109TH CONGRESS

1ST SESSION S. 1182

AN ACT

To amend title 38, United States Code, to improve health

care for veterans, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; REFERENCES TO TITLE 38,

4 UNITED STATES CODE; TABLE OF CONTENTS.

5 (a) SHORT TITLE.—This Act may be cited as the

6 ‘‘Veterans Health Care Act of 2005’’.
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1 (b) REFERENCES.—Except as otherwise expressly

2 provided, whenever in this Act an amendment or repeal

3 is expressed in terms of an amendment or repeal to a sec4 tion or other provision, the reference shall be considered

5 to be made to a section or other provision of title 38,

6 United States Code.

7 (c) TABLE OF CONTENTS.—The table of contents for

8 this Act is as follows:

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

Sec. 2. Care for newborn children of women veterans receiving maternity care.

Sec. 3. Enhancement of payer provisions for health care furnished to certain

children of Vietnam veterans.

Sec. 4. Improvements to homeless veterans service providers programs.

Sec. 5. Additional mental health providers.

Sec. 6. Pay comparability for chief nursing officer, office of nursing services.

Sec. 7. Cost comparison studies.

Sec. 8. Improvements and expansion of mental health services.

Sec. 9. Disclosure of medical records.

Sec. 10. Expansion of National Guard Outreach Program.

Sec. 11. Expansion of tele-health services.

Sec. 12. Mental health data sources report.

Sec. 13. Strategic plan for long-term care.

Sec. 14. Blind rehabilitation outpatient specialists.

Sec. 15. Compliance report.

Sec. 16. Health care and services for veterans affected by hurricane Katrina.

Sec. 17. Reimbursement for certain veterans’ outstanding emergency treatment

expenses.

Sec. 18. Conveyance of Federal land in exchange for fair market value consideration.

Sec. 19. Technical and clerical amendments.

9 SEC. 2. CARE FOR NEWBORN CHILDREN OF WOMEN VET10 ERANS RECEIVING MATERNITY CARE.

11 (a) IN GENERAL.—Subchapter VIII of chapter 17 is

12 amended by adding at the end the following:
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1 ‘‘§ 1786. Care for newborn children of women vet2 erans receiving maternity care

3 ‘‘The Secretary may furnish care to a newborn child

4 of a woman veteran, who is receiving maternity care fur5 nished by the Department, for not more than 14 days

6 after the birth of the child if the veteran delivered the child

7 in a Department facility or in another facility pursuant

8 to a Department contract for the delivery services.’’.

9 (b) CLERICAL AMENDMENT.—The table of sections

10 at the beginning of chapter 17 is amended by inserting

11 after the item relating to section 1785 the following:

‘‘1786. Care for newborn children of women veterans receiving maternity care.’’.

12 SEC. 3. ENHANCEMENT OF PAYER PROVISIONS FOR

13 HEALTH CARE FURNISHED TO CERTAIN

14 CHILDREN OF VIETNAM VETERANS.

15 (a) HEALTH CARE FOR SPINA BIFIDA AND ASSOCI16 ATED DISABILITIES.—Section 1803 is amended—

17 (1) by redesignating subsection (c) as sub18 section (d); and

19 (2) by inserting after subsection (b) the fol20 lowing:

21 ‘‘(c)(1) If a payment made by the Secretary for

22 health care under this section is less than the amount

23 billed for such health care, the health care provider or

24 agent of the health care provider may, in accordance with

25 paragraphs (2) through (4), seek payment for the dif-
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1 ference between the amount billed and the amount paid

2 by the Secretary from a responsible third party to the ex3 tent that the provider or agent would be eligible to receive

4 payment for such health care from such third party.

5 ‘‘(2) The health care provider or agent may not im6 pose any additional charge on the beneficiary who received

7 the health care, or the family of such beneficiary, for any

8 service or item for which the Secretary has made payment

9 under this section.

10 ‘‘(3) The total amount of payment a health care pro11 vider or agent may receive for health care furnished under

12 this section may not exceed the amount billed to the Sec13 retary.

14 ‘‘(4) The Secretary, upon request, shall disclose to

15 such third party information received for the purposes of

16 carrying out this section.’’.

17 (b) HEALTH CARE FOR BIRTH DEFECTS AND ASSO18 CIATED DISABILITIES.—Section 1813 is amended—

19 (1) by redesignating subsection (c) as sub20 section (d); and

21 (2) by inserting after subsection (b) the fol22 lowing:

23 ‘‘(c)(1) If payment made by the Secretary for health

24 care under this section is less than the amount billed for

25 such health care, the health care provider or agent of the
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1 health care provider may, in accordance with paragraphs

2 (2) through (4), seek payment for the difference between

3 the amount billed and the amount paid by the Secretary

4 from a responsible third party to the extent that the pro5 vider or agent would be eligible to receive payment for

6 such health care from such third party.

7 ‘‘(2) The health care provider or agent may not im8 pose any additional charge on the beneficiary who received

9 health care, or the family of such beneficiary, for any serv10 ice or item for which the Secretary has made payment

11 under this section.

12 ‘‘(3) The total amount of payment a health care pro13 vider or agent may receive for health care furnished under

14 this section may not exceed the amount billed to the Sec15 retary.

16 ‘‘(4) The Secretary, upon request, shall disclose to

17 such third party information received for the purposes of

18 carrying out this section.’’.

19 SEC. 4. IMPROVEMENTS TO HOMELESS VETERANS SERVICE

20 PROVIDERS PROGRAMS.

21 (a) PERMANENT AUTHORITY.—Section 2011 (a) is

22 amended—

23 (1) in paragraph (1), by striking ‘‘(1)’’; and

24 (2) by striking paragraph (2).

25 (b) AUTHORIZATION OF APPROPRIATIONS.—
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1 (1) COMPREHENSIVE SERVICE PROGRAMS FOR

2 HOMELESS VETERANS.—Section 2013 is amended to

3 read as follows:

4 ‘‘§ 2013. Authorization of appropriations

5 ‘‘There are authorized to be appropriated

6 $130,000,000 for fiscal year 2006 and each subsequent

7 fiscal year to carry out this subchapter.’’.

8 (2) HOMELESS VETERAN SERVICE PROVIDER

9 TECHNICAL ASSISTANCE PROGRAM.—Section

10 2064(b) is amended to read as follows:

11 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There

12 are authorized to be appropriated $1,000,000 for each of

13 fiscal years 2006 through 2011 to carry out the programs

14 under this section.’’.

15 SEC. 5. ADDITIONAL MENTAL HEALTH PROVIDERS.

16 (a) QUALIFICATIONS.—Section 7402(b) is

17 amended—

18 (1) by redesignating paragraph (10) as para19 graph (12); and

20 (2) by inserting after paragraph (9) the fol21 lowing:

22 ‘‘(10) MARRIAGE AND FAMILY THERAPIST.—To be

23 eligible to be appointed to a marriage and family therapist

24 position, a person shall—
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1 ‘‘(A) hold a master’s degree in marriage and

2 family therapy, or a comparable degree in mental

3 health, from a college or university approved by the

4 Secretary; and

5 ‘‘(B) be licensed or certified to independently

6 practice marriage and family therapy in a State, ex7 cept that the Secretary may waive the requirement

8 of licensure or certification for an individual mar9 riage and family therapist for a reasonable period of

10 time recommended by the Under Secretary for

11 Health.

12 ‘‘(11) LICENSED PROFESSIONAL MENTAL HEALTH

13 COUNSELORS.—To be eligible to be appointed to a licensed

14 professional mental health counselor position, a person

15 shall—

16 ‘‘(A) hold a master’s degree in mental health

17 counseling, or a related field, from a college or uni18 versity approved by the Secretary; and

19 ‘‘(B) be licensed or certified to independently

20 practice mental health counseling.’’.

21 (b) REPORT ON MARRIAGE AND FAMILY THERAPY

22 WORKLOAD.—

23 (1) IN GENERAL.—Not later than 90 days after

24 the date of enactment of this Act, the Under Sec25 retary for Health, Department of Veterans Affairs,
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1 shall submit to the Committee on Veterans’ Affairs

2 of the Senate and the Committee on Veterans’ Af3 fairs of the House of Representatives a report on the

4 provisions of post-traumatic stress disorder treat5 ment by marriage and family therapists.

6 (2) CONTENTS.—The report submitted under

7 paragraph (1) shall include—

8 (A) the actual and projected workloads in

9 facilities of the Veterans Readjustment Coun10 seling Service and the Veterans Health Admin11 istration for the provision of marriage and fam12 ily counseling for veterans diagnosed with, or

13 otherwise in need of treatment for, post-trau14 matic stress disorder;

15 (B) the resources available and needed to

16 support the workload projections described in

17 subparagraph (A);

18 (C) an assessment by the Under Secretary

19 for Health of the effectiveness of treatment by

20 marriage and family therapists; and

21 (D) recommendations, if any, for improve22 ments in the provision of such counseling treat23 ment.
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1 SEC. 6. PAY COMPARABILITY FOR CHIEF NURSING OFFI2 CER, OFFICE OF NURSING SERVICES.

3 Section 7404 is amended—

4 (1) in subsection (d), by striking ‘‘subchapter

5 III and in’’ and inserting ‘‘subsection (e), sub6 chapter III, and’’; and

7 (2) by adding at the end the following:

8 ‘‘(e) The position of Chief Nursing Officer, Office of

9 Nursing Services, shall be exempt from the provisions of

10 section 7451 of this title and shall be paid at a rate not

11 to exceed the maximum rate established for the Senior Ex12 ecutive Service under section 5382 of title 5 United States

13 Code, as determined by the Secretary.’’.

14 SEC. 7. COST COMPARISON STUDIES.

15 (a) STUDIES AUTHORIZED.—

16 (1) IN GENERAL.—Notwithstanding section

17 8110(a)(5), the Secretary of Veterans Affairs may

18 conduct studies to compare the amount that would

19 be expended if private contractors provided specific

20 commercial or industrial products and services for

21 the Veterans Health Administration with the

22 amount that would be expended if the Department

23 of Veterans Affairs provided such products and serv24 ices for the Veterans Health Administration.

25 (2) LIMITATION.—In the course of conducting

26 the private-public cost comparison studies under
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1 paragraph (1), a private contractor may not receive

2 an advantage for a proposal that would reduce costs

3 for the Department of Veterans Affairs by—

4 (A) not making an employer-sponsored

5 health insurance plan available to the workers

6 who are to be employed in the performance of

7 that activity or function under the contract; or

8 (B) offering to such workers an employer9 sponsored health benefits plan that requires the

10 employer to contribute less towards the pre11 mium or subscription share than the amount

12 that is paid by the Department of Veterans Af13 fairs for health benefits for civilian employees

14 under chapter 89 of title 5, United States Code.

15 (3) AUTHORIZATION OF APPROPRIATIONS.—

16 (A) IN GENERAL.—There are authorized to

17 be appropriated $15,000,000 to carry out para18 graph (1), of which—

19 (i) not more than $7,500,000 shall be

20 available to evaluate activities that have

21 been performed by employees of the Fed22 eral Government; and

23 (ii) not more than $7,500,000 shall be

24 available to evaluate activities that have

25 been performed by private contractors.
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1 (B) SUNSET DATE.—This paragraph is re2 pealed on September 30, 2007.

3 (b) REPORT.—Not later than March 15, 2007, the

4 Secretary of Veterans Affairs shall submit to the Com5 mittee on Veterans’ Affairs of the Senate and the Com6 mittee on Veterans’ Affairs of the House of Representa7 tives a report that—

8 (1) identifies the amount expended by the De9 partment of Veterans Affairs during fiscal year 2006

10 to conduct cost comparison studies, including—

11 (A) studies conducted in accordance with

12 Office of Management and Budget Circular A–

13 76; and

14 (B) studies to identify the most efficient

15 internal processes for the Department of Vet16 erans Affairs;

17 (2) summarizes the benefits and burdens of the

18 studies described in paragraph (1);

19 (3) analyzes each approach for determining—

20 (A) the best method of allocating the re21 sources of the Department of Veterans Affairs;

22 and

23 (B) the appropriate use of nongovern24 mental employees; and
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1 (4) identifies the amount of savings (calculated

2 in terms of full-time employee reinvestment), if any,

3 to the Department of Veterans Affairs as a result

4 of—

5 (A) the private-public cost comparison

6 studies conducted under subsection (a); and

7 (B) the Department of Veterans Affairs in8 ternal processes for the same positions.

9 SEC. 8. IMPROVEMENTS AND EXPANSION OF MENTAL

10 HEALTH SERVICES.

11 (a) FINDINGS.—Congress makes the following find12 ings:

13 (1) Mental health treatment capacity at com14 munity-based outpatient clinics remains inadequate

15 and inconsistent, despite the requirement under sec16 tion 1706(c) of title 38, United States Code, that

17 every primary care health care facility of the De18 partment of Veterans Affairs develop and carry out

19 a plan to meet the mental health care needs of vet20 erans who require such services.

21 (2) In 2001, the minority staff of the Com22 mittee on Veterans’ Affairs of the Senate conducted

23 a survey of community-based outpatient clinics and

24 found that there was no established systemwide
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1 baseline of acceptable mental health service levels at

2 such clinics.

3 (3) In February 2005, the Government Ac4 countability Office reported that the Department of

5 Veterans Affairs had not fully met any of the 24

6 clinical care and education recommendations made

7 in 2004 by the Special Committee on Post-Trau8 matic Stress Disorder of the Under Secretary for

9 Health, Veterans Health Administration.

10 (b) CLINICAL SERVICES AND EDUCATION.—

11 (1) IN GENERAL.—The Secretary of Veterans

12 affairs shall—

13 (A) expand the number of clinical treat14 ment teams principally dedicated to the treat15 ment of post-traumatic stress disorder in med16 ical facilities of the Department of Veterans Af17 fairs;

18 (B) expand and improve the services avail19 able to diagnose and treat substance abuse;

20 (C) expand and improve tele-health initia21 tives to provide better access to mental health

22 services in areas of the country in which the

23 Secretary determines that a need for such serv24 ices exist due to the distance of such locations
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1 from an appropriate facility of the Department

2 of Veterans Affairs;

3 (D) improve education programs available

4 to primary care delivery professionals and dedi5 cate such programs to recognize, treat, and

6 clinically manage veterans with mental health

7 care needs;

8 (E) expand the delivery of mental health

9 services in community-based outpatient clinics

10 of the Department of Veterans Affairs in which

11 such services are not available as of the date of

12 enactment of this Act; and

13 (F) expand and improve the Mental Health

14 Intensive Case Management Teams for the

15 treatment and clinical case management of vet16 erans with serious or chronic mental illness.

17 (2) AUTHORIZATION OF APPROPRIATIONS.—

18 There are authorized to be appropriated

19 $95,000,000 in each of fiscal years 2006 and 2007

20 to improve and expand the treatment services and

21 options available to veterans in need of mental

22 health treatment from the Department of Veterans

23 Affairs, of which—

24 (A) $5,000,000 shall be allocated to carry

25 out paragraph (1)(A);
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1 (B) $50,000,000 shall be allocated to carry

2 out paragraph (1)(B);

3 (C) $10,000,000 shall be allocated to carry

4 out paragraph (1)(C);

5 (D) $1,000,000 shall be allocated to carry

6 out paragraph (1)(D);

7 (E) $20,000,000 shall be allocated to carry

8 out paragraph (1)(E); and

9 (F) $5,000,000 shall be allocated to carry

10 out paragraph (1)(F).

11 (c) REQUIRED CAPACITY FOR COMMUNITY-BASED

12 OUTPATIENT CLINICS.—

13 (1) ACCOUNTABILITY FOR THE PROVISION OF

14 MENTAL HEALTH SERVICES.—The Under Secretary

15 shall take appropriate steps and provide necessary

16 incentives (including appropriate performance incen17 tives) to ensure that each Regional Director of the

18 Veterans Health Administration is encouraged to—

19 (A) prioritize the provision of mental

20 health services to veterans in need of such serv21 ices;

22 (B) foster collaborative working environ23 ments among clinicians for the provision of

24 mental health services; and
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1 (C) conduct mental health consultations

2 during primary care appointments.

3 (2) MENTAL HEALTH AND SUBSTANCE ABUSE

4 SERVICES.—

5 (A) IN GENERAL.—The Secretary shall en6 sure that each community-based outpatient clin7 ic of the Department has the capacity to pro8 vide, or monitor the provision of, mental health

9 services to enrolled veterans in need of such

10 services.

11 (B) SETTINGS.—In carrying out subpara12 graph (A), the Secretary shall ensure that men13 tal health services are provided through—

14 (i) a community-based outpatient clin15 ic of the Department by an employee of

16 the Department;

17 (ii) referral to another facility of the

18 Department;

19 (iii) contract with an appropriate

20 mental health professional in the local

21 community; or

22 (iv) tele-mental health service.

23 (3) REPORTING REQUIREMENT.—Not later than

24 January 31, 2008, the Secretary of Veterans Affairs

25 shall submit a report to Congress that—
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1 (A) describes the status and availability of

2 mental health services at community-based out3 patient clinics;

4 (B) describes the substance of services

5 available at such clinics; and

6 (C) includes the ratios between mental

7 health staff and patients at such clinics.

8 (d) COOPERATION ON MENTAL HEALTH AWARENESS

9 AND PREVENTION.—

10 (1) AGREEMENT.—The Secretary of Defense

11 and the Secretary of Veterans Affairs shall enter

12 into a Memorandum of Understanding—

13 (A) to ensure that separating service mem14 bers receive standardized individual mental

15 health and sexual trauma assessments as part

16 of separation exams; and

17 (B) that includes the development of

18 shared guidelines on how to conduct the assess19 ments.

20 (2) ESTABLISHMENT OF JOINT VETERANS AF21 FAIRS–DEPARTMENT OF DEFENSE WORKGROUP ON

22 MENTAL HEALTH.—

23 (A) IN GENERAL.—Not later than 180

24 days after the date of enactment of this Act,

25 the Secretary of Defense and the Secretary of
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1 Veterans Affairs shall establish a joint

2 workgroup on mental health, which shall be

3 comprised of not less than 7 leaders in the field

4 of mental health appointed from their respective

5 departments.

6 (B) STUDY.—Not later than 1 year after

7 the establishment of the workgroup under sub8 paragraph (A), the workgroup shall analyze the

9 feasibility, content, and scope of initiatives re10 lated to—

11 (i) combating stigmas and prejudices

12 associated with service members who suffer

13 from mental health disorders or readjust14 ment issues, through the use of peer coun15 seling programs or other educational initia16 tives;

17 (ii) ways in which the Department of

18 Veterans Affairs can make their expertise

19 in treating mental health disorders more

20 readily available to Department of Defense

21 mental health care providers;

22 (iii) family and spousal education to

23 assist family members of veterans and

24 service members to recognize and deal with
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1 signs of potential readjustment issues or

2 other mental health disorders; and

3 (iv) the seamless transition of service

4 members who have been diagnosed with

5 mental health disorders from active duty to

6 veteran status (in consultation with the

7 Seamless Transition Task Force and other

8 entities assisting in this effort).

9 (C) REPORT.—Not later than June 30,

10 2007, the Secretary of Defense and the Sec11 retary of Veterans Affairs shall submit a report

12 to Congress containing the findings and rec13 ommendations of the workgroup established

14 under this paragraph.

15 (e) PRIMARY CARE CONSULTATIONS FOR MENTAL

16 HEALTH.—

17 (1) GUIDELINES.—The Under Secretary for

18 Health, Veterans Health Administration, shall estab19 lish systemwide guidelines for screening primary

20 care patients for mental health disorders and ill21 nesses.

22 (2) TRAINING.—Based upon the guidelines es23 tablished under paragraph (1), the Under Secretary

24 for Health, Veterans Health Administration, shall

25 conduct appropriate training for clinicians of the De-
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1 partment of Veterans Affairs to carry out mental

2 health consultations.

3 (f) CLINICAL TRAINING AND PROTOCOLS.—

4 (1) FINDINGS.—Congress finds that—

5 (A) the Iraq War Clinician Guide has tre6 mendous value; and

7 (B) the Secretary of Defense and the Na8 tional Center on Post Traumatic Stress Dis9 order should continue to work together to en10 sure that the mental health care needs of serv11 ice members and veterans are met.

12 (2) COLLABORATION.—The National Center on

13 Post Traumatic Stress Disorder shall collaborate

14 with the Secretary of Defense—

15 (A) to enhance the clinical skills of military

16 clinicians through training, treatment protocols,

17 web-based interventions, and the development of

18 evidence-based interventions; and

19 (B) to promote pre-deployment resilience

20 and post-deployment readjustment among serv21 ice members serving in Operation Iraqi Free22 dom and Operation Enduring Freedom.

23 (3) TRAINING.—The National Center on Post

24 Traumatic Stress Disorder shall work with the Sec25 retary of Defense to ensure that clinicians in the De-
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1 partment of Defense are provided with the training

2 and protocols developed pursuant to paragraph

3 (2)(A).

4 (4) AUTHORIZATION OF APPROPRIATIONS.—

5 There are authorized to be appropriated $2,000,000

6 for 2006 to carry out this subsection.

7 SEC. 9. DISCLOSURE OF MEDICAL RECORDS.

8 (a) LIMITED EXCEPTION TO CONFIDENTIALITY OF

9 MEDICAL RECORDS.—Section 5701 is amended by adding

10 at the end the following:

11 ‘‘(k)(1)(A) The Secretary may disclose the name and

12 address of any individual described in subparagraph (C)

13 to an entity described in subparagraph (B) in order to

14 facilitate the determination by such entity whether the in15 dividual is, or after death will be, a suitable organ, tissue,

16 or eye donor if—

17 ‘‘(i) the individual is near death (as determined

18 by the Secretary) or is deceased; and

19 ‘‘(ii) the disclosure is permitted under regula20 tions promulgated pursuant to section 264 of the

21 Health Insurance Portability and Accountability Act

22 of 1996 (42 U.S.C. 1320d–2 note).

23 ‘‘(B) An entity described in this subparagraph is—

24 ‘‘(i) an organ procurement organization; or
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1 ‘‘(ii) an entity that the Secretary has

2 determined—

3 ‘‘(I) is substantially similar in function,

4 professionalism, and reliability to an organ pro5 curement organization; and

6 ‘‘(II) should be treated for purposes of this

7 subsection in the same manner as an organ pro8 curement organization.

9 ‘‘(C) An individual described in this subparagraph

10 is—

11 ‘‘(i) a member or former member of the Armed

12 Forces; or

13 ‘‘(ii) a dependent of a member or former mem14 ber of the Armed Forces.

15 ‘‘(2) In this subsection, the term ‘organ procurement

16 organization’ has the meaning given the term ‘qualified

17 organ procurement organization’ in section 371(b) of the

18 Public Health Service Act (42 U.S.C. 273(b)).

19 (b) DISCLOSURES FROM CERTAIN MEDICAL

20 RECORDS.—Section 7332(b)(2) is amended by adding at

21 the end the following:

22 ‘‘(E) To an entity described in paragraph

23 (1)(B) of section 5701(k) of this title, but only to

24 the extent authorized by such section.’’.
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1 SEC. 10. EXPANSION OF NATIONAL GUARD OUTREACH PRO2 GRAM.

3 (a) REQUIREMENT.—The Secretary of Veterans Af4 fairs shall expand the total number of personal employed

5 by the Department of Veterans Affairs as part of the Re6 adjustment Counseling Service’s Global War on Terrorism

7 Outreach Program (referred to in this section as the ‘‘Pro8 gram’’).

9 (b) COORDINATION.—In carrying out subsection (a),

10 the Secretary shall coordinate participation in the Pro11 gram by appropriate employees of the Veterans Benefits

12 Administration and the Veterans Health Administration.

13 (c) INFORMATION AND ASSESSMENTS.—The Sec14 retary shall ensure that—

15 (1) all appropriate health, education, and bene16 fits information is available to returning members of

17 the National Guard; and

18 (2) proper assessments of the needs in each of

19 these areas is made by the Department of Veterans

20 Affairs.

21 (d) COLLABORATION.—The Secretary of Veterans

22 Affairs shall collaborate with appropriate State National

23 Guard officials and provide such officials with any assets

24 or services of the Department of Veterans Affairs that the

25 Secretary determines to be necessary to carry out the

26 Global War on Terrorism Outreach Program.
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1 SEC. 11. EXPANSION OF TELE-HEALTH SERVICES.

2 (a) IN GENERAL.—The Secretary shall increase the

3 number of Veterans Readjustment Counseling Service fa4 cilities capable of providing health services and counseling

5 through tele-health linkages with facilities of the Veterans

6 Health Administration.

7 (b) PLAN.—The Secretary shall submit to the Com8 mittee on Veterans’ Affairs of the Senate and the Com9 mittee on Veterans’ Affairs of the House of Representa10 tives a plan to implement the requirement under sub11 section (a), which shall describe the facilities that will have

12 such capabilities at the end of each of fiscal years 2005,

13 2006, and 2007.

14 SEC. 12. MENTAL HEALTH DATA SOURCES REPORT.

15 (a) IN GENERAL.—Not less than 180 days after the

16 date of enactment of this Act, the Secretary of Veterans

17 Affairs shall submit a report to the Committee on Vet18 erans’ Affairs of the Senate and the Committee on Vet19 erans’ Affairs of the House of Representatives describing

20 the mental health data maintained by the Department of

21 Veterans Affairs.

22 (b) CONTENTS.—The report submitted under sub23 section (a) shall include—

24 (1) a comprehensive list of the sources of all

25 such data, including the geographic locations of fa-
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1 cilities of the Department of Veterans Affairs main2 taining such data;

3 (2) an assessment of the limitations or advan4 tages to maintaining the current data configuration

5 and locations; and

6 (3) any recommendations, if any, for improving

7 the collection, use, and location of mental health

8 data maintained by the Department of Veterans Af9 fairs.

10 SEC. 13. STRATEGIC PLAN FOR LONG-TERM CARE.

11 (a) PUBLICATION.—Not later than 180 days after the

12 date of enactment of this Act, the Secretary of Veterans

13 Affairs shall publish a strategic plan for long-term care.

14 (b) CONTENTS.—The plan published under sub15 section (a) shall—

16 (1) contain policies and strategies for—

17 (A) the delivery of care in domiciliaries,

18 residential treatment facilities, and nursing

19 homes, and for seriously mentally ill veterans;

20 (B) maximizing the use of State veterans

21 homes;

22 (C) locating domiciliary units as close to

23 patient populations as feasible; and

24 (D) identifying freestanding nursing homes

25 as an acceptable care model;
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1 (2) include data on—

2 (A) the care of catastrophically disabled

3 veterans; and

4 (B) the geographic distribution of cata5 strophically disabled veterans;

6 (3) address the spectrum of noninstitutional

7 long-term care options, including—

8 (A) respite care;

9 (B) home-based primary care;

10 (C) geriatric evaluation;

11 (D) adult day health care;

12 (E) skilled home health care; and

13 (F) community residential care; and

14 (4) provide—

15 (A) cost and quality comparison analyses

16 of all the different levels of care;

17 (B) detailed information about geographic

18 distribution of services and gaps in care; and

19 (C) specific plans for working with Medi20 care, Medicaid, and private insurance compa21 nies to expand care.

22 SEC. 14. BLIND REHABILITATION OUTPATIENT SPECIAL23 ISTS.

24 (a) FINDINGS.—Congress makes the following find25 ings:
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1 (1) There are approximately 135,000 blind vet2 erans throughout the United States, including ap3 proximately 35,000 who are enrolled with the De4 partment of Veterans Affairs. An aging veteran pop5 ulation and injuries incurred in Operation Iraqi

6 Freedom and Operation Enduring Freedom are in7 creasing the number of blind veterans.

8 (2) Since 1996, when the Department of Vet9 erans Affairs hired its first 14 blind rehabilitation

10 outpatient specialists (referred to in this section as

11 ‘‘Specialists’’, Specialists have been a critical part of

12 the continuum of care for blind and visually im13 paired veterans.

14 (3) The Department of Veterans Affairs oper15 ates 10 residential blind rehabilitation centers that

16 are considered among the best in the world. These

17 centers have had long waiting lists, with as many as

18 1,500 blind veterans waiting for openings in 2004.

19 (4) Specialists provide—

20 (A) critically needed services to veterans

21 who are unable to attend residential centers or

22 are waiting to enter such a program;

23 (B) a range of services, including training

24 with living skills, mobility, and adaptation of

25 manual skills; and
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1 (C) pre-admission screening and follow-up

2 care for blind rehabilitation centers.

3 (5) There are not enough Specialist positions to

4 meet the increased numbers and needs of blind vet5 erans.

6 (b) ESTABLISHMENT OF SPECIALIST POSITIONS.—

7 Not later than 30 months after the date of enactment of

8 this Act, the Secretary of Veterans Affairs shall establish

9 an additional Specialist position at not fewer than 35 addi10 tional facilities of the Department of Veterans Affairs.

11 (c) SELECTION OF FACILITIES.—In identifying the

12 most appropriate facilities to receive a Specialist position

13 under this section, the Secretary shall—

14 (1) give priority to facilities with large numbers

15 of enrolled legally blind veterans;

16 (2) ensure that each facility does not have such

17 a position; and

18 (3) ensure that each facility is in need of the

19 services of such Specialists.

20 (d) COORDINATION.—The Secretary shall coordinate

21 the provision of blind rehabilitation services for veterans

22 with services for the care of the visually impaired offered

23 by State and local agencies, especially if such State and

24 local agencies can provide similar services to veterans in

25 settings located closer to the residences of such veterans.
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1 (e) AUTHORIZATION OF APPROPRIATIONS.—There

2 are authorized to be appropriated to carry out this section

3 $3,500,000 for each of the fiscal years 2006 through

4 2011.

5 SEC. 15. COMPLIANCE REPORT.

6 Section 1706(b)(5)(A) is amended by striking

7 ‘‘2004’’ and inserting ‘‘2006’’.

8 SEC. 16. HEALTH CARE AND SERVICES FOR VETERANS AF9 FECTED BY HURRICANE KATRINA.

10 (a) REQUIREMENT FOR HOSPITAL CARE AND MED11 ICAL SERVICES FOR PRIORITY 8 VETERANS AFFECTED BY

12 HURRICANE KATRINA.—

13 (1) IN GENERAL.—Notwithstanding any other

14 provision of law and any notwithstanding any pre15 vious decisions made by the Secretary of Veterans

16 Affairs pursuant to chapter 17 of title 38 United

17 States Code, the Secretary shall provide necessary

18 medical and health care services to any veteran af19 fected by Hurricane Katrina as if such veteran was

20 enrolled for care under section 1705 of title 38,

21 United States Code.

22 (2) STATUS OF VETERANS.—For purposes of

23 managing the health care system, as required under

24 section 1705 of title 38, United States Code, a vet25 eran who seeks care under paragraph (1) shall not
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1 be considered to be an enrollee of the health care

2 system under such section unless the Secretary sub3 sequently designates such a veteran as such an en4 rollee.

5 (b) PROHIBITION ON COLLECTION OF COPAYMENTS

6 FOR VETERANS AFFECTED BY HURRICANE KATRINA.—

7 In furnishing hospital care and medical services to any

8 veteran affected by Hurricane Katrina, the Secretary shall

9 not collect from, or with respect to, such veteran any pay10 ment for such care and services otherwise required under

11 any provision of law, including any copayment for medica12 tions otherwise required under section 1722A of title 38,

13 United States Code.

14 (c) DEFINITION.—In this section, the term ‘‘veteran

15 affected by Hurricane Katrina’’ means any veteran who,

16 as of August 29, 2005, resided in the catchment region

17 of the Department of Veterans Affairs medical center in—

18 (1) New Orleans, Louisiana;

19 (2) Biloxi, Mississippi; or

20 (3) Gulfport, Mississippi.

21 (d) SUNSET PROVISION.—The authority under this

22 section shall expire on January 31, 2006.
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1 SEC. 17. REIMBURSEMENT FOR CERTAIN VETERANS’ OUT2 STANDING EMERGENCY TREATMENT EX3 PENSES.

4 (a) IN GENERAL.—Subchapter III of chapter 17 is

5 amended by inserting after section 1725 the following:

6 ‘‘§ 1725A. Reimbursement for emergency treatment

7 expenses for which certain veterans re8 main personally liable

9 ‘‘(a)(1) Subject to subsection (c), the Secretary may

10 reimburse a veteran described in subsection (b) for ex11 penses resulting from emergency treatment furnished to

12 the veteran in a non-Department facility for which the vet13 eran remains personally liable.

14 ‘‘(2) In any case in which reimbursement is author15 ized under subsection (a)(1), the Secretary, in the Sec16 retary’s discretion, may, in lieu of reimbursing the vet17 eran, make payment—

18 ‘‘(A) to a hospital or other health care provider

19 that furnished the treatment; or

20 ‘‘(B) to the person or organization that paid for

21 such treatment on behalf of the veteran.

22 ‘‘(b) A veteran referred to in subsection (a) is an indi23 vidual who—

24 ‘‘(1) is enrolled in the health care system estab25 lished under section 1705(a) of this title;
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1 ‘‘(2) received care under this chapter during the

2 24-month period preceding the furnishing of such

3 emergency treatment;

4 ‘‘(3) is entitled to care or services under a

5 health-plan contract that partially reimburses the

6 cost of the veteran’s emergency treatment;

7 ‘‘(4) is financially liable to the provider of emer8 gency care treatment for costs not covered by the

9 veteran’s health-plan contract, including copayments

10 and deductibles; and

11 ‘‘(5) is not eligible for reimbursement for med12 ical care or services under section 1725 or 1728 of

13 this title.

14 ‘‘(c)(1) Any amount paid by the Secretary under sub15 section (a) shall exclude the amount of any payment the

16 veteran would have been required to make to the United

17 States under this chapter if the veteran had received the

18 emergency treatment from the Department.

19 ‘‘(2) The Secretary may not provide reimbursement

20 under this section with respect to any item or service—

21 ‘‘(A) provided or for which payment has been

22 made, or can reasonably be expected to be made,

23 under the veteran’s health-plan contract; or

24 ‘‘(B) for which payment has been made or can

25 reasonably be expected to be made by a third party.
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1 ‘‘(3)(A) Payment by the Secretary under this section

2 on behalf of a veteran to a provider of emergency treat3 ment shall, unless rejected and refunded by the provider

4 within 30 days of receipt, extinguish any liability on the

5 part of the veteran for that treatment.

6 ‘‘(B) The absence of a contract or agreement between

7 the Secretary and the provider, any provision of a contract

8 or agreement, or an assignment to the contrary shall not

9 operate to modify, limit, or negate the requirement under

10 subparagraph (A).

11 ‘‘(4) In accordance with regulations prescribed by the

12 Secretary, the Secretary shall—

13 ‘‘(A) establish criteria for determining the

14 amount of reimbursement (which may include a

15 maximum amount) payable under this section; and

16 ‘‘(B) delineate the circumstances under which

17 such payment may be made, including requirements

18 for requesting reimbursement.

19 ‘‘(d)(1) In accordance with regulations prescribed by

20 the Secretary, the United States shall have the inde21 pendent right to recover any amount paid under this sec22 tion if, and to the extent that, a third party subsequently

23 makes a payment for the same emergency treatment.

24 ‘‘(2) Any amount paid by the United States to the

25 veteran, the veteran’s personal representative, successor,
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1 dependents, or survivors, or to any other person or organi2 zation paying for such treatment shall constitute a lien

3 in favor of the United States against any recovery the

4 payee subsequently receives from a third party for the

5 same treatment.

6 ‘‘(3) Any amount paid by the United States to the

7 provider that furnished the veteran’s emergency treatment

8 shall constitute a lien against any subsequent amount the

9 provider receives from a third party for the same emer10 gency treatment for which the United States made pay11 ment.

12 ‘‘(4) The veteran or the veteran’s personal represent13 ative, successor, dependents, or survivors shall—

14 ‘‘(A) ensure that the Secretary is promptly noti15 fied of any payment received from any third party

16 for emergency treatment furnished to the veteran;

17 ‘‘(B) immediately forward all documents relat18 ing to a payment described in subparagraph (A);

19 ‘‘(C) cooperate with the Secretary in an inves20 tigation of a payment described in subparagraph

21 (A); and

22 ‘‘(D) assist the Secretary in enforcing the

23 United States right to recover any payment made

24 under subsection (c)(3).
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1 ‘‘(e) The Secretary may waive recovery of a payment

2 made to a veteran under this section that is otherwise re3 quired under subsection (d)(1) if the Secretary determines

4 that such waiver would be in the best interest of the

5 United States, as defined by regulations prescribed by the

6 Secretary.

7 ‘‘(f) For purposes of this section—

8 ‘‘(1) the term ‘health-plan contract’ includes—

9 ‘‘(A) an insurance policy or contract, med10 ical or hospital service agreement, membership

11 or subscription contract, or similar arrange12 ment, under which health services for individ13 uals are provided or the expenses of such serv14 ices are paid;

15 ‘‘(B) an insurance program described in

16 section 1811 of the Social Security Act (42

17 U.S.C. 1395c) or established by section 1831 of

18 that Act (42 U.S.C. 1395j);

19 ‘‘(C) a State plan for medical assistance

20 approved under title XIX of such Act (42

21 U.S.C. 1396 et seq.); and

22 ‘‘(D) a workers’ compensation law or plan

23 described in section 1729(A)(2)(B) of this title;

24 ‘‘(2) the term ‘third party’ means—

25 ‘‘(A) a Federal entity;
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1 ‘‘(B) a State or political subdivision of a

2 State;

3 ‘‘(C) an employer or an employer’s insur4 ance carrier; and

5 ‘‘(D) a person or entity obligated to pro6 vide, or pay the expenses of, such emergency

7 treatment; and

8 ‘‘(3) the term ‘emergency treatment’ has the

9 meaning given such term in section 1725 of this

10 title.’’.

11 (b) CLERICAL AMENDMENT.—The table of sections

12 at the beginning of chapter 17 is amended by inserting

13 after the item relating to section 1725 the following:

‘‘1725A. Reimbursement for emergency treatment expenses for which certain

veterans remain personally liable.’’.

14 SEC. 18. CONVEYANCE OF FEDERAL LAND IN EXCHANGE

15 FOR FAIR MARKET VALUE CONSIDERATION.

16 (a) DEFINITIONS.—In this section:

17 (1) CITY.—The term ‘‘City’’ means the city of

18 Fort Thomas, Kentucky.

19 (2) FAIR MARKET VALUE CONSIDERATION.—

20 The term ‘‘fair market value consideration’’ means

21 the monetary value of the Federal land as of the

22 date of conveyance under section 2, as determined

23 by the Secretary.
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1 (3) FEDERAL LAND.—The term ‘‘Federal land’’

2 means an approximately 11.75 acre parcel of feder3 ally-owned property, including the 15 structures lo4 cated on such property, which is managed by the

5 Department of Veterans Affairs and located in the

6 northeastern portion of Tower Park in the City.

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

8 the Secretary of Veterans Affairs.

9 (b) IN GENERAL.—Subject to valid existing rights,

10 easements, and rights-of-way, the Secretary may convey

11 all right, title, and interest of the United States in and

12 to the Federal land to the City in exchange for fair market

13 value consideration.

14 (c) RELEASE FROM LIABILITY.—Effective on the

15 date of conveyance to the City of the parcel of Federal

16 land under subsection (b), the United States shall not be

17 liable for damages arising out of any act, omission, or oc18 currence relating to the Federal land and facilities con19 veyed, but shall continue to be liable for damages caused

20 by acts of negligence committed by the United States or

21 by any employee or agent of the United States before the

22 date of conveyance, consistent with chapter 171 of title

23 28, United States Code.

24 (d) ADMINISTRATIVE COSTS.—All administrative

25 costs relating to the conveyance of the Federal land under
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1 subsection (b) shall be paid by the City to the United

2 States.

3 SEC. 19. TECHNICAL AND CLERICAL AMENDMENTS.

4 (a) TITLE 38, UNITED STATES CODE.—Title 38,

5 United States Code, is amended as follows:

6 (1) TYPOGRAPHICAL ERROR.—Section

7 1117(h)(1) is amended by striking

8 ‘‘nothwithstanding’’ and inserting ‘‘notwith9 standing’’.

10 (2) INSERTION OF MISSING WORD.—Section

11 1513(a) is amended by inserting ‘‘section’’ after

12 ‘‘prescribed by’’.

13 (3) CITATION CORRECTION.—Section

14 1718(c)(2) is amended by inserting ‘‘of 1938’’ after

15 ‘‘Act’’.

16 (4) CITATION CORRECTION.—Section

17 1785(b)(1) is amended by striking ‘‘Robert B.’’ and

18 inserting ‘‘Robert T.’’.

19 (5) PUNCTUATION CORRECTION.—Section

20 2002(1) is amended by inserting a closing paren21 thesis before the period at the end.

22 (6) PUNCTUATION CORRECTION.—Section

23 2011(a)(1)(C) is amended by inserting a period at

24 the end.
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1 (7) CROSS REFERENCE CORRECTION.—Section

2 2041(a)(3)(A)(i) is amended by striking ‘‘under this

3 chapter’’ and inserting ‘‘established under section

4 3722 of this title’’.

5 (8) DELETION OF EXTRA WORDS.—Section

6 3012(a)(1)(C)(ii) is amended by striking ‘‘on or’’.

7 (9) CROSS REFERENCE CORRECTION.—Section

8 3017(b)(1)(D) is amended by striking ‘‘3011(c)’’

9 and inserting ‘‘3011(e)’’.

10 (10) STYLISTIC AMENDMENTS.—Section 3018A

11 is amended—

12 (A) in subsections (b) and (c), by striking

13 ‘‘of this section’’ each place it appears;

14 (B) in subsections (a)(4), (a)(5), (d)(1),

15 and (d)(3) by striking ‘‘of this subsection’’ each

16 place it appears; and

17 (C) in subsection (d)(3), by striking ‘‘of

18 this chapter’’ and inserting ‘‘of this title’’.

19 (11) CROSS REFERENCE CORRECTION.—Section

20 3117(b)(1) is amended—

21 (A) by striking ‘‘section 8’’ and inserting

22 ‘‘section 4(b)(1)’’; and

23 (B) by striking ‘‘633(b)’’ and inserting

24 ‘‘633(b)(1)’’.
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1 (12) INSERTION OF MISSING WORD.—Section

2 3511(a)(1) is amended by inserting ‘‘sections’’ after

3 ‘‘under both’’.

4 (13) SUBSECTION HEADINGS.—

5 (A) Sections 3461, 3462, 3481, 3565,

6 3680, and 3690 are each amended by revising

7 each subsection heading for a subsection therein

8 (appearing as a centered heading immediately

9 before the text of the subsection) so that such

10 heading appears immediately after the sub11 section designation and is set forth in capitals12 and-small-capitals typeface, followed by a period

13 and a one-em dash.

14 (B) Section 3461(c) is amended by insert15 ing after the subsection designation the fol16 lowing: ‘‘DURATION OF ENTITLEMENT.—’’.

17 (C) Section 3462 is amended—

18 (i) in subsection (d), by inserting after

19 the subsection designation the following:

20 ‘‘PRISONERS OF WAR.—’’; and

21 (ii) in subsection (e), by inserting

22 after the subsection designation the fol23 lowing: ‘‘TERMINATION OF ASSISTANCE.—

24 ’’.
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1 (14) CROSS REFERENCE CORRECTION.—Section

2 3732(c)(10)(D) is amended by striking ‘‘clause (B)

3 of paragraphs (5), (6), (7), and (8) of this sub4 section’’ and inserting ‘‘paragraphs (5)(B), (6),

5 (7)(B), and (8)(B)’’.

6 (15) DATE OF ENACTMENT REFERENCE.—Sec7 tion 3733(a)(7) is amended by striking ‘‘the date of

8 the enactment of the Veterans’ Benefits Act of

9 2003’’ and inserting ‘‘December 16, 2003’’.

10 (16) REPEAL OF OBSOLETE PROVISIONS.—Sec11 tion 4102A(c)(7) is amended—

12 (A) by striking ‘‘With respect to program

13 years beginning during or after fiscal year

14 2004, one percent of’’ and inserting ‘‘Of’’; and

15 (B) by striking ‘‘for the program year’’

16 and inserting ‘‘for any program year, one per17 cent’’.

18 (17) REPEAL OF OBSOLETE PROVISIONS.—Sec19 tion 4105(b) is amended—

20 (A) by striking ‘‘shall provide,’’ and all

21 that follows through ‘‘Affairs with’’ and insert22 ing ‘‘shall, on the 15th day of each month, pro23 vide the Secretary and the Secretary of Vet24 erans Affairs with updated information regard25 ing’’; and
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1 (B) by striking ‘‘and shall’’ and all that

2 follows through ‘‘regarding the list’’.

3 (18) CITATION CORRECTION.—Section 4110B is

4 amended—

5 (A) by striking ‘‘this Act’’ and inserting

6 ‘‘the Workforce Investment Act of 1998’’; and

7 (B) by striking ‘‘the Workforce Investment

8 Act of 1998’’ and inserting ‘‘that Act (29

9 U.S.C. 2822(b))’’.

10 (19) CROSS-REFERENCE CORRECTION.—Section

11 4331(b)(2)(C) is amended by striking ‘‘section

12 2303(a)(2)(C)(ii)’’ and inserting ‘‘section

13 2302(a)(2)(C)(ii)’’

14 (20) CAPITALIZATION CORRECTION.—Section

15 7253(d)(5) is amended by striking ‘‘court’’ and in16 serting ‘‘Court’’.

17 (21) CITATION CORRECTION.—Section

18 8111(b)(1) is amended by striking ‘‘into the stra19 tegic’’ and all that follows through ‘‘and Results

20 Act’’ and inserting ‘‘into the strategic plan of each

21 Department under section 306 of title 5 and the

22 performance plan of each Department under section

23 1115 of title 31’’.

24 (22) REPEAL OF OBSOLETE PROVISIONS.—Sec25 tion 8111 is amended further—
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1 (A) in subsection (d)—

2 (i) in paragraph (2), by striking ‘‘ef3 fective October 1, 2003,’’; and

4 (ii) in paragraph (3)(A), by striking

5 the last sentence; and

6 (B) in subsection (e)(2)—

7 (i) in the second sentence, by striking

8 ‘‘shall be implemented no later than Octo9 ber 1, 2003, and’’; and

10 (ii) in the third sentence, by striking

11 ‘‘, following implementation of the sched12 ule,’’.

13 (23) CITATION CORRECTION.—Section

14 8111A(a)(2)(B)(i) is amended by striking ‘‘Robert

15 B.’’ and inserting ‘‘Robert T.’’.

16 (b) PUBLIC LAW 107–296.—

17 (1) IN GENERAL.—Section 1704(d) of the

18 Homeland Security Act of 2002 (Public Law 107–

19 296; 116 Stat. 2315) is amended—

20 (A) by striking ‘‘101(25)(d)’’ and inserting

21 ‘‘101(25)(D)’’; and

22 (B) by striking ‘‘3011(a)(1)(A)(ii)(II)’’

23 and inserting ‘‘3011(a)(1)(A)(ii)(III)’’.
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1 (2) EFFECTIVE DATE.—The amendments made

2 by paragraph (1) shall be effective as of November

3 25, 2002.

Passed the Senate December 22 (legislative day, December 21), 2005.

Attest:

Secretary.
109TH CONGRESS

1ST SESSION S. 1182

AN ACT

To amend title 38, United States Code, to improve

health care for veterans, and for other purposes.