 2008’’. 

(b) TABLE OF CONTENTS.—The table of contents for this Act 

is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. References to title 38, United States Code. 

TITLE I—SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE 

Sec. 101. Tribute to Justin Bailey. 

Sec. 102. Findings on substance use disorders and mental health. 

Sec. 103. Expansion of substance use disorder treatment services provided by Department of Veterans Affairs. 

Sec. 104. Care for veterans with mental health and substance use disorders. 

Sec. 105. Pilot program for Internet-based substance use disorder treatment for 

veterans of Operation Iraqi Freedom and Operation Enduring Freedom. 

Sec. 106. Report on residential mental health care facilities of the Veterans Health 

Administration. 

Sec. 107. Pilot program on peer outreach and support for veterans and use of community mental health centers and Indian Health Service facilities. 

TITLE II—MENTAL HEALTH RESEARCH 

Sec. 201. Research program on comorbid post-traumatic stress disorder and substance use disorders. 

Sec. 202. Extension of authorization for Special Committee on Post-Traumatic 

Stress Disorder. 

TITLE III—ASSISTANCE FOR FAMILIES OF VETERANS 

Sec. 301. Clarification of authority of Secretary of Veterans Affairs to provide mental health services to families of veterans. 

Sec. 302. Pilot program on provision of readjustment and transition assistance to 

veterans and their families in cooperation with Vet Centers. 

TITLE IV—HEALTH CARE MATTERS 

Sec. 401. Veterans beneficiary travel program. 

Sec. 402. Mandatory reimbursement of veterans receiving emergency treatment in 

non-Department of Veterans Affairs facilities until transfer to Department facilities. 

Sec. 403. Pilot program of enhanced contract care authority for health care needs 

of veterans in highly rural areas. 

Sec. 404. Epilepsy centers of excellence. 

Sec. 405. Establishment of qualifications for peer specialist appointees. 

Sec. 406. Establishment of consolidated patient accounting centers. 

Sec. 407. Repeal of limitation on authority to conduct widespread HIV testing program. 

38 USC 101 note. 

Veterans’ Mental 

Health and 

Other Care 

Improvements 

Act of 2008. 

Oct. 10, 2008 

[S. 2162] 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4111 

Sec. 408. Provision of comprehensive health care by Secretary of Veterans Affairs 

to children of Vietnam veterans born with Spina Bifida. 

Sec. 409. Exemption from copayment requirement for veterans receiving hospice 

care. 

TITLE V—PAIN CARE 

Sec. 501. Comprehensive policy on pain management. 

TITLE VI—HOMELESS VETERANS MATTERS 

Sec. 601. Increased authorization of appropriations for comprehensive service programs. 

Sec. 602. Expansion and extension of authority for program of referral and counseling services for at-risk veterans transitioning from certain institutions. 

Sec. 603. Permanent authority for domiciliary services for homeless veterans and 

enhancement of capacity of domiciliary care programs for female veterans. 

Sec. 604. Financial assistance for supportive services for very low-income veteran 

families in permanent housing. 

TITLE VII—AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND 

MAJOR MEDICAL FACILITY LEASES 

Sec. 701. Authorization for fiscal year 2009 major medical facility projects. 

Sec. 702. Modification of authorization amounts for certain major medical facility 

construction projects previously authorized. 

Sec. 703. Authorization of fiscal year 2009 major medical facility leases. 

Sec. 704. Authorization of appropriations. 

Sec. 705. Increase in threshold for major medical facility leases requiring Congressional approval. 

Sec. 706. Conveyance of certain non-Federal land by City of Aurora, Colorado, to 

Secretary of Veterans Affairs for construction of veterans medical facility. 

Sec. 707. Report on facilities administration. 

Sec. 708. Annual report on outpatient clinics. 

Sec. 709. Name of Department of Veterans Affairs spinal cord injury center, 

Tampa, Florida. 

TITLE VIII—EXTENSION OF CERTAIN AUTHORITIES 

Sec. 801. Repeal of sunset on inclusion of noninstitutional extended care services 

in definition of medical services. 

Sec. 802. Extension of recovery audit authority. 

Sec. 803. Permanent authority for provision of hospital care, medical services, and 

nursing home care to veterans who participated in certain chemical and 

biological testing conducted by the Department of Defense. 

Sec. 804. Extension of expiring collections authorities. 

Sec. 805. Extension of nursing home care. 

Sec. 806. Permanent authority to establish research corporations. 

Sec. 807. Extension of requirement to submit annual report on the Committee on 

Care of Severely Chronically Mentally Ill Veterans. 

Sec. 808. Permanent requirement for biannual report on Women’s Advisory Committee. 

Sec. 809. Extension of pilot program on improvement of caregiver assistance services. 

TITLE IX—OTHER MATTERS 

Sec. 901. Technical amendments. 

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

Except as otherwise expressly provided, whenever in this Act 

an amendment or repeal is expressed in terms of an amendment 

to, or repeal of, a section or other provision, the reference shall 

be considered to be made to a section or other provision of title 

38, United States Code. 


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122 STAT. 4112 PUBLIC LAW 110–387—OCT. 10, 2008 

TITLE I—SUBSTANCE USE DISORDERS 

AND MENTAL HEALTH CARE 

SEC. 101. TRIBUTE TO JUSTIN BAILEY. 

This title is enacted in tribute to Justin Bailey, who, after 

returning to the United States from service as a member of the 

Armed Forces in Operation Iraqi Freedom, died in a domiciliary 

facility of the Department of Veterans Affairs while receiving care 

for post-traumatic stress disorder and a substance use disorder. 

SEC. 102. FINDINGS ON SUBSTANCE USE DISORDERS AND MENTAL 

HEALTH. 

Congress makes the following findings: 

(1) More than 1,500,000 members of the Armed Forces 

have been deployed in Operation Iraqi Freedom and Operation 

Enduring Freedom. The 2005 Department of Defense Survey 

of Health Related Behaviors Among Active Duty Personnel 

reports that 23 percent of members of the Armed Forces on 

active duty acknowledge a significant problem with alcohol 

use disorder, with similar rates of acknowledged problems with 

alcohol use disorder among members of the National Guard. 

(2) The effects of substance use disorder are wide ranging, 

including significantly increased risk of suicide, exacerbation 

of mental and physical health disorders, breakdown of family 

support, and increased risk of unemployment and homelessness. 

(3) While veterans suffering from mental health conditions, 

chronic physical illness, and polytrauma may be at increased 

risk for development of a substance use disorder, treatment 

for these veterans is complicated by the need to address adequately the physical and mental symptoms associated with 

these conditions through appropriate medical intervention. 

(4) While the Veterans Health Administration has dramatically increased health services for veterans from 1996 through 

2006, the number of veterans receiving specialized substance 

use disorder treatment services decreased 18 percent during 

that time. No comparable decrease in the national rate of 

substance use disorder has been observed during that time. 

(5) While some facilities of the Veterans Health Administration provide exemplary substance use disorder treatment services, the availability of such treatment services throughout 

the health care system of the Veterans Health Administration 

is inconsistent. 

(6) According to a 2006 report by the Government Accountability Office, the Department of Veterans Affairs significantly 

reduced its substance use disorder treatment and rehabilitation 

services between 1996 and 2006, and the Fiscal Year 2007 

National Mental Health Program Monitoring System report 

shows that little progress has been made in restoring these 

services to their pre-1996 levels. 

SEC. 103. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT 

SERVICES PROVIDED BY DEPARTMENT OF VETERANS 

AFFAIRS. 

(a) IN GENERAL.—The Secretary of Veterans Affairs shall 

ensure the provision of such services and treatment to each veteran 

enrolled in the health care system of the Department of Veterans 

38 USC 1720A 

note. 

38 USC 1720A 

note. 


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Affairs who is in need of services and treatments for a substance 

use disorder as follows: 

(1) Screening for substance use disorder in all settings, 

including primary care settings. 

(2) Short term motivational counseling services. 

(3) Marital and family counseling. 

(4) Intensive outpatient or residential care services. 

(5) Relapse prevention services. 

(6) Ongoing aftercare and outpatient counseling services. 

(7) Opiate substitution therapy services. 

(8) Pharmacological treatments aimed at reducing craving 

for drugs and alcohol. 

(9) Detoxification and stabilization services. 

(10) Coordination with groups providing peer to peer counseling. 

(11) Such other services as the Secretary considers appropriate. 

(b) PROVISION OF SERVICES.— 

(1) ALLOCATION OF RESOURCES FOR PROVISION OF SERVICES.—The Secretary shall ensure that amounts made available 

for care, treatment, and services provided under this section 

are allocated in such a manner that a full continuum of care, 

treatment, and services described in subsection (a) is available 

to veterans seeking such care, treatment, or services, without 

regard to the location of the residence of any such veterans. 

(2) MANNER OF PROVISION.—The services and treatment 

described in subsection (a) may be provided to a veteran 

described in such subsection— 

(A) at Department of Veterans Affairs medical centers 

or clinics; 

(B) by referral to other facilities of the Department 

that are accessible to such veteran; or 

(C) by contract or fee-for-service payments with 

community-based organizations for the provision of such 

services and treatments. 

(c) ALTERNATIVES IN CASE OF SERVICES DENIED DUE TO CLINICAL NECESSITY.—If the Secretary denies the provision to a veteran 

of services or treatment for a substance use disorder due to clinical 

necessity, the Secretary shall provide the veteran such other services or treatment as are medically appropriate. 

SEC. 104. CARE FOR VETERANS WITH MENTAL HEALTH AND SUBSTANCE USE DISORDERS. 

(a) IN GENERAL.—If the Secretary of Veterans Affairs provides 

a veteran inpatient or outpatient care for a substance use disorder 

and a comorbid mental health disorder, the Secretary shall ensure 

that treatment for such disorders is provided concurrently— 

(1) through a service provided by a clinician or health 

professional who has training and expertise in treatment of 

substance use disorders and mental health disorders; 

(2) by separate substance use disorder and mental health 

disorder treatment services when there is appropriate coordination, collaboration, and care management between such treatment services; or 

(3) by a team of clinicians with appropriate expertise. 

38 USC 1720A 

note. 


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122 STAT. 4114 PUBLIC LAW 110–387—OCT. 10, 2008 

(b) TEAM OF CLINICIANS WITH APPROPRIATE EXPERTISE

DEFINED.—In this section, the term ‘‘team of clinicians with appropriate expertise’’ means a team consisting of the following: 

(1) Clinicians and health professionals with expertise in 

treatment of substance use disorders and mental health disorders who act in coordination and collaboration with each 

other. 

(2) Such other professionals as the Secretary considers 

appropriate for the provision of treatment to veterans for substance use and mental health disorders. 

SEC. 105. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE USE 

DISORDER TREATMENT FOR VETERANS OF OPERATION 

IRAQI FREEDOM AND OPERATION ENDURING FREEDOM. 

(a) FINDINGS.—Congress makes the following findings: 

(1) Stigma associated with seeking treatment for mental 

health disorders has been demonstrated to prevent some veterans from seeking such treatment at a medical facility operated by the Department of Defense or the Department of Veterans Affairs. 

(2) There is a significant incidence among veterans of postdeployment mental health problems, especially among members 

of a reserve component who return as veterans to civilian 

life. 

(3) Computer-based self-guided training has been demonstrated to be an effective strategy for supplementing the 

care of psychological conditions. 

(4) Younger veterans, especially those who served in Operation Enduring Freedom or Operation Iraqi Freedom, are comfortable with and proficient at computer-based technology. 

(5) Veterans living in rural areas may find access to treatment for substance use disorder limited. 

(6) Self-assessment and treatment options for substance 

use disorders through an Internet website may reduce stigma 

and provides additional access for individuals seeking care and 

treatment for such disorders. 

(b) IN GENERAL.—Not later than October 1, 2009, the Secretary 

of Veterans Affairs shall carry out a pilot program to assess the 

feasibility and advisability of providing veterans who seek treatment for substance use disorders access to a computer-based selfassessment, education, and specified treatment program through 

a secure Internet website operated by the Secretary. Participation 

in the pilot program shall be available on a voluntary basis for 

those veterans who have served in Operation Enduring Freedom 

or Operation Iraqi Freedom. 

(c) ELEMENTS OF PILOT PROGRAM.— 

(1) IN GENERAL.—In carrying out the pilot program under 

this section, the Secretary shall ensure that— 

(A) access to the Internet website and the programs 

available on the website by a veteran (or family member) 

does not involuntarily generate an identifiable medical 

record of that access by that veteran in any medical database maintained by the Department of Veterans Affairs; 

(B) the Internet website is accessible from remote locations, especially rural areas; and 

(C) the Internet website includes a self-assessment 

tool for substance use disorders, self-guided treatment and 

Deadline. 

38 USC 1720A 

note. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4115 

educational materials for such disorders, and appropriate 

information and materials for family members of veterans. 

(2) CONSIDERATION OF SIMILAR PROJECTS.—In designing the 

pilot program under this section, the Secretary shall consider 

similar pilot projects of the Department of Defense for the 

early diagnosis and treatment of post-traumatic stress disorder 

and other mental health conditions established under section 

741 of the John Warner National Defense Authorization Act 

of Fiscal Year 2007 (Public Law 109–364; 120 Stat. 2304). 

(3) LOCATION OF PILOT PROGRAM.—The Secretary shall 

carry out the pilot program through those medical centers 

of the Department of Veterans Affairs that have established 

Centers for Excellence for Substance Abuse Treatment and 

Education or that have established a Substance Abuse Program 

Evaluation and Research Center. 

(4) CONTRACT AUTHORITY.—The Secretary may enter into 

contracts with qualified entities or organizations to carry out 

the pilot program required under this section. 

(d) DURATION OF PILOT PROGRAM.—The pilot program required 

by subsection (a) shall be carried out during the two-year period 

beginning on the date of the commencement of the pilot program. 

(e) REPORT.—Not later than six months after the completion 

of the pilot program, the Secretary shall submit to Congress a 

report on the pilot program, and shall include in that report— 

an assessment of the feasibility and advisability of continuing or 

expanding the pilot program, of any cost savings or other benefits 

associated with the pilot program, and any other recommendations. 

(f) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 

to be appropriated to the Secretary of Veterans Affairs $1,500,000 

for each of fiscal years 2010 and 2011 to carry out the pilot program 

under this section. 

SEC. 106. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES OF THE VETERANS HEALTH ADMINISTRATION. 

(a) REVIEW.— (1) IN GENERAL.—Not later than six months after the date 

of the enactment of this Act, the Secretary of Veterans Affairs 

shall, acting through the Inspector General of the Department 

of Veterans Affairs, complete a review of all residential mental 

health care facilities, including domiciliary facilities, of the 

Veterans Health Administration. 

(2) ASSESSMENT.—As part of the review required by paragraph (1), the Secretary, acting through the Inspector General, 

shall assess the following: 

(A) The availability of care in residential mental health 

care facilities in each Veterans Integrated Service Network 

(VISN). 

(B) The supervision and support provided in the residential mental health care facilities of the Veterans Health 

Administration. 

(C) The ratio of staff members at each residential 

mental health care facility to patients at such facility. 

(D) The appropriateness of rules and procedures for 

the prescription and administration of medications to 

patients in such residential mental health care facilities. 

(E) The protocols at each residential mental health 

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122 STAT. 4116 PUBLIC LAW 110–387—OCT. 10, 2008 

(3) RECOMMENDATIONS.—As part of the review required 

by paragraph (1), the Secretary, acting through the Inspector 

General, shall develop such recommendations as the Secretary 

considers appropriate for improvements to residential mental 

health care facilities of the Veterans Health Administration 

and the care provided in such facilities. 

(b) FOLLOW-UP REVIEW.—Not later than two years after the 

date of the completion of the review required by subsection (a), 

the Secretary of Veterans Affairs shall, acting through the Inspector 

General of the Department of Veterans Affairs, complete a followup review of the facilities reviewed under subsection (a) to evaluate 

any improvements made or problems remaining since the review 

under subsection (a) was completed. 

(c) REPORT.—Not later than 90 days after the completion of 

the review required by subsection (a), the Secretary of Veterans 

Affairs shall submit to the Committee on Veterans’ Affairs of the 

Senate and the Committee on Veterans’ Affairs of the House of 

Representatives a report on the findings of the Secretary with 

respect to such review. 

SEC. 107. PILOT PROGRAM ON PEER OUTREACH AND SUPPORT FOR 

VETERANS AND USE OF COMMUNITY MENTAL HEALTH 

CENTERS AND INDIAN HEALTH SERVICE FACILITIES. 

(a) PILOT PROGRAM REQUIRED.—Commencing not later than 

180 days after the date of the enactment of this Act, the Secretary 

of Veterans Affairs shall carry out a pilot program to assess the 

feasability and advisability of providing to veterans of Operation 

Iraqi Freedom and Operation Enduring Freedom, and, in particular, 

veterans who served in such operations as a member of the National 

Guard or Reserve, the following: 

(1) Peer outreach services. 

(2) Peer support services provided by licensed providers 

of peer support services or veterans who have personal experience with mental illness. 

(3) Readjustment counseling services described in section 

1712A of title 38, United States Code. 

(4) Other mental health services. 

(b) PROVISION OF CERTAIN SERVICES.—In providing services 

described in paragraphs (3) and (4) of subsection (a) under the 

pilot program to veterans who reside in rural areas and do not 

have adequate access through the Department of Veterans Affairs 

to the services described in such paragraphs, the Secretary shall, 

acting through the Office of Mental Health Services and the Office 

of Rural Health, provide such services as follows: 

(1) Through community mental health centers under contracts or other agreements if entered into by the Secretary 

of Veterans Affairs and the Secretary of Health and Human 

Services for the provision of such services for purposes of the 

pilot program. 

(2) Through the Indian Health Service, or an Indian tribe 

or tribal organization that has entered into an agreement with 

the Indian Health Service pursuant to the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450 et seq.), 

if a memorandum of understanding is entered into by the 

Secretary of Veterans Affairs and the Secretary of Health and 

Human Services for purposes of the pilot program. 

Deadline. 

38 USC 1712A 

note. 

Deadline. 


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(3) Through other appropriate entities under contracts or 

other agreements entered into by the Secretary of Veterans 

Affairs for the provision of such services for purposes of the 

pilot program. 

(c) DURATION.—The pilot program shall be carried out during 

the three-year period beginning on the date of the commencement 

of the pilot program. 

(d) PROGRAM LOCATIONS.— (1) IN GENERAL.—The pilot program shall be carried out 

within areas selected by the Secretary for the purpose of the 

pilot program in at least three Veterans Integrated Service 

Networks (VISNs). 

(2) RURAL GEOGRAPHIC LOCATIONS.—The locations selected 

shall be in rural geographic locations that, as determined by 

the Secretary, lack access to comprehensive mental health services through the Department of Veterans Affairs. 

(3) QUALIFIED PROVIDERS.—In selecting locations for the 

pilot program, the Secretary shall select locations in which 

an adequate number of licensed mental health care providers 

with credentials equivalent to those of Department mental 

health care providers are available in Indian Health Service 

facilities, community mental health centers, and other entities 

for participation in the pilot program. 

(e) PARTICIPATION IN PROGRAM.—Each community mental 

health center, facility of the Indian Health Service, or other entity 

participating in the pilot program under subsection (b) shall— 

(1) provide the services described in paragraphs (3) and 

(4) of subsection (a) to eligible veterans, including, to the extent 

practicable, telehealth services that link the center or facility 

with Department of Veterans Affairs clinicians; 

(2) use the clinical practice guidelines of the Veterans 

Health Administration or the Department of Defense in the 

provision of such services; and 

(3) meet such other requirements as the Secretary shall 

require. 

(f) COMPLIANCE WITH DEPARTMENT PROTOCOLS.—Each community mental health center, facility of the Indian Health Service, 

or other entity participating in the pilot program under subsection 

(b) shall comply with— 

(1) applicable protocols of the Department before incurring 

any liability on behalf of the Department for the provision 

of services as part of the pilot program; and 

(2) access and quality standards of the Department relevant 

to the provision of services as part of the pilot program. 

(g) PROVISION OF CLINICAL INFORMATION.—Each community 

mental health center, facility of the Indian Health Service, or other 

entity participating in the pilot program under subsection (b) shall, 

in a timely fashion, provide the Secretary with such clinical information on each veteran for whom such health center or facility provides 

mental health services under the pilot program as the Secretary 

shall require. 

(h) TRAINING.— 

(1) TRAINING OF VETERANS.—As part of the pilot program, 

the Secretary shall carry out a program of training for veterans 

described in subsection (a) to provide the services described 

in paragraphs (1) and (2) of such subsection. 

(2) TRAINING OF CLINICIANS.— 

Requirements. 


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122 STAT. 4118 PUBLIC LAW 110–387—OCT. 10, 2008 

(A) IN GENERAL.—The Secretary shall conduct a 

training program for clinicians of community mental health 

centers, Indian Health Service facilities, or other entities 

participating in the pilot program under subsection (b) 

to ensure that such clinicians can provide the services 

described in paragraphs (3) and (4) of subsection (a) in 

a manner that accounts for factors that are unique to 

the experiences of veterans who served on active duty 

in Operation Iraqi Freedom or Operation Enduring 

Freedom (including their combat and military training 

experiences). 

(B) PARTICIPATION IN TRAINING.—Personnel of each 

community mental health center, facility of the Indian 

Health Service, or other entity participating in the pilot 

program under subsection (b) shall participate in the 

training program conducted pursuant to subparagraph (A). 

(i) ANNUAL REPORTS.—Each community mental health center, 

facility of the Indian Health Service, or other entity participating 

in the pilot program under subsection (b) shall submit to the Secretary on an annual basis a report containing, with respect to 

the provision of services under subsection (b) and for the last 

full calendar year ending before the submission of such report— 

(1) the number of— 

(A) veterans served; and 

(B) courses of treatment provided; and 

(2) demographic information for such services, diagnoses, 

and courses of treatment. 

(j) PROGRAM EVALUATION.— 

(1) IN GENERAL.—The Secretary shall, through Department 

of Veterans Affairs Mental Health Services investigators and 

in collaboration with relevant program offices of the Department, design and implement a strategy for evaluating the pilot 

program. 

(2) ELEMENTS.—The strategy implemented under paragraph (1) shall assess the impact that contracting with community mental health centers, the Indian Health Service, and 

other entities participating in the pilot program under subsection (b) has on the following: 

(A) Access to mental health care by veterans in need 

of such care. 

(B) The use of telehealth services by veterans for 

mental health care needs. 

(C) The quality of mental health care and substance 

use disorder treatment services provided to veterans in 

need of such care and services. 

(D) The coordination of mental health care and other 

medical services provided to veterans. 

(k) DEFINITIONS.—In this section: 

(1) The term ‘‘community mental health center’’ has the 

meaning given such term in section 410.2 of title 42, Code 

of Federal Regulations (as in effect on the day before the 

date of the enactment of this Act). 

(2) The term ‘‘eligible veteran’’ means a veteran in need 

of mental health services who— 

(A) is enrolled in the Department of Veterans Affairs 

health care system; and 


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(B) has received a referral from a health professional 

of the Veterans Health Administration to a community 

mental health center, a facility of the Indian Health 

Service, or other entity for purposes of the pilot program. 

(3) The term ‘‘Indian Health Service’’ means the organization established by section 601(a) of the Indian Health Care 

Improvement Act (25 U.S.C. 1661(a)). 

(l) AUTHORIZATION OF APPROPRIATIONS.—There is authorized 

to be appropriated such sums as may be necessary to carry out 

the provisions of this section. 

TITLE II—MENTAL HEALTH RESEARCH 

SEC. 201. RESEARCH PROGRAM ON COMORBID POST-TRAUMATIC 

STRESS DISORDER AND SUBSTANCE USE DISORDERS. 

(a) PROGRAM REQUIRED.—The Secretary of Veterans Affairs 

shall, through the Office of Research and Development, carry out 

a program of research into comorbid post-traumatic stress disorder 

(PTSD) and substance use disorder. 

(b) DISCHARGE THROUGH NATIONAL CENTER FOR

POSTTRAUMATIC STRESS DISORDER.—The research program required 

by subsection (a) shall be carried out by the National Center for 

Posttraumatic Stress Disorder. In carrying out the program, the 

Center shall— 

(1) develop protocols and goals with respect to research 

under the program; and 

(2) coordinate research, data collection, and data dissemination under the program. 

(c) RESEARCH.—The program of research required by subsection 

(a) shall address the following: 

(1) Comorbid post-traumatic stress disorder and substance 

use disorder. 

(2) The systematic integration of treatment for post-traumatic stress disorder with treatment for substance use disorder. 

(3) The development of protocols to evaluate care of veterans with comorbid post-traumatic stress disorder and substance use disorder. 

(d) FUNDING.— 

(1) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated for the Department of Veterans Affairs 

for each of fiscal years 2009 through 2012, $2,000,000 to carry 

out this section. 

(2) AVAILABILITY.—Amounts authorized to be appropriated 

by paragraph (1) shall be made available to the National Center 

on Posttraumatic Stress Disorder for the purpose specified in 

that paragraph. 

(3) SUPPLEMENT NOT SUPPLANT.—Any amount made available to the National Center on Posttraumatic Stress Disorder 

for a fiscal year under paragraph (2) is in addition to any 

other amounts made available to the National Center on 

Posttraumatic Stress Disorder for such year under any other 

provision of law. 

38 USC 1712A 

note. 


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122 STAT. 4120 PUBLIC LAW 110–387—OCT. 10, 2008 

SEC. 202. EXTENSION OF AUTHORIZATION FOR SPECIAL COMMITTEE 

ON POST-TRAUMATIC STRESS DISORDER. 

Section 110(e)(2) of the Veterans’ Health Care Act of 1984 

(38 U.S.C. 1712A note; Public Law 98–528) is amended by striking 

‘‘through 2008’’ and inserting ‘‘through 2012’’. 

TITLE III—ASSISTANCE FOR FAMILIES 

OF VETERANS 

SEC. 301. CLARIFICATION OF AUTHORITY OF SECRETARY OF VETERANS AFFAIRS TO PROVIDE MENTAL HEALTH SERVICES 

TO FAMILIES OF VETERANS. 

(a) IN GENERAL.—Chapter 17 is amended— 

(1) in section 1701(5)(B)— 

(A) by inserting ‘‘marriage and family counseling,’’ after 

‘‘professional counseling,’’; and 

(B) by striking ‘‘as may be essential to’’ and inserting 

‘‘as the Secretary considers appropriate for’’; and 

(2) in section 1782— 

(A) in subsection (a), by inserting ‘‘marriage and family 

counseling,’’ after ‘‘professional counseling,’’; and 

(B) in subsection (b)— 

(i) by inserting ‘‘marriage and family counseling,’’ 

after ‘‘professional counseling,’’; and 

(ii) by striking ‘‘if—’’ and all that follows and 

inserting a period. 

(b) LOCATION.—Paragraph (5) of section 1701 of title 38, United 

States Code, shall not be construed to prevent the Secretary of 

Veterans Affairs from providing services described in subparagraph 

(B) of such paragraph to individuals described in such subparagraph 

in centers under section 1712A of such title (commonly referred 

to as ‘‘Vet Centers’’), Department of Veterans Affairs medical centers, community-based outpatient clinics, or in such other facilities 

of the Department of Veterans Affairs as the Secretary considers 

necessary. 

SEC. 302. PILOT PROGRAM ON PROVISION OF READJUSTMENT AND 

TRANSITION ASSISTANCE TO VETERANS AND THEIR FAMILIES IN COOPERATION WITH VET CENTERS. 

(a) PILOT PROGRAM.—The Secretary of Veterans Affairs shall 

carry out, through a non-Department of Veterans Affairs entity, 

a pilot program to assess the feasability and advisability of providing readjustment and transition assistance described in subsection (b) to veterans and their families in cooperation with centers 

under section 1712A of title 38, United States Code (commonly 

referred to as ‘‘Vet Centers’’). 

(b) READJUSTMENT AND TRANSITION ASSISTANCE.—Readjustment and transition assistance described in this subsection is assistance as follows: 

(1) Readjustment and transition assistance that is preemptive, proactive, and principle-centered. 

(2) Assistance and training for veterans and their families 

in coping with the challenges associated with making the transition from military to civilian life. 

(c) NON-DEPARTMENT OF VETERANS AFFAIRS ENTITY.— 

38 USC 1712A 

note. 

38 USC 1701 

note. 

38 USC 1701. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4121 

(1) IN GENERAL.—The Secretary shall carry out the pilot 

program through any for-profit or non-profit organization 

selected by the Secretary for purposes of the pilot program 

that has demonstrated expertise and experience in the provision 

of assistance and training described in subsection (b). 

(2) CONTRACT OR AGREEMENT.—The Secretary shall carry 

out the pilot program through a non-Department entity 

described in paragraph (1) pursuant to a contract or other 

agreement entered into by the Secretary and the entity for 

purposes of the pilot program. 

(d) COMMENCEMENT OF PILOT PROGRAM.—The pilot program 

shall commence not later than 180 days after the date of the 

enactment of this Act. 

(e) DURATION OF PILOT PROGRAM.—The pilot program shall 

be carried out during the three-year period beginning on the date 

of the commencement of the pilot program, and may be carried 

out for additional one-year periods thereafter. 

(f) LOCATION OF PILOT PROGRAM.— 

(1) IN GENERAL.—The Secretary shall provide assistance 

under the pilot program in cooperation with 10 centers 

described in subsection (a) designated by the Secretary for 

purposes of the pilot program. 

(2) DESIGNATIONS.—In designating centers described in 

subsection (a) for purposes of the pilot program, the Secretary 

shall designate centers so as to provide a balanced geographical 

representation of such centers throughout the United States, 

including the District of Columbia, the Commonwealth of 

Puerto Rico, tribal lands, and other territories and possessions 

of the United States. 

(g) PARTICIPATION OF CENTERS.—A center described in subsection (a) that is designated under subsection (f) for participation 

in the pilot program shall participate in the pilot program by 

promoting awareness of the assistance and training available to 

veterans and their families through— 

(1) the facilities and other resources of such center; 

(2) the non-Department of Veterans Affairs entity selected 

pursuant to subsection (c); and 

(3) other appropriate mechanisms. 

(h) ADDITIONAL SUPPORT.—In carrying out the pilot program, 

the Secretary may enter into contracts or other agreements, in 

addition to the contract or agreement described in subsection (c), 

with such other non-Department of Veterans Affairs entities 

meeting the requirements of subsection (c) as the Secretary considers appropriate for purposes of the pilot program. 

(i) REPORT ON PILOT PROGRAM.— 

(1) REPORT REQUIRED.—Not later than three years after 

the date of the enactment of this Act, the Secretary shall 

submit to the congressional veterans affairs committees a report 

on the pilot program. 

(2) ELEMENTS.—Each report under paragraph (1) shall 

include the following: 

(A) A description of the activities under the pilot program as of the date of such report, including the number 

of veterans and families provided assistance under the 

pilot program and the scope and nature of the assistance 

so provided. 

Deadline. 


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(B) A current assessment of the effectiveness of the 

pilot program. 

(C) Any recommendations that the Secretary considers 

appropriate for the extension or expansion of the pilot 

program. 

(3) CONGRESSIONAL VETERANS AFFAIRS COMMITTEES

DEFINED.—In this subsection, the term ‘‘congressional veterans 

affairs committees’’ means— 

(A) the Committees on Veterans’ Affairs and Appropriations of the Senate; and 

(B) the Committees on Veterans’ Affairs and Appropriations of the House of Representatives. 

(j) AUTHORIZATION OF APPROPRIATIONS.— 

(1) IN GENERAL.—There is authorized to be appropriated 

for the Department of Veterans Affairs for each of fiscal years 

2009 through 2011 $1,000,000 to carry out this section. 

(2) AVAILABILITY.—Amounts authorized to be appropriated 

by paragraph (1) shall remain available until expended. 

TITLE IV—HEALTH CARE MATTERS 

SEC. 401. VETERANS BENEFICIARY TRAVEL PROGRAM. 

(a) REPEAL OF REQUIREMENT TO ADJUST AMOUNTS DEDUCTED

FROM PAYMENTS OR ALLOWANCES FOR BENEFICIARY TRAVEL.— 

(1) IN GENERAL.—Section 111(c) is amended— 

(A) by striking paragraph (5); and 

(B) in paragraph (2), by striking ‘‘, except as provided 

in paragraph (5) of this subsection,’’. 

(2) REINSTATEMENT OF AMOUNT OF DEDUCTION SPECIFIED

BY STATUTE.—Notwithstanding any adjustment made by the 

Secretary of Veterans Affairs under paragraph (5) of section 

111(c) of title 38, United States Code, as such paragraph was 

in effect before the date of the enactment of this Act, the 

amount deducted under paragraph (1) of such section 111(c) 

on or after such date shall be the amount specified in such 

paragraph. 

(b) DETERMINATION OF MILEAGE REIMBURSEMENT RATE.—Section 111(g) is amended— 

(1) by amending paragraph (1) to read as follows: 

‘‘(1) Subject to paragraph (3), in determining the amount of 

allowances or reimbursement to be paid under this section, the 

Secretary shall use the mileage reimbursement rate for the use 

of privately owned vehicles by Government employees on official 

business (when a Government vehicle is available), as prescribed 

by the Administrator of General Services under section 5707(b) 

of title 5.’’; 

(2) by striking paragraphs (3) and (4); and 

(3) by inserting after paragraph (2) the following new paragraph (3): 

‘‘(3) Subject to the availability of appropriations, the Secretary 

may modify the amount of allowances or reimbursement to be 

paid under this section using a mileage reimbursement rate in 

excess of that prescribed under paragraph (1).’’. 

(c) REPORT.—Not later than 14 months after the date of the 

enactment of this Act, the Secretary of Veterans Affairs shall submit 

38 USC 111 

note. 

38 USC 111. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4123 

to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report 

containing an estimate of the additional costs incurred by the 

Department of Veterans Affairs because of this section, including— 

(1) any costs resulting from increased utilization of 

healthcare services by veterans eligible for travel allowances 

or reimbursements under section 111 of title 38, United States 

Code; and 

(2) the additional costs that would be incurred by the 

Department should the Secretary exercise the authority 

described in subsection (g)(3) of such section. 

(d) EFFECTIVE DATE.—The amendments made by this section 

shall apply with respect to travel expenses incurred after the expiration of the 90-day period that begins on the date of the enactment 

of this Act. 

SEC. 402. MANDATORY REIMBURSEMENT OF VETERANS RECEIVING 

EMERGENCY TREATMENT IN NON-DEPARTMENT OF VETERANS AFFAIRS FACILITIES UNTIL TRANSFER TO DEPARTMENT FACILITIES. 

(a) CERTAIN VETERANS WITHOUT SERVICE-CONNECTED DISABILITY.—Section 1725 is amended— 

(1) in subsection (a)(1), by striking ‘‘may reimburse’’ and 

inserting ‘‘shall reimburse’’; and 

(2) in subsection (f)(1), by striking subparagraph (C) and 

inserting the following new subparagraph (C): 

‘‘(C) until— 

‘‘(i) such time as the veteran can be transferred 

safely to a Department facility or other Federal facility 

and such facility is capable of accepting such transfer; 

or 

‘‘(ii) such time as a Department facility or other 

Federal facility accepts such transfer if— 

‘‘(I) at the time the veteran could have been 

transferred safely to a Department facility or other 

Federal facility, no Department facility or other 

Federal facility agreed to accept such transfer; and 

‘‘(II) the non-Department facility in which such 

medical care or services was furnished made and 

documented reasonable attempts to transfer the 

veteran to a Department facility or other Federal 

facility.’’. 

(b) CERTAIN VETERANS WITH SERVICE-CONNECTED DISABILITY.—Section 1728 is amended— 

(1) by striking subsection (a) and inserting the following 

new subsection (a): 

‘‘(a) The Secretary shall, under such regulations as the Secretary prescribes, reimburse veterans eligible for hospital care or 

medical services under this chapter for the customary and usual 

charges of emergency treatment (including travel and incidental 

expenses under the terms and conditions set forth in section 111 

of this title) for which such veterans have made payment, from 

sources other than the Department, where such emergency treatment was rendered to such veterans in need thereof for any of 

the following: 

‘‘(1) An adjudicated service-connected disability. 

Regulations. 

38 USC 1725. 

38 USC 111 

note. 


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122 STAT. 4124 PUBLIC LAW 110–387—OCT. 10, 2008 

‘‘(2) A non-service-connected disability associated with and 

held to be aggravating a service-connected disability. 

‘‘(3) Any disability of a veteran if the veteran has a total 

disability permanent in nature from a service-connected disability. 

‘‘(4) Any illness, injury, or dental condition of a veteran 

who— 

‘‘(A) is a participant in a vocational rehabilitation program (as defined in section 3101(9) of this title); and 

‘‘(B) is medically determined to have been in need 

of care or treatment to make possible the veteran’s entrance 

into a course of training, or prevent interruption of a course 

of training, or hasten the return to a course of training 

which was interrupted because of such illness, injury, or 

dental condition.’’; 

(2) in subsection (b), by striking ‘‘care or services’’ both 

places it appears and inserting ‘‘emergency treatment’’; and 

(3) by adding at the end the following new subsection: 

‘‘(c) In this section, the term ‘emergency treatment’ has the 

meaning given such term in section 1725(f)(1) of this title.’’. 

SEC. 403. PILOT PROGRAM OF ENHANCED CONTRACT CARE 

AUTHORITY FOR HEALTH CARE NEEDS OF VETERANS IN 

HIGHLY RURAL AREAS. 

(a) PILOT PROGRAM REQUIRED.— 

(1) IN GENERAL.—The Secretary of Veterans Affairs shall 

conduct a pilot program under which the Secretary provides 

covered health services to covered veterans through qualifying 

non-Department of Veterans Affairs health care providers. 

(2) COMMENCEMENT.—The Secretary shall commence the 

conduct of the pilot program on the date that is 120 days 

after the date of the enactment of this Act. 

(3) TERMINATION.—A veteran may receive health services 

under the pilot program only during the three-year period 

beginning on the date of the commencement of the pilot program under paragraph (2). 

(4) PROGRAM LOCATIONS.—The pilot program shall be carried out within areas selected by the Secretary for the purposes 

of the pilot program in at least five Veterans Integrated Service 

Networks (VISNs). Of the Veterans Integrated Service Networks so selected— 

(A) not less than four such networks shall include 

at least three highly rural counties, as determined by the 

Secretary upon consideration of the most recent decennial 

census; 

(B) not less than one such network, not including a 

network selected under subparagraph (A), shall include 

only one highly rural county, as determined by the Secretary upon consideration of the most recent decennial 

census; 

(C) all such networks shall include area within the 

borders of at least four States; and 

(D) no such networks shall be participants in the 

Healthcare Effectiveness through Resource Optimization 

pilot program of the Department of Veterans Affairs. 

(b) COVERED VETERANS.— 

Deadline. 

38 USC 1703 

note. 


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(1) IN GENERAL.—For purposes of the pilot program under 

this section, a covered veteran is any highly rural veteran 

who is— 

(A) enrolled in the system of patient enrollment established under section 1705(a) of title 38, United States Code, 

as of the date of the commencement of the pilot program 

under subsection (a)(2); or 

(B) eligible for health care under section 1710(e)(3)(C) 

of title 38, United States Code. 

(2) HIGHLY RURAL VETERANS.—For purposes of this subsection, a highly rural veteran is any veteran who— 

(A) resides in a location that is— 

(i) more than 60 miles driving distance from the 

nearest Department health care facility providing primary care services, if the veteran is seeking such services; 

(ii) more than 120 miles driving distance from 

the nearest Department health care facility providing 

acute hospital care, if the veteran is seeking such 

care; or 

(iii) more than 240 miles driving distance from 

the nearest Department health care facility providing 

tertiary care, if the veteran is seeking such care; or 

(B) in the case of a veteran who resides in a location 

less than the distance specified in clause (i), (ii), or (iii) 

of subparagraph (A), as applicable, experiences such hardship or other difficulties in travel to the nearest appropriate 

Department health care facility that such travel is not 

in the best interest of the veteran, as determined by the 

Secretary pursuant to regulations prescribed for purposes 

of this subsection. 

(c) COVERED HEALTH SERVICES.—For purposes of the pilot program under this section, a covered health service with respect 

to a covered veteran is any hospital care, medical service, rehabilitative service, or preventative health service that is authorized to 

be provided by the Secretary to the veteran under chapter 17 

of title 38, United States Code, or any other provision of law. 

(d) QUALIFYING NON-DEPARTMENT HEALTH CARE PROVIDERS.— 

For purposes of the pilot program under this section, an entity 

or individual is a qualifying non-Department health care provider 

of a covered health service if the Secretary determines that the 

entity or individual is qualified to furnish such service to veterans 

under the pilot program. 

(e) ELECTION.—A covered veteran seeking to be provided covered health services under the pilot program under this section 

shall submit to the Secretary an application therefor in such form, 

and containing such information as the Secretary shall specify 

for purposes of the pilot program. 

(f) PROVISION OF SERVICES THROUGH CONTRACT.—The Secretary 

shall provide covered health services to veterans under the pilot 

program under this section through contracts with qualifying nonDepartment health care providers for the provision of such services. 

(g) EXCHANGE OF MEDICAL INFORMATION.—In conducting the 

pilot program under this section, the Secretary shall develop and 

utilize a functional capability to provide for the exchange of appropriate medical information between the Department and nonVerDate Aug 31 2005 23:14 Nov 05, 2008 Jkt 079139 PO 00387 Frm 00017 Fmt 6580 Sfmt 6581 E:\PUBLAW\PUBL387.110 PUBL387

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122 STAT. 4126 PUBLIC LAW 110–387—OCT. 10, 2008 

Department health care providers providing health services under 

the pilot program. 

(h) REPORTS.—Not later than the 30 days after the end of 

each year in which the pilot program under this section is conducted, the Secretary shall submit to the Committee of Veterans’ 

Affairs of the Senate and the Committee on Veterans’ Affairs of 

the House of Representatives a report which includes— 

(1) the assessment of the Secretary of the pilot program 

during the preceding year, including its cost, volume, quality, 

patient satisfaction, benefit to veterans, and such other findings 

and conclusions with respect to pilot program as the Secretary 

considers appropriate; and 

(2) such recommendations as the Secretary considers appropriate regarding— 

(A) the continuation of the pilot program; 

(B) extension of the pilot program to other or all Veterans Integrated Service Networks of the Department; 

(C) making the pilot program permanent. 

SEC. 404. EPILEPSY CENTERS OF EXCELLENCE. 

(a) IN GENERAL.—Subchapter II of chapter 73 is amended by 

adding at the end the following new section: 

‘‘§ 7330A. Epilepsy centers of excellence 

‘‘(a) ESTABLISHMENT OF CENTERS.—(1) Not later than 120 days 

after the date of the enactment of the Veterans’ Mental Health 

and Other Care Improvements Act of 2008, the Secretary shall 

designate at least four but not more than six Department health 

care facilities as locations for epilepsy centers of excellence for 

the Department. 

‘‘(2) Of the facilities designated under paragraph (1), not less 

than two shall be centers designated under section 7327 of this 

title. 

‘‘(3) Of the facilities designated under paragraph (1), not less 

than two shall be facilities that are not centers designated under 

section 7327 of this title. 

‘‘(4) Subject to the availability of appropriations for such purpose, the Secretary shall establish and operate an epilepsy center 

of excellence at each location designated under paragraph (1). 

‘‘(b) DESIGNATION OF FACILITIES.—(1) In designating locations 

for epilepsy centers of excellence under subsection (a), the Secretary 

shall solicit proposals from Department health care facilities seeking 

designation as a location for an epilepsy center of excellence. 

‘‘(2) The Secretary may not designate a facility as a location 

for an epilepsy center of excellence under subsection (a) unless 

the peer review panel established under subsection (c) has determined under that subsection that the proposal submitted by such 

facility seeking designation as a location for an epilepsy center 

of excellence is among those proposals that meet the highest 

competitive standards of scientific and clinical merit. 

‘‘(3) In choosing from among the facilities meeting the requirements of paragraph (2), the Secretary shall also consider appropriate geographic distribution when designating the epilepsy centers 

of excellence under subsection (a). 

‘‘(c) PEER REVIEW PANEL.—(1) The Under Secretary for Health 

shall establish a peer review panel to assess the scientific and 

clinical merit of proposals that are submitted to the Secretary 

Deadline. 


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for the designation of epilepsy centers of excellence under this 

section. 

‘‘(2)(A) The membership of the peer review panel shall consist 

of experts on epilepsy, including post-traumatic epilepsy. 

‘‘(B) Members of the peer review panel shall serve for a period 

of no longer than two years, except as specified in subparagraph 

(C). 

‘‘(C) Of the members first appointed to the panel, one half 

shall be appointed for a period of three years and one half shall 

be appointed for a period of two years, as designated by the Under 

Secretary at the time of appointment. 

‘‘(3) The peer review panel shall review each proposal submitted 

to the panel by the Under Secretary for Health and shall submit 

its views on the relative scientific and clinical merit of each such 

proposal to the Under Secretary. 

‘‘(4) The peer review panel shall, in conjunction with the 

national coordinator designated under subsection (e), conduct regular evaluations of each epilepsy center of excellence established 

and operated under subsection (a) to ensure compliance with the 

requirements of this section. 

‘‘(5) The peer review panel shall not be subject to the Federal 

Advisory Committee Act. 

‘‘(d) EPILEPSY CENTER OF EXCELLENCE DEFINED.—In this section, the term ‘epilepsy center of excellence’ means a health care 

facility that has (or in the foreseeable future can develop) the 

necessary capacity to function as a center of excellence in research, 

education, and clinical care activities in the diagnosis and treatment 

of epilepsy and has (or may reasonably be anticipated to develop) 

each of the following: 

‘‘(1) An affiliation with an accredited medical school that 

provides education and training in neurology, including an 

arrangement with such school under which medical residents 

receive education and training in the diagnosis and treatment 

of epilepsy (including neurosurgery). 

‘‘(2) The ability to attract the participation of scientists 

who are capable of ingenuity and creativity in health care 

research efforts. 

‘‘(3) An advisory committee composed of veterans and 

appropriate health care and research representatives of the 

facility and of the affiliated school or schools to advise the 

directors of such facility and such center on policy matters 

pertaining to the activities of the center during the period 

of the operation of such center. 

‘‘(4) The capability to conduct effectively evaluations of 

the activities of such center. 

‘‘(5) The capability to assist in the expansion of the Department’s use of information systems and databases to improve 

the quality and delivery of care for veterans enrolled within 

the Department’s health care system. 

‘‘(6) The capability to assist in the expansion of the Department telehealth program to develop, transmit, monitor, and 

review neurological diagnostic tests. 

‘‘(7) The ability to perform epilepsy research, education, 

and clinical care activities in collaboration with Department 

medical facilities that have centers for research, education, 

and clinical care activities on complex multi-trauma associated 


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with combat injuries established under section 7327 of this 

title. 

‘‘(e) NATIONAL COORDINATOR FOR EPILEPSY PROGRAMS.—(1) To 

assist the Secretary and the Under Secretary for Health in carrying 

out this section, the Secretary shall designate an individual in 

the Veterans Health Administration to act as a national coordinator 

for epilepsy programs of the Veterans Health Administration. 

‘‘(2) The duties of the national coordinator for epilepsy programs 

shall include the following: 

‘‘(A) To supervise the operation of the centers established 

pursuant to this section. 

‘‘(B) To coordinate and support the national consortium 

of providers with interest in treating epilepsy at Department 

health care facilities lacking such centers in order to ensure 

better access to state-of-the-art diagnosis, research, clinical 

care, and education for traumatic brain injury and epilepsy 

throughout the health care system of the Department. 

‘‘(C) To conduct, in conjunction with the peer review panel 

established under subsection (c), regular evaluations of the 

epilepsy centers of excellence to ensure compliance with the 

requirements of this section. 

‘‘(D) To coordinate (as part of an integrated national 

system) education, clinical care, and research activities within 

all facilities with an epilepsy center of excellence. 

‘‘(E) To develop jointly a national consortium of providers 

with interest in treating epilepsy at Department health care 

facilities lacking an epilepsy center of excellence in order to 

ensure better access to state-of-the-art diagnosis, research, clinical care, and education for traumatic brain injury and epilepsy 

throughout the health care system of the Department. Such 

consortium should include a designated epilepsy referral clinic 

in each Veterans Integrated Service Network. 

‘‘(3) In carrying out duties under this subsection, the national 

coordinator for epilepsy programs shall report to the official of 

the Veterans Health Administration responsible for neurology. 

‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—(1) There are authorized to be appropriated $6,000,000 for each of fiscal years 2009 

through 2013 for the support of the clinical care, research, and 

education activities of the epilepsy centers of excellence established 

and operated pursuant to subsection (a)(2). 

‘‘(2) There are authorized to be appropriated for each fiscal 

year after fiscal year 2013 such sums as may be necessary for 

the support of the clinical care, research, and education activities 

of the epilepsy centers of excellence established and operated pursuant to subsection (a)(2). 

‘‘(3) The Secretary shall ensure that funds for such centers 

are designated for the first three years of operation as a special 

purpose program for which funds are not allocated through the 

Veterans Equitable Resource Allocation system. 

‘‘(4) In addition to amounts authorized to be appropriated under 

paragraphs (1) and (2) for a fiscal year, the Under Secretary for 

Health shall allocate to such centers from other funds appropriated 

generally for the Department medical services account and medical 

and prosthetics research account, as appropriate, such amounts 

as the Under Secretary for Health determines appropriate. 

‘‘(5) In addition to amounts authorized to be appropriated under 

paragraphs (1) and (2) for a fiscal year, there are authorized to 

Designation. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4129 

be appropriated such sums as may be necessary to fund the national 

coordinator established by subsection (e).’’. 

(b) CLERICAL AMENDMENT.—The table of sections at the beginning of chapter 73 is amended by inserting after the item relating 

to section 7330 the following new item: 

‘‘7330A. Epilepsy centers of excellence.’’. 

SEC. 405. ESTABLISHMENT OF QUALIFICATIONS FOR PEER SPECIALIST 

APPOINTEES. 

(a) IN GENERAL.—Section 7402(b) is amended— 

(1) by redesignating the paragraph (11) relating to other 

health care positions as paragraph (14); and 

(2) by inserting after paragraph (12) the following new 

paragraph (13): 

‘‘(13) PEER SPECIALIST.—To be eligible to be appointed to a 

peer specialist position, a person must— 

‘‘(A) be a veteran who has recovered or is recovering from 

a mental health condition; and 

‘‘(B) be certified by— 

‘‘(i) a not-for-profit entity engaged in peer specialist 

training as having met such criteria as the Secretary shall 

establish for a peer specialist position; or 

‘‘(ii) a State as having satisfied relevant State requirements for a peer specialist position.’’. 

(b) PEER SPECIALIST TRAINING.—Section 7402 is amended by 

adding at the end the following new subsection: 

‘‘(g) The Secretary may enter into contracts with not-for-profit 

entities to provide— 

‘‘(1) peer specialist training to veterans; and 

‘‘(2) certification for veterans under subsection 

(b)(13)(B)(i).’’. 

SEC. 406. ESTABLISHMENT OF CONSOLIDATED PATIENT ACCOUNTING 

CENTERS. 

(a) ESTABLISHMENT OF CENTERS.—Chapter 17 is amended by 

inserting after section 1729A the following new section: 

‘‘§ 1729B. Consolidated patient accounting centers 

‘‘(a) IN GENERAL.—Not later than five years after the date 

of the enactment of this section, the Secretary of Veterans Affairs 

shall establish not more than seven consolidated patient accounting 

centers for conducting industry-modeled regionalized billing and 

collection activities of the Department. 

‘‘(b) FUNCTIONS.—The centers shall carry out the following functions: 

‘‘(1) Reengineer and integrate all business processes of 

the revenue cycle of the Department. 

‘‘(2) Standardize and coordinate all activities of the Department related to the revenue cycle for all health care services 

furnished to veterans for non-service-connected medical conditions. 

‘‘(3) Apply commercial industry standards for measures 

of access, timeliness, and performance metrics with respect 

to revenue enhancement of the Department. 

‘‘(4) Apply other requirements with respect to such revenue 

cycle improvement as the Secretary may specify.’’. 

Deadline. 

38 USC 7402. 


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122 STAT. 4130 PUBLIC LAW 110–387—OCT. 10, 2008 

(b) CLERICAL AMENDMENT.—The table of sections at the beginning of such chapter is amended by inserting after the item relating 

to section 1729A the following: 

‘‘1729B. Consolidated patient accounting centers.’’. 

SEC. 407. REPEAL OF LIMITATION ON AUTHORITY TO CONDUCT WIDESPREAD HIV TESTING PROGRAM. 

Section 124 of the Veterans’ Benefits and Services Act of 1988 

(title I of Public Law 100–322, as amended; 38 U.S.C. 7333 note) 

is repealed. 

SEC. 408. PROVISION OF COMPREHENSIVE HEALTH CARE BY SECRETARY OF VETERANS AFFAIRS TO CHILDREN OF 

VIETNAM VETERANS BORN WITH SPINA BIFIDA. 

(a) PROVISION OF COMPREHENSIVE HEALTH CARE.—Section 

1803(a) is amended by striking ‘‘such health care as the Secretary 

determines is needed by the child for the spina bifida or any 

disability that is associated with such condition’’ and inserting 

‘‘health care under this section’’. 

(b) EFFECTIVE DATE.—The amendment made by subsection (a) 

shall apply with respect to care furnished after the date of the 

enactment of this Act. 

SEC. 409. EXEMPTION FROM COPAYMENT REQUIREMENT FOR VETERANS RECEIVING HOSPICE CARE. 

Section 1710 is amended— 

(1) in subsection (f)(1), by inserting ‘‘(except if such care 

constitutes hospice care)’’ after ‘‘nursing home care’’; and 

(2) in subsection (g)(1), by inserting ‘‘(except if such care 

constitutes hospice care)’’ after ‘‘medical services’’. 

TITLE V—PAIN CARE 

SEC. 501. COMPREHENSIVE POLICY ON PAIN MANAGEMENT. 

(a) COMPREHENSIVE POLICY REQUIRED.—Not later than October 

1, 2009, the Secretary of Veterans Affairs shall develop and implement a comprehensive policy on the management of pain experienced by veterans enrolled for health care services provided by 

the Department of Veterans Affairs. 

(b) SCOPE OF POLICY.—The policy required by subsection (a) 

shall cover each of the following: 

(1) The Department-wide management of acute and chronic 

pain experienced by veterans. 

(2) The standard of care for pain management to be used 

throughout the Department. 

(3) The consistent application of pain assessments to be 

used throughout the Department. 

(4) The assurance of prompt and appropriate pain care 

treatment and management by the Department, system-wide, 

when medically necessary. 

(5) Department programs of research related to acute and 

chronic pain suffered by veterans, including pain attributable 

to central and peripheral nervous system damage characteristic 

of injuries incurred in modern warfare. 

(6) Department programs of pain care education and 

training for health care personnel of the Department. 

Deadline. 

38 USC 7311 

note. 

38 USC 1803 

note. 

38 USC 1803. 


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(7) Department programs of patient education for veterans 

suffering from acute or chronic pain and their families. 

(c) UPDATES.—The Secretary shall revise the policy required 

by subsection (a) on a periodic basis in accordance with experience 

and evolving best practice guidelines. 

(d) CONSULTATION.—The Secretary shall develop the policy 

required by subsection (a), and revise such policy under subsection 

(c), in consultation with veterans service organizations and 

organizations with expertise in the assessment, diagnosis, treatment, and management of pain. 

(e) ANNUAL REPORT.— 

(1) IN GENERAL.—Not later than 180 days after the date 

of the completion and initial implementation of the policy 

required by subsection (a) and on October 1 of every fiscal 

year thereafter through fiscal year 2018, the Secretary shall 

submit to the Committee on Veterans’ Affairs of the Senate 

and the Committee on Veterans’ Affairs of the House of Representatives a report on the implementation of the policy 

required by subsection (a). 

(2) CONTENTS.—The report required by paragraph (1) shall 

include the following: 

(A) A description of the policy developed and implemented under subsection (a) and any revisions to such 

policy under subsection (c). 

(B) A description of the performance measures used 

to determine the effectiveness of such policy in improving 

pain care for veterans system-wide. 

(C) An assessment of the adequacy of Department pain 

management services based on a survey of patients managed in Department clinics. 

(D) An assessment of the research projects of the 

Department relevant to the treatment of the types of acute 

and chronic pain suffered by veterans. 

(E) An assessment of the training provided to Department health care personnel with respect to the diagnosis, 

treatment, and management of acute and chronic pain. 

(F) An assessment of the patient pain care education 

programs of the Department. 

(f) VETERANS SERVICE ORGANIZATION DEFINED.—In this section, 

the term ‘‘veterans service organization’’ means any organization 

recognized by the Secretary for the representation of veterans under 

section 5902 of title 38, United States Code. 

TITLE VI—HOMELESS VETERANS 

MATTERS 

SEC. 601. INCREASED AUTHORIZATION OF APPROPRIATIONS FOR COMPREHENSIVE SERVICE PROGRAMS. 

Section 2013 is amended by striking ‘‘$130,000,000’’ and 

inserting ‘‘$150,000,000’’. 

38 USC 2013. 


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122 STAT. 4132 PUBLIC LAW 110–387—OCT. 10, 2008 

SEC. 602. EXPANSION AND EXTENSION OF AUTHORITY FOR PROGRAM 

OF REFERRAL AND COUNSELING SERVICES FOR AT-RISK 

VETERANS TRANSITIONING FROM CERTAIN INSTITUTIONS. 

(a) PROGRAM AUTHORITY.—Subsection (a) of section 2023 is 

amended by striking ‘‘a demonstration program for the purpose 

of determining the costs and benefits of providing’’ and inserting 

‘‘a program of’’. 

(b) SCOPE OF PROGRAM.—Subsection (b) of such section is 

amended— 

(1) by striking ‘‘DEMONSTRATION’’ in the subsection heading; 

(2) by striking ‘‘demonstration’’; and 

(3) by striking ‘‘in at least six locations’’ and inserting 

‘‘in at least 12 locations’’. 

(c) EXTENSION OF AUTHORITY.—Subsection (d) of such section 

is amended by striking ‘‘shall cease’’ and all that follows and 

inserting ‘‘shall cease on September 30, 2012.’’. 

(d) CONFORMING AMENDMENTS.— 

(1) Subsection (c)(1) of such section is amended by striking 

‘‘demonstration’’. 

(2) The heading of such section is amended to read as 

follows: 

‘‘§ 2023. Referral and counseling services: veterans at risk 

of homelessness who are transitioning from certain 

institutions’’. 

(3) Section 2022(f)(2)(C) of such title is amended by striking 

‘‘demonstration’’. 

(e) CLERICAL AMENDMENT.—The table of sections at the beginning of chapter 20 is amended by striking the item relating to 

section 2023 and inserting the following: 

‘‘2023. Referral and counseling services: veterans at risk of homelessness who are 

transitioning from certain institutions.’’. 

SEC. 603. PERMANENT AUTHORITY FOR DOMICILIARY SERVICES FOR 

HOMELESS VETERANS AND ENHANCEMENT OF CAPACITY 

OF DOMICILIARY CARE PROGRAMS FOR FEMALE VETERANS. 

Subsection (b) of section 2043 is amended to read as follows: 

‘‘(b) ENHANCEMENT OF CAPACITY OF DOMICILIARY CARE PROGRAMS FOR FEMALE VETERANS.—The Secretary shall take appropriate actions to ensure that the domiciliary care programs of 

the Department are adequate, with respect to capacity and with 

respect to safety, to meet the needs of veterans who are women.’’. 

SEC. 604. FINANCIAL ASSISTANCE FOR SUPPORTIVE SERVICES FOR 

VERY LOW-INCOME VETERAN FAMILIES IN PERMANENT 

HOUSING. 

(a) PURPOSE.—The purpose of this section is to facilitate the 

provision of supportive services for very low-income veteran families 

in permanent housing. 

(b) FINANCIAL ASSISTANCE.— 

(1) IN GENERAL.—Subchapter V of chapter 20 is amended 

by adding at the end the following new section: 

38 USC 2044 

note. 

Termination 

date. 

38 USC 2023. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4133 

‘‘§ 2044. Financial assistance for supportive services for very 

low-income veteran families in permanent housing 

‘‘(a) DISTRIBUTION OF FINANCIAL ASSISTANCE.—(1) The Secretary shall provide financial assistance to eligible entities approved 

under this section to provide and coordinate the provision of supportive services described in subsection (b) for very low-income 

veteran families occupying permanent housing. 

‘‘(2) Financial assistance under this section shall consist of 

grants for each such family for which an approved eligible entity 

is providing or coordinating the provision of supportive services. 

‘‘(3)(A) The Secretary shall provide such grants to each eligible 

entity that is providing or coordinating the provision of supportive 

services. 

‘‘(B) The Secretary is authorized to establish intervals of payment for the administration of such grants and establish a maximum amount to be awarded, in accordance with the services being 

provided and their duration. 

‘‘(4) In providing financial assistance under paragraph (1), the 

Secretary shall give preference to entities providing or coordinating 

the provision of supportive services for very low-income veteran 

families who are transitioning from homelessness to permanent 

housing. 

‘‘(5) The Secretary shall ensure that, to the extent practicable, 

financial assistance under this subsection is equitably distributed 

across geographic regions, including rural communities and tribal 

lands. 

‘‘(6) Each entity receiving financial assistance under this section 

to provide supportive services to a very low-income veteran family 

shall notify that family that such services are being paid for, in 

whole or in part, by the Department. 

‘‘(7) The Secretary may require entities receiving financial 

assistance under this section to submit a report to the Secretary 

that describes the projects carried out with such financial assistance. 

‘‘(b) SUPPORTIVE SERVICES.—The supportive services referred 

to in subsection (a) are the following: 

‘‘(1) Services provided by an eligible entity or a subcontractor of an eligible entity that address the needs of very 

low-income veteran families occupying permanent housing, 

including— 

‘‘(A) outreach services; 

‘‘(B) case management services; 

‘‘(C) assistance in obtaining any benefits from the 

Department which the veteran may be eligible to receive, 

including, but not limited to, vocational and rehabilitation 

counseling, employment and training service, educational 

assistance, and health care services; and 

‘‘(D) assistance in obtaining and coordinating the provision of other public benefits provided in federal, State, 

or local agencies, or any organization defined in subsection 

(f), including— 

‘‘(i) health care services (including obtaining health 

insurance); 

‘‘(ii) daily living services; 

‘‘(iii) personal financial planning; 

‘‘(iv) transportation services; 

‘‘(v) income support services; 

Notification. 

Grants. 


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122 STAT. 4134 PUBLIC LAW 110–387—OCT. 10, 2008 

‘‘(vi) fiduciary and representative payee services; 

‘‘(vii) legal services to assist the veteran family 

with issues that interfere with the family’s ability to 

obtain or retain housing or supportive services; 

‘‘(viii) child care; 

‘‘(ix) housing counseling; and 

‘‘(x) other services necessary for maintaining independent living. 

‘‘(2) Services described in paragraph (1) that are delivered 

to very low-income veteran families who are homeless and 

who are scheduled to become residents of permanent housing 

within 90 days pending the location or development of housing 

suitable for permanent housing. 

‘‘(3) Services described in paragraph (1) for very low-income 

veteran families who have voluntarily chosen to seek other 

housing after a period of tenancy in permanent housing, that 

are provided, for a period of 90 days after such families exit 

permanent housing or until such families commence receipt 

of other housing services adequate to meet their current needs, 

but only to the extent that services under this paragraph are 

designed to support such families in their choice to transition 

into housing that is responsive to their individual needs and 

preferences. 

‘‘(c) APPLICATION FOR FINANCIAL ASSISTANCE.—(1) An eligible 

entity seeking financial assistance under subsection (a) shall submit 

to the Secretary an application therefor in such form, in such 

manner, and containing such commitments and information as the 

Secretary determines to be necessary to carry out this section. 

‘‘(2) Each application submitted by an eligible entity under 

paragraph (1) shall contain— 

‘‘(A) a description of the supportive services proposed to 

be provided by the eligible entity and the identified needs 

for those services; 

‘‘(B) a description of the types of very low-income veteran 

families proposed to be provided such services; 

‘‘(C) an estimate of the number of very low-income veteran 

families proposed to be provided such services; 

‘‘(D) evidence of the experience of the eligible entity in 

providing supportive services to very low-income veteran families; and 

‘‘(E) a description of the managerial capacity of the eligible 

entity— 

‘‘(i) to coordinate the provision of supportive services 

with the provision of permanent housing by the eligible 

entity or by other organizations; 

‘‘(ii) to assess continuously the needs of very low-income 

veteran families for supportive services; 

‘‘(iii) to coordinate the provision of supportive services 

with the services of the Department; 

‘‘(iv) to tailor supportive services to the needs of very 

low-income veteran families; and 

‘‘(v) to seek continuously new sources of assistance 

to ensure the long-term provision of supportive services 

to very low-income veteran families. 

‘‘(3) The Secretary shall establish criteria for the selection of 

eligible entities to be provided financial assistance under this section. 

Criteria. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4135 

‘‘(d) TECHNICAL ASSISTANCE.—(1) The Secretary shall provide 

training and technical assistance to participating eligible entities 

regarding the planning, development, and provision of supportive 

services to very low-income veteran families occupying permanent 

housing, through the Technical Assistance grants program in section 

2064 of this title. 

‘‘(2) The Secretary may provide the training described in paragraph (1) directly or through grants or contracts with appropriate 

public or nonprofit private entities. 

‘‘(e) FUNDING.—(1) From amounts appropriated to the Department for Medical Services, there shall be available to carry out 

subsection (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. ‘‘(2) Not more than $750,000 may be available under paragraph 

(1) in any fiscal year to provide technical assistance under subsection (d). 

‘‘(3) There is authorized to be appropriated $1,000,000 for each 

of the fiscal year 2009 through 2011 to carry out the provisions 

of subsection (d). 

‘‘(f) DEFINITIONS.—In this section: 

‘‘(1) The term ‘consumer cooperative’ has the meaning given 

such term in section 202 of the Housing Act of 1959 (12 U.S.C. 

1701q). 

‘‘(2) The term ‘eligible entity’ means— 

‘‘(A) a private nonprofit organization; or 

‘‘(B) a consumer cooperative. 

‘‘(3) The term ‘homeless’ has the meaning given that term 

in section 103 of the McKinney-Vento Homeless Assistance 

Act (42 U.S.C. 11302). 

‘‘(4) The term ‘permanent housing’ means community-based 

housing without a designated length of stay. 

‘‘(5) The term ‘private nonprofit organization’ means any 

of the following: 

‘‘(A) Any incorporated private institution or foundation— 

‘‘(i) no part of the net earnings of which inures 

to the benefit of any member, founder, contributor, 

or individual; 

‘‘(ii) which has a governing board that is responsible for the operation of the supportive services provided under this section; and 

‘‘(iii) which is approved by the Secretary as to 

financial responsibility. 

‘‘(B) A for-profit limited partnership, the sole general 

partner of which is an organization meeting the requirements of clauses (i), (ii), and (iii) of subparagraph (A). 

‘‘(C) A corporation wholly owned and controlled by 

an organization meeting the requirements of clauses (i), 

(ii), and (iii) of subparagraph (A). 

‘‘(D) A tribally designated housing entity (as defined 

in section 4 of the Native American Housing Assistance 

and Self-Determination Act of 1996 (25 U.S.C. 4103)). 

‘‘(6)(A) Subject to subparagraphs (B) and (C), the term 

‘very low-income veteran family’ means a veteran family whose 

income does not exceed 50 percent of the median income for 

Appropriation 

authorization. 


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122 STAT. 4136 PUBLIC LAW 110–387—OCT. 10, 2008 

an area specified by the Secretary for purposes of this section, 

as determined by the Secretary in accordance with this paragraph. 

‘‘(B) The Secretary shall make appropriate adjustments 

to the income requirement under subparagraph (A) based on 

family size. 

‘‘(C) The Secretary may establish an income ceiling higher 

or lower than 50 percent of the median income for an area 

if the Secretary determines that such variations are necessary 

because the area has unusually high or low construction costs, 

fair market rents (as determined under section 8 of the United 

States Housing Act of 1937 (42 U.S.C. 1437f)), or family 

incomes. 

‘‘(7) The term ‘veteran family’ includes a veteran who is 

a single person and a family in which the head of household 

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

(2) CLERICAL AMENDMENT.—The table of sections at the 

beginning of chapter 20 is amended by inserting after the 

item relating to section 2043 the following new item: 

‘‘2044. Financial assistance for supportive services for very low-income veteran families in permanent housing.’’. 

(c) STUDY OF EFFECTIVENESS OF PERMANENT HOUSING PROGRAM.— 

(1) IN GENERAL.—For fiscal years 2009 and 2010, the Secretary shall conduct a study of the effectiveness of the permanent housing program under section 2044 of title 38, United 

States Code, as added by subsection (b), in meeting the needs 

of very low-income veteran families, as that term is defined 

in that section. 

(2) COMPARISON.—In the study required by paragraph (1), 

the Secretary shall compare the results of the program referred 

to in that subsection with other programs of the Department 

of Veterans Affairs dedicated to the delivery of housing and 

services to veterans. 

(3) CRITERIA.—In making the comparison required in paragraph (2), the Secretary shall examine the following: 

(A) The satisfaction of veterans targeted by the programs described in paragraph (2). 

(B) The health status of such veterans. 

(C) The housing provided such veterans under such 

programs. 

(D) The degree to which such veterans are encouraged 

to productive activity by such programs. 

(4) REPORT.—Not later than March 31, 2011, the Secretary 

shall submit to the Committee on Veterans’ Affairs of the 

Senate and the Committee on Veterans’ Affairs of the House 

of Representatives a report on the results of the study required 

by paragraph (1). 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4137 

TITLE VII—AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND 

MAJOR MEDICAL FACILITY LEASES 

SEC. 701. AUTHORIZATION FOR FISCAL YEAR 2009 MAJOR MEDICAL 

FACILITY PROJECTS. 

The Secretary of Veterans Affairs may carry out the following 

major medical facility projects in fiscal year 2009 in the amount 

specified for each project: 

(1) Seismic corrections, Building 2, at the Department of 

Veterans Affairs Palo Alto Health Care System, Palo Alto Division Palo Alto, California, in an amount not to exceed 

$54,000,000. 

(2) Construction of a polytrauma healthcare and rehabilitation center at the Department of Veterans Affairs Medical 

Center, San Antonio, Texas, in an amount not to exceed 

$66,000,000. 

(3) Seismic corrections, Building 1, at the Department of 

Veterans Affairs Medical Center, San Juan, Puerto Rico, in 

an amount not to exceed $225,900,000. 

SEC. 702. MODIFICATION OF AUTHORIZATION AMOUNTS FOR CERTAIN 

MAJOR MEDICAL FACILITY CONSTRUCTION PROJECTS 

PREVIOUSLY AUTHORIZED. 

(a) MODIFICATION OF MAJOR MEDICAL FACILITY AUTHORIZATIONS.—Section 801(a) of the Veterans Benefits, Health Care, and 

Information Technology Act of 2006 (Public Law 109–461) is 

amended— 

(1) in paragraph (1)— 

(A) by striking ‘‘$300,000,000’’ and inserting 

‘‘$625,000,000’’; and 

(B) by striking the second sentence; and 

(2) in paragraph (3), by striking ‘‘$98,000,000’’ and inserting 

‘‘$568,400,000’’. 

(b) MODIFICATION OF AUTHORIZATION FOR CERTAIN MAJOR MEDICAL FACILITY CONSTRUCTION PROJECTS PREVIOUSLY AUTHORIZED

IN CONNECTION WITH CAPITAL ASSET REALIGNMENT INITIATIVE.— 

(1) CORRECTION OF PATIENT PRIVACY DEFICIENCIES AT THE

DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, GAINESVILLE, FLORIDA.—Paragraph (5) of section 802 of the Veterans 

Benefits, Health Care, and Information Technology Act of 2006 

(Public Law 109–461) is amended by striking ‘‘$85,200,000’’ 

and inserting ‘‘$136,700,000’’. 

(2) CONSTRUCTION OF A NEW MEDICAL CENTER FACILITY

AT THE DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, 

LAS VEGAS, NEVADA.—Paragraph (7) of such section is amended 

by striking ‘‘$406,000,000’’ and inserting ‘‘$600,400,000’’. 

(3) CONSTRUCTION OF A NEW OUTPATIENT CLINIC, LEE

COUNTY, FLORIDA.—Paragraph (8) of such section is amended— 

(A) by striking ‘‘ambulatory’’ and all that follows 

through ‘‘purchase,’’ and inserting ‘‘outpatient clinic in’’; 

and 

(B) by striking ‘‘$65,100,000’’ and inserting 

‘‘$131,800,000’’. 

120 Stat. 3443. 

120 Stat. 3442. 


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122 STAT. 4138 PUBLIC LAW 110–387—OCT. 10, 2008 

(4) CONSTRUCTION OF A NEW MEDICAL CENTER FACILITY, 

ORLANDO, FLORIDA.—Paragraph (11) of such section is amended 

by striking ‘‘$377,700,000’’ and inserting ‘‘$656,800,000’’. 

(5) CONSOLIDATION OF CAMPUSES AT THE UNIVERSITY DRIVE

AND H. JOHN HEINZ III DIVISIONS, PITTSBURGH, PENNSYLVANIA.— 

Paragraph (12) of such section is amended by striking 

‘‘$189,205,000’’ and inserting ‘‘$295,600,000’’. 

SEC. 703. AUTHORIZATION OF FISCAL YEAR 2009 MAJOR MEDICAL 

FACILITY LEASES. 

The Secretary of Veterans Affairs may carry out the following 

major medical facility leases in fiscal year 2009 at the locations 

specified, and in an amount for each lease not to exceed the amount 

shown for such location: 

(1) For an outpatient clinic, Brandon, Florida, $4,326,000. 

(2) For an outpatient clinic, Colorado Springs, Colorado, 

$10,300,000. 

(3) For an outpatient clinic, Eugene, Oregon, $5,826,000. 

(4) For the expansion of an outpatient clinic, Green Bay, 

Wisconsin, $5,891,000. 

(5) For an outpatient clinic, Greenville, South Carolina, 

$3,731,000. 

(6) For an outpatient clinic, Mansfield, Ohio, $2,212,000. 

(7) For an outpatient clinic, Mayaguez, Puerto Rico, 

$6,276,000. 

(8) For an outpatient clinic, Mesa, Arizona, $5,106,000. 

(9) For interim research space, Palo Alto, California, 

$8,636,000. 

(10) For the expansion of an outpatient clinic, Savannah, 

Georgia, $3,168,000. 

(11) For an outpatient clinic, Sun City, Arizona, $2,295,000. 

(12) For a primary care annex, Tampa, Florida, $8,652,000. 

(13) For an outpatient clinic, Peoria, Illinois, $3,600,000. 

SEC. 704. AUTHORIZATION OF APPROPRIATIONS. 

(a) AUTHORIZATION OF APPROPRIATIONS FOR FISCAL YEAR 2009 

MAJOR MEDICAL FACILITY PROJECTS.—There is authorized to be 

appropriated for the Secretary of Veterans Affairs for fiscal year 

2009 for the Construction, Major Projects, account— 

(1) $345,900,000 for the projects authorized in section 701; 

and 

(2) $1,493,495,000 for the increased amounts authorized 

for projects whose authorizations are modified by section 702. 

(b) AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR 2009 

MAJOR MEDICAL FACILITY LEASES.—There is authorized to be appropriated for the Secretary of Veterans Affairs for fiscal year 2009 

for the Medical Facilities account, $70,019,000, for the leases 

authorized in section 703. 

SEC. 705. INCREASE IN THRESHOLD FOR MAJOR MEDICAL FACILITY 

LEASES REQUIRING CONGRESSIONAL APPROVAL. 

Section 8104(a)(3)(B) is amended by striking ‘‘$600,000’’ and 

inserting ‘‘$1,000,000’’. 

38 USC 8104. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4139 

SEC. 706. CONVEYANCE OF CERTAIN NON-FEDERAL LAND BY CITY OF 

AURORA, COLORADO, TO SECRETARY OF VETERANS 

AFFAIRS FOR CONSTRUCTION OF VETERANS MEDICAL 

FACILITY. 

Section 410 of title IV of division I of the Consolidated Appropriations Act, 2008 (Public Law 110–161; 121 Stat. 2276) is 

amended to read as follows: 

‘‘SEC. 410. CONVEYANCE OF CERTAIN NON-FEDERAL LAND. 

‘‘(a) DEFINITIONS.—In this section: 

‘‘(1) CITY.—The term ‘City’ means the City of Aurora, Colorado. 

‘‘(2) DEED.—The term ‘deed’ means the quitclaim deed— 

‘‘(A) conveyed to the City by the Secretary (acting 

through the Director of the National Park Service); and 

‘‘(B) dated May 24, 1999. 

‘‘(3) NON-FEDERAL LAND.—The term ‘non-Federal land’ 

means— 

‘‘(A) parcel I of the former United States Army Garrison 

Fitzsimons, Adams County, Colorado, as more specifically 

described in the deed; and 

‘‘(B) the parcel of land described in the deed. 

‘‘(4) SECRETARY.—The term ‘Secretary’ means the Secretary 

of the Interior. 

‘‘(b) DUTY OF SECRETARY.—To allow the City to convey by 

donation to the United States the non-Federal land to be used 

by the Secretary of Veterans Affairs for the construction of a veterans medical facility, not later than 60 days after the date of 

enactment of this section, the Secretary shall execute each 

instrument that is necessary to release all rights, conditions, and 

restrictions retained by the United States in and to the non-Federal 

land conveyed in the deed.’’. 

SEC. 707. REPORT ON FACILITIES ADMINISTRATION. 

Not later than 60 days after the date of the enactment of 

this Act, the Secretary of Veterans Affairs shall submit to the 

Committee on Veterans’ Affairs of the Senate and the Committee 

on Veterans’ Affairs of the House of Representatives a report on 

the progress of the Secretary in complying with section 312A of 

title 38, United States Code. 

SEC. 708. ANNUAL REPORT ON OUTPATIENT CLINICS. 

(a) ANNUAL REPORT REQUIRED.—Subchapter I of chapter 81 

is amended by adding at the end the following new section: 

‘‘§ 8119. Annual report on outpatient clinics 

‘‘(a) ANNUAL REPORT REQUIRED.—The Secretary shall submit 

to the committees an annual report on community-based outpatient 

clinics and other outpatient clinics of the Department. The report 

shall be submitted each year not later than the date on which 

the budget for the next fiscal year is submitted to the Congress 

under section 1105 of title 31. 

‘‘(b) CONTENTS OF REPORT.—Each report required under subsection (a) shall include the following: 

‘‘(1) A list of each community-based outpatient clinic and 

other outpatient clinic of the Department, and for each such 

clinic, the type of clinic, location, size, number of health professionals employed by the clinic, workload, whether the clinic 

Deadline. 


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122 STAT. 4140 PUBLIC LAW 110–387—OCT. 10, 2008 

is leased or constructed and operated by the Secretary, and 

the annual cost of operating the clinic. 

‘‘(2) A list of community-based outpatient clinics and other 

outpatient clinics that the Secretary opened during the fiscal 

year preceding the fiscal year during which the report is submitted and a list of clinics the Secretary proposes opening 

during the fiscal year during which the report is submitted 

and the subsequent fiscal year, together with the cost of activating each such clinic and the information required to be 

provided under paragraph (1) for each such clinic and proposed 

clinic. 

‘‘(3) A list of proposed community-based outpatient clinics 

and other outpatient clinics that are, as of the date of the 

submission of the report, under review by the National Review 

Panel and a list of possible locations for future clinics identified 

in the Department’s strategic planning process, including any 

identified locations in rural and underserved areas. 

‘‘(4) A prioritized list of sites of care identified by the 

Secretary that the Secretary could establish without carrying 

out construction or entering into a lease, including— 

‘‘(A) any such sites that could be expanded by hiring 

additional staff or allocating staff to Federal facilities or 

facilities operating in collaboration with the Federal 

Government; and 

‘‘(B) any sites established, or able to be established, 

under sections 8111 and 8153 of this title.’’. 

(b) DEADLINE FOR FIRST ANNUAL REPORT.—The Secretary of 

Veterans Affairs shall submit the first report required under section 

8119(a) of title 38, United States Code, as added by subsection 

(a), by not later than 90 days after the date of the enactment 

of this Act. 

(c) CLERICAL AMENDMENT.—The table of sections at the beginning of such chapter is amended by adding at the end of the 

items relating to subchapter I the following new item: 

‘‘8119. Annual report on outpatient clinics.’’. 

SEC. 709. NAME OF DEPARTMENT OF VETERANS AFFAIRS SPINAL CORD 

INJURY CENTER, TAMPA, FLORIDA. 

The spinal cord injury center located at the James A. Haley 

Department of Veterans Affairs Medical Center in Tampa, Florida, 

shall after the date of the enactment of this Act be known and 

designated as the ‘‘Michael Bilirakis Department of Veterans Affairs 

Spinal Cord Injury Center’’. Any reference to such center in any 

law, regulation, map, document, record, or other paper of the United 

States shall be considered to be a reference to the ‘‘Michael Bilirakis 

Department of Veterans Affairs Spinal Cord Injury Center’’. 

TITLE VIII—EXTENSION OF CERTAIN 

AUTHORITIES 

SEC. 801. REPEAL OF SUNSET ON INCLUSION OF NONINSTITUTIONAL 

EXTENDED CARE SERVICES IN DEFINITION OF MEDICAL 

SERVICES. 

Section 1701 is amended— 

(1) by striking paragraph (10); and 

38 USC 1701. 

38 USC 8119 

note. 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4141 

(2) in paragraph (6)— 

(A) by redesignating subparagraphs (E) and (F) as 

subparagraphs (F) and (G), respectively; and 

(B) by inserting after subparagraph (D) the following 

new subparagraph (E): 

‘‘(E) Noninstitutional extended care services, including 

alternatives to institutional extended care that the Secretary may furnish directly, by contract, or through provision of case management by another provider or payer.’’. 

SEC. 802. EXTENSION OF RECOVERY AUDIT AUTHORITY. 

Section 1703(d)(4) is amended by striking ‘‘September 30, 2008’’ 

and inserting ‘‘September 30, 2013’’. 

SEC. 803. PERMANENT AUTHORITY FOR PROVISION OF HOSPITAL 

CARE, MEDICAL SERVICES, AND NURSING HOME CARE TO 

VETERANS WHO PARTICIPATED IN CERTAIN CHEMICAL 

AND BIOLOGICAL TESTING CONDUCTED BY THE DEPARTMENT OF DEFENSE. 

(a) PERMANENT AUTHORITY.—Subsection (e)(3) of section 1710 

is amended— 

(1) in subparagraph (B), by inserting ‘‘and’’ after the semicolon; 

(2) in subparagraph (C), by striking ‘‘; and’’ and inserting 

a period; and 

(3) by striking subparagraph (D). 

(b) CONFORMING AMENDMENT.—Subsection (e)(1)(E) of such section is amended by striking ‘‘paragraphs (2) and (3)’’ and inserting 

‘‘paragraph (2)’’. 

SEC. 804. EXTENSION OF EXPIRING COLLECTIONS AUTHORITIES. 

(a) HEALTH CARE COPAYMENTS.—Section 1710(f)(2)(B) is 

amended by striking ‘‘September 30, 2008’’ and inserting ‘‘September 30, 2010’’. 

(b) MEDICAL CARE COST RECOVERY.—Section 1729(a)(2)(E) is 

amended by striking ‘‘October 1, 2008’’ and inserting ‘‘October 1, 

2010’’. 

SEC. 805. EXTENSION OF NURSING HOME CARE. 

Section 1710A(d) is amended by striking ‘‘December 31, 2008’’ 

and inserting ‘‘December 31, 2013’’. 

SEC. 806. PERMANENT AUTHORITY TO ESTABLISH RESEARCH CORPORATIONS. 

(a) REPEAL.—Chapter 73 is amended by striking section 7368. 

(b) CLERICAL AMENDMENT.—The table of sections at the beginning of such chapter is amended by striking the item relating 

to section 7368. 

SEC. 807. EXTENSION OF REQUIREMENT TO SUBMIT ANNUAL REPORT 

ON THE COMMITTEE ON CARE OF SEVERELY CHRONICALLY MENTALLY ILL VETERANS. 

Section 7321(d)(2) is amended by striking ‘‘through 2008’’ and 

inserting ‘‘through 2012’’. 

SEC. 808. PERMANENT REQUIREMENT FOR BIANNUAL REPORT ON 

WOMEN’S ADVISORY COMMITTEE. 

Section 542(c)(1) is amended by striking ‘‘through 2008’’. 

38 USC 1703. 


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122 STAT. 4142 PUBLIC LAW 110–387—OCT. 10, 2008 

SEC. 809. EXTENSION OF PILOT PROGRAM ON IMPROVEMENT OF CAREGIVER ASSISTANCE SERVICES. 

Section 214 of the Veterans Benefits, Health Care, and Information Technology Act of 2006 (Public Law 109–461; 38 U.S.C. 1710B 

note) is amended— 

(1) in subsection (b), by striking ‘‘two-year period’’ and 

inserting ‘‘three-year period’’; and 

(2) in subsection (d), by striking ‘‘fiscal years 2007 and 

2008’’ and inserting ‘‘fiscal years 2007 through 2009’’. 

TITLE IX—OTHER MATTERS 

SEC. 901. TECHNICAL AMENDMENTS. 

(a) TITLE 38.—Title 38, United States Code, is amended— 

(1) in section 1712A— 

(A) by striking subsection (g); 

(B) by redesignating subsections (d) through (i) as subsections (c) through (f), respectively; and 

(C) in subsection (f), as so redesignated, by striking 

‘‘(including a Resource Center designated under subsection 

(h)(3)(A) of this section)’’; 

(2) in section 2065(b)(3)(C), by striking ‘‘)’’; 

(3) in the table of sections at the beginning of chapter 

36, by striking the item relating to section 3684A and inserting 

the following new item: 

‘‘3684A. Procedures relating to computer matching program.’’; 

(4) in section 4110(c)(1), by striking ‘‘15’’ and inserting 

‘‘16’’; 

(5) in the table of sections at the beginning of chapter 

51, by striking the item relating to section 5121 and inserting 

the following new item: 

‘‘5121. Payment of certain accrued benefits upon death of a beneficiary.’’; 

(6) in section 7458(b)(2), by striking ‘‘pro rated’’ and 

inserting ‘‘pro-rated’’; 

(7) in section 8117(a)(1), by striking ‘‘such such’’ and 

inserting ‘‘such’’; and 

(8) in each of sections 1708(d), 7314(f), 7320(j)(2), 7325(i)(2), 

and 7328(i)(2), by striking ‘‘medical care account’’ and inserting 

‘‘medical services account’’. 

(b) VETERANS BENEFITS, HEALTH CARE, AND INFORMATION

TECHNOLOGY ACT OF 2006.—Section 807(e) of the Veterans Benefits, 

Health Care, and Information Technology Act of 2006 (Public Law 


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PUBLIC LAW 110–387—OCT. 10, 2008 122 STAT. 4143 

LEGISLATIVE HISTORY—S. 2162: 

SENATE REPORTS: No. 110–281 (Comm. on Veterans’ Affairs). 

CONGRESSIONAL RECORD, Vol. 154 (2008): 

June 3, considered and passed Senate. 

Sept. 24, considered and passed House, amended. 

Sept. 27, Senate concurred in House amendment. 

Æ 

109–461) is amended by striking ‘‘Medical Care’’ each place it 

appears and inserting ‘‘Medical Facilities’’. 

Approved October 10, 2008. 

120 Stat. 3445. 


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