II 

Calendar No. 360 

111TH CONGRESS 

2D SESSION S. 1237 

[Report No. 111–175] 

To amend title 38, United States Code, to expand the grant program for 

homeless veterans with special needs to include male homeless veterans 

with minor dependents and to establish a grant program for reintegration 

of homeless women veterans and homeless veterans with children, and 

for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 11, 2009 

Mrs. MURRAY (for herself, Mr. JOHNSON, Mr. REED, Mr. MERKLEY, Mr. 

SPECTER, Mr. BAUCUS, and Mr. BYRD) introduced the following bill; 

which was read twice and referred to the Committee on Veterans’ Affairs 

APRIL 29, 2010 

Reported by Mr. AKAKA, with an amendment and an amendment to the title 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To amend title 38, United States Code, to expand the grant 

program for homeless veterans with special needs to include male homeless veterans with minor dependents and 

to establish a grant program for reintegration of homeless women veterans and homeless veterans with children, 

and for other purposes. 


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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. 

4 This Act may be cited as the ‘‘Homeless Women Vet5 erans and Homeless Veterans with Children Act of 2009’’. 

6 SEC. 2. EXPANSION OF GRANT PROGRAM FOR HOMELESS 

7 VETERANS WITH SPECIAL NEEDS. 

8 (a) INCLUSION UNDER GRANT PROGRAM FOR HOME9 LESS VETERANS WITH SPECIAL NEEDS OF ENTITIES EL10 IGIBLE FOR COMPREHENSIVE SERVICE PROGRAM GRANTS

11 AND PER DIEM PAYMENTS FOR SERVICES TO HOMELESS

12 VETERANS.—Subsection (a) of section 2061 of title 38, 

13 United States Code, is amended— 

14 (1) by striking ‘‘to grant and per diem pro15 viders’’ and inserting ‘‘to entities eligible for grants 

16 and per diem payments under sections 2011 and 

17 2012 of this title’’; and 

18 (2) by striking ‘‘by those facilities and pro19 viders’’ and inserting ‘‘by those facilities and enti20 ties’’. 

21 (b) INCLUSION OF MALE HOMELESS VETERANS

22 WITH MINOR DEPENDENTS.—Subsection (b) of such sec23 tion is amended— 

24 (1) in paragraph (1), by striking ‘‘, including 

25 women who have care of minor dependents’’; 


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1 (2) in paragraph (3), by striking ‘‘or’’; 

2 (3) in paragraph (4), by striking the period at 

3 the end and inserting ‘‘; or’’; and 

4 (4) by adding at the end the following new 

5 paragraph: 

6 ‘‘(5) veterans who have care of minor depend7 ents.’’. 

8 (c) AUTHORIZATION OF PROVISION OF SERVICES TO

9 DEPENDENTS.—Such section is further amended— 

10 (1) by redesignating subsection (c) as sub11 section (d); and 

12 (2) by inserting after subsection (b) the fol13 lowing new subsection (c): 

14 ‘‘(c) PROVISION OF SERVICES TO DEPENDENTS.—A 

15 recipient of a grant under subsection (a) may use such 

16 grant to provide services directly to a dependent of a 

17 homeless veteran with special needs described in sub18 section (b) who is under the care of such homeless veteran 

19 while such homeless veteran receives services from the 

20 grant recipient under this section.’’. 


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1 SEC. 3. GRANT PROGRAM FOR REINTEGRATION OF HOME2 LESS WOMEN VETERANS AND HOMELESS 

3 VETERANS WITH CHILDREN. 

4 (a) IN GENERAL.—Chapter 20 of title 38, United 

5 States Code, is amended by inserting after section 2021 

6 the following new section: 

7 ‘‘§ 2021A. Grant program for reintegration of home8 less women veterans and homeless vet9 erans with children 

10 ‘‘(a) GRANTS.—Subject to the availability of appro11 priations provided for such purpose, the Secretary of 

12 Labor shall award grants to eligible programs and facili13 ties to provide the services described in subsection (c) to 

14 expedite the reintegration into the labor force of the fol15 lowing: 

16 ‘‘(1) Homeless women veterans. 

17 ‘‘(2) Homeless veterans with children. 

18 ‘‘(b) ELIGIBLE PROGRAMS AND FACILITIES.—An eli19 gible program or facility for purposes of this section is 

20 a program or facility that provides dedicated services for 

21 homeless women veterans or homeless veterans with chil22 dren. 

23 ‘‘(c) SERVICES.—The services described in this sub24 section are the following: 

25 ‘‘(1) Job training. 

26 ‘‘(2) Counseling. 


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1 ‘‘(3) Job placement services, including job read2 iness, literacy, and skills training. 

3 ‘‘(4) Child care. 

4 ‘‘(d) MONITORING OF USE OF FUNDS.—The Sec5 retary of Labor shall monitor and evaluate the use of 

6 amounts granted under this section. In monitoring and 

7 evaluating the use of such amounts, the Secretary shall 

8 collect from grantees such information as the Secretary 

9 considers appropriate, including data on the results or out10 comes of the services provided to each homeless veteran 

11 under this section. 

12 ‘‘(e) ADMINISTRATION THROUGH ASSISTANT SEC13 RETARY FOR VETERANS’ EMPLOYMENT AND TRAINING.— 

14 The Secretary of Labor shall carry out this section 

15 through the Assistant Secretary for Veterans’ Employ16 ment and Training. 

17 ‘‘(f) BIENNIAL REPORT TO CONGRESS.—The Sec18 retary of Labor shall include as part of the report required 

19 by section 2021(d) of this title an evaluation of the grant 

20 program under this section. The information included in 

21 such report under this subsection shall include— 

22 ‘‘(1) an evaluation of services furnished to vet23 erans under this section; and 

24 ‘‘(2) an analysis of the information collected 

25 under subsection (d). 


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1 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—(1) 

2 There is authorized to be appropriated to carry out this 

3 section $10,000,000 for each of fiscal years 2010 through 

4 2014. 

5 ‘‘(2) The amount authorized to be appropriated by 

6 paragraph (1) is in addition to any amounts authorized 

7 to be appropriated by section 2021(e) of this title. 

8 ‘‘(3) Funds appropriated to carry out this section 

9 shall remain available until expended. Funds obligated in 

10 any fiscal year to carry out this section may be expended 

11 in that fiscal year and the succeeding fiscal year.’’. 

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

13 at the beginning of chapter 20 of such title is amended 

14 by inserting after the item relating to section 2021 the 

15 following new item: 

‘‘2021A. Grant program for reintegration of homeless women veterans and 

homeless veterans with children.’’. 

16 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

18 ‘‘Homeless Veterans and Other Veterans Health Care Au19 thorities Act of 2010’’. 

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

21 this Act is as follows: 

Sec. 1. Short title; table of contents. 

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

TITLE I—HOMELESS VETERANS MATTERS 

Sec. 101. Enhancement of comprehensive service programs. 


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Sec. 102. Grant program for workforce reintegration of homeless women veterans 

and homeless veterans with children. 

Sec. 103. Expansion of grant program for homeless veterans with special needs. 

Sec. 104. Program on prevention of veteran homelessness. 

Sec. 105. Homeless Veterans Management Information System. 

Sec. 106. Rental assistance for veterans through Department of Housing and 

Urban Development. 

Sec. 107. Special Assistant for Veterans Affairs in Office of Secretary of Housing 

and Urban Development. 

Sec. 108. Plan to end veteran homelessness. 

TITLE II—TOXIC SUBSTANCES EXPOSURE 

Sec. 201. Extension of eligibility for health care for veterans with disabilities who 

served in Persian Gulf War notwithstanding lack of evidence to 

conclude such disabilities are associated with such service. 

TITLE III—HEALTH CARE MATTERS 

Sec. 301. Increase in number of authorized Assistant Secretaries and Deputy Assistant Secretaries. 

Sec. 302. Establishment of Director of Physician Assistant Services in Veterans 

Health Administration. 

Sec. 303. Department of Veterans Affairs Medical Center Quality Report Card 

Initiative. 

Sec. 304. Report on pay-for-performance compensation under health care services 

contracts. 

Sec. 305. Expansion of State home care for parents of veterans who died while 

serving in the Armed Forces. 

Sec. 306. Automatic enrollment of eligible demobilizing members of the National 

Guard and Reserve in health care and dental care programs of 

the Department of Veterans Affairs. 

Sec. 307. Provision of chiropractic services to veterans enrolled in health care system of Department of Veterans Affairs. 

Sec. 308. Name of Department of Veterans Affairs outpatient clinic, Alexandria, 

Minnesota. 

TITLE IV—OTHER MATTERS 

Sec. 401. Funding. 

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

2 Except as otherwise expressly provided, whenever in 

3 this Act an amendment or repeal is expressed in terms of 

4 an amendment to, or repeal of, a section or other provision, 

5 the reference shall be considered to be made to a section or 

6 other provision of title 38, United States Code. 


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1 TITLE I—HOMELESS VETERANS 

2 MATTERS 

3 SEC. 101. ENHANCEMENT OF COMPREHENSIVE SERVICE 

4 PROGRAMS. 

5 (a) ENHANCEMENT OF GRANTS.—Section 2011 is 

6 amended— 

7 (1) in subsection (b)(1)(A), by striking ‘‘expan8 sion, remodeling, or alteration of existing facilities, or 

9 acquisition of facilities,’’ and inserting ‘‘new con10 struction of facilities, expansion, remodeling, or alter11 ation of existing facilities, or acquisition of facili12 ties’’; and 

13 (2) in subsection (c)— 

14 (A) in the first sentence, by striking ‘‘A 

15 grant’’ and inserting ‘‘(1) A grant’’; 

16 (B) in the second sentence of paragraph (1), 

17 as designated by subparagraph (A), by striking 

18 ‘‘The amount’’ and inserting the following: 

19 ‘‘(2) The amount’’; and 

20 (C) by adding at the end the following new 

21 paragraph: 

22 ‘‘(3)(A) The Secretary may not deny an application 

23 from an entity that seeks a grant under this section to carry 

24 out a project described in subsection (b)(1)(A) solely on the 

25 basis that the entity proposes to use funding from other priVerDate Mar 15 2010 23:15 Apr 29, 2010 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6203 E:\BILLS\S1237.RS S1237

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1 vate or public sources, if the entity demonstrates that a pri2 vate nonprofit organization will provide oversight and site 

3 control for the project. 

4 ‘‘(B) In this paragraph, the term ‘private nonprofit 

5 organization’ means the following: 

6 ‘‘(i) An incorporated private institution, organi7 zation, or foundation— 

8 ‘‘(I) that has received, or has temporary 

9 clearance to receive, tax-exempt status under 

10 paragraph (2), (3), or (19) of section 501(c) of 

11 the Internal Revenue Code of 1986; 

12 ‘‘(II) for which no part of the net earnings 

13 of the institution, organization, or foundation 

14 inures to the benefit of any member, founder, or 

15 contributor of the institution, organization, or 

16 foundation; and 

17 ‘‘(III) that the Secretary determines is fi18 nancially responsible. 

19 ‘‘(ii) A for-profit limited partnership or limited 

20 liability company, the sole general partner or man21 ager of which is an organization that is described by 

22 subclauses (I) through (III) of clause (i). 

23 ‘‘(iii) A corporation wholly owned and controlled 

24 by an organization that is described by subclauses (I) 

25 through (III) of clause (i).’’. 


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1 (b) GRANT AND PER DIEM PAYMENTS.— 

2 (1) STUDY AND DEVELOPMENT OF PAYMENT

3 METHOD.—Not later than one year after the date of 

4 the enactment of this Act, the Secretary of Veterans 

5 Affairs shall— 

6 (A) complete a study of all matters relating 

7 to the method used by the Secretary to make per 

8 diem payments under section 2012(a) of title 38, 

9 United States Code; and 

10 (B) develop an improved method for ade11 quately reimbursing recipients of grants under 

12 section 2011 of such title for services furnished to 

13 homeless veterans. 

14 (2) CONSIDERATION.—In developing the method 

15 required by paragraph (1)(B), the Secretary may con16 sider payments and grants received by recipients of 

17 grants described in such paragraph from other de18 partments and agencies of Federal and local govern19 ments and from private entities. 

20 (3) REPORT.—Not later than one year after the 

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

22 submit to Congress a report on— 

23 (A) the findings of the Secretary with re24 spect to the study required by subparagraph (A) 

25 of paragraph (1); 


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1 (B) the method developed under subpara2 graph (B) of such paragraph; and 

3 (C) any recommendations of the Secretary 

4 for revising the method described in subpara5 graph (A) of such paragraph and any legislative 

6 action the Secretary considers necessary to im7 plement such method. 

8 (c) AUTHORIZATION OF APPROPRIATIONS.—Section 

9 2013 is amended by striking ‘‘subchapter $150,000,000’’ 

10 and all that follows through the period and inserting the 

11 following: ‘‘subchapter— 

12 ‘‘(1) $150,000,000 for each of fiscal years 2007 

13 through 2009; 

14 ‘‘(2) $200,000,000 for fiscal year 2010; and 

15 ‘‘(3) such sums as may be necessary for each of 

16 fiscal years 2011 through 2014.’’. 

17 (d) MINIMUM FUNDING IN RURAL AREAS.—Section 

18 2011 is amended by adding at the end the following new 

19 subsection: 

20 ‘‘(i) MINIMUM FUNDING IN RURAL AREAS.—The Sec21 retary shall ensure that not less than five percent of the 

22 aggregate of the grant amounts awarded under this section 

23 in each fiscal year is awarded to eligible entities located 

24 in rural areas.’’. 


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1 SEC. 102. GRANT PROGRAM FOR WORKFORCE REINTEGRA2 TION OF HOMELESS WOMEN VETERANS AND 

3 HOMELESS VETERANS WITH CHILDREN. 

4 (a) IN GENERAL.—Subchapter III of chapter 20 is 

5 amended by inserting after section 2021 the following new 

6 section: 

7 ‘‘§ 2021A. Grant program for reintegration of homeless 

8 women veterans and homeless veterans 

9 with children 

10 ‘‘(a) GRANTS.—Subject to the availability of appro11 priations for such purpose, the Secretary of Labor shall 

12 award grants to eligible programs and facilities to provide 

13 the services described in subsection (c) to expedite the re14 integration into the labor force of the following: 

15 ‘‘(1) Homeless women veterans. 

16 ‘‘(2) Homeless veterans with children. 

17 ‘‘(b) ELIGIBLE PROGRAMS AND FACILITIES.—A pro18 gram or facility is an eligible program or facility for pur19 poses of this section if the program or facility provides dedi20 cated services for homeless women veterans or homeless vet21 erans with children. 

22 ‘‘(c) SERVICES.—The services described in this sub23 section are the following: 

24 ‘‘(1) Job training. 

25 ‘‘(2) Counseling. 


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1 ‘‘(3) Job placement services, including job readi2 ness, literacy, and skills training. 

3 ‘‘(4) Child care. 

4 ‘‘(d) MINIMUM.—The Secretary shall ensure that not 

5 less than five percent of the aggregate of the grant amounts 

6 awarded under this section in each fiscal year is awarded 

7 to eligible programs and facilities located in rural areas. 

8 ‘‘(e) MONITORING OF USE OF FUNDS.—The Secretary 

9 of Labor shall monitor and evaluate the use of amounts 

10 granted under this section. In monitoring and evaluating 

11 the use of such amounts, the Secretary shall collect from 

12 grantees such information as the Secretary considers appro13 priate, including data on the results or outcomes of the serv14 ices provided to each homeless veteran under this section. 

15 ‘‘(f) ADMINISTRATION.—The Secretary of Labor shall 

16 carry out this section through the Assistant Secretary of 

17 Labor for Veterans’ Employment and Training. 

18 ‘‘(g) BIENNIAL REPORT TO CONGRESS.—The Secretary 

19 of Labor shall include as part of the report required by sec20 tion 2021(d) of this title an evaluation of the grant program 

21 under this section. The information included in such report 

22 under this subsection shall include— 

23 ‘‘(1) an evaluation of services furnished to vet24 erans under this section; and 


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1 ‘‘(2) an analysis of the information collected 

2 under subsection (d). 

3 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—(1) 

4 There is authorized to be appropriated to carry out this 

5 section $10,000,000 for each of fiscal years 2010 through 

6 2014. 

7 ‘‘(2) The amount authorized to be appropriated by 

8 paragraph (1) is in addition to any amounts authorized 

9 to be appropriated by section 2021(e) of this title. 

10 ‘‘(3) Funds appropriated to carry out this section shall 

11 remain available until expended. Funds obligated in any 

12 fiscal year to carry out this section may be expended in 

13 that fiscal year and the succeeding fiscal year.’’. 

14 (b) CLERICAL AMENDMENT.—The table of sections at 

15 the beginning of chapter 20 is amended by inserting after 

16 the item relating to section 2021 the following new item: 

‘‘2021A. Grant program for reintegration of homeless women veterans and homeless veterans with children.’’. 

17 SEC. 103. EXPANSION OF GRANT PROGRAM FOR HOMELESS 

18 VETERANS WITH SPECIAL NEEDS. 

19 (a) INCLUSION OF ENTITIES ELIGIBLE FOR COM20 PREHENSIVE SERVICE PROGRAM GRANTS AND PER DIEM

21 PAYMENTS FOR SERVICES TO HOMELESS VETERANS.— 

22 Subsection (a) of section 2061 is amended— 

23 (1) by striking ‘‘to grant and per diem pro24 viders’’ and inserting ‘‘to entities eligible for grants 


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1 and per diem payments under sections 2011 and 

2 2012 of this title’’; and 

3 (2) by striking ‘‘by those facilities and pro4 viders’’ and inserting ‘‘by those facilities and enti5 ties’’. 

6 (b) INCLUSION OF MALE HOMELESS VETERANS WITH

7 MINOR DEPENDENTS.—Subsection (b) of such section is 

8 amended— 

9 (1) in paragraph (1), by striking ‘‘, including 

10 women who have care of minor dependents’’; 

11 (2) in paragraph (3), by striking ‘‘or’’; 

12 (3) in paragraph (4), by striking the period at 

13 the end and inserting ‘‘; or’’; and 

14 (4) by adding at the end the following new para15 graph: 

16 ‘‘(5) individuals who have care of minor depend17 ents.’’. 

18 (c) AUTHORIZATION OF PROVISION OF SERVICES TO

19 DEPENDENTS.—Such section is further amended— 

20 (1) by redesignating subsection (c) as subsection 

21 (d); and 

22 (2) by inserting after subsection (b) the following 

23 new subsection (c): 

24 ‘‘(c) PROVISION OF SERVICES TO DEPENDENTS.—A re25 cipient of a grant under subsection (a) may use amounts 


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1 under the grant to provide services directly to a dependent 

2 of a homeless veteran with special needs who is under the 

3 care of such homeless veteran while such homeless veteran 

4 receives services from the grant recipient under this sec5 tion.’’. 

6 SEC. 104. PROGRAM ON PREVENTION OF VETERAN HOME7 LESSNESS. 

8 (a) PROGRAM ON PREVENTION OF VETERAN HOME9 LESSNESS.— 

10 (1) IN GENERAL.—Subchapter VII of chapter 20 

11 is amended by adding at the end the following new 

12 section: 

13 ‘‘§ 2067. Prevention of veteran homelessness 

14 ‘‘(a) PREVENTION OF VETERAN HOMELESSNESS.—Not 

15 later than 180 days after the date of the enactment of this 

16 section, the Secretary shall establish a program to prevent 

17 veteran homelessness by— 

18 ‘‘(1) identifying in a timely fashion any veteran 

19 who is homeless or at imminent risk of becoming 

20 homeless; and 

21 ‘‘(2) providing, directly or in conjunction with 

22 an existing program, assistance to veterans identified 

23 under paragraph (1). 

24 ‘‘(b) TYPES OF ASSISTANCE.—The assistance provided 

25 under subsection (a)(2) may include the following: 


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1 ‘‘(1) The provision of short-term or medium-term 

2 rental assistance. 

3 ‘‘(2) Housing relocation and stabilization serv4 ices, including housing search, mediation, and out5 reach to property owners. 

6 ‘‘(3) Services to resolve personal credit issues 

7 that have led to negative credit reports. 

8 ‘‘(4) Assistance with paying security or utility 

9 deposits and utility payments. 

10 ‘‘(5) Assistance with covering costs associated 

11 with moving. 

12 ‘‘(6) A referral to a program of another depart13 ment or agency of the Federal Government. 

14 ‘‘(7) Such other activities as the Secretary con15 siders appropriate to prevent veterans homelessness. 

16 ‘‘(c) NO DUPLICATION OF SERVICES.—The Secretary 

17 may provide assistance under subsection (a)(2) to a veteran 

18 receiving supportive services from an eligible entity receiv19 ing financial assistance under section 2044 of this title only 

20 to the extent that the assistance provided under subsection 

21 (a)(2) does not duplicate the supportive services provided 

22 to such veteran by such entity or by any other Federal, 

23 State, or local entity. 

24 ‘‘(d) PROTECTION FROM ABUSE.—To protect the pro25 gram established under subsection (a) from abuse, the SecVerDate Mar 15 2010 23:15 Apr 29, 2010 Jkt 089200 PO 00000 Frm 00017 Fmt 6652 Sfmt 6203 E:\BILLS\S1237.RS S1237

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1 retary may establish a limit on the number of times that 

2 a particular veteran may receive assistance under the pro3 gram in a fiscal year. 

4 ‘‘(e) STAFFING.—The Secretary shall assign such em5 ployees at such locations as the Secretary considers nec6 essary to carry out this section. 

7 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There are 

8 authorized to be appropriated to carry out this section 

9 $50,000,000 for each of fiscal years 2010 through 2014.’’. 

10 (2) CLERICAL AMENDMENT.—The table of sec11 tions at the beginning of chapter 20 of such title is 

12 amended by adding at the end the following new item: 

‘‘2067. Prevention of veteran homelessness.’’. 

13 (b) RESPONSIBILITIES OF HOMELESS VETERANS PRO14 GRAM COORDINATORS.—Section 2003(a) is amended— 

15 (1) in paragraph (3), by striking ‘‘The housing’’ 

16 and inserting ‘‘Any housing’’; 

17 (2) by redesignating paragraph (7) as para18 graph (8); and 

19 (3) by inserting after paragraph (6) the fol20 lowing new paragraph (7): 

21 ‘‘(7) The program under section 2067 of this 

22 title.’’. 

23 (c) REPORT.— 

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

25 the date of the establishment of the program required 


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1 by section 2067 of title 38, United States Code, as 

2 added by subsection (a), the Secretary of Veterans Af3 fairs shall submit to Congress a report on the oper4 ation of such program. 

5 (2) ELEMENTS.—The report required by para6 graph (1) shall include the following: 

7 (A) The types and sources of assistance pro8 vided under such section 2067. 

9 (B) An assessment of the effectiveness of the 

10 services provided under such section. 

11 SEC. 105. HOMELESS VETERANS MANAGEMENT INFORMA12 TION SYSTEM. 

13 (a) IN GENERAL.—Subchapter VII of chapter 20, as 

14 amended by section 104, is further amended by adding at 

15 the end the following new section: 

16 ‘‘§ 2068. Homeless Veterans Management Information 

17 System 

18 ‘‘(a) METHOD FOR DATA COLLECTION AND AGGREGA19 TION.—(1) Not later than one year after the date of the en20 actment of this section, the Secretary shall, in consultation 

21 with the Special Assistant for Veterans Affairs of the De22 partment of Housing and Urban Development and the 

23 United States Interagency Council on Homelessness estab24 lished under section 201 of the McKinney-Vento Homeless 

25 Assistance Act (42 U.S.C. 11311), establish a method for 


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1 the collection and aggregation of data on homeless veterans 

2 participating in programs of the Department of Veterans 

3 Affairs and the Department of Housing and Urban Devel4 opment, including the following with respect to such vet5 erans: 

6 ‘‘(A) Age, race, sex, disability status, marital 

7 status, income, employment history, and whether the 

8 veteran is a parent. 

9 ‘‘(B) If the veteran received assistance for hous10 ing, the number of days that the veteran resided in 

11 such housing and the type of such housing. 

12 ‘‘(C) If the veteran is no longer participating in 

13 a program of assistance for the homeless, the reason 

14 the veteran left the program. 

15 ‘‘(2) The method required by paragraph (1) shall en16 sure that each veteran is counted only once. 

17 ‘‘(b) ANNUAL DATA COLLECTION AND AGGREGA18 TION.—Not later than one year after the method is estab19 lished under subsection (a), and annually thereafter, the 

20 Secretary shall collect and aggregate data using the method 

21 established under subsection (a). 

22 ‘‘(c) ANNUAL REPORTS.—Not later than two years 

23 after the date of enactment of this section and annually 

24 thereafter, the Secretary shall submit to Congress a report 

25 on the data collected and aggregated under subsection (b). 


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1 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this sec3 tion— 

4 ‘‘(1) $10,000,000 for fiscal year 2010; and 

5 ‘‘(2) such sums as may be necessary for fiscal 

6 years 2011 through 2014.’’. 

7 (b) CLERICAL AMENDMENT.—The table of sections at 

8 the beginning of chapter 20 is amended by adding at the 

9 end the following new item: 

‘‘2068. Homeless Veterans Management Information System.’’. 

10 SEC. 106. RENTAL ASSISTANCE FOR VETERANS THROUGH 

11 DEPARTMENT OF HOUSING AND URBAN DE12 VELOPMENT. 

13 Section 8(o)(19) of the United States Housing Act of 

14 1937 (42 U.S.C. 1437f(o)(19)) is amended to read as fol15 lows: 

16 ‘‘(19) RENTAL VOUCHERS FOR VETERANS AF17 FAIRS SUPPORTED HOUSING PROGRAM.— 

18 ‘‘(A) RENTAL VOUCHERS.—The Secretary 

19 shall make available to public housing agencies 

20 described in subparagraph (C) the amounts de21 scribed in subparagraph (B), to provide rental 

22 assistance through a supported housing program 

23 administered in conjunction with the Depart24 ment of Veterans Affairs. 


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1 ‘‘(B) AMOUNT.—The amounts specified in 

2 this subparagraph are the amounts necessary to 

3 ensure that— 

4 ‘‘(i) not more than 30,000 vouchers for 

5 rental assistance under this paragraph are 

6 outstanding at any one time during fiscal 

7 year 2010; 

8 ‘‘(ii) not more than 40,000 vouchers for 

9 rental assistance under this paragraph are 

10 outstanding at any one time during fiscal 

11 year 2011; 

12 ‘‘(iii) not more than 50,000 vouchers 

13 for rental assistance under this paragraph 

14 are outstanding at any one time during fis15 cal year 2012; and 

16 ‘‘(iv) not more than 60,000 vouchers 

17 for rental assistance under this paragraph 

18 are outstanding at any one time during fis19 cal year 2013 and each fiscal year there20 after. 

21 ‘‘(C) PUBLIC HOUSING AGENCIES.—A pub22 lic housing agency described in this subpara23 graph is a public housing agency that— 

24 ‘‘(i) has a partnership with a Depart25 ment of Veterans Affairs medical center or 


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1 an entity determined to be appropriate by 

2 the Secretary of Veterans Affairs; 

3 ‘‘(ii) is located in an area that the Sec4 retary of Veterans Affairs determines has a 

5 high concentration of veterans in need of as6 sistance; 

7 ‘‘(iii) has demonstrated expertise in 

8 providing housing for homeless individuals; 

9 and 

10 ‘‘(iv) meets any other criteria that the 

11 Secretary, in consultation with the Sec12 retary of Veterans Affairs may prescribe. 

13 ‘‘(D) CASE MANAGEMENT.—The Secretary 

14 of Veterans Affairs shall ensure that the case 

15 managers described in section 2003(b) of title 38, 

16 United States Code, provide appropriate case 

17 management for each veteran who receives rental 

18 assistance under this paragraph that— 

19 ‘‘(i) assists the veteran in— 

20 ‘‘(I) locating available housing; 

21 ‘‘(II) working with the appro22 priate public housing agency; 

23 ‘‘(III) accessing benefits and 

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1 partments and agencies of the Federal 

2 Government; 

3 ‘‘(IV) negotiating with landlords; 

4 and 

5 ‘‘(V) other areas, as the Secretary 

6 determines is necessary to help the vet7 eran maintain housing or avoid home8 lessness; and 

9 ‘‘(ii) ensures that a veteran with a se10 vere disability, including a veteran that has 

11 been homeless for a substantial period of 

12 time, is referred to sufficient supportive 

13 services to provide the veteran with stable 

14 housing, including— 

15 ‘‘(I) mental health services, in16 cluding treatment and recovery sup17 port services; 

18 ‘‘(II) substance abuse treatment 

19 and recovery support services, includ20 ing counseling, treatment planning, re21 covery coaching, and relapse preven22 tion; 

23 ‘‘(III) integrated, coordinated 

24 treatment and recovery support serv25 ices for co-occurring disorders; 


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1 ‘‘(IV) health education, including 

2 referrals for medical and dental care; 

3 ‘‘(V) services designed to help in4 dividuals make progress toward self5 sufficiency and recovery, including job 

6 training, assistance in seeking employ7 ment, benefits advocacy, money man8 agement, life-skills training, self-help 

9 programs, and engagement and moti10 vational interventions; 

11 ‘‘(VI) parental skills and family 

12 support; and 

13 ‘‘(VII) other supportive services 

14 that promote an end to chronic home15 lessness.’’. 

16 SEC. 107. SPECIAL ASSISTANT FOR VETERANS AFFAIRS IN 

17 OFFICE OF SECRETARY OF HOUSING AND 

18 URBAN DEVELOPMENT. 

19 Section 4 of the Department of Housing and Urban 

20 Development Act (42 U.S.C. 3533) is amended by adding 

21 at the end the following new subsection: 

22 ‘‘(g) SPECIAL ASSISTANT FOR VETERANS AFFAIRS.— 

23 ‘‘(1) ESTABLISHMENT.—There shall be in the 

24 Department a Special Assistant for Veterans Affairs, 

25 who shall be in the Office of the Secretary. 


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1 ‘‘(2) APPOINTMENT.—The Special Assistant for 

2 Veterans Affairs shall be appointed by the Secretary, 

3 based solely on merit and shall be covered under the 

4 provisions of title 5, United States Code, governing 

5 appointments in the competitive service. 

6 ‘‘(3) RESPONSIBILITIES.—The Special Assistant 

7 for Veterans Affairs shall be responsible for— 

8 ‘‘(A) ensuring that veterans have access to 

9 housing and homeless assistance under each pro10 gram of the Department providing such assist11 ance; 

12 ‘‘(B) coordinating all programs and activi13 ties of the Department relating to veterans; and 

14 ‘‘(C) carrying out such other duties as may 

15 be assigned to the Special Assistant by the Sec16 retary or by law.’’. 

17 SEC. 108. PLAN TO END VETERAN HOMELESSNESS. 

18 (a) IN GENERAL.—Not later than one year after the 

19 date of enactment of this Act, the Secretary of Veterans Af20 fairs shall submit to Congress a comprehensive plan to end 

21 homelessness among veterans that includes— 

22 (1) an analysis of programs of the Department 

23 of Veterans Affairs and other departments and agen24 cies of the Federal Government that are designed to 


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1 prevent homelessness among veterans and assist vet2 erans who are homeless; 

3 (2) an evaluation of whether and how partner4 ships between the programs described in paragraph 

5 (1) would contribute to ending homelessness among 

6 veterans; 

7 (3) recommendations for improving the pro8 grams described in paragraph (1), creating partner9 ships between such programs, or eliminating pro10 grams that are no longer effective; 

11 (4) recommendations for new programs to pre12 vent and end homelessness among veterans, including 

13 an estimation of the cost of such programs; 

14 (5) a timeline for implementing the plan; and 

15 (6) such other information as the Secretary de16 termines necessary. 

17 (b) CONSIDERATION OF VETERANS LOCATED IN RURAL

18 AREAS.—The analysis, evaluation, and recommendations 

19 included in the report required by subsection (a) shall in20 clude consideration of the circumstances and requirements 

21 that are unique to veterans located in rural areas. 


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1 TITLE II—TOXIC SUBSTANCES 

2 EXPOSURE 

3 SEC. 201. EXTENSION OF ELIGIBILITY FOR HEALTH CARE 

4 FOR VETERANS WITH DISABILITIES WHO 

5 SERVED IN PERSIAN GULF WAR NOTWITH6 STANDING LACK OF EVIDENCE TO CONCLUDE 

7 SUCH DISABILITIES ARE ASSOCIATED WITH 

8 SUCH SERVICE. 

9 (a) IN GENERAL.—Subsection (e)(3)(B) of section 

10 1710 is amended by inserting after ‘‘December 31, 2002’’ 

11 the following: ‘‘, except that such care and services may also 

12 be provided to such a veteran during the period beginning 

13 on the date of the enactment of the Homeless Veterans and 

14 Other Veterans Health Care Authorities Act of 2010 and 

15 ending on December 31, 2012’’. 

16 (b) TECHNICAL CORRECTION.—Subsection (a)(2)(F) of 

17 such section is amended by striking ‘‘conditions’’ and in18 serting ‘‘occupational or environmental hazards’’. 


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1 TITLE III—HEALTH CARE 

2 MATTERS 

3 SEC. 301. INCREASE IN NUMBER OF AUTHORIZED ASSIST4 ANT SECRETARIES AND DEPUTY ASSISTANT 

5 SECRETARIES. 

6 (a) INCREASE IN NUMBER OF AUTHORIZED ASSIST7 ANT SECRETARIES; REVISION OF FUNCTIONS.—Section 308 

8 is amended— 

9 (1) in subsection (a), by striking ‘‘seven’’ and in10 serting ‘‘eight’’ in the first sentence; and 

11 (2) in subsection (b)— 

12 (A) in paragraph (6), by striking ‘‘Capital’’ 

13 and inserting ‘‘Construction capital’’; and 

14 (B) in paragraph (10) by striking ‘‘Pro15 curement’’ and inserting ‘‘Acquisition’’. 

16 (b) INCREASE IN NUMBER OF AUTHORIZED DEPUTY

17 ASSISTANT SECRETARIES.—Section 308(d)(1) is amended 

18 by striking ‘‘19’’ and inserting ‘‘27’’ in the first sentence. 

19 (c) CONFORMING AMENDMENTS TO TITLE 38, UNITED

20 STATES CODE.—Title 38, United States Code, is amended 

21 as follows: 

22 (1) Section 312A is repealed. 

23 (2) The table of sections at the beginning of 

24 chapter 3 is amended by striking the item relating to 

25 section 312A. 


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1 (d) CONFORMING AMENDMENT TO TITLE 5, UNITED

2 STATES CODE.—Section 5315 of title 5, United States 

3 Code, is amended by striking ‘‘Assistant Secretaries, De4 partment of Veterans Affairs (7)’’ and inserting ‘‘Assistant 

5 Secretaries, Department of Veterans Affairs (8)’’. 

6 SEC. 302. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN AS7 SISTANT SERVICES IN VETERANS HEALTH AD8 MINISTRATION. 

9 (a) IN GENERAL.—Section 7306(a) is amended by 

10 striking paragraph (9) and inserting the following new 

11 paragraph (9): 

12 ‘‘(9) The Director of Physician Assistant Serv13 ices, who shall— 

14 ‘‘(A) serve in a full-time capacity at the 

15 Central Office of the Department; 

16 ‘‘(B) be a qualified physician assistant; and 

17 ‘‘(C) be responsible and report directly to 

18 the Chief Patient Care Services Officer of the 

19 Veterans Health Administration on all matters 

20 relating to the education and training, employ21 ment, appropriate utilization, and optimal par22 ticipation of physician assistants within the pro23 grams and initiatives of the Administration.’’. 

24 (b) DEADLINE FOR IMPLEMENTATION.—The Secretary 

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1 ing as the Director of Physician Assistant Services under 

2 paragraph (9) of section 7306(a) of title 38, United States 

3 Code, as amended by subsection (a), by not later than 120 

4 days after the date of the enactment of this Act. 

5 SEC. 303. DEPARTMENT OF VETERANS AFFAIRS MEDICAL 

6 CENTER QUALITY REPORT CARD INITIATIVE. 

7 (a) PURPOSE.—The purpose of this section is to pro8 vide for the establishment within the Department of Vet9 erans Affairs of an initiative (to be known as the ‘‘Medical 

10 Center Quality Report Card Initiative’’) to ensure that in11 formation on the quality and performance of medical cen12 ters administered by the Secretary of Veterans Affairs is 

13 readily available and accessible for purposes as follows: 

14 (1) To inform patients and consumers about 

15 health care quality in such medical centers. 

16 (2) To assist health care providers of the Depart17 ment in identifying opportunities for quality im18 provement and cost containment. 

19 (3) To enhance the understanding of policy mak20 ers and public officials of health care issues, raise 

21 public awareness of medical center quality issues, and 

22 help constituents of such policy makers and officials 

23 identify quality health care options for the Depart24 ment. 


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1 (b) ESTABLISHMENT.—Subchapter I of chapter 17 is 

2 amended by inserting after section 1706 the following new 

3 section: 

4 ‘‘§ 1706A. Management of health care: Medical Center 

5 Quality Report Card Initiative 

6 ‘‘(a) IN GENERAL.—Not later than 18 months after the 

7 date of the enactment of the Homeless Veterans and Other 

8 Veterans Health Care Authorities Act of 2010, the Secretary 

9 shall establish and implement an initiative, to be known 

10 as the ‘Medical Center Quality Report Card Initiative’ (in 

11 this section referred to as the ‘Initiative’), to publish infor12 mation on health care quality in Department medical cen13 ters. 

14 ‘‘(b) PUBLICATION OF INFORMATION ON QUALITY AND

15 PERFORMANCE OF DEPARTMENT MEDICAL CENTERS.— 

16 (1)(A) Under the Initiative, not less frequently than twice 

17 each year, the Secretary shall make available to the public, 

18 on the Hospital Compare website of the Centers for Med19 icaid and Medicare Services, data consisting of the most 

20 current information on the quality and performance of each 

21 Department medical center. Such information shall include 

22 quality measures that allow for an assessment with respect 

23 to health care provided by Department medical centers, of 

24 the following: 

25 ‘‘(i) Effectiveness. 


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1 ‘‘(ii) Safety. 

2 ‘‘(iii) Timeliness. 

3 ‘‘(iv) Efficiency. 

4 ‘‘(v) Patient-centeredness. 

5 ‘‘(vi) Patient satisfaction. 

6 ‘‘(vii) Satisfaction of health professionals em7 ployed at Department medical centers. 

8 ‘‘(viii) The equity of care provided to various 

9 patient populations, including female, geriatric, dis10 abled, rural, homeless, mentally ill, and racial and 

11 ethnic minority populations. 

12 ‘‘(B) For each quality measure made available under 

13 subparagraph (A), the Secretary shall include— 

14 ‘‘(i) quality measures that are common to the 

15 health care industry and are based on information re16 ported in paragraph (2); and 

17 ‘‘(ii) such other information as the Secretary 

18 considers appropriate. 

19 ‘‘(C) The Secretary shall conduct focus groups with 

20 veterans to identify additional types of quality information 

21 and display formats regarding such quality measures that 

22 would be meaningful to the needs of veterans. 

23 ‘‘(2)(A) In making data available pursuant to para24 graph (1), the Secretary shall, except as provided in sub25 paragraph (B), include to the maximum extent practicable 


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1 information about Department medical centers using best 

2 available measures that reflect emerging quality and safety 

3 trends and the priorities of veteran-centered care. 

4 ‘‘(B) In making data available to the public under 

5 paragraph (1), the Secretary may provide information in 

6 addition to the information required by subparagraph (A) 

7 or provide information in lieu of the information required 

8 by subparagraph (A) if the Secretary— 

9 ‘‘(i) not later than 15 days before the date on 

10 which such data is made available to the public, sub11 mits to the Committee on Veterans’ Affairs of the Sen12 ate and the Committee on Veterans’ Affairs of the 

13 House of Representatives a certification in writing 

14 that such additional or substituted information is 

15 more appropriate for purposes of carrying out the re16 quirement of paragraph (2)(B); and 

17 ‘‘(ii) includes with such data and in such certifi18 cation an indication of which information has been 

19 added or substituted under this subparagraph. 

20 ‘‘(3)(A) In making data available as provided for 

21 under paragraph (1), the Secretary may make risk adjust22 ments to quality measures to account for differences relating 

23 to— 


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1 ‘‘(i) the characteristics of a Department medical 

2 center, such as licensed bed size, geography, and 

3 teaching hospital status; and 

4 ‘‘(ii) patient characteristics, such as health sta5 tus, severity of illness, and socioeconomic status. 

6 ‘‘(B) If the Secretary makes data available under 

7 paragraph (1) using risk-adjusted quality measures, the 

8 Secretary shall establish procedures for making the 

9 unadjusted data available to the public in a manner deter10 mined appropriate by the Secretary. 

11 ‘‘(4) Under the Initiative, the Secretary may verify 

12 data made available under this subsection to ensure accu13 racy and validity. 

14 ‘‘(5) Before disclosing to the public any data under 

15 this subsection, the Secretary shall disclose the methodology 

16 for the publication of such data and the nature and scope 

17 of such data to— 

18 ‘‘(A) each organization the Secretary considers 

19 relevant to such data; and 

20 ‘‘(B) each Department medical center that is the 

21 subject of such data. 

22 ‘‘(6)(A) The Secretary shall submit to the Committee 

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

24 Veterans’ Affairs of the House of Representatives a copy of 


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1 each set of data made available to the public under para2 graph (1). 

3 ‘‘(B) The Secretary shall ensure that each set of data 

4 made available to the public under paragraph (1) is made 

5 available— 

6 ‘‘(i) in an electronic format; 

7 ‘‘(ii) in a manner that can be understood by in8 dividuals who are not medical professionals and indi9 viduals with low functional health literacy; and 

10 ‘‘(iii) at each Department medical center covered 

11 by the set of data. 

12 ‘‘(C) The Secretary shall ensure that information on 

13 health care quality made available under paragraph (1) is 

14 made available in a manner that is conducive for compari15 sons with other local medical centers or regional medical 

16 centers, as appropriate. 

17 ‘‘(D) The Secretary shall establish procedures for mak18 ing the information included in the data made available 

19 to the public under paragraph (1) available to the public 

20 upon request in non-electronic format, such as through a 

21 toll-free telephone number. 

22 ‘‘(7) The analytic methodologies and limitations on in23 formation sources utilized by the Secretary to develop and 

24 disseminate comparative information under this subsection 

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1 claimer as part of the dissemination of such information, 

2 and include the appropriate and inappropriate uses of such 

3 information. 

4 ‘‘(c) IDENTIFYING AND REPORTING ACTIONS THAT

5 COULD LEAD TO FALSE OR ARTIFICIAL IMPROVEMENTS IN

6 QUALITY MEASUREMENTS.—Not less frequently than annu7 ally, the Secretary shall compare quality measures data 

8 submitted by each Department medical center to the Sec9 retary with quality measures data submitted to the Sec10 retary in the prior year or years by each such Department 

11 medical center in order to identify and report actions that 

12 could lead to false or artificial improvements in the quality 

13 measurements of such Department medical centers for pur14 poses of this section. 

15 ‘‘(d) PRIVACY AND SECURITY.—(1) The Secretary shall 

16 develop and implement effective safeguards to protect 

17 against the unauthorized use or disclosure of Department 

18 medical center data that is made available under this sec19 tion. 

20 ‘‘(2) The Secretary shall develop and implement effec21 tive safeguards to protect against the dissemination under 

22 this section of inconsistent, incomplete, invalid, inaccurate, 

23 or subjective Department medical center data. 

24 ‘‘(3) The Secretary shall ensure that identifiable pa25 tient data is not released to the public under this section. 


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1 ‘‘(e) REPORTS.—(1) The Secretary shall periodically 

2 submit to Congress a report on the effectiveness of the Ini3 tiative. 

4 ‘‘(2) Each report required by paragraph (1) shall in5 clude the following: 

6 ‘‘(A) An assessment of the effectiveness of the Ini7 tiative in meeting the purpose described in section 

8 302(a) of the Homeless Veterans and Other Veterans 

9 Health Care Authorities Act of 2010. 

10 ‘‘(B) If necessary, a description of the measures 

11 the Secretary can undertake to ensure that the Initia12 tive meets such purpose. 

13 ‘‘(3) The Secretary shall carry out each measure the 

14 Secretary includes in a report under paragraph (2)(B). 

15 ‘‘(4) The Secretary shall make each report submitted 

16 under paragraph (1) available to the public. 

17 ‘‘(f) DEPARTMENT MEDICAL CENTER DEFINED.—In 

18 this section, the term ‘Department medical center’ means 

19 a Department of Veterans Affairs Medical Center adminis20 tered by the Secretary. 

21 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

22 are authorized to be appropriated to carry out this section 

23 such sums as may be necessary for each of fiscal years 2010 

24 through 2018.’’. 


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1 (c) CLERICAL AMENDMENT.—The table of sections at 

2 the beginning of chapter 17 is amended by inserting after 

3 the item relating to section 1706 the following new item: 

‘‘1706A. Management of health care: Medical Center Quality Report Card Initiative.’’. 

4 SEC. 304. REPORT ON PAY-FOR-PERFORMANCE COMPENSA5 TION UNDER HEALTH CARE SERVICES CON6 TRACTS. 

7 (a) IN GENERAL.—Not later than 180 days after the 

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

9 Affairs shall submit to the Committee on Veterans’ Affairs 

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

11 the House of Representatives a report on the use by the De12 partment of Veterans Affairs of pay-for-performance com13 pensation mechanisms in the provision of health care serv14 ices in contracts which compensate contractors of the De15 partment for the provision of health care services through 

16 community based outpatient clinics. 

17 (b) ELEMENTS.—The report required by subsection (a) 

18 shall include the following: 

19 (1) An assessment of the feasibility and advis20 ability of utilizing pay-for-performance compensation 

21 mechanisms in the provision of health care services by 

22 the Department in contracts described in subsection 

23 (a). 


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1 (2) The number of community based outpatient 

2 clinics of the Department that were operating under 

3 a pay-for-performance compensation mechanism in 

4 the provision of health care services on the day before 

5 the date of the enactment of this Act and the impact 

6 such mechanisms have had with respect to— 

7 (A) providing incentives for community 

8 based outpatient clinics to provide high quality 

9 health care; and 

10 (B) providing incentives to better assure pa11 tient satisfaction. 

12 (c) INCORPORATION OF VIEWS AND EXPERIENCES OF

13 PRIVATE HEALTH CARE SYSTEMS.—In meeting the re14 quirements of this section the Secretary shall incorporate 

15 the views and experiences of representatives of at least two 

16 private health care systems that have utilized pay-for-per17 formance compensation mechanisms in the operation of 

18 medical clinics to ascertain whether such mechanisms have 

19 had an effect on the delivery of quality, timely, medical care 

20 in the private sector. 

21 SEC. 305. EXPANSION OF STATE HOME CARE FOR PARENTS 

22 OF VETERANS WHO DIED WHILE SERVING IN 

23 THE ARMED FORCES. 

24 In administering section 51.210(d) of title 38, Code 

25 of Federal Regulations, the Secretary of Veterans Affairs 


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1 shall permit a State home to provide services to, in addition 

2 to non-veterans described in such subsection, a non-veteran 

3 any of whose children died while serving in the Armed 

4 Forces. 

5 SEC. 306. AUTOMATIC ENROLLMENT OF ELIGIBLE DEMOBI6 LIZING MEMBERS OF THE NATIONAL GUARD 

7 AND RESERVE IN HEALTH CARE AND DENTAL 

8 CARE PROGRAMS OF THE DEPARTMENT OF 

9 VETERANS AFFAIRS. 

10 (a) AUTOMATIC ENROLLMENT.— 

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

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

13 Veterans Affairs shall, in consultation and coordina14 tion with the Secretary of Defense, take appropriate 

15 actions to provide for the automatic enrollment of 

16 covered members in the health care or dental care pro17 grams for veterans of the Department of Veterans Af18 fairs for which they will be eligible upon discharge or 

19 release from active duty in the Armed Forces. 

20 (2) COVERED MEMBERS.—In this section, a cov21 ered member is any member of a reserve component 

22 of the Armed Forces who is being discharged or re23 leased from active duty in the Armed Forces and who 

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1 ticipate in a health care or dental care program for 

2 veterans of the Department of Veterans Affairs. 

3 (3) ENROLLMENT DURING DEMOBILIZATION AND

4 DISCHARGE PROCESS.—The Secretary of Veterans Af5 fairs shall, in consultation and coordination with the 

6 Secretary of Defense, ensure that the automatic enroll7 ment described in paragraph (1) occurs during the 

8 participation of covered members in the demobiliza9 tion and discharge process used for members of the re10 serve components of the Armed Forces. 

11 (b) ASSISTANCE.— 

12 (1) IN GENERAL.—In providing for the enroll13 ment of covered members under subsection (a), the 

14 Secretary of Veterans Affairs shall, in consultation 

15 and coordination with the Secretary of Defense, pro16 vide covered members assistance in the completion of 

17 any enrollment activities required under such sub18 section. Such assistance shall be provided during the 

19 demobilization and discharge process of such members 

20 utilizing such personnel of the Department of Vet21 erans Affairs, including personnel of the Veterans 

22 Health Administration and the Veterans Benefits Ad23 ministration, as the Secretary shall assign for such 

24 purposes. 


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1 (2) EDUCATION AND OUTREACH.—In providing 

2 assistance under paragraph (1) to covered members, 

3 the personnel of the Department providing such as4 sistance shall also provide such members— 

5 (A) information about the programs, bene6 fits, and services of the Department for which 

7 they may be eligible, including— 

8 (i) how such members can apply for 

9 and access such programs, benefits, and 

10 services; and 

11 (ii) the advantages of enrolling in such 

12 programs, benefits, and services; and 

13 (B) a list of Department of Veterans Affairs 

14 medical facilities, including medical centers, out15 patient clinics, mental health centers, and bene16 fits offices located within 100 miles of the resi17 dence in which the covered member will first re18 side after being discharged or released from ac19 tive duty in the Armed Forces. 

20 (c) PERSONNEL.—Beginning not later than 180 days 

21 after the date of the enactment of this Act, the Secretary 

22 of Veterans Affairs shall, in consultation and coordination 

23 with the Secretary of Defense and the appropriate officials 

24 of each State, ensure that sufficient personnel are present, 

25 including such personnel as are assigned under subsection 


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1 (b)(1), at each demobilization and discharge event of a re2 serve component of the Armed Forces for the performance 

3 by covered members of any enrollment activities pursuant 

4 to subsection (a) and for any assistance in the performance 

5 of such activities under subsection (b). 

6 (d) FACILITIES AND OTHER RESOURCES.—Beginning 

7 not later than 180 days after the date of the enactment of 

8 this Act, the Secretary of Defense shall ensure that the fa9 cilities and other resources (including space and computer 

10 facilities) for the demobilization and discharge process used 

11 for members of reserve components of the Armed Forces in12 clude adequate facilities and resources for the performance 

13 by covered members of any enrollment activities required 

14 under subsection (a) and for any assistance in the perform15 ance of such activities under subsection (b). 

16 (e) PROTECTION OF PRIVACY.—Any enrollment activi17 ties performed by covered members pursuant to subsection 

18 (a) shall provide appropriate protections for the privacy of 

19 such members and their personal information in accordance 

20 with applicable requirements of law. 

21 (f) OPT OUT PROVISIONS.— 

22 (1) OPTION NOT TO ENROLL.—During the demo23 bilization and discharge process for a covered member 

24 and prior to enrolling the member pursuant to sub25 section (a), the Secretary of Veterans Affairs shall, in 


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1 coordination with the Secretary of Defense, provide 

2 the member with the option to decline such enroll3 ment. 

4 (2) NOTICE TO SECRETARY; PROHIBITION ON EN5 ROLLMENT.—If a covered member provides notice to 

6 the Secretary of Veterans Affairs that the member de7 clines enrollment under paragraph (1), the Secretary 

8 may not enroll the member pursuant to subsection 

9 (a). 

10 (g) CONSTRUCTION.—Nothing in this section shall be 

11 construed to require a member of a reserve component of 

12 the Armed Forces to participate in any health care or den13 tal care program or use any service of the Department of 

14 Veterans Affairs. 

15 (h) REPORTS.— 

16 (1) IN GENERAL.—Not later than one year after 

17 the date of the enactment of this Act and each year 

18 thereafter for five years, the Secretary of Veterans Af19 fairs shall, in consultation and coordination with the 

20 Secretary of Defense, submit a report on the imple21 mentation of the requirements of this section to— 

22 (A) the Committee on Veterans’ Affairs and 

23 the Committee on Appropriations of the Senate; 

24 and 


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1 (B) the Committee on Veterans’ Affairs and 

2 the Committee on Appropriations of the House of 

3 Representatives. 

4 (2) ELEMENTS.—Each report required by para5 graph (1) shall include the following: 

6 (A) A description of the activities under7 taken by the Secretary of Veterans Affairs to 

8 carry out the requirements of this section. 

9 (B) An assessment of the effect of such ac10 tivities on— 

11 (i) the enrollment of covered members 

12 in health care and dental care programs for 

13 veterans of the Department of Veterans Af14 fairs; and 

15 (ii) the participation of such members 

16 in such programs. 

17 (C) An assessment of the potential budg18 etary impact and demand for services that ac19 tions taken under subsection (a) may have on the 

20 Department of Veterans Affairs and any need for 

21 additional staff or resources to meet that de22 mand. 

23 (D) Such recommendations for legislative or 

24 administrative action as the Secretary of Vet25 erans Affairs considers appropriate in order to 


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1 improve or enhance the requirements of this sec2 tion so as to further facilitate the enrollment of 

3 covered members in health care and dental care 

4 programs for veterans of the Department of Vet5 erans Affairs. 

6 (E) Such other matters with respect to the 

7 requirements of this section as the Secretary of 

8 Veterans Affairs considers appropriate. 

9 (i) DEFINITIONS.—In this section: 

10 (1) ENROLLMENT.—The term ‘‘enrollment’’, with 

11 respect to a covered member in a health care or dental 

12 care program for veterans of the Department of Vet13 erans Affairs, means the collection and recording of 

14 appropriate information on such member in the rec15 ordkeeping system of the Department of Veterans Af16 fairs to facilitate participation of such member in 

17 such program if such member is eligible for such par18 ticipation and elects such participation. 

19 (2) STATE.—The term ‘‘State’’ means each of the 

20 several States of the United States, the District of Co21 lumbia, and any commonwealth, territory, or posses22 sion of the United States. 


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1 SEC. 307. PROVISION OF CHIROPRACTIC SERVICES TO VET2 ERANS ENROLLED IN HEALTH CARE SYSTEM 

3 OF DEPARTMENT OF VETERANS AFFAIRS. 

4 (a) COMPREHENSIVE POLICY ON CHIROPRACTIC SERV5 ICES.— 

6 (1) IN GENERAL.—Not later than October 1, 

7 2010, the Secretary of Veterans Affairs shall develop 

8 and implement a comprehensive policy on the provi9 sion of chiropractic services provided at the expense 

10 of the Department of Veterans Affairs to veterans en11 rolled in the health care system of the Department. 

12 (2) SCOPE OF POLICY.—The policy required by 

13 paragraph (1) shall cover each of the following: 

14 (A) The Department-wide protocols gov15 erning referrals for chiropractic services. 

16 (B) The Department-wide protocols gov17 erning direct access to chiropractic services. 

18 (C) The Department-wide protocols gov19 erning the scope of practice of chiropractic prac20 titioners. 

21 (D) The definition of chiropractic services 

22 to be provided. 

23 (E) The assurance of prompt and appro24 priate chiropractic services by the Department, 

25 system-wide, when medically appropriate. 


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1 (F) Department programs of education and 

2 training for health care personnel of the Depart3 ment regarding the benefits of chiropractic serv4 ices. 

5 (G) Department programs of patient edu6 cation for veterans suffering from back pain and 

7 related disorders. 

8 (3) UPDATES.—The Secretary shall revise the 

9 policy required by paragraph (1) on a periodic basis 

10 in accordance with experience and evolving best prac11 tice guidelines. 

12 (4) CONSULTATION.—The Secretary shall develop 

13 the policy required by paragraph (1), and revise such 

14 policy under paragraph (3), in consultation with vet15 erans service organizations and other organizations 

16 with expertise regarding the benefits of chiropractic 

17 services. 

18 (b) LOCATIONS FOR PROVISION OF CHIROPRACTIC

19 SERVICES.—In carrying out the policy required by sub20 section (a), the Secretary shall provide chiropractic services 

21 at— 

22 (1) not less than two locations in each Veterans 

23 Integrated Service Network (VISN); and 

24 (2) such locations as the Secretary considers ap25 propriate based on the Secretary’s assessment of deVerDate Mar 15 2010 23:15 Apr 29, 2010 Jkt 089200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6203 E:\BILLS\S1237.RS S1237

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1 mand for chiropractic services provided by the De2 partment, including consideration of the following: 

3 (A) The average time a veteran seeking 

4 chiropractic services from the Department is re5 quired to wait for such services. 

6 (B) Rates of fee-based care. 

7 (C) Such other considerations as the Sec8 retary considers appropriate. 

9 (c) ANNUAL REPORT.— 

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

11 the date of the completion and initial implementation 

12 of the policy required by subsection (a)(1) and on Oc13 tober 1 of every fiscal year thereafter through fiscal 

14 year 2020, the Secretary shall submit to the Com15 mittee on Veterans’ Affairs of the Senate and the 

16 Committee on Veterans’ Affairs of the House of Rep17 resentatives a report on the implementation of the 

18 policy required by subsection (a)(1). 

19 (2) ELEMENTS.—The report required by para20 graph (1) shall include the following: 

21 (A) A description of the policy developed 

22 and implemented under paragraph (1) of sub23 section (a) and any revisions to such policy 

24 under paragraph (3) of such subsection. 


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1 (B) A description of the performance meas2 ures used to determine the effectiveness of such 

3 policy in improving the availability of chiro4 practic services for veterans system-wide. 

5 (C) An assessment of the adequacy of De6 partment chiropractic services based on a survey 

7 of patients managed in Department clinics. 

8 (D) An assessment of the training provided 

9 to Department health care personnel with respect 

10 to the benefits of chiropractic services and the 

11 appropriate referral of patients for chiropractic 

12 services. 

13 (E) An assessment of the patient pain care 

14 education programs of the Department. 

15 (F) The number of episodes of chiropractic 

16 services (including referrals for chiropractic serv17 ices to non-Department providers) granted in the 

18 preceding fiscal year, disaggregated by facility. 

19 (d) VETERANS SERVICE ORGANIZATION DEFINED.—In 

20 this section, the term ‘‘veterans service organization’’ means 

21 any organization recognized by the Secretary for the rep22 resentation of veterans under section 5902 of title 38, 

23 United States Code. 


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1 SEC. 308. NAME OF DEPARTMENT OF VETERANS AFFAIRS 

2 OUTPATIENT CLINIC, ALEXANDRIA, MIN3 NESOTA. 

4 (a) DESIGNATION.—The Department of Veterans Af5 fairs outpatient clinic in Alexandria, Minnesota, shall after 

6 the date of the enactment of this Act be known and des7 ignated as the ‘‘Max J. Beilke Department of Veterans Af8 fairs Outpatient Clinic’’. 

9 (b) REFERENCES.—Any reference in any law, regula10 tion, map, document, record, or other paper of the United 

11 States to the outpatient clinic referred to in subsection (a) 

12 shall be considered to be a reference to the Max J. Beilke 

13 Department of Veterans Affairs Outpatient Clinic. 

14 TITLE IV—OTHER MATTERS 

15 SEC. 401. FUNDING. 

16 (a) IN GENERAL.—Subject to subsection (b), amounts 

17 to carry out this Act and the amendments made by this 

18 Act shall be derived, in whole or in part, from the following: 

19 (1) In fiscal years after fiscal year 2009, from 

20 amounts appropriated or otherwise available for fiscal 

21 year 2009 for the Department of Veterans Affairs for 

22 medical services that remain available for obligation 

23 as of the date of the enactment of this Act. 

24 (2) In fiscal years after fiscal year 2010, from 

25 amounts appropriated or otherwise available for fiscal 

26 year 2010 for the Department of Veterans Affairs for 


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1 medical services that remain available for obligation 

2 as of October 1, 2010. 

3 (b) LIMITATION.—Amounts described in subsection (a) 

4 shall not be available in accordance with that subsection 

5 to the extent, as determined by the Secretary, the avail6 ability of such amounts in accordance with that subsection 

7 would otherwise limit or impede the delivery of health care 

8 services to veterans. 

Amend the title so as to read: ‘‘A bill to amend title 

38, United States Code, to improve the provision of assistance to homeless veterans and the provision of health 

care to veterans, and for other purposes.’’. 


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Calendar No. 360 

111TH CONGRESS 

2D SESSION S. 1237 

[Report No. 111–175] 

A BILL 

To amend title 38, United States Code, to expand 

and for other purposes. veterans and homeless veterans with children, program for reintegration of homeless women with minor dependents and to establish a grant special needs to include male homeless veterans the grant program for homeless veterans with 

APRIL 29, 2010 

Reported with an amendment and an amendment to the 

title 


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