In the House of Representatives, U. S., 

April 21, 2010. 

Resolved, That the bill from the Senate (S. 1963) entitled ‘‘An Act to amend title 38, United States Code, to provide assistance to caregivers of veterans, to improve the provision of health care to veterans, and for other purposes.’’, do 

pass with the following 

AMENDMENT: 

Strike out all after the enacting clause and insert: 

1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Caregivers and Veterans Omnibus Health Services Act of 

4 2010’’. 

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

6 this Act is as follows: 

Sec. 1. Short title; table of contents. 

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

TITLE I—CAREGIVER SUPPORT 

Sec. 101. Assistance and support services for caregivers. 

Sec. 102. Medical care for family caregivers. 

Sec. 103. Counseling and mental health services for caregivers. 

Sec. 104. Lodging and subsistence for attendants. 

TITLE II—WOMEN VETERANS HEALTH CARE MATTERS 

Sec. 201. Study of barriers for women veterans to health care from the Department of Veterans Affairs. 

Sec. 202. Training and certification for mental health care providers of the Department of Veterans Affairs on care for veterans suffering from 

sexual trauma and post-traumatic stress disorder. 

Sec. 203. Pilot program on counseling in retreat settings for women veterans 

newly separated from service in the Armed Forces. 
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Sec. 204. Service on certain advisory committees of women recently separated 

from service in the Armed Forces. 

Sec. 205. Pilot program on assistance for child care for certain veterans receiving 

health care. 

Sec. 206. Care for newborn children of women veterans receiving maternity care. 

TITLE III—RURAL HEALTH IMPROVEMENTS 

Sec. 301. Improvements to the Education Debt Reduction Program. 

Sec. 302. Visual impairment and orientation and mobility professionals education assistance program. 

Sec. 303. Demonstration projects on alternatives for expanding care for veterans 

in rural areas. 

Sec. 304. Program on readjustment and mental health care services for veterans 

who served in Operation Enduring Freedom and Operation 

Iraqi Freedom. 

Sec. 305. Travel reimbursement for veterans receiving treatment at facilities of 

the Department of Veterans Affairs. 

Sec. 306. Pilot program on incentives for physicians who assume inpatient responsibilities at community hospitals in health professional 

shortage areas. 

Sec. 307. Grants for veterans service organizations for transportation of highly 

rural veterans. 

Sec. 308. Modification of eligibility for participation in pilot program of enhanced contract care authority for health care needs of certain 

veterans. 

TITLE IV—MENTAL HEALTH CARE MATTERS 

Sec. 401. Eligibility of members of the Armed Forces who serve in Operation Enduring Freedom or Operation Iraqi Freedom for counseling and 

services through Readjustment Counseling Service. 

Sec. 402. Restoration of authority of Readjustment Counseling Service to provide 

referral and other assistance upon request to former members of 

the Armed Forces not authorized counseling. 

Sec. 403. Study on suicides among veterans. 

TITLE V—OTHER HEALTH CARE MATTERS 

Sec. 501. Repeal of certain annual reporting requirements. 

Sec. 502. Submittal date of annual report on Gulf War research. 

Sec. 503. Payment for care furnished to CHAMPVA beneficiaries. 

Sec. 504. Disclosure of patient treatment information from medical records of patients lacking decisionmaking capacity. 

Sec. 505. Enhancement of quality management. 

Sec. 506. Pilot program on use of community-based organizations and local and 

State government entities to ensure that veterans receive care 

and benefits for which they are eligible. 

Sec. 507. Specialized residential care and rehabilitation for certain veterans. 

Sec. 508. Expanded study on the health impact of Project Shipboard Hazard and 

Defense. 

Sec. 509. Use of non-Department facilities for rehabilitation of individuals with 

traumatic brain injury. 

Sec. 510. Pilot program on provision of dental insurance plans to veterans and 

survivors and dependents of veterans. 
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Sec. 511. Prohibition on collection of copayments from veterans who are catastrophically disabled. 

Sec. 512. Higher priority status for certain veterans who are medal of honor recipients. 

Sec. 513. Hospital care, medical services, and nursing home care for certain Vietnam-era veterans exposed to herbicide and veterans of the Persian Gulf War. 

Sec. 514. Establishment of Director of Physician Assistant Services in Veterans 

Health Administration. 

Sec. 515. Committee on Care of Veterans with Traumatic Brain Injury. 

Sec. 516. Increase in amount available to disabled veterans for improvements and 

structural alterations furnished as part of home health services. 

Sec. 517. Extension of statutorily defined copayments for certain veterans for hospital care and nursing home care. 

Sec. 518. Extension of authority to recover cost of certain care and services from 

disabled veterans with health-plan contracts. 

TITLE VI—DEPARTMENT PERSONNEL MATTERS 

Sec. 601. Enhancement of authorities for retention of medical professionals. 

Sec. 602. Limitations on overtime duty, weekend duty, and alternative work 

schedules for nurses. 

Sec. 603. Reauthorization of health professionals educational assistance scholarship program. 

Sec. 604. Loan repayment program for clinical researchers from disadvantaged 

backgrounds. 

TITLE VII—HOMELESS VETERANS MATTERS 

Sec. 701. Per diem grant payments to nonconforming entities. 

TITLE VIII—NONPROFIT RESEARCH AND EDUCATION 

CORPORATIONS 

Sec. 801. General authorities on establishment of corporations. 

Sec. 802. Clarification of purposes of corporations. 

Sec. 803. Modification of requirements for boards of directors of corporations. 

Sec. 804. Clarification of powers of corporations. 

Sec. 805. Redesignation of section 7364A of title 38, United States Code. 

Sec. 806. Improved accountability and oversight of corporations. 

TITLE IX—CONSTRUCTION AND NAMING MATTERS 

Sec. 901. Authorization of medical facility projects. 

Sec. 902. Designation of Merril Lundman Department of Veterans Affairs Outpatient Clinic, Havre, Montana. 

Sec. 903. Designation of William C. Tallent Department of Veterans Affairs Outpatient Clinic, Knoxville, Tennessee. 

Sec. 904. Designation of Max J. Beilke Department of Veterans Affairs Outpatient Clinic, Alexandria, Minnesota. 

TITLE X—OTHER MATTERS 

Sec. 1001. Expansion of authority for Department of Veterans Affairs police officers. 

Sec. 1002. Uniform allowance for Department of Veterans Affairs police officers. 
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Sec. 1003. Submission of reports to Congress by Secretary of Veterans Affairs in 

electronic form. 

Sec. 1004. Determination of budgetary effects for purposes of compliance with 

Statutory Pay-As-You-Go Act of 2010. 

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. 

7 TITLE I—CAREGIVER SUPPORT 

8 SEC. 101. ASSISTANCE AND SUPPORT SERVICES FOR CARE9 GIVERS. 

10 (a) ASSISTANCE AND SUPPORT SERVICES.— 

11 (1) IN GENERAL.—Subchapter II of chapter 17 is 

12 amended by adding at the end the following new sec13 tion: 

14 ‘‘§ 1720G. Assistance and support services for care15 givers 

16 ‘‘(a) PROGRAM OF COMPREHENSIVE ASSISTANCE FOR

17 FAMILY CAREGIVERS.—(1)(A) The Secretary shall establish 

18 a program of comprehensive assistance for family caregivers 

19 of eligible veterans. 

20 ‘‘(B) The Secretary shall only provide support under 

21 the program required by subparagraph (A) to a family 

22 caregiver of an eligible veteran if the Secretary determines 

23 it is in the best interest of the eligible veteran to do so. 
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1 ‘‘(2) For purposes of this subsection, an eligible veteran 

2 is any individual who— 

3 ‘‘(A) is a veteran or member of the Armed Forces 

4 undergoing medical discharge from the Armed Forces; 

5 ‘‘(B) has a serious injury (including traumatic 

6 brain injury, psychological trauma, or other mental 

7 disorder) incurred or aggravated in the line of duty 

8 in the active military, naval, or air service on or 

9 after September 11, 2001; and 

10 ‘‘(C) is in need of personal care services because 

11 of— 

12 ‘‘(i) an inability to perform one or more ac13 tivities of daily living; 

14 ‘‘(ii) a need for supervision or protection 

15 based on symptoms or residuals of neurological 

16 or other impairment or injury; or 

17 ‘‘(iii) such other matters as the Secretary 

18 considers appropriate. 

19 ‘‘(3)(A) As part of the program required by paragraph 

20 (1), the Secretary shall provide to family caregivers of eligi21 ble veterans the following assistance: 

22 ‘‘(i) To each family caregiver who is approved as 

23 a provider of personal care services for an eligible vet24 eran under paragraph (6)— 
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1 ‘‘(I) such instruction, preparation, and 

2 training as the Secretary considers appropriate 

3 for the family caregiver to provide personal care 

4 services to the eligible veteran; 

5 ‘‘(II) ongoing technical support consisting 

6 of information and assistance to address, in a 

7 timely manner, the routine, emergency, and spe8 cialized caregiving needs of the family caregiver 

9 in providing personal care services to the eligible 

10 veteran; 

11 ‘‘(III) counseling; and 

12 ‘‘(IV) lodging and subsistence under section 

13 111(e) of this title. 

14 ‘‘(ii) To each family caregiver who is designated 

15 as the primary provider of personal care services for 

16 an eligible veteran under paragraph (7)— 

17 ‘‘(I) the assistance described in clause (i); 

18 ‘‘(II) such mental health services as the Sec19 retary determines appropriate; 

20 ‘‘(III) respite care of not less than 30 days 

21 annually, including 24-hour per day care of the 

22 veteran commensurate with the care provided by 

23 the family caregiver to permit extended respite; 

24 ‘‘(IV) medical care under section 1781 of 

25 this title; and 
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1 ‘‘(V) a monthly personal caregiver stipend. 

2 ‘‘(B) Respite care provided under subparagraph 

3 (A)(ii)(III) shall be medically and age-appropriate and in4 clude in-home care. 

5 ‘‘(C)(i) The amount of the monthly personal caregiver 

6 stipend provided under subparagraph (A)(ii)(V) shall be de7 termined in accordance with a schedule established by the 

8 Secretary that specifies stipends based upon the amount 

9 and degree of personal care services provided. 

10 ‘‘(ii) The Secretary shall ensure, to the extent prac11 ticable, that the schedule required by clause (i) specifies that 

12 the amount of the monthly personal caregiver stipend pro13 vided to a primary provider of personal care services for 

14 the provision of personal care services to an eligible veteran 

15 is not less than the monthly amount a commercial home 

16 health care entity would pay an individual in the geo17 graphic area of the eligible veteran to provide equivalent 

18 personal care services to the eligible veteran. 

19 ‘‘(iii) If personal care services are not available from 

20 a commercial home health entity in the geographic area of 

21 an eligible veteran, the amount of the monthly personal 

22 caregiver stipend payable under the schedule required by 

23 clause (i) with respect to the eligible veteran shall be deter24 mined by taking into consideration the costs of commercial 

25 providers of personal care services in providing personal 
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1 care services in geographic areas other than the geographic 

2 area of the eligible veteran with similar costs of living. 

3 ‘‘(4) An eligible veteran and a family member of the 

4 eligible veteran seeking to participate in the program re5 quired by paragraph (1) shall jointly submit to the Sec6 retary an application therefor in such form and in such 

7 manner as the Secretary considers appropriate. 

8 ‘‘(5) For each application submitted jointly by an eli9 gible veteran and family member, the Secretary shall evalu10 ate— 

11 ‘‘(A) the eligible veteran— 

12 ‘‘(i) to identify the personal care services re13 quired by the eligible veteran; and 

14 ‘‘(ii) to determine whether such require15 ments could be significantly or substantially sat16 isfied through the provision of personal care 

17 services from a family member; and 

18 ‘‘(B) the family member to determine the amount 

19 of instruction, preparation, and training, if any, the 

20 family member requires to provide the personal care 

21 services required by the eligible veteran— 

22 ‘‘(i) as a provider of personal care services 

23 for the eligible veteran; and 

24 ‘‘(ii) as the primary provider of personal 

25 care services for the eligible veteran. 
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1 ‘‘(6)(A) The Secretary shall provide each family mem2 ber of an eligible veteran who makes a joint application 

3 under paragraph (4) the instruction, preparation, and 

4 training determined to be required by such family member 

5 under paragraph (5)(B). 

6 ‘‘(B) Upon the successful completion by a family mem7 ber of an eligible veteran of instruction, preparation, and 

8 training under subparagraph (A), the Secretary shall ap9 prove the family member as a provider of personal care 

10 services for the eligible veteran. 

11 ‘‘(C) The Secretary shall, subject to regulations the 

12 Secretary shall prescribe, provide for necessary travel, lodg13 ing, and per diem expenses incurred by a family member 

14 of an eligible veteran in undergoing instruction, prepara15 tion, and training under subparagraph (A). 

16 ‘‘(D) If the participation of a family member of an 

17 eligible veteran in instruction, preparation, and training 

18 under subparagraph (A) would interfere with the provision 

19 of personal care services to the eligible veteran, the Sec20 retary shall, subject to regulations as the Secretary shall 

21 prescribe and in consultation with the veteran, provide res22 pite care to the eligible veteran during the provision of such 

23 instruction, preparation, and training to the family mem24 ber so that the family member can participate in such in-
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1 struction, preparation, and training without interfering 

2 with the provision of such services to the eligible veteran. 

3 ‘‘(7)(A) For each eligible veteran with at least one fam4 ily member who is described by subparagraph (B), the Sec5 retary shall designate one family member of such eligible 

6 veteran as the primary provider of personal care services 

7 for such eligible veteran. 

8 ‘‘(B) A primary provider of personal care services des9 ignated for an eligible veteran under subparagraph (A) 

10 shall be selected from among family members of the eligible 

11 veteran who— 

12 ‘‘(i) are approved under paragraph (6) as a pro13 vider of personal care services for the eligible veteran; 

14 ‘‘(ii) elect to provide the personal care services to 

15 the eligible veteran that the Secretary determines the 

16 eligible veteran requires under paragraph (5)(A)(i); 

17 ‘‘(iii) has the consent of the eligible veteran to be 

18 the primary provider of personal care services for the 

19 eligible veteran; and 

20 ‘‘(iv) are considered by the Secretary as com21 petent to be the primary provider of personal care 

22 services for the eligible veteran. 

23 ‘‘(C) An eligible veteran receiving personal care serv24 ices from a family member designated as the primary pro25 vider of personal care services for the eligible veteran under 
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1 subparagraph (A) may, in accordance with procedures the 

2 Secretary shall establish for such purposes, revoke consent 

3 with respect to such family member under subparagraph 

4 (B)(iii). 

5 ‘‘(D) If a family member designated as the primary 

6 provider of personal care services for an eligible veteran 

7 under subparagraph (A) subsequently fails to meet any re8 quirement set forth in subparagraph (B), the Secretary— 

9 ‘‘(i) shall immediately revoke the family mem10 ber’s designation under subparagraph (A); and 

11 ‘‘(ii) may designate, in consultation with the eli12 gible veteran, a new primary provider of personal 

13 care services for the eligible veteran under such sub14 paragraph. 

15 ‘‘(E) The Secretary shall take such actions as may be 

16 necessary to ensure that the revocation of a designation 

17 under subparagraph (A) with respect to an eligible veteran 

18 does not interfere with the provision of personal care serv19 ices required by the eligible veteran. 

20 ‘‘(8) If an eligible veteran lacks the capacity to make 

21 a decision under this subsection, the Secretary may, in ac22 cordance with regulations and policies of the Department 

23 regarding appointment of guardians or the use of powers 

24 of attorney, appoint a surrogate for the eligible veteran who 
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1 may make decisions and take action under this subsection 

2 on behalf of the eligible veteran. 

3 ‘‘(9)(A) The Secretary shall monitor the well-being of 

4 each eligible veteran receiving personal care services under 

5 the program required by paragraph (1). 

6 ‘‘(B) The Secretary shall document each finding the 

7 Secretary considers pertinent to the appropriate delivery of 

8 personal care services to an eligible veteran under the pro9 gram. 

10 ‘‘(C) The Secretary shall establish procedures to ensure 

11 appropriate follow-up regarding findings described in sub12 paragraph (B). Such procedures may include the following: 

13 ‘‘(i) Visiting an eligible veteran in the eligible 

14 veteran’s home to review directly the quality of per15 sonal care services provided to the eligible veteran. 

16 ‘‘(ii) Taking such corrective action with respect 

17 to the findings of any review of the quality of per18 sonal care services provided an eligible veteran as the 

19 Secretary considers appropriate, which may in20 clude— 

21 ‘‘(I) providing additional training to a 

22 family caregiver; and 

23 ‘‘(II) suspending or revoking the approval 

24 of a family caregiver under paragraph (6) or the 
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1 designation of a family caregiver under para2 graph (7). 

3 ‘‘(10) The Secretary shall carry out outreach to inform 

4 eligible veterans and family members of eligible veterans of 

5 the program required by paragraph (1) and the benefits of 

6 participating in the program. 

7 ‘‘(b) PROGRAM OF GENERAL CAREGIVER SUPPORT

8 SERVICES.—(1) The Secretary shall establish a program of 

9 support services for caregivers of covered veterans who are 

10 enrolled in the health care system established under section 

11 1705(a) of this title (including caregivers who do not reside 

12 with such veterans). 

13 ‘‘(2) For purposes of this subsection, a covered veteran 

14 is any individual who needs personal care services because 

15 of— 

16 ‘‘(A) an inability to perform one or more activi17 ties of daily living; 

18 ‘‘(B) a need for supervision or protection based 

19 on symptoms or residuals of neurological or other im20 pairment or injury; or 

21 ‘‘(C) such other matters as the Secretary shall 

22 specify. 

23 ‘‘(3)(A) The support services furnished to caregivers of 

24 covered veterans under the program required by paragraph 

25 (1) shall include the following: 
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1 ‘‘(i) Services regarding the administering of per2 sonal care services, which, subject to subparagraph 

3 (B), shall include— 

4 ‘‘(I) educational sessions made available 

5 both in person and on an Internet website; 

6 ‘‘(II) use of telehealth and other available 

7 technologies; and 

8 ‘‘(III) teaching techniques, strategies, and 

9 skills for caring for a disabled veteran; 

10 ‘‘(ii) Counseling and other services under section 

11 1782 of this title. 

12 ‘‘(iii) Respite care under section 1720B of this 

13 title that is medically and age appropriate for the 

14 veteran (including 24-hour per day in-home care). 

15 ‘‘(iv) Information concerning the supportive 

16 services available to caregivers under this subsection 

17 and other public, private, and nonprofit agencies that 

18 offer support to caregivers. 

19 ‘‘(B) If the Secretary certifies to the Committees on 

20 Veterans’ Affairs of the Senate and the House of Representa21 tives that funding available for a fiscal year is insufficient 

22 to fund the provision of services specified in one or more 

23 subclauses of subparagraph (A)(i), the Secretary shall not 

24 be required under subparagraph (A) to provide the services 

25 so specified in the certification during the period beginning 
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1 on the date that is 180 days after the date the certification 

2 is received by the Committees and ending on the last day 

3 of the fiscal year. 

4 ‘‘(4) In providing information under paragraph 

5 (3)(A)(iv), the Secretary shall collaborate with the Assistant 

6 Secretary for Aging of the Department of Health and 

7 Human Services in order to provide caregivers access to 

8 aging and disability resource centers under the Administra9 tion on Aging of the Department of Health and Human 

10 Services. 

11 ‘‘(5) In carrying out the program required by para12 graph (1), the Secretary shall conduct outreach to inform 

13 covered veterans and caregivers of covered veterans about 

14 the program. The outreach shall include an emphasis on 

15 covered veterans and caregivers of covered veterans living 

16 in rural areas. 

17 ‘‘(c) CONSTRUCTION.—(1) A decision by the Secretary 

18 under this section affecting the furnishing of assistance or 

19 support shall be considered a medical determination. 

20 ‘‘(2) Nothing in this section shall be construed to cre21 ate— 

22 ‘‘(A) an employment relationship between the 

23 Secretary and an individual in receipt of assistance 

24 or support under this section; or 
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1 ‘‘(B) any entitlement to any assistance or sup2 port provided under this section. 

3 ‘‘(d) DEFINITIONS.—In this section: 

4 ‘‘(1) The term ‘caregiver’, with respect to an eli5 gible veteran under subsection (a) or a covered vet6 eran under subsection (b), means an individual who 

7 provides personal care services to the veteran. 

8 ‘‘(2) The term ‘family caregiver’, with respect to 

9 an eligible veteran under subsection (a), means a 

10 family member who is a caregiver of the veteran. 

11 ‘‘(3) The term ‘family member’, with respect to 

12 an eligible veteran under subsection (a), means an in13 dividual who— 

14 ‘‘(A) is a member of the family of the vet15 eran, including— 

16 ‘‘(i) a parent; 

17 ‘‘(ii) a spouse; 

18 ‘‘(iii) a child; 

19 ‘‘(iv) a step-family member; and 

20 ‘‘(v) an extended family member; or 

21 ‘‘(B) lives with the veteran but is not a 

22 member of the family of the veteran. 

23 ‘‘(4) The term ‘personal care services’, with re24 spect to an eligible veteran under subsection (a) or a 
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1 covered veteran under subsection (b), means services 

2 that provide the veteran the following: 

3 ‘‘(A) Assistance with one or more inde4 pendent activities of daily living. 

5 ‘‘(B) Any other non-institutional extended 

6 care (as such term is used in section 1701(6)(E) 

7 of this title). 

8 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There are 

9 authorized to be appropriated to carry out the programs 

10 required by subsections (a) and (b)— 

11 ‘‘(1) $60,000,000 for fiscal year 2010; and 

12 ‘‘(2) $1,542,000,000 for the period of fiscal years 

13 2011 through 2015.’’. 

14 (2) CLERICAL AMENDMENT.—The table of sec15 tions at the beginning of chapter 17 is amended by 

16 inserting after the item related to section 1720F the 

17 following new item: 

‘‘1720G. Assistance and support services for caregivers.’’. 

18 (3) EFFECTIVE DATE.— 

19 (A) IN GENERAL.—The amendments made 

20 by this subsection shall take effect on the date 

21 that is 270 days after the date of the enactment 

22 of this Act. 

23 (B) IMPLEMENTATION.—The Secretary of 

24 Veterans Affairs shall commence the programs 

25 required by subsections (a) and (b) of section 
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1 1720G of title 38, United States Code, as added 

2 by paragraph (1) of this subsection, on the date 

3 on which the amendments made by this sub4 section take effect. 

5 (b) IMPLEMENTATION PLAN AND REPORT.— 

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

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

8 Veterans Affairs shall— 

9 (A) develop a plan for the implementation 

10 of the program of comprehensive assistance for 

11 family caregivers required by section 

12 1720G(a)(1) of title 38, United States Code, as 

13 added by subsection (a)(1) of this section; and 

14 (B) submit to the Committee on Veterans’ 

15 Affairs of the Senate and the Committee on Vet16 erans’ Affairs of the House of Representatives a 

17 report on such plan. 

18 (2) CONSULTATION.—In developing the plan re19 quired by paragraph (1)(A), the Secretary shall con20 sult with the following: 

21 (A) Individuals described in section 

22 1720G(a)(2) of title 38, United States Code, as 

23 added by subsection (a)(1) of this section. 
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1 (B) Family members of such individuals 

2 who provide personal care services to such indi3 viduals. 

4 (C) The Secretary of Defense with respect to 

5 matters concerning personal care services for 

6 members of the Armed Forces undergoing med7 ical discharge from the Armed Forces who are el8 igible to benefit from personal care services fur9 nished under the program of comprehensive as10 sistance required by section 1720G(a)(1) of such 

11 title, as so added. 

12 (D) Veterans service organizations, as recog13 nized by the Secretary for the representation of 

14 veterans under section 5902 of such title. 

15 (E) National organizations that specialize 

16 in the provision of assistance to individuals with 

17 the types of disabilities that family caregivers 

18 will encounter while providing personal care 

19 services under the program of comprehensive as20 sistance required by section 1720G(a)(1) of such 

21 title, as so added. 

22 (F) National organizations that specialize 

23 in provision of assistance to family members of 

24 veterans who provide personal care services to 

25 such veterans. 
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1 (G) Such other organizations with an inter2 est in the provision of care to veterans and as3 sistance to family caregivers as the Secretary 

4 considers appropriate. 

5 (3) REPORT CONTENTS.—The report required by 

6 paragraph (1)(B) shall contain the following: 

7 (A) The plan required by paragraph (1)(A). 

8 (B) A description of the individuals, care9 givers, and organizations consulted by the Sec10 retary of Veterans Affairs under paragraph (2). 

11 (C) A description of such consultations. 

12 (D) The recommendations of such individ13 uals, caregivers, and organizations, if any, that 

14 were not adopted and incorporated into the plan 

15 required by paragraph (1)(A), and the reasons 

16 the Secretary did not adopt such recommenda17 tions. 

18 (c) ANNUAL EVALUATION REPORT.— 

19 (1) IN GENERAL.—Not later than 2 years after 

20 the date described in subsection (a)(3)(A) and annu21 ally thereafter, the Secretary shall submit to the Com22 mittee on Veterans’ Affairs of the Senate and the 

23 Committee on Veterans’ Affairs of the House of Rep24 resentatives a comprehensive report on the implemen-
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1 tation of section 1720G of title 38, United States 

2 Code, as added by subsection (a)(1). 

3 (2) CONTENTS.—The report required by para4 graph (1) shall include the following: 

5 (A) With respect to the program of com6 prehensive assistance for family caregivers re7 quired by subsection (a)(1) of such section 1720G 

8 and the program of general caregiver support 

9 services required by subsection (b)(1) of such sec10 tion— 

11 (i) the number of caregivers that re12 ceived assistance under such programs; 

13 (ii) the cost to the Department of pro14 viding assistance under such programs; 

15 (iii) a description of the outcomes 

16 achieved by, and any measurable benefits of, 

17 carrying out such programs; 

18 (iv) an assessment of the effectiveness 

19 and the efficiency of the implementation of 

20 such programs; and 

21 (v) such recommendations, including 

22 recommendations for legislative or adminis23 trative action, as the Secretary considers 

24 appropriate in light of carrying out such 

25 programs. 
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1 (B) With respect to the program of com2 prehensive assistance for family caregivers re3 quired by such subsection (a)(1)— 

4 (i) a description of the outreach activi5 ties carried out by the Secretary under such 

6 program; and 

7 (ii) an assessment of the manner in 

8 which resources are expended by the Sec9 retary under such program, particularly 

10 with respect to the provision of monthly 

11 personal caregiver stipends under para12 graph (3)(A)(ii)(v) of such subsection (a). 

13 (C) With respect to the provision of general 

14 caregiver support services required by such sub15 section (b)(1)— 

16 (i) a summary of the support services 

17 made available under the program; 

18 (ii) the number of caregivers who re19 ceived support services under the program; 

20 (iii) the cost to the Department of pro21 viding each support service provided under 

22 the program; and 

23 (iv) such other information as the Sec24 retary considers appropriate. 
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1 (d) REPORT ON EXPANSION OF FAMILY CAREGIVER

2 ASSISTANCE.— 

3 (1) IN GENERAL.—Not later than 2 years after 

4 the date described in subsection (a)(3)(A), the Sec5 retary shall submit to the Committee on Veterans’ Af6 fairs of the Senate and the Committee on Veterans’ 

7 Affairs of the House of Representatives a report on 

8 the feasibility and advisability of expanding the pro9 vision of assistance under section 1720G(a) of title 

10 38, United States Code, as added by subsection (a)(1), 

11 to family caregivers of veterans who have a serious 

12 injury incurred or aggravated in the line of duty in 

13 the active military, naval, or air service before Sep14 tember 11, 2001. 

15 (2) RECOMMENDATIONS.—The report required by 

16 paragraph (1) shall include such recommendations as 

17 the Secretary considers appropriate with respect to 

18 the expansion described in such paragraph. 

19 SEC. 102. MEDICAL CARE FOR FAMILY CAREGIVERS. 

20 Section 1781(a) is amended— 

21 (1) in paragraph (2), by striking ‘‘and’’ at the 

22 end; 

23 (2) in paragraph (3), by inserting ‘‘and’’ at the 

24 end; and 
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1 (3) by inserting after paragraph (3), the fol2 lowing new paragraph: 

3 ‘‘(4) an individual designated as a primary pro4 vider of personal care services under section 

5 1720G(a)(7)(A) of this title who is not entitled to care 

6 or services under a health-plan contract (as defined in 

7 section 1725(f) of this title);’’. 

8 SEC. 103. COUNSELING AND MENTAL HEALTH SERVICES 

9 FOR CAREGIVERS. 

10 (a) IN GENERAL.—Section 1782(c) is amended— 

11 (1) in paragraph (1), by striking ‘‘; or’’ and in12 serting a semicolon; 

13 (2) by redesignating paragraph (2) as para14 graph (3); and 

15 (3) by inserting after paragraph (1) the fol16 lowing new paragraph (2): 

17 ‘‘(2) a family caregiver of an eligible veteran or 

18 a caregiver of a covered veteran (as those terms are 

19 defined in section 1720G of this title); or’’. 

20 (b) CONFORMING AMENDMENT.—The section heading 

21 of section 1782 is amended by adding at the end, the fol22 lowing: ‘‘and caregivers’’. 

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

24 the beginning of chapter 17 is amended by striking the item 
25 

•S 1963 EAH 

1 relating to section 1782 and inserting the following new 

2 item: 

‘‘1782. Counseling, training, and mental health services for immediate family 

members and caregivers.’’. 

3 SEC. 104. LODGING AND SUBSISTENCE FOR ATTENDANTS. 

4 Section 111(e) is amended— 

5 (1) by striking ‘‘When’’ and inserting the fol6 lowing: ‘‘(1) Except as provided in paragraph (2), 

7 when’’; and 

8 (2) by adding at the end the following new para9 graphs: 

10 ‘‘(2)(A) Without regard to whether an eligible veteran 

11 entitled to mileage under this section for travel to a Depart12 ment facility for the purpose of medical examination, treat13 ment, or care requires an attendant in order to perform 

14 such travel, an attendant of such veteran described in sub15 paragraph (B) may be allowed expenses of travel (including 

16 lodging and subsistence) upon the same basis as such vet17 eran during— 

18 ‘‘(i) the period of time in which such veteran is 

19 traveling to and from a Department facility for the 

20 purpose of medical examination, treatment, or care; 

21 and 

22 ‘‘(ii) the duration of the medical examination, 

23 treatment, or care episode for such veteran. 
26 

•S 1963 EAH 

1 ‘‘(B) An attendant of a veteran described in this sub2 paragraph is a provider of personal care services for such 

3 veteran who is approved under paragraph (6) of section 

4 1720G(a) of this title or designated under paragraph (7) 

5 of such section 1720G(a). 

6 ‘‘(C) The Secretary may prescribe regulations to carry 

7 out this paragraph. Such regulations may include provi8 sions— 

9 ‘‘(i) to limit the number of attendants that may 

10 receive expenses of travel under this paragraph for a 

11 single medical examination, treatment, or care epi12 sode of an eligible veteran; and 

13 ‘‘(ii) to require such attendants to use certain 

14 travel services. 

15 ‘‘(D) In this subsection, the term ‘eligible veteran’ has 

16 the meaning given that term in section 1720G(a)(2) of this 

17 title.’’. 

18 TITLE II—WOMEN VETERANS 

19 HEALTH CARE MATTERS 

20 SEC. 201. STUDY OF BARRIERS FOR WOMEN VETERANS TO 

21 HEALTH CARE FROM THE DEPARTMENT OF 

22 VETERANS AFFAIRS. 

23 (a) STUDY REQUIRED.—The Secretary of Veterans Af24 fairs shall conduct a comprehensive study of the barriers 

25 to the provision of comprehensive health care by the Depart-
27 

•S 1963 EAH 

1 ment of Veterans Affairs encountered by women who are 

2 veterans. In conducting the study, the Secretary shall— 

3 (1) survey women veterans who seek or receive 

4 hospital care or medical services provided by the De5 partment of Veterans Affairs as well as women vet6 erans who do not seek or receive such care or services; 

7 (2) administer the survey to a representative 

8 sample of women veterans from each Veterans Inte9 grated Service Network; and 

10 (3) ensure that the sample of women veterans 

11 surveyed is of sufficient size for the study results to 

12 be statistically significant and is a larger sample 

13 than that of the study referred to in subsection (b). 

14 (b) USE OF PREVIOUS STUDY.—In conducting the 

15 study required by subsection (a), the Secretary shall build 

16 on the work of the study of the Department of Veterans Af17 fairs titled ‘‘National Survey of Women Veterans in Fiscal 

18 Year 2007–2008’’. 

19 (c) ELEMENTS OF STUDY.—In conducting the study 

20 required by subsection (a), the Secretary shall conduct re21 search on the effects of the following on the women veterans 

22 surveyed in the study: 

23 (1) The perceived stigma associated with seeking 

24 mental health care services. 
28 

•S 1963 EAH 

1 (2) The effect of driving distance or availability 

2 of other forms of transportation to the nearest medical 

3 facility on access to care. 

4 (3) The availability of child care. 

5 (4) The acceptability of integrated primary care, 

6 women’s health clinics, or both. 

7 (5) The comprehension of eligibility requirements 

8 for, and the scope of services available under, hospital 

9 care and medical services. 

10 (6) The perception of personal safety and com11 fort in inpatient, outpatient, and behavioral health 

12 facilities. 

13 (7) The gender sensitivity of health care pro14 viders and staff to issues that particularly affect 

15 women. 

16 (8) The effectiveness of outreach for health care 

17 services available to women veterans. 

18 (9) The location and operating hours of health 

19 care facilities that provide services to women veterans. 

20 (10) Such other significant barriers as the Sec21 retary considers appropriate. 

22 (d) DISCHARGE BY CONTRACT.—The Secretary shall 

23 enter into a contract with a qualified independent entity 

24 or organization to carry out the study and research re25 quired under this section. 
29 

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1 (e) MANDATORY REVIEW OF DATA BY CERTAIN DE2 PARTMENT DIVISIONS.— 

3 (1) IN GENERAL.—The Secretary shall ensure 

4 that the head of each division of the Department of 

5 Veterans Affairs specified in paragraph (2) reviews 

6 the results of the study conducted under this section. 

7 The head of each such division shall submit findings 

8 with respect to the study to the Under Secretary for 

9 Health and to other pertinent program offices within 

10 the Department of Veterans Affairs with responsibil11 ities relating to health care services for women vet12 erans. 

13 (2) SPECIFIED DIVISIONS.—The divisions of the 

14 Department of Veterans Affairs specified in this para15 graph are the following: 

16 (A) The Center for Women Veterans estab17 lished under section 318 of title 38, United 

18 States Code. 

19 (B) The Advisory Committee on Women 

20 Veterans established under section 542 of such 

21 title. 

22 (f) REPORTS.— 

23 (1) REPORT ON IMPLEMENTATION.—Not later 

24 than 6 months after the date on which the Depart25 ment of Veterans Affairs publishes a final report on 
30 

•S 1963 EAH 

1 the study titled ‘‘National Survey of Women Veterans 

2 in Fiscal Year 2007–2008’’, the Secretary shall sub3 mit to Congress a report on the status of the imple4 mentation of this section. 

5 (2) REPORT ON STUDY.—Not later than 30 

6 months after the date on which the Department pub7 lishes such final report, the Secretary shall submit to 

8 Congress a report on the study required under this 

9 section. The report shall include recommendations for 

10 such administrative and legislative action as the Sec11 retary considers appropriate. The report shall also in12 clude the findings of the head of each division of the 

13 Department specified under subsection (e)(2) and of 

14 the Under Secretary for Health. 

15 (g) AUTHORIZATION OF APPROPRIATIONS.—There is 

16 authorized to be appropriated to the Secretary of Veterans 

17 Affairs $4,000,000 to carry out this section. 

18 SEC. 202. TRAINING AND CERTIFICATION FOR MENTAL 

19 HEALTH CARE PROVIDERS OF THE DEPART20 MENT OF VETERANS AFFAIRS ON CARE FOR 

21 VETERANS SUFFERING FROM SEXUAL TRAU22 MA AND POST-TRAUMATIC STRESS DIS23 ORDER. 

24 Section 1720D is amended— 
31 

•S 1963 EAH 

1 (1) by redesignating subsection (d) as subsection 

2 (f); and 

3 (2) by inserting after subsection (c) the following 

4 new subsections: 

5 ‘‘(d)(1) The Secretary shall carry out a program to 

6 provide graduate medical education, training, certification, 

7 and continuing medical education for mental health profes8 sionals who provide counseling, care, and services under 

9 subsection (a). 

10 ‘‘(2) In carrying out the program required by para11 graph (1), the Secretary shall ensure that— 

12 ‘‘(A) all mental health professionals described in 

13 such paragraph have been trained in a consistent 

14 manner; and 

15 ‘‘(B) training described in such paragraph in16 cludes principles of evidence-based treatment and care 

17 for sexual trauma and post-traumatic stress disorder. 

18 ‘‘(e) Each year, the Secretary shall submit to Congress 

19 an annual report on the counseling, care, and services pro20 vided to veterans pursuant to this section. Each report shall 

21 include data for the year covered by the report with respect 

22 to each of the following: 

23 ‘‘(1) The number of mental health professionals, 

24 graduate medical education trainees, and primary 

25 care providers who have been certified under the pro-
32 

•S 1963 EAH 

1 gram required by subsection (d) and the amount and 

2 nature of continuing medical education provided 

3 under such program to such professionals, trainees, 

4 and providers who are so certified. 

5 ‘‘(2) The number of women veterans who received 

6 counseling and care and services under subsection (a) 

7 from professionals and providers who received train8 ing under subsection (d). 

9 ‘‘(3) The number of graduate medical education, 

10 training, certification, and continuing medical edu11 cation courses provided by reason of subsection (d). 

12 ‘‘(4) The number of trained full-time equivalent 

13 employees required in each facility of the Department 

14 to meet the needs of veterans requiring treatment and 

15 care for sexual trauma and post-traumatic stress dis16 order. 

17 ‘‘(5) Such recommendations for improvements in 

18 the treatment of women veterans with sexual trauma 

19 and post-traumatic stress disorder as the Secretary 

20 considers appropriate. 

21 ‘‘(6) Such other information as the Secretary 

22 considers appropriate.’’. 
33 

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1 SEC. 203. PILOT PROGRAM ON COUNSELING IN RETREAT 

2 SETTINGS FOR WOMEN VETERANS NEWLY 

3 SEPARATED FROM SERVICE IN THE ARMED 

4 FORCES. 

5 (a) PILOT PROGRAM REQUIRED.— 

6 (1) IN GENERAL.—Commencing not later than 

7 180 days after the date of the enactment of this Act, 

8 the Secretary of Veterans Affairs shall carry out, 

9 through the Readjustment Counseling Service of the 

10 Veterans Health Administration, a pilot program to 

11 evaluate the feasibility and advisability of providing 

12 reintegration and readjustment services described in 

13 subsection (b) in group retreat settings to women vet14 erans who are recently separated from service in the 

15 Armed Forces after a prolonged deployment. 

16 (2) PARTICIPATION AT ELECTION OF VETERAN.— 

17 The participation of a veteran in the pilot program 

18 under this section shall be at the election of the vet19 eran. 

20 (b) COVERED SERVICES.—The services provided to a 

21 woman veteran under the pilot program shall include the 

22 following: 

23 (1) Information on reintegration into the vet24 eran’s family, employment, and community. 

25 (2) Financial counseling. 

26 (3) Occupational counseling. 
34 

•S 1963 EAH 

1 (4) Information and counseling on stress reduc2 tion. 

3 (5) Information and counseling on conflict reso4 lution. 

5 (6) Such other information and counseling as the 

6 Secretary considers appropriate to assist a woman 

7 veteran under the pilot program in reintegration into 

8 the veteran’s family, employment, and community. 

9 (c) LOCATIONS.—The Secretary shall carry out the 

10 pilot program at not fewer than three locations selected by 

11 the Secretary for purposes of the pilot program. 

12 (d) DURATION.—The pilot program shall be carried 

13 out during the 2-year period beginning on the date of the 

14 commencement of the pilot program. 

15 (e) REPORT.—Not later than 180 days after the com16 pletion of the pilot program, the Secretary shall submit to 

17 Congress a report on the pilot program. The report shall 

18 contain the findings and conclusions of the Secretary as a 

19 result of the pilot program, and shall include such rec20 ommendations for the continuation or expansion of the pilot 

21 program as the Secretary considers appropriate. 

22 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

23 authorized to be appropriated to the Secretary of Veterans 

24 Affairs for each of fiscal years 2010 and 2011, $2,000,000 

25 to carry out the pilot program. 
35 

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1 SEC. 204. SERVICE ON CERTAIN ADVISORY COMMITTEES OF 

2 WOMEN RECENTLY SEPARATED FROM SERV3 ICE IN THE ARMED FORCES. 

4 (a) ADVISORY COMMITTEE ON WOMEN VETERANS.— 

5 Section 542(a)(2)(A) is amended— 

6 (1) in clause (ii), by striking ‘‘and’’ at the end; 

7 (2) in clause (iii), by striking the period at the 

8 end and inserting ‘‘; and’’; and 

9 (3) by inserting after clause (iii) the following 

10 new clause: 

11 ‘‘(iv) women veterans who are recently separated 

12 from service in the Armed Forces.’’. 

13 (b) ADVISORY COMMITTEE ON MINORITY VETERANS.— 

14 Section 544(a)(2)(A) is amended— 

15 (1) in clause (iii), by striking ‘‘and’’ at the end; 

16 (2) in clause (iv), by striking the period at the 

17 end and inserting ‘‘; and’’; and 

18 (3) by inserting after clause (iv) the following 

19 new clause: 

20 ‘‘(v) women veterans who are minority group 

21 members and are recently separated from service in 

22 the Armed Forces.’’. 

23 (c) APPLICABILITY.—The amendments made by this 

24 section shall apply to appointments made on or after the 

25 date of the enactment of this Act. 
36 

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1 SEC. 205. PILOT PROGRAM ON ASSISTANCE FOR CHILD 

2 CARE FOR CERTAIN VETERANS RECEIVING 

3 HEALTH CARE. 

4 (a) PILOT PROGRAM REQUIRED.—The Secretary of 

5 Veterans Affairs shall carry out a pilot program to assess 

6 the feasibility and advisability of providing, subject to sub7 section (b), assistance to qualified veterans described in sub8 section (c) to obtain child care so that such veterans can 

9 receive health care services described in subsection (c). 

10 (b) LIMITATION ON PERIOD OF PAYMENTS.—Assist11 ance may only be provided to a qualified veteran under 

12 the pilot program for receipt of child care during the period 

13 that the qualified veteran— 

14 (1) receives the types of health care services de15 scribed in subsection (c) at a facility of the Depart16 ment; and 

17 (2) requires travel to and return from such facil18 ity for the receipt of such health care services. 

19 (c) QUALIFIED VETERANS.—For purposes of this sec20 tion, a qualified veteran is a veteran who is— 

21 (1) the primary caretaker of a child or children; 

22 and 

23 (2)(A) receiving from the Department— 

24 (i) regular mental health care services; 

25 (ii) intensive mental health care services; or 
37 

•S 1963 EAH 

1 (iii) such other intensive health care services 

2 that the Secretary determines that provision of 

3 assistance to the veteran to obtain child care 

4 would improve access to such health care services 

5 by the veteran; or 

6 (B) in need of regular or intensive mental health 

7 care services from the Department, and but for lack 

8 of child care services, would receive such health care 

9 services from the Department. 

10 (d) LOCATIONS.—The Secretary shall carry out the 

11 pilot program in no fewer than three Veterans Integrated 

12 Service Networks selected by the Secretary for purposes of 

13 the pilot program. 

14 (e) DURATION.—The pilot program shall be carried 

15 out during the 2-year period beginning on the date of the 

16 commencement of the pilot program. 

17 (f) FORMS OF CHILD CARE ASSISTANCE.— 

18 (1) IN GENERAL.—Child care assistance under 

19 this section may include the following: 

20 (A) Stipends for the payment of child care 

21 offered by licensed child care centers (either di22 rectly or through a voucher program) which shall 

23 be, to the extent practicable, modeled after the 

24 Department of Veterans Affairs Child Care Sub25 sidy Program established pursuant to section 
38 

•S 1963 EAH 

1 630 of the Treasury and General Government 

2 Appropriations Act, 2002 (Public Law 107–67; 

3 115 Stat. 552). 

4 (B) Direct provision of child care at an on5 site facility of the Department of Veterans Af6 fairs. 

7 (C) Payments to private child care agencies. 

8 (D) Collaboration with facilities or pro9 grams of other Federal departments or agencies. 

10 (E) Such other forms of assistance as the 

11 Secretary considers appropriate. 

12 (2) AMOUNTS OF STIPENDS.—In the case that 

13 child care assistance under this section is provided as 

14 a stipend under paragraph (1)(A), such stipend shall 

15 cover the full cost of such child care. 

16 (g) REPORT.—Not later than 6 months after the com17 pletion of the pilot program, the Secretary shall submit to 

18 Congress a report on the pilot program. The report shall 

19 include the findings and conclusions of the Secretary as a 

20 result of the pilot program, and shall include such rec21 ommendations for the continuation or expansion of the pilot 

22 program as the Secretary considers appropriate. 

23 (h) AUTHORIZATION OF APPROPRIATIONS.—There is 

24 authorized to be appropriated to the Secretary of Veterans 
39 

•S 1963 EAH 

1 Affairs to carry out the pilot program $1,500,000 for each 

2 of fiscal years 2010 and 2011. 

3 SEC. 206. CARE FOR NEWBORN CHILDREN OF WOMEN VET4 ERANS RECEIVING MATERNITY CARE. 

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

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

7 ‘‘§ 1786. Care for newborn children of women veterans 

8 receiving maternity care 

9 ‘‘(a) IN GENERAL.—The Secretary may furnish health 

10 care services described in subsection (b) to a newborn child 

11 of a woman veteran who is receiving maternity care fur12 nished by the Department for not more than seven days 

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

14 in— 

15 ‘‘(1) a facility of the Department; or 

16 ‘‘(2) another facility pursuant to a Department 

17 contract for services relating to such delivery. 

18 ‘‘(b) COVERED HEALTH CARE SERVICES.—Health 

19 care services described in this subsection are all post-deliv20 ery care services, including routine care services, that a 

21 newborn child requires.’’. 

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

23 the beginning of chapter 17 is amended by inserting after 

24 the item relating to section 1785 the following new item: 

‘‘1786. Care for newborn children of women veterans receiving maternity care.’’. 
40 

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1 TITLE III—RURAL HEALTH 

2 IMPROVEMENTS 

3 SEC. 301. IMPROVEMENTS TO THE EDUCATION DEBT RE4 DUCTION PROGRAM. 

5 (a) INCLUSION OF EMPLOYEE RETENTION AS PUR6 POSE OF PROGRAM.—Section 7681(a)(2) is amended by in7 serting ‘‘and retention’’ after ‘‘recruitment’’ the first time 

8 it appears. 

9 (b) EXPANSION OF ELIGIBILITY.—Section 7682 is 

10 amended— 

11 (1) in subsection (a)(1), by striking ‘‘a recently 

12 appointed’’ and inserting ‘‘an’’; and 

13 (2) by striking subsection (c). 

14 (c) INCREASE IN MAXIMUM ANNUAL AMOUNT OF PAY15 MENTS.—Paragraph (1) of subsection (d) of section 7683 

16 is amended— 

17 (1) by striking ‘‘$44,000’’ and inserting 

18 ‘‘$60,000’’; and 

19 (2) by striking ‘‘$10,000’’ and inserting 

20 ‘‘$12,000’’. 

21 (d) EXCEPTION TO LIMITATION ON AMOUNT FOR CER22 TAIN PARTICIPANTS.—Such subsection is further amended 

23 by adding at the end the following new paragraph: 

24 ‘‘(3)(A) The Secretary may waive the limitations 

25 under paragraphs (1) and (2) in the case of a participant 
41 

•S 1963 EAH 

1 described in subparagraph (B). In the case of such a waiver, 

2 the total amount of education debt repayments payable to 

3 that participant is the total amount of the principal and 

4 the interest on the participant’s loans referred to in sub5 section (a). 

6 ‘‘(B) A participant described in this subparagraph is 

7 a participant in the Program who the Secretary determines 

8 serves in a position for which there is a shortage of qualified 

9 employees by reason of either the location or the require10 ments of the position.’’. 

11 SEC. 302. VISUAL IMPAIRMENT AND ORIENTATION AND MO12 BILITY PROFESSIONALS EDUCATION ASSIST13 ANCE PROGRAM. 

14 (a) ESTABLISHMENT OF PROGRAM.—Part V is amend15 ed by inserting after chapter 74 the following new chapter: 

16 ‘‘CHAPTER 75—VISUAL IMPAIRMENT AND 

17 ORIENTATION AND MOBILITY PROFES18 SIONALS EDUCATIONAL ASSISTANCE 

19 PROGRAM 

‘‘Sec. 

‘‘7501. Establishment of scholarship program; purpose. 

‘‘7502. Application and acceptance. 

‘‘7503. Amount of assistance; duration. 

‘‘7504. Agreement. 

‘‘7505. Repayment for failure to satisfy requirements of agreement. 
42 

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1 ‘‘§ 7501. Establishment of scholarship program; pur2 pose 

3 ‘‘(a) ESTABLISHMENT.—Subject to the availability of 

4 appropriations, the Secretary shall establish and carry out 

5 a scholarship program to provide financial assistance in 

6 accordance with this chapter to individuals who— 

7 ‘‘(1) are accepted for enrollment or currently en8 rolled in a program of study leading to a degree or 

9 certificate in visual impairment or orientation and 

10 mobility, or a dual degree or certification in both 

11 such areas, at an accredited (as determined by the 

12 Secretary) educational institution that is in a State; 

13 and 

14 ‘‘(2) enter into an agreement with the Secretary 

15 as described in section 7504 of this title. 

16 ‘‘(b) PURPOSE.—The purpose of the scholarship pro17 gram is to increase the supply of qualified blind rehabilita18 tion specialists for the Department and the Nation. 

19 ‘‘(c) OUTREACH.—The Secretary shall publicize the 

20 scholarship program to educational institutions throughout 

21 the United States, with an emphasis on disseminating in22 formation to such institutions with high numbers of His23 panic students and to Historically Black Colleges and Uni24 versities. 
43 

•S 1963 EAH 

1 ‘‘§ 7502. Application and acceptance 

2 ‘‘(a) APPLICATION.—(1) To apply and participate in 

3 the scholarship program under this chapter, an individual 

4 shall submit to the Secretary an application for such par5 ticipation together with an agreement described in section 

6 7504 of this title under which the participant agrees to serve 

7 a period of obligated service in the Department as provided 

8 in the agreement in return for payment of educational as9 sistance as provided in the agreement. 

10 ‘‘(2) In distributing application forms and agreement 

11 forms to individuals desiring to participate in the scholar12 ship program, the Secretary shall include with such forms 

13 the following: 

14 ‘‘(A) A fair summary of the rights and liabilities 

15 of an individual whose application is approved (and 

16 whose agreement is accepted) by the Secretary. 

17 ‘‘(B) A full description of the terms and condi18 tions that apply to participation in the scholarship 

19 program and service in the Department. 

20 ‘‘(b) APPROVAL.—(1) Upon the Secretary’s approval 

21 of an individual’s participation in the scholarship pro22 gram, the Secretary shall, in writing, promptly notify the 

23 individual of that acceptance. 

24 ‘‘(2) An individual becomes a participant in the schol25 arship program upon such approval by the Secretary. 
44 

•S 1963 EAH 

1 ‘‘§ 7503. Amount of assistance; duration 

2 ‘‘(a) AMOUNT OF ASSISTANCE.—The amount of the fi3 nancial assistance provided an individual under the schol4 arship program under this chapter shall be the amount de5 termined by the Secretary as being necessary to pay the 

6 tuition and fees of the individual. In the case of an indi7 vidual enrolled in a program of study leading to a dual 

8 degree or certification in both the areas of study described 

9 in section 7501(a)(1) of this title, the tuition and fees shall 

10 not exceed the amounts necessary for the minimum number 

11 of credit hours to achieve such dual degree or certification. 

12 ‘‘(b) RELATIONSHIP TO OTHER ASSISTANCE.—Finan13 cial assistance may be provided to an individual under the 

14 scholarship program to supplement other educational assist15 ance to the extent that the total amount of educational as16 sistance received by the individual during an academic 

17 year does not exceed the total tuition and fees for such aca18 demic year. 

19 ‘‘(c) MAXIMUM AMOUNT OF ASSISTANCE.—(1) The 

20 total amount of assistance provided under the scholarship 

21 program for an academic year to an individual who is a 

22 full-time student may not exceed $15,000. 

23 ‘‘(2) In the case of an individual who is a part-time 

24 student, the total amount of assistance provided under the 

25 scholarship program shall bear the same ratio to the 

26 amount that would be paid under paragraph (1) if the par-
45 

•S 1963 EAH 

1 ticipant were a full-time student in the program of study 

2 being pursued by the individual as the coursework carried 

3 by the individual to full-time coursework in that program 

4 of study. 

5 ‘‘(3) The total amount of assistance provided to an in6 dividual under the scholarship program may not exceed 

7 $45,000. 

8 ‘‘(d) MAXIMUM DURATION OF ASSISTANCE.—Finan9 cial assistance may not be provided to an individual under 

10 the scholarship program for more than six academic years. 

11 ‘‘§ 7504. Agreement 

12 ‘‘An agreement between the Secretary and a partici13 pant in the scholarship program under this chapter shall 

14 be in writing, shall be signed by the participant, and shall 

15 include— 

16 ‘‘(1) the Secretary’s agreement to provide the 

17 participant with financial assistance as authorized 

18 under this chapter; 

19 ‘‘(2) the participant’s agreement— 

20 ‘‘(A) to accept such financial assistance; 

21 ‘‘(B) to maintain enrollment and attend22 ance in the program of study described in section 

23 7501(a)(1) of this title; 

24 ‘‘(C) while enrolled in such program, to 

25 maintain an acceptable level of academic stand-
46 

•S 1963 EAH 

1 ing (as determined by the educational institution 

2 offering such program under regulations pre3 scribed by the Secretary); and 

4 ‘‘(D) after completion of the program, to 

5 serve as a full-time employee in the Department 

6 for a period of three years, to be served within 

7 the first six years after the participant has com8 pleted such program and received a degree or 

9 certificate described in section 7501(a)(1) of this 

10 title; and 

11 ‘‘(3) any other terms and conditions that the 

12 Secretary considers appropriate for carrying out this 

13 chapter. 

14 ‘‘§ 7505. Repayment for failure to satisfy requirements 

15 of agreement 

16 ‘‘(a) IN GENERAL.—An individual who receives edu17 cational assistance under the scholarship program under 

18 this chapter shall repay to the Secretary an amount equal 

19 to the unearned portion of such assistance if the individual 

20 fails to satisfy the requirements of the agreement entered 

21 into under section 7504 of this title, except in circumstances 

22 authorized by the Secretary. 

23 ‘‘(b) AMOUNT OF REPAYMENT.—The Secretary shall 

24 establish, by regulations, procedures for determining the 

25 amount of the repayment required under this section and 
47 

•S 1963 EAH 

1 the circumstances under which an exception to the required 

2 repayment may be granted. 

3 ‘‘(c) WAIVER OR SUSPENSION OF COMPLIANCE.—The 

4 Secretary shall prescribe regulations providing for the 

5 waiver or suspension of any obligation of an individual for 

6 service or payment under this chapter (or an agreement 

7 under this chapter) whenever— 

8 ‘‘(1) noncompliance by the individual is due to 

9 circumstances beyond the control of the individual; or 

10 ‘‘(2) the Secretary determines that the waiver or 

11 suspension of compliance is in the best interest of the 

12 United States. 

13 ‘‘(d) OBLIGATION AS DEBT TO UNITED STATES.—An 

14 obligation to repay the Secretary under this section is, for 

15 all purposes, a debt owed the United States. A discharge 

16 in bankruptcy under title 11 does not discharge a person 

17 from such debt if the discharge order is entered less than 

18 five years after the date of the termination of the agreement 

19 or contract on which the debt is based.’’. 

20 (b) CLERICAL AMENDMENTS.—The tables of chapters 

21 at the beginning of title 38, and of part V, are each amend22 ed by inserting after the item relating to chapter 74 the 

23 following new item: 

‘‘75. Visual Impairment and Orientation and Mobility Professionals 

Educational Assistance Program ...................................... 7501’’. 
48 

•S 1963 EAH 

1 (c) IMPLEMENTATION.—The Secretary of Veterans Af2 fairs shall implement chapter 75 of title 38, United States 

3 Code, as added by subsection (a), not later than 6 months 

4 after the date of the enactment of this Act. 

5 SEC. 303. DEMONSTRATION PROJECTS ON ALTERNATIVES 

6 FOR EXPANDING CARE FOR VETERANS IN 

7 RURAL AREAS. 

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

9 may, through the Director of the Office of Rural Health, 

10 carry out demonstration projects to examine the feasibility 

11 and advisability of alternatives for expanding care for vet12 erans in rural areas, which may include the following: 

13 (1) Establishing a partnership between the De14 partment of Veterans Affairs and the Centers for 

15 Medicare and Medicaid Services of the Department of 

16 Health and Human Services to coordinate care for 

17 veterans in rural areas at critical access hospitals (as 

18 designated or certified under section 1820 of the So19 cial Security Act (42 U.S.C. 1395i–4)). 

20 (2) Establishing a partnership between the De21 partment of Veterans Affairs and the Department of 

22 Health and Human Services to coordinate care for 

23 veterans in rural areas at community health centers. 
49 

•S 1963 EAH 

1 (3) Expanding coordination between the Depart2 ment of Veterans Affairs and the Indian Health Serv3 ice to expand care for Indian veterans. 

4 (b) GEOGRAPHIC DISTRIBUTION.—The Secretary shall 

5 ensure that the demonstration projects carried out under 

6 subsection (a) are located at facilities that are geographi7 cally distributed throughout the United States. 

8 (c) REPORT.—Not later than 2 years after the date of 

9 the enactment of this Act, the Secretary shall submit a re10 port on the results of the demonstration projects carried out 

11 under subsection (a) to— 

12 (1) the Committee on Veterans’ Affairs and the 

13 Committee on Appropriations of the Senate; and 

14 (2) the Committee on Veterans’ Affairs and the 

15 Committee on Appropriations of the House of Rep16 resentatives. 

17 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

18 authorized to be appropriated to carry out this section 

19 $5,000,000 for fiscal year 2010 and each fiscal year there20 after. 
50 

•S 1963 EAH 

1 SEC. 304. PROGRAM ON READJUSTMENT AND MENTAL 

2 HEALTH CARE SERVICES FOR VETERANS WHO 

3 SERVED IN OPERATION ENDURING FREEDOM 

4 AND OPERATION IRAQI FREEDOM. 

5 (a) PROGRAM REQUIRED.—Not later than 180 days 

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

7 of Veterans Affairs shall establish a program to provide— 

8 (1) to veterans of Operation Enduring Freedom 

9 and Operation Iraqi Freedom, particularly veterans 

10 who served in such operations while in the National 

11 Guard and the Reserves— 

12 (A) peer outreach services; 

13 (B) peer support services; 

14 (C) readjustment counseling and services de15 scribed in section 1712A of title 38, United 

16 States Code; and 

17 (D) mental health services; and 

18 (2) to members of the immediate family of vet19 erans described in paragraph (1), during the 3-year 

20 period beginning on the date of the return of such vet21 erans from deployment in Operation Enduring Free22 dom or Operation Iraqi Freedom, education, support, 

23 counseling, and mental health services to assist in— 

24 (A) the readjustment of such veterans to ci25 vilian life; 
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1 (B) in the case such veterans have an in2 jury or illness incurred during such deployment, 

3 the recovery of such veterans from such injury or 

4 illness; and 

5 (C) the readjustment of the family following 

6 the return of such veterans. 

7 (b) CONTRACTS WITH COMMUNITY MENTAL HEALTH

8 CENTERS AND OTHER QUALIFIED ENTITIES.—In carrying 

9 out the program required by subsection (a), the Secretary 

10 may contract with community mental health centers and 

11 other qualified entities to provide the services required by 

12 such subsection only in areas the Secretary determines are 

13 not adequately served by other health care facilities or vet 

14 centers of the Department of Veterans Affairs. Such con15 tracts shall require each contracting community health cen16 ter or entity— 

17 (1) to the extent practicable, to use telehealth 

18 services for the delivery of services required by sub19 section (a); 

20 (2) to the extent practicable, to employ veterans 

21 trained under subsection (c) in the provision of serv22 ices covered by that subsection; 

23 (3) to participate in the training program con24 ducted in accordance with subsection (d); 
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1 (4) to comply with applicable protocols of the 

2 Department before incurring any liability on behalf 

3 of the Department for the provision of services re4 quired by subsection (a); 

5 (5) for each veteran for whom a community 

6 mental health center or other qualified entity provides 

7 mental health services under such contract, to provide 

8 the Department with such clinical summary informa9 tion as the Secretary shall require; 

10 (6) to submit annual reports to the Secretary 

11 containing, with respect to the program required by 

12 subsection (a) and for the last full calendar year end13 ing before the submittal of such report— 

14 (A) the number of the veterans served, vet15 erans diagnosed, and courses of treatment pro16 vided to veterans as part of the program required 

17 by subsection (a); and 

18 (B) demographic information for such serv19 ices, diagnoses, and courses of treatment; and 

20 (7) to meet such other requirements as the Sec21 retary shall require. 

22 (c) TRAINING OF VETERANS FOR PROVISION OF PEER23 OUTREACH AND PEER-SUPPORT SERVICES.—In carrying 

24 out the program required by subsection (a), the Secretary 

25 shall contract with a national not-for-profit mental health 
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1 organization to carry out a national program of training 

2 for veterans described in subsection (a) to provide the serv3 ices described in subparagraphs (A) and (B) of paragraph 

4 (1) of such subsection. 

5 (d) TRAINING OF CLINICIANS FOR PROVISION OF

6 SERVICES.—The Secretary shall conduct a training pro7 gram for clinicians of community mental health centers or 

8 entities that have contracts with the Secretary under sub9 section (b) to ensure that such clinicians can provide the 

10 services required by subsection (a) in a manner that— 

11 (1) recognizes factors that are unique to the expe12 rience of veterans who served on active duty in Oper13 ation Enduring Freedom or Operation Iraqi Freedom 

14 (including their combat and military training experi15 ences); and 

16 (2) uses best practices and technologies. 

17 (e) VET CENTER DEFINED.—In this section, the term 

18 ‘‘vet center’’ means a center for readjustment counseling 

19 and related mental health services for veterans under section 

20 1712A of title 38, United States Code. 

21 SEC. 305. TRAVEL REIMBURSEMENT FOR VETERANS RE22 CEIVING TREATMENT AT FACILITIES OF THE 

23 DEPARTMENT OF VETERANS AFFAIRS. 

24 (a) ENHANCEMENT OF ALLOWANCE BASED UPON

25 MILEAGE TRAVELED.—Section 111 is amended— 
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1 (1) in subsection (a), by striking ‘‘traveled,’’ and 

2 inserting ‘‘(at a rate of 41.5 cents per mile),’’; and 

3 (2) by amending subsection (g) to read as fol4 lows: 

5 ‘‘(g)(1) Beginning one year after the date of the enact6 ment of the Caregivers and Veterans Omnibus Health Serv7 ices Act of 2010, the Secretary may adjust the mileage rate 

8 described in subsection (a) to be equal to the mileage reim9 bursement rate for the use of privately owned vehicles by 

10 Government employees on official business (when a Govern11 ment vehicle is available), as prescribed by the Adminis12 trator of General Services under section 5707(b) of title 5. 

13 ‘‘(2) If an adjustment in the mileage rate under para14 graph (1) results in a lower mileage rate than the mileage 

15 rate otherwise specified in subsection (a), the Secretary 

16 shall, not later than 60 days before the date of the imple17 mentation of the mileage rate as so adjusted, submit to Con18 gress a written report setting forth the adjustment in the 

19 mileage rate under this subsection, together with a justifica20 tion for the decision to make the adjustment in the mileage 

21 rate under this subsection.’’. 

22 (b) COVERAGE OF COST OF TRANSPORTATION BY

23 AIR.—Subsection (a) of section 111, as amended by sub24 section (a)(1), is further amended by inserting after the first 

25 sentence the following new sentence: ‘‘Actual necessary ex-
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1 pense of travel includes the reasonable costs of airfare if 

2 travel by air is the only practical way to reach a Depart3 ment facility.’’. 

4 (c) ELIMINATION OF LIMITATION BASED ON MAXIMUM

5 ANNUAL RATE OF PENSION.—Subsection (b)(1)(D)(i) of 

6 such section is amended by inserting ‘‘who is not traveling 

7 by air and’’ before ‘‘whose annual’’. 

8 (d) DETERMINATION OF PRACTICALITY.—Subsection 

9 (b) of such section is amended by adding at the end the 

10 following new paragraph: 

11 ‘‘(4) In determining for purposes of subsection (a) 

12 whether travel by air is the only practical way for a veteran 

13 to reach a Department facility, the Secretary shall consider 

14 the medical condition of the veteran and any other impedi15 ments to the use of ground transportation by the veteran.’’. 

16 (e) NO EXPANSION OF ELIGIBILITY FOR BENEFICIARY

17 TRAVEL.—The amendments made by subsections (b) and 

18 (d) of this section may not be construed as expanding or 

19 otherwise modifying eligibility for payments or allowances 

20 for beneficiary travel under section 111 of title 38, United 

21 States Code, as in effect on the day before the date of the 

22 enactment of this Act. 

23 (f) CLARIFICATION OF RELATION TO PUBLIC TRANS24 PORTATION IN VETERANS HEALTH ADMINISTRATION HAND25 BOOK.—Not later than 30 days after the date of the enact-
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1 ment of this Act, the Secretary of Veterans Affairs shall re2 vise the Veterans Health Administration Handbook to clar3 ify that an allowance for travel based on mileage paid 

4 under section 111(a) of title 38, United States Code, may 

5 exceed the cost of such travel by public transportation re6 gardless of medical necessity. 

7 SEC. 306. PILOT PROGRAM ON INCENTIVES FOR PHYSI8 CIANS WHO ASSUME INPATIENT RESPON9 SIBILITIES AT COMMUNITY HOSPITALS IN 

10 HEALTH PROFESSIONAL SHORTAGE AREAS. 

11 (a) PILOT PROGRAM REQUIRED.—The Secretary of 

12 Veterans Affairs shall carry out a pilot program to assess 

13 the feasability and advisability of each of the following: 

14 (1) The provision of financial incentives to eligi15 ble physicians who obtain and maintain inpatient 

16 privileges at community hospitals in health profes17 sional shortage areas in order to facilitate the provi18 sion by such physicians of primary care and mental 

19 health services to veterans at such hospitals. 

20 (2) The collection of payments from third-party 

21 providers for care provided by eligible physicians to 

22 nonveterans while discharging inpatient responsibil23 ities at community hospitals in the course of exer24 cising the privileges described in paragraph (1). 
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1 (b) ELIGIBLE PHYSICIANS.—For purposes of this sec2 tion, an eligible physician is a primary care or mental 

3 health physician employed by the Department of Veterans 

4 Affairs on a full-time basis. 

5 (c) DURATION OF PROGRAM.—The pilot program shall 

6 be carried out during the 3-year period beginning on the 

7 date of the commencement of the pilot program. 

8 (d) LOCATIONS.— 

9 (1) IN GENERAL.—The pilot program shall be 

10 carried out at not less than five community hospitals 

11 in each of not less than two Veterans Integrated Serv12 ices Networks. The hospitals shall be selected by the 

13 Secretary using the results of the survey required 

14 under subsection (e). 

15 (2) QUALIFYING COMMUNITY HOSPITALS.—A 

16 community hospital may be selected by the Secretary 

17 as a location for the pilot program if— 

18 (A) the hospital is located in a health pro19 fessional shortage area; and 

20 (B) the number of eligible physicians will21 ing to assume inpatient responsibilities at the 

22 hospital (as determined using the result of the 

23 survey) is sufficient for purposes of the pilot pro24 gram. 
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1 (e) SURVEY OF PHYSICIAN INTEREST IN PARTICIPA2 TION.— 

3 (1) IN GENERAL.—Not later than 120 days after 

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

5 shall conduct a survey of eligible physicians to deter6 mine the extent of the interest of such physicians in 

7 participating in the pilot program. 

8 (2) ELEMENTS.—The survey shall disclose the 

9 type, amount, and nature of the financial incentives 

10 to be provided under subsection (h) to physicians par11 ticipating in the pilot program. 

12 (f) PHYSICIAN PARTICIPATION.— 

13 (1) IN GENERAL.—The Secretary shall select 

14 physicians for participation in the pilot program 

15 from among eligible physicians who— 

16 (A) express interest in participating in the 

17 pilot program in the survey conducted under 

18 subsection (e); 

19 (B) are in good standing with the Depart20 ment; and 

21 (C) primarily have clinical responsibilities 

22 with the Department. 

23 (2) VOLUNTARY PARTICIPATION.—Participation 

24 in the pilot program shall be voluntary. Nothing in 

25 this section shall be construed to require a physician 
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1 working for the Department to assume inpatient re2 sponsibilities at a community hospital unless other3 wise required as a term or condition of employment 

4 with the Department. 

5 (g) ASSUMPTION OF INPATIENT PHYSICIAN RESPON6 SIBILITIES.— 

7 (1) IN GENERAL.—Each eligible physician se8 lected for participation in the pilot program shall as9 sume and maintain inpatient responsibilities, includ10 ing inpatient responsibilities with respect to non11 veterans, at one or more community hospitals selected 

12 by the Secretary for participation in the pilot pro13 gram under subsection (d). 

14 (2) COVERAGE UNDER FEDERAL TORT CLAIMS

15 ACT.—If an eligible physician participating in the 

16 pilot program carries out on-call responsibilities at a 

17 community hospital where privileges to practice at 

18 such hospital are conditioned upon the provision of 

19 services to individuals who are not veterans while the 

20 physician is on call for such hospital, the provision 

21 of such services by the physician shall be considered 

22 an action within the scope of the physician’s office or 

23 employment for purposes of chapter 171 of title 28, 

24 United States Code (commonly referred to as the 

25 ‘‘Federal Tort Claims Act’’). 
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1 (h) COMPENSATION.— 

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

3 each eligible physician participating in the pilot pro4 gram with such compensation (including pay and 

5 other appropriate compensation) as the Secretary 

6 considers appropriate to compensate such physician 

7 for the discharge of any inpatient responsibilities by 

8 such physician at a community hospital for which 

9 such physician would not otherwise be compensated 

10 by the Department as a full-time employee of the De11 partment. 

12 (2) WRITTEN AGREEMENT.—The amount of any 

13 compensation to be provided a physician under the 

14 pilot program shall be specified in a written agree15 ment entered into by the Secretary and the physician 

16 for purposes of the pilot program. 

17 (3) TREATMENT OF COMPENSATION.—The Sec18 retary shall consult with the Director of the Office of 

19 Personnel Management on the inclusion of a provi20 sion in the written agreement required under para21 graph (2) that describes the treatment under Federal 

22 law of any compensation provided a physician under 

23 the pilot program, including treatment for purposes 

24 of retirement under the civil service laws. 
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1 (i) COLLECTIONS FROM THIRD PARTIES.—In car2 rying out the pilot program for the purpose described in 

3 subsection (a)(2), the Secretary shall implement a variety 

4 and range of requirements and mechanisms for the collec5 tion from third-party payors of amounts to reimburse the 

6 Department for health care services provided to nonveterans 

7 under the pilot program by eligible physicians discharging 

8 inpatient responsibilities under the pilot program. 

9 (j) REPORT.—Not later than 1 year after the date of 

10 the enactment of this Act and annually thereafter, the Sec11 retary shall submit to Congress a report on the pilot pro12 gram, including the following: 

13 (1) The findings of the Secretary with respect to 

14 the pilot program. 

15 (2) The number of veterans and nonveterans pro16 vided inpatient care by physicians participating in 

17 the pilot program. 

18 (3) The amounts payable and collected under 

19 subsection (i). 

20 (k) DEFINITIONS.—In this section: 

21 (1) HEALTH PROFESSIONAL SHORTAGE AREA.— 

22 The term ‘‘health professional shortage area’’ has the 

23 meaning given the term in section 332(a) of the Pub24 lic Health Service Act (42 U.S.C. 254e(a)). 
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1 (2) INPATIENT RESPONSIBILITIES.—The term 

2 ‘‘inpatient responsibilities’’ means on-call responsibil3 ities customarily required of a physician by a com4 munity hospital as a condition of granting privileges 

5 to the physician to practice in the hospital. 

6 SEC. 307. GRANTS FOR VETERANS SERVICE ORGANIZA7 TIONS FOR TRANSPORTATION OF HIGHLY 

8 RURAL VETERANS. 

9 (a) GRANTS AUTHORIZED.— 

10 (1) IN GENERAL.—The Secretary of Veterans Af11 fairs shall establish a grant program to provide inno12 vative transportation options to veterans in highly 

13 rural areas. 

14 (2) ELIGIBLE RECIPIENTS.—The following may 

15 be awarded a grant under this section: 

16 (A) State veterans service agencies. 

17 (B) Veterans service organizations. 

18 (3) USE OF FUNDS.—A State veterans service 

19 agency or veterans service organization awarded a 

20 grant under this section may use the grant amount 

21 to— 

22 (A) assist veterans in highly rural areas to 

23 travel to Department of Veterans Affairs medical 

24 centers; and 
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1 (B) otherwise assist in providing transpor2 tation in connection with the provision of med3 ical care to veterans in highly rural areas. 

4 (4) MAXIMUM AMOUNT.—The amount of a grant 

5 under this section may not exceed $50,000. 

6 (5) NO MATCHING REQUIREMENT.—The recipient 

7 of a grant under this section shall not be required to 

8 provide matching funds as a condition for receiving 

9 such grant. 

10 (b) REGULATIONS.—The Secretary shall prescribe reg11 ulations for— 

12 (1) evaluating grant applications under this sec13 tion; and 

14 (2) otherwise administering the program estab15 lished by this section. 

16 (c) DEFINITIONS.—In this section: 

17 (1) HIGHLY RURAL.—The term ‘‘highly rural’’, 

18 in the case of an area, means that the area consists 

19 of a county or counties having a population of less 

20 than seven persons per square mile. 

21 (2) VETERANS SERVICE ORGANIZATION.—The 

22 term ‘‘veterans service organization’’ means any orga23 nization recognized by the Secretary of Veterans Af24 fairs for the representation of veterans under section 

25 5902 of title 38, United States Code. 
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1 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated $3,000,000 for each of fiscal 

3 years 2010 through 2014 to carry out this section. 

4 SEC. 308. MODIFICATION OF ELIGIBILITY FOR PARTICIPA5 TION IN PILOT PROGRAM OF ENHANCED CON6 TRACT CARE AUTHORITY FOR HEALTH CARE 

7 NEEDS OF CERTAIN VETERANS. 

8 Subsection (b) of section 403 of the Veterans’ Mental 

9 Health and other Care Improvements Act of 2008 (Public 

10 Law 110–387; 122 Stat. 4125; 38 U.S.C. 1703 note) is 

11 amended to read as follows: 

12 ‘‘(b) COVERED VETERANS.—For purposes of the pilot 

13 program under this section, a covered veteran is any vet14 eran who— 

15 ‘‘(1) is— 

16 ‘‘(A) enrolled in the system of patient en17 rollment established under section 1705(a) of 

18 title 38, United States Code, as of the date of the 

19 commencement of the pilot program under sub20 section (a)(2); or 

21 ‘‘(B) eligible for health care under section 

22 1710(e)(3) of such title; and 

23 ‘‘(2) resides in a location that is— 

24 ‘‘(A) more than 60 minutes driving distance 

25 from the nearest Department health care facility 
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1 providing primary care services, if the veteran is 

2 seeking such services; 

3 ‘‘(B) more than 120 minutes driving dis4 tance from the nearest Department health care 

5 facility providing acute hospital care, if the vet6 eran is seeking such care; or 

7 ‘‘(C) more than 240 minutes driving dis8 tance from the nearest Department health care 

9 facility providing tertiary care, if the veteran is 

10 seeking such care.’’. 

11 TITLE IV—MENTAL HEALTH 

12 CARE MATTERS 

13 SEC. 401. ELIGIBILITY OF MEMBERS OF THE ARMED 

14 FORCES WHO SERVE IN OPERATION ENDUR15 ING FREEDOM OR OPERATION IRAQI FREE16 DOM FOR COUNSELING AND SERVICES 

17 THROUGH READJUSTMENT COUNSELING 

18 SERVICE. 

19 (a) IN GENERAL.—Any member of the Armed Forces, 

20 including a member of the National Guard or Reserve, who 

21 serves on active duty in the Armed Forces in Operation 

22 Enduring Freedom or Operation Iraqi Freedom is eligible 

23 for readjustment counseling and related mental health serv24 ices under section 1712A of title 38, United States Code, 
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1 through the Readjustment Counseling Service of the Vet2 erans Health Administration. 

3 (b) NO REQUIREMENT FOR CURRENT ACTIVE DUTY

4 SERVICE.—A member of the Armed Forces who meets the 

5 requirements for eligibility for counseling and services 

6 under subsection (a) is entitled to counseling and services 

7 under that subsection regardless of whether or not the mem8 ber is currently on active duty in the Armed Forces at the 

9 time of receipt of counseling and services under that sub10 section. 

11 (c) REGULATIONS.—The eligibility of members of the 

12 Armed Forces for counseling and services under subsection 

13 (a) shall be subject to such regulations as the Secretary of 

14 Defense and the Secretary of Veterans Affairs shall jointly 

15 prescribe for purposes of this section. 

16 (d) SUBJECT TO AVAILABILITY OF APPROPRIATIONS.— 

17 The provision of counseling and services under subsection 

18 (a) shall be subject to the availability of appropriations for 

19 such purpose. 

20 SEC. 402. RESTORATION OF AUTHORITY OF READJUST21 MENT COUNSELING SERVICE TO PROVIDE RE22 FERRAL AND OTHER ASSISTANCE UPON RE23 QUEST TO FORMER MEMBERS OF THE ARMED 

24 FORCES NOT AUTHORIZED COUNSELING. 

25 Section 1712A is amended— 
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1 (1) by redesignating subsections (c) through (f) 

2 as subsections (d) through (g), respectively; and 

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

4 new subsection (c): 

5 ‘‘(c) Upon receipt of a request for counseling under this 

6 section from any individual who has been discharged or re7 leased from active military, naval, or air service but who 

8 is not otherwise eligible for such counseling, the Secretary 

9 shall— 

10 ‘‘(1) provide referral services to assist such indi11 vidual, to the maximum extent practicable, in obtain12 ing mental health care and services from sources out13 side the Department; and 

14 ‘‘(2) if pertinent, advise such individual of such 

15 individual’s rights to apply to the appropriate mili16 tary, naval, or air service, and to the Department, for 

17 review of such individual’s discharge or release from 

18 such service.’’. 

19 SEC. 403. STUDY ON SUICIDES AMONG VETERANS. 

20 (a) STUDY REQUIRED.—The Secretary of Veterans Af21 fairs shall conduct a study to determine the number of vet22 erans who died by suicide between January 1, 1999, and 

23 the date of the enactment of this Act. 
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1 (b) COORDINATION.—In carrying out the study under 

2 subsection (a) the Secretary of Veterans Affairs shall coordi3 nate with— 

4 (1) the Secretary of Defense; 

5 (2) veterans service organizations; 

6 (3) the Centers for Disease Control and Preven7 tion; and 

8 (4) State public health offices and veterans agen9 cies. 

10 (c) REPORT TO CONGRESS.—The Secretary of Veterans 

11 Affairs shall submit to the Committee on Veterans’ Affairs 

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

13 the House of Representatives a report on the study required 

14 under subsection (a) and the findings of the Secretary. 

15 (d) VETERANS SERVICE ORGANIZATION DEFINED.—In 

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

17 any organization recognized by the Secretary for the rep18 resentation of veterans under section 5902 of title 38, 

19 United States Code. 

20 TITLE V—OTHER HEALTH CARE 

21 MATTERS 

22 SEC. 501. REPEAL OF CERTAIN ANNUAL REPORTING RE23 QUIREMENTS. 

24 (a) NURSE PAY REPORT.—Section 7451 is amended— 

25 (1) by striking subsection (f); and 
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1 (2) by redesignating subsection (g) as subsection 

2 (f). 

3 (b) LONG-TERM PLANNING REPORT.— 

4 (1) IN GENERAL.—Section 8107 is repealed. 

5 (2) CONFORMING AMENDMENT.—The table of sec6 tions at the beginning of chapter 81 is amended by 

7 striking the item relating to section 8107. 

8 SEC. 502. SUBMITTAL DATE OF ANNUAL REPORT ON GULF 

9 WAR RESEARCH. 

10 Section 707(c)(1) of the Persian Gulf War Veterans’ 

11 Health Status Act (title VII of Public Law 102–585; 38 

12 U.S.C. 527 note) is amended by striking ‘‘Not later than 

13 March 1 of each year’’ and inserting ‘‘Not later than July 

14 1, 2010, and July 1 of each of the five following years’’. 

15 SEC. 503. PAYMENT FOR CARE FURNISHED TO CHAMPVA 

16 BENEFICIARIES. 

17 Section 1781 is amended by adding at the end the fol18 lowing new subsection: 

19 ‘‘(e) Payment by the Secretary under this section on 

20 behalf of a covered beneficiary for medical care shall con21 stitute payment in full and extinguish any liability on the 

22 part of the beneficiary for that care.’’. 
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1 SEC. 504. DISCLOSURE OF PATIENT TREATMENT INFORMA2 TION FROM MEDICAL RECORDS OF PATIENTS 

3 LACKING DECISIONMAKING CAPACITY. 

4 Section 7332(b)(2) is amended by adding at the end 

5 the following new subparagraph: 

6 ‘‘(F)(i) To a representative of a patient who 

7 lacks decision-making capacity, when a practitioner 

8 deems the content of the given record necessary for 

9 that representative to make an informed decision re10 garding the patient’s treatment. 

11 ‘‘(ii) In this subparagraph, the term ‘representa12 tive’ means an individual, organization, or other 

13 body authorized under section 7331 of this title and 

14 its implementing regulations to give informed consent 

15 on behalf of a patient who lacks decision-making ca16 pacity.’’. 

17 SEC. 505. ENHANCEMENT OF QUALITY MANAGEMENT. 

18 (a) ENHANCEMENT OF QUALITY MANAGEMENT

19 THROUGH QUALITY MANAGEMENT OFFICERS.— 

20 (1) IN GENERAL.—Subchapter II of chapter 73 is 

21 amended by inserting after section 7311 the following 

22 new section: 

23 ‘‘§ 7311A. Quality management officers 

24 ‘‘(a) NATIONAL QUALITY MANAGEMENT OFFICER.—(1) 

25 The Under Secretary for Health shall designate an official 

26 of the Veterans Health Administration to act as the prin-
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1 cipal quality management officer for the quality-assurance 

2 program required by section 7311 of this title. The official 

3 so designated may be known as the ‘National Quality Man4 agement Officer of the Veterans Health Administration’ (in 

5 this section referred to as the ‘National Quality Manage6 ment Officer’). 

7 ‘‘(2) The National Quality Management Officer shall 

8 report directly to the Under Secretary for Health in the 

9 discharge of responsibilities and duties of the Officer under 

10 this section. 

11 ‘‘(3) The National Quality Management Officer shall 

12 be the official within the Veterans Health Administration 

13 who is principally responsible for the quality-assurance 

14 program referred to in paragraph (1). In carrying out that 

15 responsibility, the Officer shall be responsible for the fol16 lowing: 

17 ‘‘(A) Establishing and enforcing the require18 ments of the program referred to in paragraph (1). 

19 ‘‘(B) Developing an aggregate quality metric 

20 from existing data sources, such as the Inpatient 

21 Evaluation Center of the Department, the National 

22 Surgical Quality Improvement Program, and the Ex23 ternal Peer Review Program of the Veterans Health 

24 Administration, that could be used to assess reliably 

25 the quality of care provided at individual Depart-
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1 ment medical centers and associated community 

2 based outpatient clinics. 

3 ‘‘(C) Ensuring that existing measures of quality, 

4 including measures from the Inpatient Evaluation 

5 Center, the National Surgical Quality Improvement 

6 Program, System-Wide Ongoing Assessment and Re7 view reports of the Department, and Combined As8 sessment Program reviews of the Office of Inspector 

9 General of the Department, are monitored routinely 

10 and analyzed in a manner that ensures the timely de11 tection of quality of care issues. 

12 ‘‘(D) Encouraging research and development in 

13 the area of quality metrics for the purposes of improv14 ing how the Department measures quality in indi15 vidual facilities. 

16 ‘‘(E) Carrying out such other responsibilities 

17 and duties relating to quality management in the 

18 Veterans Health Administration as the Under Sec19 retary for Health shall specify. 

20 ‘‘(4) The requirements under paragraph (3) shall in21 clude requirements regarding the following: 

22 ‘‘(A) A confidential system for the submittal of 

23 reports by Veterans Health Administration personnel 

24 regarding quality management at Department facili25 ties. 
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1 ‘‘(B) Mechanisms for the peer review of the ac2 tions of individuals appointed in the Veterans Health 

3 Administration in the position of physician. 

4 ‘‘(b) QUALITY MANAGEMENT OFFICERS FOR VISNS.— 

5 (1) The Regional Director of each Veterans Integrated Serv6 ices Network shall appoint an official of the Network to act 

7 as the quality management officer of the Network. 

8 ‘‘(2) The quality management officer for a Veterans 

9 Integrated Services Network shall report to the Regional Di10 rector of the Veterans Integrated Services Network, and to 

11 the National Quality Management Officer, regarding the 

12 discharge of the responsibilities and duties of the officer 

13 under this section. 

14 ‘‘(3) The quality management officer for a Veterans 

15 Integrated Services Network shall— 

16 ‘‘(A) direct the quality management office in the 

17 Network; and 

18 ‘‘(B) coordinate, monitor, and oversee the quality 

19 management programs and activities of the Adminis20 tration medical facilities in the Network in order to 

21 ensure the thorough and uniform discharge of quality 

22 management requirements under such programs and 

23 activities throughout such facilities. 

24 ‘‘(c) QUALITY MANAGEMENT OFFICERS FOR MEDICAL

25 FACILITIES.—(1) The director of each Veterans Health Ad-
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1 ministration medical facility shall appoint a quality man2 agement officer for that facility. 

3 ‘‘(2) The quality management officer for a facility 

4 shall report directly to the director of the facility, and to 

5 the quality management officer of the Veterans Integrated 

6 Services Network in which the facility is located, regarding 

7 the discharge of the responsibilities and duties of the quality 

8 management officer under this section. 

9 ‘‘(3) The quality management officer for a facility 

10 shall be responsible for designing, disseminating, and im11 plementing quality management programs and activities 

12 for the facility that meet the requirements established by 

13 the National Quality Management Officer under subsection 

14 (a). 

15 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—(1) Ex16 cept as provided in paragraph (2), there are authorized to 

17 be appropriated such sums as may be necessary to carry 

18 out this section. 

19 ‘‘(2) There is authorized to be appropriated to carry 

20 out the provisions of subparagraphs (B), (C), and (D) of 

21 subsection (a)(3), $25,000,000 for the two-year period of fis22 cal years beginning after the date of the enactment of this 

23 section.’’. 

24 (2) CLERICAL AMENDMENT.—The table of sec25 tions at the beginning of chapter 73 is amended by 
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1 inserting after the item relating to section 7311 the 

2 following new item: 

‘‘7311A. Quality management officers.’’. 

3 (b) REPORTS ON QUALITY CONCERNS UNDER QUAL4 ITY-ASSURANCE PROGRAM.—Section 7311(b) is amended by 

5 adding at the end the following new paragraph: 

6 ‘‘(4) As part of the quality-assurance program, the 

7 Under Secretary for Health shall establish mechanisms 

8 through which employees of Veterans Health Administra9 tion facilities may submit reports, on a confidential basis, 

10 on matters relating to quality of care in Veterans Health 

11 Administration facilities to the quality management offi12 cers of such facilities under section 7311A(c) of this title. 

13 The mechanisms shall provide for the prompt and thorough 

14 review of any reports so submitted by the receiving offi15 cials.’’. 

16 (c) REVIEW OF CURRENT HEALTH CARE QUALITY

17 SAFEGUARDS.— 

18 (1) IN GENERAL.—The Secretary of Veterans Af19 fairs shall conduct a comprehensive review of all cur20 rent policies and protocols of the Department of Vet21 erans Affairs for maintaining health care quality and 

22 patient safety at Department medical facilities. The 

23 review shall include a review and assessment of the 

24 National Surgical Quality Improvement Program, in25 cluding an assessment of— 
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1 (A) the efficacy of the quality indicators 

2 under the program; 

3 (B) the efficacy of the data collection meth4 ods under the program; 

5 (C) the efficacy of the frequency with which 

6 regular data analyses are performed under the 

7 program; and 

8 (D) the extent to which the resources allo9 cated to the program are adequate to fulfill the 

10 stated function of the program. 

11 (2) REPORT.—Not later than 60 days after the 

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

13 submit to Congress a report on the review conducted 

14 under paragraph (1), including the findings of the 

15 Secretary as a result of the review and such rec16 ommendations as the Secretary considers appropriate 

17 in light of the review. 

18 SEC. 506. PILOT PROGRAM ON USE OF COMMUNITY-BASED 

19 ORGANIZATIONS AND LOCAL AND STATE 

20 GOVERNMENT ENTITIES TO ENSURE THAT 

21 VETERANS RECEIVE CARE AND BENEFITS 

22 FOR WHICH THEY ARE ELIGIBLE. 

23 (a) PILOT PROGRAM REQUIRED.—The Secretary of 

24 Veterans Affairs shall carry out a pilot program to assess 
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1 the feasibility and advisability of using community-based 

2 organizations and local and State government entities— 

3 (1) to increase the coordination of community, 

4 local, State, and Federal providers of health care and 

5 benefits for veterans to assist veterans who are 

6 transitioning from military service to civilian life in 

7 such transition; 

8 (2) to increase the availability of high quality 

9 medical and mental health services to veterans 

10 transitioning from military service to civilian life; 

11 (3) to provide assistance to families of veterans 

12 who are transitioning from military service to civil13 ian life to help such families adjust to such transi14 tion; and 

15 (4) to provide outreach to veterans and their 

16 families to inform them about the availability of ben17 efits and connect them with appropriate care and 

18 benefit programs. 

19 (b) DURATION OF PROGRAM.—The pilot program shall 

20 be carried out during the 2-year period beginning on the 

21 date that is 180 days after the date of the enactment of 

22 this Act. 

23 (c) PROGRAM LOCATIONS.— 
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1 (1) IN GENERAL.—The pilot program shall be 

2 carried out at five locations selected by the Secretary 

3 for purposes of the pilot program. 

4 (2) CONSIDERATIONS.—In selecting locations for 

5 the pilot program, the Secretary shall consider the ad6 visability of selecting locations in— 

7 (A) rural areas; 

8 (B) areas with populations that have a high 

9 proportion of minority group representation; 

10 (C) areas with populations that have a high 

11 proportion of individuals who have limited ac12 cess to health care; and 

13 (D) areas that are not in close proximity to 

14 an active duty military installation. 

15 (d) GRANTS.—The Secretary shall carry out the pilot 

16 program through the award of grants to community-based 

17 organizations and local and State government entities. 

18 (e) SELECTION OF GRANT RECIPIENTS.— 

19 (1) IN GENERAL.—A community-based organiza20 tion or local or State government entity seeking a 

21 grant under the pilot program shall submit to the 

22 Secretary an application therefor in such form and in 

23 such manner as the Secretary considers appropriate. 

24 (2) ELEMENTS.—Each application submitted 

25 under paragraph (1) shall include the following: 
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1 (A) A description of the consultations, if 

2 any, with the Department of Veterans Affairs in 

3 the development of the proposal under the appli4 cation. 

5 (B) A plan to coordinate activities under 

6 the pilot program, to the greatest extent possible, 

7 with the local, State, and Federal providers of 

8 services for veterans to reduce duplication of 

9 services and to enhance the effect of such services. 

10 (f) USE OF GRANT FUNDS.—The Secretary shall pre11 scribe appropriate uses of grant funds received under the 

12 pilot program. 

13 (g) REPORT ON PROGRAM.— 

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

15 the completion of the pilot program, the Secretary 

16 shall submit to Congress a report on the pilot pro17 gram. 

18 (2) ELEMENTS.—The report required by para19 graph (1) shall include the following: 

20 (A) The findings and conclusions of the Sec21 retary with respect to the pilot program. 

22 (B) An assessment of the benefits to veterans 

23 of the pilot program. 
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1 (C) The recommendations of the Secretary 

2 as to the advisability of continuing the pilot pro3 gram. 

4 SEC. 507. SPECIALIZED RESIDENTIAL CARE AND REHABILI5 TATION FOR CERTAIN VETERANS. 

6 Section 1720 is amended by adding at the end the fol7 lowing new subsection: 

8 ‘‘(g) The Secretary may contract with appropriate en9 tities to provide specialized residential care and rehabilita10 tion services to a veteran of Operation Enduring Freedom 

11 or Operation Iraqi Freedom who the Secretary determines 

12 suffers from a traumatic brain injury, has an accumulation 

13 of deficits in activities of daily living and instrumental ac14 tivities of daily living, and because of these deficits, would 

15 otherwise require admission to a nursing home even though 

16 such care would generally exceed the veteran’s nursing 

17 needs.’’. 

18 SEC. 508. EXPANDED STUDY ON THE HEALTH IMPACT OF 

19 PROJECT SHIPBOARD HAZARD AND DEFENSE. 

20 (a) IN GENERAL.—Not later than 90 days after the 

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

22 Affairs shall enter into a contract with the Institute of Med23 icine of the National Academies to conduct an expanded 

24 study on the health impact of Project Shipboard Hazard 

25 and Defense (Project SHAD). 
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1 (b) COVERED VETERANS.—The study required by sub2 section (a) shall include, to the extent practicable, all vet3 erans who participated in Project Shipboard Hazard and 

4 Defense. 

5 (c) USE OF EXISTING STUDIES.—The study required 

6 by subsection (a) may use results from the study covered 

7 in the report titled ‘‘Long-Term Health Effects of Participa8 tion in Project SHAD’’ of the Institute of Medicine of the 

9 National Academies. 

10 SEC. 509. USE OF NON-DEPARTMENT FACILITIES FOR REHA11 BILITATION OF INDIVIDUALS WITH TRAU12 MATIC BRAIN INJURY. 

13 Section 1710E is amended— 

14 (1) by redesignating subsection (b) as subsection 

15 (c); 

16 (2) by inserting after subsection (a) the following 

17 new subsection (b): 

18 ‘‘(b) COVERED INDIVIDUALS.—The care and services 

19 provided under subsection (a) shall be made available to 

20 an individual— 

21 ‘‘(1) who is described in section 1710C(a) of this 

22 title; and 

23 ‘‘(2)(A) to whom the Secretary is unable to pro24 vide such treatment or services at the frequency or for 

25 the duration prescribed in such plan; or 
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1 ‘‘(B) for whom the Secretary determines that it 

2 is optimal with respect to the recovery and rehabilita3 tion for such individual.’’; and 

4 (3) by adding at the end the following new sub5 section: 

6 ‘‘(d) STANDARDS.—The Secretary may not provide 

7 treatment or services as described in subsection (a) at a 

8 non-Department facility under such subsection unless such 

9 facility maintains standards for the provision of such treat10 ment or services established by an independent, peer-re11 viewed organization that accredits specialized rehabilita12 tion programs for adults with traumatic brain injury.’’. 

13 SEC. 510. PILOT PROGRAM ON PROVISION OF DENTAL IN14 SURANCE PLANS TO VETERANS AND SUR15 VIVORS AND DEPENDENTS OF VETERANS. 

16 (a) PILOT PROGRAM REQUIRED.—The Secretary of 

17 Veterans Affairs shall carry out a pilot program to assess 

18 the feasibility and advisability of providing a dental insur19 ance plan to veterans and survivors and dependents of vet20 erans described in subsection (b). 

21 (b) COVERED VETERANS AND SURVIVORS AND DE22 PENDENTS.—The veterans and survivors and dependents of 

23 veterans described in this subsection are as follows: 
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1 (1) Any veteran who is enrolled in the system of 

2 annual patient enrollment under section 1705 of title 

3 38, United States Code. 

4 (2) Any survivor or dependent of a veteran who 

5 is eligible for medical care under section 1781 of such 

6 title. 

7 (c) DURATION OF PROGRAM.—The pilot program shall 

8 be carried out during the 3-year period beginning on the 

9 date that is 270 days after the date of the enactment of 

10 this Act. 

11 (d) LOCATIONS.—The pilot program shall be carried 

12 out in such Veterans Integrated Services Networks as the 

13 Secretary considers appropriate for purposes of the pilot 

14 program. 

15 (e) ADMINISTRATION.—The Secretary shall contract 

16 with a dental insurer to administer the dental insurance 

17 plan provided under the pilot program. 

18 (f) BENEFITS.—The dental insurance plan under the 

19 pilot program shall provide such benefits for dental care 

20 and treatment as the Secretary considers appropriate for 

21 the dental insurance plan, including diagnostic services, 

22 preventative services, endodontics and other restorative 

23 services, surgical services, and emergency services. 

24 (g) ENROLLMENT.— 
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1 (1) VOLUNTARY.—Enrollment in the dental in2 surance plan under the pilot program shall be vol3 untary. 

4 (2) MINIMUM PERIOD.—Enrollment in the dental 

5 insurance plan shall be for such minimum period as 

6 the Secretary shall prescribe for purposes of this sec7 tion. 

8 (h) PREMIUMS.— 

9 (1) IN GENERAL.—Premiums for coverage under 

10 the dental insurance plan under the pilot program 

11 shall be in such amount or amounts as the Secretary 

12 shall prescribe to cover all costs associated with the 

13 pilot program. 

14 (2) ANNUAL ADJUSTMENT.—The Secretary shall 

15 adjust the premiums payable under the pilot program 

16 for coverage under the dental insurance plan on an 

17 annual basis. Each individual covered by the dental 

18 insurance plan at the time of such an adjustment 

19 shall be notified of the amount and effective date of 

20 such adjustment. 

21 (3) RESPONSIBILITY FOR PAYMENT.—Each indi22 vidual covered by the dental insurance plan shall pay 

23 the entire premium for coverage under the dental in24 surance plan, in addition to the full cost of any co25 payments. 
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1 (i) VOLUNTARY DISENROLLMENT.— 

2 (1) IN GENERAL.—With respect to enrollment in 

3 the dental insurance plan under the pilot program, 

4 the Secretary shall— 

5 (A) permit the voluntary disenrollment of 

6 an individual in the dental insurance plan if the 

7 disenrollment occurs during the 30-day period 

8 beginning on the date of the enrollment of the in9 dividual in the dental insurance plan; and 

10 (B) permit the voluntary disenrollment of 

11 an individual in the dental insurance plan for 

12 such circumstances as the Secretary shall pre13 scribe for purposes of this subsection, but only to 

14 the extent such disenrollment does not jeopardize 

15 the fiscal integrity of the dental insurance plan. 

16 (2) ALLOWABLE CIRCUMSTANCES.—The cir17 cumstances prescribed under paragraph (1)(B) shall 

18 include the following: 

19 (A) If an individual enrolled in the dental 

20 insurance plan relocates to a location outside the 

21 jurisdiction of the dental insurance plan that 

22 prevents use of the benefits under the dental in23 surance plan. 

24 (B) If an individual enrolled in the dental 

25 insurance plan is prevented by a serious medical 
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1 condition from being able to obtain benefits 

2 under the dental insurance plan. 

3 (C) Such other circumstances as the Sec4 retary shall prescribe for purposes of this sub5 section. 

6 (3) ESTABLISHMENT OF PROCEDURES.—The 

7 Secretary shall establish procedures for determina8 tions on the permissibility of voluntary 

9 disenrollments under paragraph (1)(B). Such proce10 dures shall ensure timely determinations on the per11 missibility of such disenrollments. 

12 (j) RELATIONSHIP TO DENTAL CARE PROVIDED BY

13 SECRETARY.—Nothing in this section shall affect the re14 sponsibility of the Secretary to provide dental care under 

15 section 1712 of title 38, United States Code, and the partici16 pation of an individual in the dental insurance plan under 

17 the pilot program shall not affect the individual’s entitle18 ment to outpatient dental services and treatment, and re19 lated dental appliances, under that section. 

20 (k) REGULATIONS.—The dental insurance plan under 

21 the pilot program shall be administered under such regula22 tions as the Secretary shall prescribe. 
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1 SEC. 511. PROHIBITION ON COLLECTION OF COPAYMENTS 

2 FROM VETERANS WHO ARE CATASTROPH3 ICALLY DISABLED. 

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

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

6 ‘‘§ 1730A. Prohibition on collection of copayments 

7 from catastrophically disabled veterans 

8 ‘‘Notwithstanding subsections (f) and (g) of section 

9 1710 and section 1722A(a) of this title or any other provi10 sion of law, the Secretary may not require a veteran who 

11 is catastrophically disabled, as defined by the Secretary, to 

12 make any copayment for the receipt of hospital care or med13 ical services under the laws administered by the Sec14 retary.’’. 

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

16 the beginning of chapter 17 is amended by inserting after 

17 the item relating to section 1730 the following new item: 

‘‘1730A. Prohibition on collection of copayments from catastrophically disabled 

veterans.’’. 

18 SEC. 512. HIGHER PRIORITY STATUS FOR CERTAIN VET19 ERANS WHO ARE MEDAL OF HONOR RECIPI20 ENTS. 

21 Section 1705(a)(3) is amended by inserting ‘‘veterans 

22 who were awarded the medal of honor under section 3741, 

23 6241, or 8741 of title 10 or section 491 of title 14,’’ after 

24 ‘‘the Purple Heart,’’. 
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1 SEC. 513. HOSPITAL CARE, MEDICAL SERVICES, AND NURS2 ING HOME CARE FOR CERTAIN VIETNAM-ERA 

3 VETERANS EXPOSED TO HERBICIDE AND VET4 ERANS OF THE PERSIAN GULF WAR. 

5 Section 1710(e) is amended— 

6 (1) in paragraph (3)— 

7 (A) by striking ‘‘subsection (a)(2)(F)—’’ 

8 and all that follows through ‘‘(C) in the case’’ 

9 and inserting ‘‘subsection (a)(2)(F) in the case’’; 

10 and 

11 (B) by redesignating clauses (i) and (ii) of 

12 the former subparagraph (C) as subparagraphs 

13 (A) and (B) of such paragraph (3) and by re14 aligning the margin of such new subparagraphs 

15 two ems to the left; and 

16 (2) in paragraph (1)(C)— 

17 (A) by striking ‘‘paragraphs (2) and (3)’’ 

18 and inserting ‘‘paragraph (2)’’; and 

19 (B) by inserting after ‘‘on active duty’’ the 

20 following: ‘‘between August 2, 1990, and Novem21 ber 11, 1998,’’. 
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1 SEC. 514. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN AS2 SISTANT SERVICES IN VETERANS HEALTH AD3 MINISTRATION. 

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

5 striking paragraph (9) and inserting the following new 

6 paragraph (9): 

7 ‘‘(9) The Director of Physician Assistant Serv8 ices, who shall— 

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

10 Central Office of the Department; 

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

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

13 the Chief Patient Care Services Officer of the 

14 Veterans Health Administration on all matters 

15 relating to the education and training, employ16 ment, appropriate use, and optimal participa17 tion of physician assistants within the programs 

18 and initiatives of the Administration.’’. 

19 (b) DEADLINE FOR IMPLEMENTATION.—The Secretary 

20 of Veterans Affairs shall ensure that an individual is serv21 ing as the Director of Physician Assistant Services under 

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

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

24 days after the date of the enactment of this Act. 
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1 SEC. 515. COMMITTEE ON CARE OF VETERANS WITH TRAU2 MATIC BRAIN INJURY. 

3 (a) ESTABLISHMENT OF COMMITTEE.—Subchapter II 

4 of chapter 73 is amended by inserting after section 7321 

5 the following new section: 

6 ‘‘§ 7321A. Committee on Care of Veterans with Trau7 matic Brain Injury 

8 ‘‘(a) ESTABLISHMENT.—The Secretary shall establish 

9 in the Veterans Health Administration a committee to be 

10 known as the ‘Committee on Care of Veterans with Trau11 matic Brain Injury’. The Under Secretary for Health shall 

12 appoint employees of the Department with expertise in the 

13 care of veterans with traumatic brain injury to serve on 

14 the committee. 

15 ‘‘(b) RESPONSIBILITIES OF COMMITTEE.—The com16 mittee shall assess, and carry out a continuing assessment 

17 of, the capability of the Veterans Health Administration to 

18 meet effectively the treatment and rehabilitation needs of 

19 veterans with traumatic brain injury. In carrying out that 

20 responsibility, the committee shall— 

21 ‘‘(1) evaluate the care provided to such veterans 

22 through the Veterans Health Administration; 

23 ‘‘(2) identify systemwide problems in caring for 

24 such veterans in facilities of the Veterans Health Ad25 ministration; 
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1 ‘‘(3) identify specific facilities within the Vet2 erans Health Administration at which program en3 richment is needed to improve treatment and reha4 bilitation of such veterans; and 

5 ‘‘(4) identify model programs which the com6 mittee considers to have been successful in the treat7 ment and rehabilitation of such veterans and which 

8 should be implemented more widely in or through fa9 cilities of the Veterans Health Administration. 

10 ‘‘(c) ADVICE AND RECOMMENDATIONS.—The com11 mittee shall— 

12 ‘‘(1) advise the Under Secretary regarding the 

13 development of policies for the care and rehabilitation 

14 of veterans with traumatic brain injury; and 

15 ‘‘(2) make recommendations to the Under Sec16 retary— 

17 ‘‘(A) for improving programs of care of such 

18 veterans at specific facilities and throughout the 

19 Veterans Health Administration; 

20 ‘‘(B) for establishing special programs of 

21 education and training relevant to the care of 

22 such veterans for employees of the Veterans 

23 Health Administration; 

24 ‘‘(C) regarding research needs and priorities 

25 relevant to the care of such veterans; and 
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1 ‘‘(D) regarding the appropriate allocation 

2 of resources for all such activities. 

3 ‘‘(d) ANNUAL REPORT.—Not later than June 1, 2010, 

4 and each year thereafter, the Secretary shall submit to the 

5 Committee on Veterans’ Affairs of the Senate and the Com6 mittee on Veterans’ Affairs of the House of Representatives 

7 a report on the implementation of this section. Each such 

8 report shall include the following for the calendar year pre9 ceding the year in which the report is submitted: 

10 ‘‘(1) A list of the members of the committee. 

11 ‘‘(2) The assessment of the Under Secretary for 

12 Health, after review of the findings of the committee, 

13 regarding the capability of the Veterans Health Ad14 ministration, on a systemwide and facility-by-facility 

15 basis, to meet effectively the treatment and rehabilita16 tion needs of veterans with traumatic brain injury. 

17 ‘‘(3) The plans of the committee for further as18 sessments. 

19 ‘‘(4) The findings and recommendations made by 

20 the committee to the Under Secretary for Health and 

21 the views of the Under Secretary on such findings and 

22 recommendations. 

23 ‘‘(5) A description of the steps taken, plans made 

24 (and a timetable for the execution of such plans), and 

25 resources to be applied toward improving the capa-
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1 bility of the Veterans Health Administration to meet 

2 effectively the treatment and rehabilitation needs of 

3 veterans with traumatic brain injury.’’. 

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

5 the beginning of chapter 73 is amended by inserting after 

6 the item relating to section 7321 the following new item: 

‘‘7321A. Committee on Care of Veterans with Traumatic Brain Injury.’’. 

7 SEC. 516. INCREASE IN AMOUNT AVAILABLE TO DISABLED 

8 VETERANS FOR IMPROVEMENTS AND STRUC9 TURAL ALTERATIONS FURNISHED AS PART 

10 OF HOME HEALTH SERVICES. 

11 (a) INCREASE.—Section 1717(a)(2) is amended by 

12 striking subparagraphs (A) and (B) and inserting the fol13 lowing: 

14 ‘‘(A) in the case of medical services furnished 

15 under section 1710(a)(1) of this title, or for a dis16 ability described in section 1710(a)(2)(C) of this 

17 title— 

18 ‘‘(i) in the case of a veteran who first ap19 plies for benefits under this paragraph before the 

20 date of the Caregivers and Veterans Omnibus 

21 Health Services Act of 2010, $4,100; or 

22 ‘‘(ii) in the case of a veteran who first ap23 plies for benefits under this paragraph on or 

24 after the date of the Caregivers and Veterans 
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1 Omnibus Health Services Act of 2010, $6,800; 

2 and 

3 ‘‘(B) in the case of medical services furnished 

4 under any other provision of section 1710(a) of this 

5 title— 

6 ‘‘(i) in the case of a veteran who first ap7 plies for benefits under this paragraph before the 

8 date of the Caregivers and Veterans Omnibus 

9 Health Services Act of 2010, $1,200; or 

10 ‘‘(ii) in the case of a veteran who first ap11 plies for benefits under this paragraph on or 

12 after the date of the Caregivers and Veterans 

13 Omnibus Health Services Act of 2010, $2,000.’’. 

14 (b) CONSTRUCTION.—A veteran who exhausts such vet15 eran’s eligibility for benefits under section 1717(a)(2) of 

16 such title before the date of the enactment of this Act, is 

17 not entitled to additional benefits under such section by rea18 son of the amendments made by subsection (a). 

19 SEC. 517. EXTENSION OF STATUTORILY DEFINED COPAY20 MENTS FOR CERTAIN VETERANS FOR HOS21 PITAL CARE AND NURSING HOME CARE. 

22 Subparagraph (B) of section 1710(f)(2) is amended to 

23 read as follows: 

24 ‘‘(B) before September 30, 2012, an amount 

25 equal to $10 for every day the veteran receives 
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1 hospital care and $5 for every day the veteran 

2 receives nursing home care.’’. 

3 SEC. 518. EXTENSION OF AUTHORITY TO RECOVER COST OF 

4 CERTAIN CARE AND SERVICES FROM DIS5 ABLED VETERANS WITH HEALTH-PLAN CON6 TRACTS. 

7 Subparagraph (E) of section 1729(a)(2) is amended 

8 to read as follows: 

9 ‘‘(E) for which care and services are fur10 nished before October 1, 2012, under this chapter 

11 to a veteran who— 

12 ‘‘(i) has a service-connected disability; 

13 and 

14 ‘‘(ii) is entitled to care (or payment of 

15 the expenses of care) under a health-plan 

16 contract.’’. 

17 TITLE VI—DEPARTMENT 

18 PERSONNEL MATTERS 

19 SEC. 601. ENHANCEMENT OF AUTHORITIES FOR RETEN20 TION OF MEDICAL PROFESSIONALS. 

21 (a) SECRETARIAL AUTHORITY TO EXTEND TITLE 38 

22 STATUS TO ADDITIONAL POSITIONS.— 

23 (1) IN GENERAL.—Paragraph (3) of section 7401 

24 is amended by striking ‘‘and blind rehabilitation out25 patient specialists.’’ and inserting the following: 
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1 ‘‘blind rehabilitation outpatient specialists, and such 

2 other classes of health care occupations as the Sec3 retary considers necessary for the recruitment and re4 tention needs of the Department subject to the fol5 lowing requirements: 

6 ‘‘(A) Such other classes of health care occu7 pations— 

8 ‘‘(i) are not occupations relating to ad9 ministrative, clerical, or physical plant 

10 maintenance and protective services; 

11 ‘‘(ii) that would otherwise receive basic 

12 pay in accordance with the General Sched13 ule under section 5332 of title 5; 

14 ‘‘(iii) provide, as determined by the 

15 Secretary, direct patient care services or 

16 services incident to direct patient services; 

17 and 

18 ‘‘(iv) would not otherwise be available 

19 to provide medical care or treatment for 

20 veterans. 

21 ‘‘(B) Not later than 45 days before the Sec22 retary appoints any personnel for a class of 

23 health care occupations that is not specifically 

24 listed in this paragraph, the Secretary shall sub25 mit to the Committee on Veterans’ Affairs of the 
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•S 1963 EAH 

1 Senate, the Committee on Veterans’ Affairs of the 

2 House of Representatives, and the Office of Man3 agement and Budget notice of such appointment. 

4 ‘‘(C) Before submitting notice under sub5 paragraph (B), the Secretary shall solicit com6 ments from any labor organization representing 

7 employees in such class and include such com8 ments in such notice.’’. 

9 (2) APPOINTMENT OF NURSE ASSISTANTS.—Such 

10 paragraph is further amended by inserting ‘‘nurse as11 sistants,’’ after ‘‘licensed practical or vocational 

12 nurses,’’. 

13 (b) PROBATIONARY PERIODS FOR REGISTERED

14 NURSES.—Section 7403(b) is amended— 

15 (1) in paragraph (1), by striking ‘‘Appoint16 ments’’ and inserting ‘‘Except as otherwise provided 

17 in this subsection, appointments’’; 

18 (2) by redesignating paragraph (2) as para19 graph (4); and 

20 (3) by inserting after paragraph (1) the fol21 lowing new paragraphs: 

22 ‘‘(2) With respect to the appointment of a registered 

23 nurse under this chapter, paragraph (1) shall apply with 

24 respect to such appointment regardless of whether such ap25 pointment is on a full-time basis or a part-time basis. 
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1 ‘‘(3) An appointment described in subsection (a) on 

2 a part-time basis of a person who has previously served on 

3 a full-time basis for the probationary period for the position 

4 concerned shall be without a probationary period.’’. 

5 (c) PROHIBITION ON TEMPORARY PART-TIME REG6 ISTERED NURSE APPOINTMENTS IN EXCESS OF 2 YEARS.— 

7 Section 7405 is amended by adding at the end the following 

8 new subsection: 

9 ‘‘(g)(1) Except as provided in paragraph (3), employ10 ment of a registered nurse on a temporary part-time basis 

11 under subsection (a)(1) shall be for a probationary period 

12 of two years. 

13 ‘‘(2) Except as provided in paragraph (3), upon com14 pletion by a registered nurse of the probationary period de15 scribed in paragraph (1)— 

16 ‘‘(A) the employment of such nurse shall— 

17 ‘‘(i) no longer be considered temporary; and 

18 ‘‘(ii) be considered an appointment de19 scribed in section 7403(a) of this title; and 

20 ‘‘(B) the nurse shall be considered to have served 

21 the probationary period required by section 7403(b). 

22 ‘‘(3) This subsection shall not apply to appointments 

23 made on a term limited basis of less than or equal to three 

24 years of— 
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1 ‘‘(A) nurses with a part-time appointment re2 sulting from an academic affiliation or teaching posi3 tion in a nursing academy of the Department; 

4 ‘‘(B) nurses appointed as a result of a specific 

5 research proposal or grant; or 

6 ‘‘(C) nurses who are not citizens of the United 

7 States and appointed under section 7407(a) of this 

8 title.’’. 

9 (d) RATE OF BASIC PAY FOR APPOINTEES TO THE OF10 FICE OF THE UNDER SECRETARY FOR HEALTH SET TO

11 RATE OF BASIC PAY FOR SENIOR EXECUTIVE SERVICE PO12 SITIONS.— 

13 (1) IN GENERAL.—Section 7404(a) is amended— 

14 (A) by striking ‘‘The annual’’ and inserting 

15 ‘‘(1) The annual’’; 

16 (B) by striking ‘‘The pay’’ and inserting the 

17 following: 

18 ‘‘(2) The pay’’; 

19 (C) by striking ‘‘under the preceding sen20 tence’’ and inserting ‘‘under paragraph (1)’’; 

21 and 

22 (D) by adding at the end the following new 

23 paragraph: 

24 ‘‘(3)(A) The rate of basic pay for a position to which 

25 an Executive order applies under paragraph (1) and is not 
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1 described by paragraph (2) shall be set in accordance with 

2 section 5382 of title 5 as if such position were a Senior 

3 Executive Service position (as such term is defined in sec4 tion 3132(a) of title 5). 

5 ‘‘(B) A rate of basic pay for a position may not be 

6 set under subparagraph (A) in excess of— 

7 ‘‘(i) in the case the position is not described in 

8 clause (ii), the rate of basic pay payable for level III 

9 of the Executive Schedule; or 

10 ‘‘(ii) in the case that the position is covered by 

11 a performance appraisal system that meets the certifi12 cation criteria established by regulation under section 

13 5307(d) of title 5, the rate of basic pay payable for 

14 level II of the Executive Schedule. 

15 ‘‘(C) Notwithstanding the provisions of subsection (d) 

16 of section 5307 of title 5, the Secretary may make any cer17 tification under that subsection instead of the Office of Per18 sonnel Management and without concurrence of the Office 

19 of Management and Budget.’’. 

20 (2) EFFECTIVE DATE.—The amendments made 

21 by paragraph (1) shall take effect on the first day of 

22 the first pay period beginning after the day that is 

23 180 days after the date of the enactment of this Act. 

24 (e) SPECIAL INCENTIVE PAY FOR DEPARTMENT PHAR25 MACIST EXECUTIVES.—Section 7410 is amended— 
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1 (1) by striking ‘‘The Secretary may’’ and insert2 ing the following: 

3 ‘‘(a) IN GENERAL.—The Secretary may’’; and 

4 (2) by adding at the end the following new sub5 section: 

6 ‘‘(b) SPECIAL INCENTIVE PAY FOR DEPARTMENT

7 PHARMACIST EXECUTIVES.—(1) In order to recruit and re8 tain highly qualified Department pharmacist executives, the 

9 Secretary may authorize the Under Secretary for Health 

10 to pay special incentive pay of not more than $40,000 per 

11 year to an individual of the Veterans Health Administra12 tion who is a pharmacist executive. 

13 ‘‘(2) In determining whether and how much special 

14 pay to provide to such individual, the Under Secretary 

15 shall consider the following: 

16 ‘‘(A) The grade and step of the position of the in17 dividual. 

18 ‘‘(B) The scope and complexity of the position of 

19 the individual. 

20 ‘‘(C) The personal qualifications of the indi21 vidual. 

22 ‘‘(D) The characteristics of the labor market con23 cerned. 

24 ‘‘(E) Such other factors as the Secretary con25 siders appropriate. 
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1 ‘‘(3) Special incentive pay under paragraph (1) for 

2 an individual is in addition to all other pay (including 

3 basic pay) and allowances to which the individual is enti4 tled. 

5 ‘‘(4) Except as provided in paragraph (5), special in6 centive pay under paragraph (1) for an individual shall 

7 be considered basic pay for all purposes, including retire8 ment benefits under chapters 83 and 84 of title 5, and other 

9 benefits. 

10 ‘‘(5) Special incentive pay under paragraph (1) for 

11 an individual shall not be considered basic pay for purposes 

12 of adverse actions under subchapter V of this chapter. 

13 ‘‘(6) Special incentive pay under paragraph (1) may 

14 not be awarded to an individual in an amount that would 

15 result in an aggregate amount of pay (including bonuses 

16 and awards) received by such individual in a year under 

17 this title that is greater than the annual pay of the Presi18 dent.’’. 

19 (f) PAY FOR PHYSICIANS AND DENTISTS.— 

20 (1) NON-FOREIGN COST OF LIVING ADJUSTMENT

21 ALLOWANCE.—Section 7431(b) is amended by adding 

22 at the end the following new paragraph: 

23 ‘‘(5) The non-foreign cost of living adjustment 

24 allowance authorized under section 5941 of title 5 for 

25 physicians and dentists whose pay is set under this 
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1 section shall be determined as a percentage of base 

2 pay only.’’. 

3 (2) MARKET PAY DETERMINATIONS FOR PHYSI4 CIANS AND DENTISTS IN ADMINISTRATIVE OR EXECU5 TIVE LEADERSHIP POSITIONS.—Section 

6 7431(c)(4)(B)(i) is amended by adding at the end the 

7 following: ‘‘The Secretary may exempt physicians and 

8 dentists occupying administrative or executive leader9 ship positions from the requirements of the previous 

10 sentence.’’. 

11 (3) EXCEPTION TO PROHIBITION ON REDUCTION

12 OF MARKET PAY.—Section 7431(c)(7) is amended by 

13 striking ‘‘concerned.’’ and inserting ‘‘concerned, un14 less there is a change in board certification or reduc15 tion of privileges.’’. 

16 (g) ADJUSTMENT OF PAY CAP FOR NURSES.—Section 

17 7451(c)(2) is amended by striking ‘‘level V’’ and inserting 

18 ‘‘level IV’’. 

19 (h) EXEMPTION FOR CERTIFIED REGISTERED NURSE

20 ANESTHETISTS FROM LIMITATION ON AUTHORIZED COM21 PETITIVE PAY.—Section 7451(c)(2) is further amended by 

22 adding at the end the following new sentence: ‘‘The max23 imum rate of basic pay for a grade for the position of cer24 tified registered nurse anesthetist pursuant to an adjust-
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1 ment under subsection (d) may exceed the maximum rate 

2 otherwise provided in the preceding sentence.’’. 

3 (i) INCREASED LIMITATION ON SPECIAL PAY FOR

4 NURSE EXECUTIVES.—Section 7452(g)(2) is amended by 

5 striking ‘‘$25,000’’ and inserting ‘‘$100,000’’. 

6 (j) LOCALITY PAY SCALE COMPUTATIONS.— 

7 (1) EDUCATION, TRAINING, AND SUPPORT FOR

8 FACILITY DIRECTORS IN WAGE SURVEYS.—Section 

9 7451(d)(3) is amended by adding at the end the fol10 lowing new subparagraph: 

11 ‘‘(F) The Under Secretary for Health shall provide ap12 propriate education, training, and support to directors of 

13 Department health care facilities in the conduct and use 

14 of surveys, including the use of third-party surveys, under 

15 this paragraph.’’. 

16 (2) INFORMATION ON METHODOLOGY USED IN

17 WAGE SURVEYS.—Section 7451(e)(4) is amended— 

18 (A) by redesignating subparagraph (D) as 

19 subparagraph (E); and 

20 (B) by inserting after subparagraph (C) the 

21 following new subparagraph (D): 

22 ‘‘(D) In any case in which the director conducts 

23 such a wage survey during the period covered by the 

24 report and makes adjustment in rates of basic pay 

25 applicable to one or more covered positions at the fa-
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1 cility, information on the methodology used in mak2 ing such adjustment or adjustments.’’. 

3 (3) DISCLOSURE OF INFORMATION TO PERSONS

4 IN COVERED POSITIONS.—Section 7451(e), as amend5 ed by paragraph (2) of this subsection, is further 

6 amended by adding at the end the following new 

7 paragraph: 

8 ‘‘(6)(A) Upon the request of an individual described 

9 in subparagraph (B) for a report provided under para10 graph (4) with respect to a Department health-care facility, 

11 the Under Secretary for Health or the director of such facil12 ity shall provide to the individual the most current report 

13 for such facility provided under such paragraph. 

14 ‘‘(B) An individual described in this subparagraph 

15 is— 

16 ‘‘(i) an individual in a covered position at a De17 partment health-care facility; or 

18 ‘‘(ii) a representative of the labor organization 

19 representing that individual who is designated by 

20 that individual to make the request.’’. 

21 (k) ELIGIBILITY OF PART-TIME NURSES FOR ADDI22 TIONAL NURSE PAY.— 

23 (1) IN GENERAL.—Section 7453 is amended— 
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1 (A) in subsection (a), by striking ‘‘a nurse’’ 

2 and inserting ‘‘a full-time nurse or part-time 

3 nurse’’; 

4 (B) in subsection (b)— 

5 (i) in the first sentence— 

6 (I) by striking ‘‘on a tour of 

7 duty’’; 

8 (II) by striking ‘‘service on such 

9 tour’’ and inserting ‘‘such service’’; 

10 and 

11 (III) by striking ‘‘of such tour’’ 

12 and inserting ‘‘of such service’’; and 

13 (ii) in the second sentence, by striking 

14 ‘‘of such tour’’ and inserting ‘‘of such serv15 ice’’; 

16 (C) in subsection (c)— 

17 (i) by striking ‘‘on a tour of duty’’; 

18 and 

19 (ii) by striking ‘‘service on such tour’’ 

20 and inserting ‘‘such service’’; and 

21 (D) in subsection (e)— 

22 (i) in paragraph (1), by striking 

23 ‘‘eight hours in a day’’ and inserting ‘‘eight 

24 consecutive hours’’; and 
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1 (ii) in paragraph (5)(A), by striking 

2 ‘‘tour of duty’’ and inserting ‘‘period of 

3 service’’. 

4 (2) EXCLUSION OF APPLICATION OF ADDITIONAL

5 NURSE PAY PROVISIONS TO CERTAIN ADDITIONAL EM6 PLOYEES.—Paragraph (3) of section 7454(b) is 

7 amended to read as follows: 

8 ‘‘(3) Employees appointed under section 7408 of this 

9 title performing service on a tour of duty, any part of which 

10 is within the period commencing at midnight Friday and 

11 ending at midnight Sunday, shall receive additional pay 

12 in addition to the rate of basic pay provided such employees 

13 for each hour of service on such tour at a rate equal to 

14 25 percent of such employee’s hourly rate of basic pay.’’. 

15 (l) ENHANCED AUTHORITY TO INCREASE RATES OF

16 BASIC PAY TO OBTAIN OR RETAIN SERVICES OF CERTAIN

17 PERSONS.—Section 7455(c) is amended to read as follows: 

18 ‘‘(c)(1) Subject to paragraph (2), the amount of any 

19 increase under subsection (a) in the minimum rate for any 

20 grade may not (except in the case of nurse anesthetists, li21 censed practical nurses, licensed vocational nurses, nursing 

22 positions otherwise covered by title 5, pharmacists, and li23 censed physical therapists) exceed the maximum rate of 

24 basic pay (excluding any locality-based comparability pay-
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1 ment under section 5304 of title 5 or similar provision of 

2 law) for the grade or level by more than 30 percent. 

3 ‘‘(2) No rate may be established under this section in 

4 excess of the rate of basic pay payable for level IV of the 

5 Executive Schedule.’’. 

6 SEC. 602. LIMITATIONS ON OVERTIME DUTY, WEEKEND 

7 DUTY, AND ALTERNATIVE WORK SCHEDULES 

8 FOR NURSES. 

9 (a) OVERTIME DUTY.— 

10 (1) IN GENERAL.—Subchapter IV of chapter 74 

11 is amended by adding at the end the following new 

12 section: 

13 ‘‘§ 7459. Nursing staff: special rules for overtime duty 

14 ‘‘(a) LIMITATION.—Except as provided in subsection 

15 (c), the Secretary may not require nursing staff to work 

16 more than 40 hours (or 24 hours if such staff is covered 

17 under section 7456 of this title) in an administrative work 

18 week or more than eight consecutive hours (or 12 hours if 

19 such staff is covered under section 7456 or 7456A of this 

20 title). 

21 ‘‘(b) VOLUNTARY OVERTIME.—(1) Nursing staff may 

22 on a voluntary basis elect to work hours otherwise prohib23 ited by subsection (a). 

24 ‘‘(2) The refusal of nursing staff to work hours prohib25 ited by subsection (a) shall not be grounds— 
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1 ‘‘(A) to discriminate (within the meaning of sec2 tion 704(a) of the Civil Rights Act of 1964 (42 U.S.C. 

3 2000e–3(a))) against the staff; 

4 ‘‘(B) to dismiss or discharge the staff; or 

5 ‘‘(C) for any other adverse personnel action 

6 against the staff. 

7 ‘‘(c) OVERTIME UNDER EMERGENCY CIR8 CUMSTANCES.—(1) Subject to paragraph (2), the Secretary 

9 may require nursing staff to work hours otherwise prohib10 ited by subsection (a) if— 

11 ‘‘(A) the work is a consequence of an emergency 

12 that could not have been reasonably anticipated; 

13 ‘‘(B) the emergency is non-recurring and is not 

14 caused by or aggravated by the inattention of the Sec15 retary or lack of reasonable contingency planning by 

16 the Secretary; 

17 ‘‘(C) the Secretary has exhausted all good faith, 

18 reasonable attempts to obtain voluntary workers; 

19 ‘‘(D) the nurse staff have critical skills and ex20 pertise that are required for the work; and 

21 ‘‘(E) the work involves work for which the stand22 ard of care for a patient assignment requires con23 tinuity of care through completion of a case, treat24 ment, or procedure. 
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1 ‘‘(2) Nursing staff may not be required to work hours 

2 under this subsection after the requirement for a direct role 

3 by the staff in responding to medical needs resulting from 

4 the emergency ends. 

5 ‘‘(d) NURSING STAFF DEFINED.—In this section, the 

6 term ‘nursing staff’ includes the following: 

7 ‘‘(1) A registered nurse. 

8 ‘‘(2) A licensed practical or vocational nurse. 

9 ‘‘(3) A nurse assistant appointed under this 

10 chapter or title 5. 

11 ‘‘(4) Any other nurse position designated by the 

12 Secretary for purposes of this section.’’. 

13 (2) CLERICAL AMENDMENT.—The table of sec14 tions at the beginning of chapter 74 is amended by 

15 inserting after the item relating to section 7458 the 

16 following new item: 

‘‘7459. Nursing staff: special rules for overtime duty.’’. 

17 (b) WEEKEND DUTY.—Section 7456 is amended— 

18 (1) by striking subsection (c); and 

19 (2) by redesignating subsection (d) as subsection 

20 (c). 

21 (c) ALTERNATE WORK SCHEDULES.— 

22 (1) IN GENERAL.—Section 7456A(b)(1)(A) is 

23 amended by striking ‘‘three regularly scheduled’’ and 

24 all that follows through the period at the end and in25 serting ‘‘six regularly scheduled 12-hour tours of duty 
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1 within a 14-day period shall be considered for all 

2 purposes to have worked a full 80-hour pay period.’’. 

3 (2) CONFORMING AMENDMENTS.—Section 

4 7456A(b) is amended— 

5 (A) in the subsection heading, by striking 

6 ‘‘36/40’’ and inserting ‘‘72/80’’; 

7 (B) in paragraph (2)(A), by striking ‘‘40- 

8 hour basic work week’’ and inserting ‘‘80-hour 

9 pay period’’; and 

10 (C) in paragraph (3), by striking ‘‘regu11 larly’’. 

12 SEC. 603. REAUTHORIZATION OF HEALTH PROFESSIONALS 

13 EDUCATIONAL ASSISTANCE SCHOLARSHIP 

14 PROGRAM. 

15 (a) IN GENERAL.—Section 7618 is amended by strik16 ing ‘‘December 31, 1998’’ and inserting ‘‘December 31, 

17 2014’’. 

18 (b) EXPANSION OF ELIGIBILITY REQUIREMENTS.— 

19 Section 7612(b)(2) is amended by striking ‘‘(under section’’ 

20 and all that follows through ‘‘or vocational nurse.’’ and in21 serting the following: ‘‘as an appointee under paragraph 

22 (1) or (3) of section 7401 of this title.’’. 

23 (c) ADDITIONAL PROGRAM REQUIREMENTS.—Sub24 chapter II of chapter 76, as amended by subsections (a) and 

25 (b), is further amended— 
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1 (1) by redesignating section 7618 as section 

2 7619; and 

3 (2) by inserting after section 7617 the following 

4 new section: 

5 ‘‘§ 7618. Additional program requirements 

6 ‘‘(a) PROGRAM MODIFICATION.—Notwithstanding any 

7 provision of this subchapter, the Secretary shall carry out 

8 this subchapter after the date of the enactment of this sec9 tion by modifying the Scholarship Program in such a man10 ner that the program and hiring processes are designed to 

11 fully employ Scholarship Program graduates as soon as 

12 possible, if not immediately, upon graduation and comple13 tion of necessary certifications, and to actively assist and 

14 monitor graduates to ensure certifications are obtained in 

15 a minimal amount of time following graduation. 

16 ‘‘(b) CLINICAL TOURS.—The Secretary shall require 

17 participants in the Scholarship Program to perform clin18 ical tours in assignments or locations determined by the 

19 Secretary while the participants are enrolled in the course 

20 of education or training for which the scholarship is pro21 vided. 

22 ‘‘(c) MENTORS.—The Secretary shall ensure that at the 

23 commencement of the period of obligated service of a partic24 ipant in the Scholarship Program, the participant is as-
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1 signed to a mentor who is employed in the same facility 

2 where the participant performs such service.’’. 

3 (d) CLERICAL AMENDMENT.—The table of sections at 

4 the beginning of chapter 76 is amended by striking the item 

5 relating to section 7618 and inserting the following new 

6 items: 

‘‘7618. Additional program requirements. 

‘‘7619. Expiration of program.’’. 

7 SEC. 604. LOAN REPAYMENT PROGRAM FOR CLINICAL RE8 SEARCHERS FROM DISADVANTAGED BACK9 GROUNDS. 

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

11 may, in consultation with the Secretary of Health and 

12 Human Services, use the authorities available in section 

13 487E of the Public Health Service Act (42 U.S.C. 288–5) 

14 for the repayment of the principal and interest of edu15 cational loans of appropriately qualified health profes16 sionals who are from disadvantaged backgrounds in order 

17 to secure clinical research by such professionals for the Vet18 erans Health Administration. 

19 (b) LIMITATIONS.—The exercise by the Secretary of 

20 Veterans Affairs of the authorities referred to in subsection 

21 (a) shall be subject to the conditions and limitations speci22 fied in paragraphs (2) and (3) of section 487E(a) of the 

23 Public Health Service Act (42 U.S.C. 288–5(a)(2) and (3)). 
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1 (c) FUNDING.—Amounts for the repayment of prin2 cipal and interest of educational loans under this section 

3 shall be derived from amounts available to the Secretary 

4 of Veterans Affairs for the Veterans Health Administration 

5 for Medical Services. 

6 TITLE VII—HOMELESS 

7 VETERANS MATTERS 

8 SEC. 701. PER DIEM GRANT PAYMENTS TO NONCON9 FORMING ENTITIES. 

10 Section 2012 is amended by adding at the end the fol11 lowing new subsection: 

12 ‘‘(d) PER DIEM PAYMENTS TO NONCONFORMING ENTI13 TIES.—(1) The Secretary may make funds available for per 

14 diem payments under this section to the following grant 

15 recipients or eligible entities: 

16 ‘‘(A) Grant recipients or eligible entities that— 

17 ‘‘(i) meet each of the transitional and sup18 portive services criteria prescribed by the Sec19 retary pursuant to subsection (a)(1); and 

20 ‘‘(ii) furnish services to homeless individ21 uals, of which less than 75 percent are veterans. 

22 ‘‘(B) Grant recipients or eligible entities that— 

23 ‘‘(i) meet at least one, but not all, of the 

24 transitional and supportive services criteria pre-
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1 scribed by the Secretary pursuant to subsection 

2 (a)(1); and 

3 ‘‘(ii) furnish services to homeless individ4 uals, of which not less than 75 percent are vet5 erans. 

6 ‘‘(C) Grant recipients or eligible entities that— 

7 ‘‘(i) meet at least one, but not all, of the 

8 transitional and supportive services criteria pre9 scribed by the Secretary pursuant to subsection 

10 (a)(1); and 

11 ‘‘(ii) furnish services to homeless individ12 uals, of which less than 75 percent are veterans. 

13 ‘‘(2) Notwithstanding subsection (a)(2), in providing 

14 per diem payments under this subsection, the Secretary 

15 shall determine the rate of such per diem payments in ac16 cordance with the following order of priority: 

17 ‘‘(A) Grant recipients or eligible entities de18 scribed by paragraph (1)(A). 

19 ‘‘(B) Grant recipients or eligible entities de20 scribed by paragraph (1)(B). 

21 ‘‘(C) Grant recipients or eligible entities de22 scribed by paragraph (1)(C). 

23 ‘‘(3) For purposes of this subsection, an eligible entity 

24 is a nonprofit entity and may be an entity that is ineligible 

25 to receive a grant under section 2011 of this title, but whom 
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1 the Secretary determines carries out the purposes described 

2 in that section.’’. 

3 TITLE VIII—NONPROFIT RE4 SEARCH AND EDUCATION 

5 CORPORATIONS 

6 SEC. 801. GENERAL AUTHORITIES ON ESTABLISHMENT OF 

7 CORPORATIONS. 

8 (a) AUTHORIZATION OF MULTI-MEDICAL CENTER RE9 SEARCH CORPORATIONS.— 

10 (1) IN GENERAL.—Section 7361 is amended— 

11 (A) by redesignating subsection (b) as sub12 section (e); and 

13 (B) by inserting after subsection (a) the fol14 lowing new subsection (b): 

15 ‘‘(b)(1) Subject to paragraph (2), a corporation estab16 lished under this subchapter may facilitate the conduct of 

17 research, education, or both at more than one medical cen18 ter. Such a corporation shall be known as a ‘multi-medical 

19 center research corporation’. 

20 ‘‘(2) The board of directors of a multi-medical center 

21 research corporation under this subsection shall include the 

22 official at each Department medical center concerned who 

23 is, or who carries out the responsibilities of, the medical 

24 center director of such center as specified in section 

25 7363(a)(1)(A)(i) of this title. 
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1 ‘‘(3) In facilitating the conduct of research, education, 

2 or both at more than one Department medical center under 

3 this subchapter, a multi-medical center research corpora4 tion may administer receipts and expenditures relating to 

5 such research, education, or both, as applicable, performed 

6 at the Department medical centers concerned.’’. 

7 (2) EXPANSION OF EXISTING CORPORATIONS TO

8 MULTI-MEDICAL CENTER RESEARCH CORPORA9 TIONS.—Such section is further amended by adding 

10 at the end the following new subsection: 

11 ‘‘(f) A corporation established under this subchapter 

12 may act as a multi-medical center research corporation 

13 under this subchapter in accordance with subsection (b) 

14 if— 

15 ‘‘(1) the board of directors of the corporation ap16 proves a resolution permitting facilitation by the cor17 poration of the conduct of research, education, or both 

18 at the other Department medical center or medical 

19 centers concerned; and 

20 ‘‘(2) the Secretary approves the resolution of the 

21 corporation under paragraph (1).’’. 

22 (b) RESTATEMENT AND MODIFICATION OF AUTHORI23 TIES ON APPLICABILITY OF STATE LAW.— 

24 (1) IN GENERAL.—Section 7361 as amended by 

25 subsection (a) of this section, is further amended by 
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1 inserting after subsection (b) the following new sub2 section (c): 

3 ‘‘(c) Any corporation established under this subchapter 

4 shall be established in accordance with the nonprofit cor5 poration laws of the State in which the applicable Depart6 ment medical center is located and shall, to the extent not 

7 inconsistent with any Federal law, be subject to the laws 

8 of such State. In the case of any multi-medical center re9 search corporation that facilitates the conduct of research, 

10 education, or both at Department medical centers located 

11 in different States, the corporation shall be established in 

12 accordance with the nonprofit corporation laws of the State 

13 in which one of such Department medical centers is lo14 cated.’’. 

15 (2) CONFORMING AMENDMENT.—Section 7365 is 

16 repealed. 

17 (c) CLARIFICATION OF STATUS OF CORPORATIONS.— 

18 Section 7361, as amended by this section, is further amend19 ed— 

20 (1) in subsection (a), by striking the second sen21 tence; and 

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

23 new subsection (d): 

24 ‘‘(d)(1) Except as otherwise provided in this sub25 chapter or under regulations prescribed by the Secretary, 
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1 any corporation established under this subchapter, and its 

2 officers, directors, and employees, shall be required to com3 ply only with those Federal laws, regulations, and executive 

4 orders and directives that apply generally to private non5 profit corporations. 

6 ‘‘(2) A corporation under this subchapter is not— 

7 ‘‘(A) owned or controlled by the United States; 

8 or 

9 ‘‘(B) an agency or instrumentality of the United 

10 States.’’. 

11 (d) REINSTATEMENT OF REQUIREMENT FOR 501(C)(3) 

12 STATUS OF CORPORATIONS.—Subsection (e) of section 

13 7361, as redesignated by subsection (a)(1), is further 

14 amended by inserting ‘‘section 501(c)(3) of’’ after ‘‘exempt 

15 from taxation under’’. 

16 SEC. 802. CLARIFICATION OF PURPOSES OF CORPORA17 TIONS. 

18 (a) CLARIFICATION OF PURPOSES.—Subsection (a) of 

19 section 7362 is amended in the first sentence— 

20 (1) by striking ‘‘Any corporation’’ and all that 

21 follows through ‘‘facilitate’’ and inserting ‘‘A corpora22 tion established under this subchapter shall be estab23 lished to provide a flexible funding mechanism for the 

24 conduct of approved research and education at one or 
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1 more Department medical centers and to facilitate 

2 functions related to the conduct of’’; and 

3 (2) by inserting before the period at the end the 

4 following: ‘‘or centers’’. 

5 (b) MODIFICATION OF DEFINED TERM RELATING TO

6 EDUCATION AND TRAINING.—Subsection (b) of such section 

7 is amended in the matter preceding paragraph (1) by strik8 ing ‘‘the term ‘education and training’ ’’ and inserting ‘‘the 

9 term ‘education’ includes education and training and’’. 

10 (c) REPEAL OF ROLE OF CORPORATIONS WITH RE11 SPECT TO FELLOWSHIPS.—Paragraph (1) of subsection (b) 

12 of such section is amended by striking the flush matter fol13 lowing subparagraph (C). 

14 (d) AVAILABILITY OF EDUCATION FOR FAMILIES OF

15 VETERAN PATIENTS.—Paragraph (2) of subsection (b) of 

16 such section is amended by striking ‘‘to patients and to the 

17 families’’ and inserting ‘‘and includes education and train18 ing for patients and families’’. 

19 SEC. 803. MODIFICATION OF REQUIREMENTS FOR BOARDS 

20 OF DIRECTORS OF CORPORATIONS. 

21 (a) REQUIREMENTS FOR DEPARTMENT BOARD MEM22 BERS.—Paragraph (1) of section 7363(a) is amended to 

23 read as follows: 

24 ‘‘(1) with respect to the Department medical cen25 ter— 
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1 ‘‘(A)(i) the director (or directors of each De2 partment medical center, in the case of a multi3 medical center research corporation); 

4 ‘‘(ii) the chief of staff; and 

5 ‘‘(iii) as appropriate for the activities of 

6 such corporation, the associate chief of staff for 

7 research and the associate chief of staff for edu8 cation; or 

9 ‘‘(B) in the case of a Department medical 

10 center at which one or more of the positions re11 ferred to in subparagraph (A) do not exist, the 

12 official or officials who are responsible for car13 rying out the responsibilities of such position or 

14 positions at the Department medical center; 

15 and’’. 

16 (b) REQUIREMENTS FOR NON-DEPARTMENT BOARD

17 MEMBERS.—Paragraph (2) of such section is amended— 

18 (1) by inserting ‘‘not less than two’’ before 

19 ‘‘members’’; and 

20 (2) by striking ‘‘and who’’ and all that follows 

21 through the period at the end and inserting ‘‘and who 

22 have backgrounds, or business, legal, financial, med23 ical, or scientific expertise, of benefit to the operations 

24 of the corporation.’’. 
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1 (c) CONFLICTS OF INTEREST.—Subsection (c) of sec2 tion 7363 is amended by striking ‘‘, employed by, or have 

3 any other financial relationship with’’ and inserting ‘‘or 

4 employed by’’. 

5 SEC. 804. CLARIFICATION OF POWERS OF CORPORATIONS. 

6 (a) IN GENERAL.—Section 7364 is amended to read 

7 as follows: 

8 ‘‘§ 7364. General powers 

9 ‘‘(a) IN GENERAL.—(1) A corporation established 

10 under this subchapter may, solely to carry out the purposes 

11 of this subchapter— 

12 ‘‘(A) accept, administer, retain, and spend funds 

13 derived from gifts, contributions, grants, fees, reim14 bursements, and bequests from individuals and public 

15 and private entities; 

16 ‘‘(B) enter into contracts and agreements with 

17 individuals and public and private entities; 

18 ‘‘(C) subject to paragraph (2), set fees for edu19 cation and training facilitated under section 7362 of 

20 this title, and receive, retain, administer, and spend 

21 funds in furtherance of such education and training; 

22 ‘‘(D) reimburse amounts to the applicable appro23 priation account of the Department for the Office of 

24 General Counsel for any expenses of that Office in 
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1 providing legal services attributable to research and 

2 education agreements under this subchapter; and 

3 ‘‘(E) employ such employees as the corporation 

4 considers necessary for such purposes and fix the com5 pensation of such employees. 

6 ‘‘(2) Fees charged pursuant to paragraph (1)(C) for 

7 education and training described in that paragraph to in8 dividuals who are officers or employees of the Department 

9 may not be paid for by any funds appropriated to the De10 partment. 

11 ‘‘(3) Amounts reimbursed to the Office of General 

12 Counsel under paragraph (1)(D) shall be available for use 

13 by the Office of the General Counsel only for staff and train14 ing, and related travel, for the provision of legal services 

15 described in that paragraph and shall remain available for 

16 such use without fiscal year limitation. 

17 ‘‘(b) TRANSFER AND ADMINISTRATION OF FUNDS.—(1) 

18 Except as provided in paragraph (2), any funds received 

19 by the Secretary for the conduct of research or education 

20 at a Department medical center or centers, other than funds 

21 appropriated to the Department, may be transferred to and 

22 administered by a corporation established under this sub23 chapter for such purposes. 

24 ‘‘(2) A Department medical center may reimburse the 

25 corporation for all or a portion of the pay, benefits, or both 
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1 of an employee of the corporation who is assigned to the 

2 Department medical center if the assignment is carried out 

3 pursuant to subchapter VI of chapter 33 of title 5. 

4 ‘‘(3) A Department medical center may retain and use 

5 funds provided to it by a corporation established under this 

6 subchapter. Such funds shall be credited to the applicable 

7 appropriation account of the Department and shall be 

8 available, without fiscal year limitation, for the purposes 

9 of that account. 

10 ‘‘(c) RESEARCH PROJECTS.—Except for reasonable 

11 and usual preliminary costs for project planning before its 

12 approval, a corporation established under this subchapter 

13 may not spend funds for a research project unless the project 

14 is approved in accordance with procedures prescribed by 

15 the Under Secretary for Health for research carried out 

16 with Department funds. Such procedures shall include a 

17 scientific review process. 

18 ‘‘(d) EDUCATION ACTIVITIES.—Except for reasonable 

19 and usual preliminary costs for activity planning before 

20 its approval, a corporation established under this sub21 chapter may not spend funds for an education activity un22 less the activity is approved in accordance with procedures 

23 prescribed by the Under Secretary for Health. 

24 ‘‘(e) POLICIES AND PROCEDURES.—The Under Sec25 retary for Health may prescribe policies and procedures to 
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1 guide the spending of funds by corporations established 

2 under this subchapter that are consistent with the purpose 

3 of such corporations as flexible funding mechanisms and 

4 with Federal and State laws and regulations, and executive 

5 orders, circulars, and directives that apply generally to the 

6 receipt and expenditure of funds by nonprofit organizations 

7 exempt from taxation under section 501(c)(3) of the Inter8 nal Revenue Code of 1986.’’. 

9 (b) CONFORMING AMENDMENT.—Section 7362(a), as 

10 amended by section 802(a)(1) of this Act, is further amend11 ed by striking the last sentence. 

12 SEC. 805. REDESIGNATION OF SECTION 7364A OF TITLE 38, 

13 UNITED STATES CODE. 

14 (a) REDESIGNATION.—Section 7364A is redesignated 

15 as section 7365. 

16 (b) CLERICAL AMENDMENTS.—The table of sections at 

17 the beginning of chapter 73 is amended— 

18 (1) by striking the item relating to section 

19 7364A; and 

20 (2) by striking the item relating to section 7365 

21 and inserting the following new item: 

‘‘7365. Coverage of employees under certain Federal tort claims laws.’’. 
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1 SEC. 806. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF 

2 CORPORATIONS. 

3 (a) ADDITIONAL INFORMATION IN ANNUAL RE4 PORTS.—Subsection (b) of section 7366 is amended to read 

5 as follows: 

6 ‘‘(b)(1) Each corporation shall submit to the Secretary 

7 each year a report providing a detailed statement of the 

8 operations, activities, and accomplishments of the corpora9 tion during that year. 

10 ‘‘(2)(A) A corporation with revenues in excess of 

11 $500,000 for any year shall obtain an audit of the corpora12 tion for that year. 

13 ‘‘(B) A corporation with annual revenues between 

14 $100,000 and $500,000 shall obtain an audit of the cor15 poration at least once every three years. 

16 ‘‘(C) Any audit under this paragraph shall be per17 formed by an independent auditor. 

18 ‘‘(3) The corporation shall include in each report to 

19 the Secretary under paragraph (1) the following: 

20 ‘‘(A) The most recent audit of the corporation 

21 under paragraph (2). 

22 ‘‘(B) The most recent Internal Revenue Service 

23 Form 990 ‘Return of Organization Exempt from In24 come Tax’ or equivalent and the applicable schedules 

25 under such form.’’. 
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1 (b) CONFLICT OF INTEREST POLICIES.—Subsection (c) 

2 of such section is amended to read as follows: 

3 ‘‘(c) Each director, officer, and employee of a corpora4 tion established under this subchapter shall be subject to a 

5 conflict of interest policy adopted by that corporation.’’. 

6 (c) ESTABLISHMENT OF APPROPRIATE PAYEE RE7 PORTING THRESHOLD.—Subsection (d)(3)(C) of such sec8 tion is amended by striking ‘‘$35,000’’ and inserting 

9 ‘‘$50,000’’. 

10 TITLE IX—CONSTRUCTION AND 

11 NAMING MATTERS 

12 SEC. 901. AUTHORIZATION OF MEDICAL FACILITY 

13 PROJECTS. 

14 (a) AUTHORIZATION OF FISCAL YEAR 2010 MAJOR

15 MEDICAL FACILITY PROJECTS.—The Secretary of Veterans 

16 Affairs may carry out the following major medical facility 

17 projects in fiscal year 2010, with each project to be carried 

18 out in the amount specified for such project: 

19 (1) Construction (including acquisition of land) 

20 for the realignment of services and closure projects at 

21 the Department of Veterans Affairs Medical Center in 

22 Livermore, California, in an amount not to exceed 

23 $55,430,000. 

24 (2) Construction (including acquisition of land) 

25 for a new medical facility at the Department of Vet-
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1 erans Affairs Medical Center in Louisville, Kentucky, 

2 in an amount not to exceed $75,000,000. 

3 (3) Construction (including acquisition of land) 

4 for a clinical expansion for a Mental Health Facility 

5 at the Department of Veterans Affairs Medical Center 

6 in Dallas, Texas, in an amount not to exceed 

7 $15,640,000. 

8 (4) Construction (including acquisition of land) 

9 for a replacement bed tower and clinical expansion at 

10 the Department of Veterans Affairs Medical Center in 

11 St. Louis, Missouri, in an amount not to exceed 

12 $43,340,000. 

13 (b) EXTENSION OF AUTHORIZATION FOR MAJOR MED14 ICAL FACILITY CONSTRUCTION PROJECTS PREVIOUSLY AU15 THORIZED.—The Secretary of Veterans Affairs may carry 

16 out the following major medical facility projects in fiscal 

17 year 2010, as follows with each project to be carried out 

18 in the amount specified for such project: 

19 (1) Replacement of the existing Department of 

20 Veterans Affairs Medical Center in Denver, Colorado, 

21 in an amount not to exceed $800,000,000. 

22 (2) Construction of Outpatient and Inpatient 

23 Improvements in Bay Pines, Florida, in an amount 

24 not to exceed $194,400,000. 

25 (c) AUTHORIZATION OF APPROPRIATIONS.— 
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1 (1) AUTHORIZATION OF APPROPRIATIONS FOR

2 CONSTRUCTION.—There is authorized to be appro3 priated to the Secretary of Veterans Affairs for fiscal 

4 year 2010, or the year in which funds are appro5 priated, for the Construction, Major Projects ac6 count— 

7 (A) $189,410,000 for the projects authorized 

8 in subsection (a); and 

9 (B) $994,400,000 for the projects authorized 

10 in subsection (b). 

11 (2) LIMITATION.—The projects authorized in 

12 subsections (a) and (b) may only be carried out 

13 using— 

14 (A) funds appropriated for fiscal year 2010 

15 pursuant to the authorization of appropriations 

16 in paragraph (1); 

17 (B) funds available for Construction, Major 

18 Projects for a fiscal year before fiscal year 2010 

19 that remain available for obligation; 

20 (C) funds available for Construction, Major 

21 Projects for a fiscal year after fiscal year 2010 

22 that remain available for obligation; 

23 (D) funds appropriated for Construction, 

24 Major Projects for fiscal year 2010 for a category 

25 of activity not specific to a project; 
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1 (E) funds appropriated for Construction, 

2 Major Projects for a fiscal year before 2010 for 

3 a category of activity not specific to a project; 

4 and 

5 (F) funds appropriated for Construction, 

6 Major Projects for a fiscal year after 2010 for a 

7 category of activity not specific to a project. 

8 SEC. 902. DESIGNATION OF MERRIL LUNDMAN DEPART9 MENT OF VETERANS AFFAIRS OUTPATIENT 

10 CLINIC, HAVRE, MONTANA. 

11 (a) DESIGNATION.—The Department of Veterans Af12 fairs outpatient clinic in Havre, Montana, shall after the 

13 date of the enactment of this Act be known and designated 

14 as the ‘‘Merril Lundman Department of Veterans Affairs 

15 Outpatient Clinic’’. 

16 (b) REFERENCES.—Any reference in any law, regula17 tion, map, document, record, or other paper of the United 

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

19 shall be considered to be a reference to the Merril Lundman 

20 Department of Veterans Affairs Outpatient Clinic. 

21 SEC. 903. DESIGNATION OF WILLIAM C. TALLENT DEPART22 MENT OF VETERANS AFFAIRS OUTPATIENT 

23 CLINIC, KNOXVILLE, TENNESSEE. 

24 (a) DESIGNATION.—The Department of Veterans Af25 fairs Outpatient Clinic in Knoxville, Tennessee, shall after 
131 

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1 the date of the enactment of this Act be known and des2 ignated as the ‘‘William C. Tallent Department of Veterans 

3 Affairs Outpatient Clinic’’. 

4 (b) REFERENCES.—Any reference in any law, regula5 tion, map, document, record, or other paper of the United 

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

7 shall be considered to be a reference to the William C. 

8 Tallent Department of Veterans Affairs Outpatient Clinic. 

9 SEC. 904. DESIGNATION OF MAX J. BEILKE DEPARTMENT OF 

10 VETERANS AFFAIRS OUTPATIENT CLINIC, AL11 EXANDRIA, MINNESOTA. 

12 (a) DESIGNATION.—The Department of Veterans Af13 fairs outpatient clinic in Alexandria, Minnesota, shall after 

14 the date of the enactment of this Act be known and des15 ignated as the ‘‘Max J. Beilke Department of Veterans Af16 fairs Outpatient Clinic’’. 

17 (b) REFERENCES.—Any reference in any law, regula18 tion, map, document, record, or other paper of the United 

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

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

21 Department of Veterans Affairs Outpatient Clinic. 

22 TITLE X—OTHER MATTERS 

23 SEC. 1001. EXPANSION OF AUTHORITY FOR DEPARTMENT 

24 OF VETERANS AFFAIRS POLICE OFFICERS. 

25 Section 902 is amended— 
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1 (1) in subsection (a)— 

2 (A) by amending paragraph (1) to read as 

3 follows: 

4 ‘‘(1) Employees of the Department who are Depart5 ment police officers shall, with respect to acts occurring on 

6 Department property— 

7 ‘‘(A) enforce Federal laws; 

8 ‘‘(B) enforce the rules prescribed under section 

9 901 of this title; 

10 ‘‘(C) enforce traffic and motor vehicle laws of a 

11 State or local government (by issuance of a citation 

12 for violation of such laws) within the jurisdiction of 

13 which such Department property is located as author14 ized by an express grant of authority under applica15 ble State or local law; 

16 ‘‘(D) carry the appropriate Department-issued 

17 weapons, including firearms, while off Department 

18 property in an official capacity or while in an offi19 cial travel status; 

20 ‘‘(E) conduct investigations, on and off Depart21 ment property, of offenses that may have been com22 mitted on property under the original jurisdiction of 

23 Department, consistent with agreements or other con24 sultation with affected Federal, State, or local law en25 forcement agencies; and 
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1 ‘‘(F) carry out, as needed and appropriate, the 

2 duties described in subparagraphs (A) through (E) 

3 when engaged in duties authorized by other Federal 

4 statutes.’’; 

5 (B) by striking paragraph (2) and redesig6 nating paragraph (3) as paragraph (2); and 

7 (C) in paragraph (2), as redesignated by 

8 subparagraph (B) of this paragraph, by insert9 ing ‘‘, and on any arrest warrant issued by com10 petent judicial authority’’ before the period; and 

11 (2) by amending subsection (c) to read as fol12 lows: 

13 ‘‘(c) The powers granted to Department police officers 

14 designated under this section shall be exercised in accord15 ance with guidelines approved by the Secretary and the At16 torney General.’’. 

17 SEC. 1002. UNIFORM ALLOWANCE FOR DEPARTMENT OF 

18 VETERANS AFFAIRS POLICE OFFICERS. 

19 Section 903 is amended— 

20 (1) by striking subsection (b) and inserting the 

21 following new subsection (b): 

22 ‘‘(b)(1) The amount of the allowance that the Secretary 

23 may pay under this section is the lesser of— 

24 ‘‘(A) the amount currently allowed as prescribed 

25 by the Office of Personnel Management; or 
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1 ‘‘(B) estimated costs or actual costs as deter2 mined by periodic surveys conducted by the Depart3 ment. 

4 ‘‘(2) During any fiscal year no officer shall receive 

5 more for the purchase of a uniform described in subsection 

6 (a) than the amount established under this subsection.’’; 

7 and 

8 (2) by striking subsection (c) and inserting the 

9 following new subsection (c): 

10 ‘‘(c) The allowance established under subsection (b) 

11 shall be paid at the beginning of a Department police offi12 cer’s employment for those appointed on or after October 

13 1, 2010. In the case of any other Department police officer, 

14 an allowance in the amount established under subsection 

15 (b) shall be paid upon the request of the officer.’’. 

16 SEC. 1003. SUBMISSION OF REPORTS TO CONGRESS BY SEC17 RETARY OF VETERANS AFFAIRS IN ELEC18 TRONIC FORM. 

19 (a) IN GENERAL.—Chapter 1 is amended by adding 

20 at the end the following new section: 

21 ‘‘§ 118. Submission of reports to Congress in electronic 

22 form 

23 ‘‘(a) IN GENERAL.—Whenever the Secretary or any 

24 other official of the Department is required by law to sub25 mit to Congress (or any committee of either chamber of Con-
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1 gress) a report, the Secretary or other official shall submit 

2 to Congress (or such committee) a copy of the report in an 

3 electronic format. 

4 ‘‘(b) TREATMENT.—The submission of a copy of a re5 port in accordance with this section shall be treated as 

6 meeting any requirement of law to submit such report to 

7 Congress (or any committee of either chamber of Congress). 

8 ‘‘(c) REPORT DEFINED.—For purposes of this section, 

9 the term ‘report’ includes any certification, notification, or 

10 other communication in writing.’’. 

11 (b) TECHNICAL AND CLERICAL AMENDMENTS.—The 

12 table of sections at the beginning of chapter 1 is amended— 

13 (1) by striking the item relating to section 117; 

14 and 

15 (2) by adding at the end the following new items: 

‘‘117. Advance appropriations for certain medical care accounts. 

‘‘118. Reports to Congress: submission in electronic form.’’. 

16 SEC. 1004. DETERMINATION OF BUDGETARY EFFECTS FOR 

17 PURPOSES OF COMPLIANCE WITH STATU18 TORY PAY-AS-YOU-GO ACT OF 2010. 

19 The budgetary effects of this Act, for the purpose of 

20 complying with the Statutory Pay-As-You-Go Act of 2010, 

21 shall be determined by reference to the latest statement titled 

22 ‘‘Budgetary Effects of PAYGO Legislation’’ for this Act, 

23 submitted for printing in the Congressional Record by the 

24 Chairman of the House Budget Committee, provided that 
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1 such statement has been submitted prior to the vote on pas2 sage. 

Attest: 

Clerk. 

S. 1963 

AMENDMENT