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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1963 Enrolled Bill (ENR)]

        S.1963

                      One Hundred Eleventh Congress

                                 of the

                        United States of America

                          AT THE SECOND SESSION

          Begun and held at the City of Washington on Tuesday,
             the fifth day of January, two thousand and ten

                                 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.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
    (a) Short Title.--This Act may be cited as the ``Caregivers and 
Veterans Omnibus Health Services Act of 2010''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

                       TITLE I--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.
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.
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.
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.
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.
    Except as otherwise expressly provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or repeal 
of, a section or other provision, the reference shall be considered to 
be made to a section or other provision of title 38, United States 
Code.

                       TITLE I--CAREGIVER SUPPORT

    SEC. 101. ASSISTANCE AND SUPPORT SERVICES FOR CAREGIVERS.
    (a) Assistance and Support Services.--
        (1) In general.--Subchapter II of chapter 17 is amended by 
    adding at the end the following new section:
``Sec. 1720G. Assistance and support services for caregivers
    ``(a) Program of Comprehensive Assistance for Family Caregivers.--
(1)(A) The Secretary shall establish a program of comprehensive 
assistance for family caregivers of eligible veterans.
    ``(B) The Secretary shall only provide support under the program 
required by subparagraph (A) to a family caregiver of an eligible 
veteran if the Secretary determines it is in the best interest of the 
eligible veteran to do so.
    ``(2) For purposes of this subsection, an eligible veteran is any 
individual who--
        ``(A) is a veteran or member of the Armed Forces undergoing 
    medical discharge from the Armed Forces;
        ``(B) has a serious injury (including traumatic brain injury, 
    psychological trauma, or other mental disorder) incurred or 
    aggravated in the line of duty in the active military, naval, or 
    air service on or after September 11, 2001; and
        ``(C) is in need of personal care services because of--
            ``(i) an inability to perform one or more activities of 
        daily living;
            ``(ii) a need for supervision or protection based on 
        symptoms or residuals of neurological or other impairment or 
        injury; or
            ``(iii) such other matters as the Secretary considers 
        appropriate.
    ``(3)(A) As part of the program required by paragraph (1), the 
Secretary shall provide to family caregivers of eligible veterans the 
following assistance:
        ``(i) To each family caregiver who is approved as a provider of 
    personal care services for an eligible veteran under paragraph 
    (6)--
            ``(I) such instruction, preparation, and training as the 
        Secretary considers appropriate for the family caregiver to 
        provide personal care services to the eligible veteran;
            ``(II) ongoing technical support consisting of information 
        and assistance to address, in a timely manner, the routine, 
        emergency, and specialized caregiving needs of the family 
        caregiver in providing personal care services to the eligible 
        veteran;
            ``(III) counseling; and
            ``(IV) lodging and subsistence under section 111(e) of this 
        title.
        ``(ii) To each family caregiver who is designated as the 
    primary provider of personal care services for an eligible veteran 
    under paragraph (7)--
            ``(I) the assistance described in clause (i);
            ``(II) such mental health services as the Secretary 
        determines appropriate;
            ``(III) respite care of not less than 30 days annually, 
        including 24-hour per day care of the veteran commensurate with 
        the care provided by the family caregiver to permit extended 
        respite;
            ``(IV) medical care under section 1781 of this title; and
            ``(V) a monthly personal caregiver stipend.
    ``(B) Respite care provided under subparagraph (A)(ii)(III) shall 
be medically and age-appropriate and include in-home care.
    ``(C)(i) The amount of the monthly personal caregiver stipend 
provided under subparagraph (A)(ii)(V) shall be determined in 
accordance with a schedule established by the Secretary that specifies 
stipends based upon the amount and degree of personal care services 
provided.
    ``(ii) The Secretary shall ensure, to the extent practicable, that 
the schedule required by clause (i) specifies that the amount of the 
monthly personal caregiver stipend provided to a primary provider of 
personal care services for the provision of personal care services to 
an eligible veteran is not less than the monthly amount a commercial 
home health care entity would pay an individual in the geographic area 
of the eligible veteran to provide equivalent personal care services to 
the eligible veteran.
    ``(iii) If personal care services are not available from a 
commercial home health entity in the geographic area of an eligible 
veteran, the amount of the monthly personal caregiver stipend payable 
under the schedule required by clause (i) with respect to the eligible 
veteran shall be determined by taking into consideration the costs of 
commercial providers of personal care services in providing personal 
care services in geographic areas other than the geographic area of the 
eligible veteran with similar costs of living.
    ``(4) An eligible veteran and a family member of the eligible 
veteran seeking to participate in the program required by paragraph (1) 
shall jointly submit to the Secretary an application therefor in such 
form and in such manner as the Secretary considers appropriate.
    ``(5) For each application submitted jointly by an eligible veteran 
and family member, the Secretary shall evaluate--
        ``(A) the eligible veteran--
            ``(i) to identify the personal care services required by 
        the eligible veteran; and
            ``(ii) to determine whether such requirements could be 
        significantly or substantially satisfied through the provision 
        of personal care services from a family member; and
        ``(B) the family member to determine the amount of instruction, 
    preparation, and training, if any, the family member requires to 
    provide the personal care services required by the eligible 
    veteran--
            ``(i) as a provider of personal care services for the 
        eligible veteran; and
            ``(ii) as the primary provider of personal care services 
        for the eligible veteran.
    ``(6)(A) The Secretary shall provide each family member of an 
eligible veteran who makes a joint application under paragraph (4) the 
instruction, preparation, and training determined to be required by 
such family member under paragraph (5)(B).
    ``(B) Upon the successful completion by a family member of an 
eligible veteran of instruction, preparation, and training under 
subparagraph (A), the Secretary shall approve the family member as a 
provider of personal care services for the eligible veteran.
    ``(C) The Secretary shall, subject to regulations the Secretary 
shall prescribe, provide for necessary travel, lodging, and per diem 
expenses incurred by a family member of an eligible veteran in 
undergoing instruction, preparation, and training under subparagraph 
(A).
    ``(D) If the participation of a family member of an eligible 
veteran in instruction, preparation, and training under subparagraph 
(A) would interfere with the provision of personal care services to the 
eligible veteran, the Secretary shall, subject to regulations as the 
Secretary shall prescribe and in consultation with the veteran, provide 
respite care to the eligible veteran during the provision of such 
instruction, preparation, and training to the family member so that the 
family member can participate in such instruction, preparation, and 
training without interfering with the provision of such services to the 
eligible veteran.
    ``(7)(A) For each eligible veteran with at least one family member 
who is described by subparagraph (B), the Secretary shall designate one 
family member of such eligible veteran as the primary provider of 
personal care services for such eligible veteran.
    ``(B) A primary provider of personal care services designated for 
an eligible veteran under subparagraph (A) shall be selected from among 
family members of the eligible veteran who--
        ``(i) are approved under paragraph (6) as a provider of 
    personal care services for the eligible veteran;
        ``(ii) elect to provide the personal care services to the 
    eligible veteran that the Secretary determines the eligible veteran 
    requires under paragraph (5)(A)(i);
        ``(iii) has the consent of the eligible veteran to be the 
    primary provider of personal care services for the eligible 
    veteran; and
        ``(iv) are considered by the Secretary as competent to be the 
    primary provider of personal care services for the eligible 
    veteran.
    ``(C) An eligible veteran receiving personal care services from a 
family member designated as the primary provider of personal care 
services for the eligible veteran under subparagraph (A) may, in 
accordance with procedures the Secretary shall establish for such 
purposes, revoke consent with respect to such family member under 
subparagraph (B)(iii).
    ``(D) If a family member designated as the primary provider of 
personal care services for an eligible veteran under subparagraph (A) 
subsequently fails to meet any requirement set forth in subparagraph 
(B), the Secretary--
        ``(i) shall immediately revoke the family member's designation 
    under subparagraph (A); and
        ``(ii) may designate, in consultation with the eligible 
    veteran, a new primary provider of personal care services for the 
    eligible veteran under such subparagraph.
    ``(E) The Secretary shall take such actions as may be necessary to 
ensure that the revocation of a designation under subparagraph (A) with 
respect to an eligible veteran does not interfere with the provision of 
personal care services required by the eligible veteran.
    ``(8) If an eligible veteran lacks the capacity to make a decision 
under this subsection, the Secretary may, in accordance with 
regulations and policies of the Department regarding appointment of 
guardians or the use of powers of attorney, appoint a surrogate for the 
eligible veteran who may make decisions and take action under this 
subsection on behalf of the eligible veteran.
    ``(9)(A) The Secretary shall monitor the well-being of each 
eligible veteran receiving personal care services under the program 
required by paragraph (1).
    ``(B) The Secretary shall document each finding the Secretary 
considers pertinent to the appropriate delivery of personal care 
services to an eligible veteran under the program.
    ``(C) The Secretary shall establish procedures to ensure 
appropriate follow-up regarding findings described in subparagraph (B). 
Such procedures may include the following:
        ``(i) Visiting an eligible veteran in the eligible veteran's 
    home to review directly the quality of personal care services 
    provided to the eligible veteran.
        ``(ii) Taking such corrective action with respect to the 
    findings of any review of the quality of personal care services 
    provided an eligible veteran as the Secretary considers 
    appropriate, which may include--
            ``(I) providing additional training to a family caregiver; 
        and
            ``(II) suspending or revoking the approval of a family 
        caregiver under paragraph (6) or the designation of a family 
        caregiver under paragraph (7).
    ``(10) The Secretary shall carry out outreach to inform eligible 
veterans and family members of eligible veterans of the program 
required by paragraph (1) and the benefits of participating in the 
program.
    ``(b) Program of General Caregiver Support Services.--(1) The 
Secretary shall establish a program of support services for caregivers 
of covered veterans who are enrolled in the health care system 
established under section 1705(a) of this title (including caregivers 
who do not reside with such veterans).
    ``(2) For purposes of this subsection, a covered veteran is any 
individual who needs personal care services because of--
        ``(A) an inability to perform one or more activities of daily 
    living;
        ``(B) a need for supervision or protection based on symptoms or 
    residuals of neurological or other impairment or injury; or
        ``(C) such other matters as the Secretary shall specify.
    ``(3)(A) The support services furnished to caregivers of covered 
veterans under the program required by paragraph (1) shall include the 
following:
        ``(i) Services regarding the administering of personal care 
    services, which, subject to subparagraph (B), shall include--
            ``(I) educational sessions made available both in person 
        and on an Internet website;
            ``(II) use of telehealth and other available technologies; 
        and
            ``(III) teaching techniques, strategies, and skills for 
        caring for a disabled veteran;
        ``(ii) Counseling and other services under section 1782 of this 
    title.
        ``(iii) Respite care under section 1720B of this title that is 
    medically and age appropriate for the veteran (including 24-hour 
    per day in-home care).
        ``(iv) Information concerning the supportive services available 
    to caregivers under this subsection and other public, private, and 
    nonprofit agencies that offer support to caregivers.
    ``(B) If the Secretary certifies to the Committees on Veterans' 
Affairs of the Senate and the House of Representatives that funding 
available for a fiscal year is insufficient to fund the provision of 
services specified in one or more subclauses of subparagraph (A)(i), 
the Secretary shall not be required under subparagraph (A) to provide 
the services so specified in the certification during the period 
beginning on the date that is 180 days after the date the certification 
is received by the Committees and ending on the last day of the fiscal 
year.
    ``(4) In providing information under paragraph (3)(A)(iv), the 
Secretary shall collaborate with the Assistant Secretary for Aging of 
the Department of Health and Human Services in order to provide 
caregivers access to aging and disability resource centers under the 
Administration on Aging of the Department of Health and Human Services.
    ``(5) In carrying out the program required by paragraph (1), the 
Secretary shall conduct outreach to inform covered veterans and 
caregivers of covered veterans about the program. The outreach shall 
include an emphasis on covered veterans and caregivers of covered 
veterans living in rural areas.
    ``(c) Construction.--(1) A decision by the Secretary under this 
section affecting the furnishing of assistance or support shall be 
considered a medical determination.
    ``(2) Nothing in this section shall be construed to create--
        ``(A) an employment relationship between the Secretary and an 
    individual in receipt of assistance or support under this section; 
    or
        ``(B) any entitlement to any assistance or support provided 
    under this section.
    ``(d) Definitions.--In this section:
        ``(1) The term `caregiver', with respect to an eligible veteran 
    under subsection (a) or a covered veteran under subsection (b), 
    means an individual who provides personal care services to the 
    veteran.
        ``(2) The term `family caregiver', with respect to an eligible 
    veteran under subsection (a), means a family member who is a 
    caregiver of the veteran.
        ``(3) The term `family member', with respect to an eligible 
    veteran under subsection (a), means an individual who--
            ``(A) is a member of the family of the veteran, including--
                ``(i) a parent;
                ``(ii) a spouse;
                ``(iii) a child;
                ``(iv) a step-family member; and
                ``(v) an extended family member; or
            ``(B) lives with the veteran but is not a member of the 
        family of the veteran.
        ``(4) The term `personal care services', with respect to an 
    eligible veteran under subsection (a) or a covered veteran under 
    subsection (b), means services that provide the veteran the 
    following:
            ``(A) Assistance with one or more independent activities of 
        daily living.
            ``(B) Any other non-institutional extended care (as such 
        term is used in section 1701(6)(E) of this title).
    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out the programs required by subsections (a) and 
(b)--
        ``(1) $60,000,000 for fiscal year 2010; and
        ``(2) $1,542,000,000 for the period of fiscal years 2011 
    through 2015.''.
        (2) Clerical amendment.--The table of sections at the beginning 
    of chapter 17 is amended by inserting after the item related to 
    section 1720F the following new item:

``1720G. Assistance and support services for caregivers.''.

        (3) Effective date.--
            (A) In general.--The amendments made by this subsection 
        shall take effect on the date that is 270 days after the date 
        of the enactment of this Act.
            (B) Implementation.--The Secretary of Veterans Affairs 
        shall commence the programs required by subsections (a) and (b) 
        of section 1720G of title 38, United States Code, as added by 
        paragraph (1) of this subsection, on the date on which the 
        amendments made by this subsection take effect.
    (b) Implementation Plan and Report.--
        (1) In general.--Not later than 180 days after the date of the 
    enactment of this Act, the Secretary of Veterans Affairs shall--
            (A) develop a plan for the implementation of the program of 
        comprehensive assistance for family caregivers required by 
        section 1720G(a)(1) of title 38, United States Code, as added 
        by subsection (a)(1) of this section; and
            (B) submit to the Committee on Veterans' Affairs of the 
        Senate and the Committee on Veterans' Affairs of the House of 
        Representatives a report on such plan.
        (2) Consultation.--In developing the plan required by paragraph 
    (1)(A), the Secretary shall consult with the following:
            (A) Individuals described in section 1720G(a)(2) of title 
        38, United States Code, as added by subsection (a)(1) of this 
        section.
            (B) Family members of such individuals who provide personal 
        care services to such individuals.
            (C) The Secretary of Defense with respect to matters 
        concerning personal care services for members of the Armed 
        Forces undergoing medical discharge from the Armed Forces who 
        are eligible to benefit from personal care services furnished 
        under the program of comprehensive assistance required by 
        section 1720G(a)(1) of such title, as so added.
            (D) Veterans service organizations, as recognized by the 
        Secretary for the representation of veterans under section 5902 
        of such title.
            (E) National organizations that specialize in the provision 
        of assistance to individuals with the types of disabilities 
        that family caregivers will encounter while providing personal 
        care services under the program of comprehensive assistance 
        required by section 1720G(a)(1) of such title, as so added.
            (F) National organizations that specialize in provision of 
        assistance to family members of veterans who provide personal 
        care services to such veterans.
            (G) Such other organizations with an interest in the 
        provision of care to veterans and assistance to family 
        caregivers as the Secretary considers appropriate.
        (3) Report contents.--The report required by paragraph (1)(B) 
    shall contain the following:
            (A) The plan required by paragraph (1)(A).
            (B) A description of the individuals, caregivers, and 
        organizations consulted by the Secretary of Veterans Affairs 
        under paragraph (2).
            (C) A description of such consultations.
            (D) The recommendations of such individuals, caregivers, 
        and organizations, if any, that were not adopted and 
        incorporated into the plan required by paragraph (1)(A), and 
        the reasons the Secretary did not adopt such recommendations.
    (c) Annual Evaluation Report.--
        (1) In general.--Not later than 2 years after the date 
    described in subsection (a)(3)(A) and annually thereafter, the 
    Secretary shall submit to the Committee on Veterans' Affairs of the 
    Senate and the Committee on Veterans' Affairs of the House of 
    Representatives a comprehensive report on the implementation of 
    section 1720G of title 38, United States Code, as added by 
    subsection (a)(1).
        (2) Contents.--The report required by paragraph (1) shall 
    include the following:
            (A) With respect to the program of comprehensive assistance 
        for family caregivers required by subsection (a)(1) of such 
        section 1720G and the program of general caregiver support 
        services required by subsection (b)(1) of such section--
                (i) the number of caregivers that received assistance 
            under such programs;
                (ii) the cost to the Department of providing assistance 
            under such programs;
                (iii) a description of the outcomes achieved by, and 
            any measurable benefits of, carrying out such programs;
                (iv) an assessment of the effectiveness and the 
            efficiency of the implementation of such programs; and
                (v) such recommendations, including recommendations for 
            legislative or administrative action, as the Secretary 
            considers appropriate in light of carrying out such 
            programs.
            (B) With respect to the program of comprehensive assistance 
        for family caregivers required by such subsection (a)(1)--
                (i) a description of the outreach activities carried 
            out by the Secretary under such program; and
                (ii) an assessment of the manner in which resources are 
            expended by the Secretary under such program, particularly 
            with respect to the provision of monthly personal caregiver 
            stipends under paragraph (3)(A)(ii)(v) of such subsection 
            (a).
            (C) With respect to the provision of general caregiver 
        support services required by such subsection (b)(1)--
                (i) a summary of the support services made available 
            under the program;
                (ii) the number of caregivers who received support 
            services under the program;
                (iii) the cost to the Department of providing each 
            support service provided under the program; and
                (iv) such other information as the Secretary considers 
            appropriate.
    (d) Report on Expansion of Family Caregiver Assistance.--
        (1) In general.--Not later than 2 years after the date 
    described in subsection (a)(3)(A), the Secretary shall submit to 
    the Committee on Veterans' Affairs of the Senate and the Committee 
    on Veterans' Affairs of the House of Representatives a report on 
    the feasibility and advisability of expanding the provision of 
    assistance under section 1720G(a) of title 38, United States Code, 
    as added by subsection (a)(1), to family caregivers of veterans who 
    have a serious injury incurred or aggravated in the line of duty in 
    the active military, naval, or air service before September 11, 
    2001.
        (2) Recommendations.--The report required by paragraph (1) 
    shall include such recommendations as the Secretary considers 
    appropriate with respect to the expansion described in such 
    paragraph.
    SEC. 102. MEDICAL CARE FOR FAMILY CAREGIVERS.
    Section 1781(a) is amended--
        (1) in paragraph (2), by striking ``and'' at the end;
        (2) in paragraph (3), by inserting ``and'' at the end; and
        (3) by inserting after paragraph (3), the following new 
    paragraph:
        ``(4) an individual designated as a primary provider of 
    personal care services under section 1720G(a)(7)(A) of this title 
    who is not entitled to care or services under a health-plan 
    contract (as defined in section 1725(f) of this title);''.
    SEC. 103. COUNSELING AND MENTAL HEALTH SERVICES FOR CAREGIVERS.
    (a) In General.--Section 1782(c) is amended--
        (1) in paragraph (1), by striking ``; or'' and inserting a 
    semicolon;
        (2) by redesignating paragraph (2) as paragraph (3); and
        (3) by inserting after paragraph (1) the following new 
    paragraph (2):
        ``(2) a family caregiver of an eligible veteran or a caregiver 
    of a covered veteran (as those terms are defined in section 1720G 
    of this title); or''.
    (b) Conforming Amendment.--The section heading of section 1782 is 
amended by adding at the end, the following: ``and caregivers''.
    (c) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by striking the item relating to section 1782 and 
inserting the following new item:

``1782. Counseling, training, and mental health services for immediate 
          family members and caregivers.''.
    SEC. 104. LODGING AND SUBSISTENCE FOR ATTENDANTS.
    Section 111(e) is amended--
        (1) by striking ``When'' and inserting the following: ``(1) 
    Except as provided in paragraph (2), when''; and
        (2) by adding at the end the following new paragraphs:
    ``(2)(A) Without regard to whether an eligible veteran entitled to 
mileage under this section for travel to a Department facility for the 
purpose of medical examination, treatment, or care requires an 
attendant in order to perform such travel, an attendant of such veteran 
described in subparagraph (B) may be allowed expenses of travel 
(including lodging and subsistence) upon the same basis as such veteran 
during--
        ``(i) the period of time in which such veteran is traveling to 
    and from a Department facility for the purpose of medical 
    examination, treatment, or care; and
        ``(ii) the duration of the medical examination, treatment, or 
    care episode for such veteran.
    ``(B) An attendant of a veteran described in this subparagraph is a 
provider of personal care services for such veteran who is approved 
under paragraph (6) of section 1720G(a) of this title or designated 
under paragraph (7) of such section 1720G(a).
    ``(C) The Secretary may prescribe regulations to carry out this 
paragraph. Such regulations may include provisions--
        ``(i) to limit the number of attendants that may receive 
    expenses of travel under this paragraph for a single medical 
    examination, treatment, or care episode of an eligible veteran; and
        ``(ii) to require such attendants to use certain travel 
    services.
    ``(D) In this subsection, the term `eligible veteran' has the 
meaning given that term in section 1720G(a)(2) of this title.''.

              TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

    SEC. 201. STUDY OF BARRIERS FOR WOMEN VETERANS TO HEALTH CARE FROM 
      THE DEPARTMENT OF VETERANS AFFAIRS.
    (a) Study Required.--The Secretary of Veterans Affairs shall 
conduct a comprehensive study of the barriers to the provision of 
comprehensive health care by the Department of Veterans Affairs 
encountered by women who are veterans. In conducting the study, the 
Secretary shall--
        (1) survey women veterans who seek or receive hospital care or 
    medical services provided by the Department of Veterans Affairs as 
    well as women veterans who do not seek or receive such care or 
    services;
        (2) administer the survey to a representative sample of women 
    veterans from each Veterans Integrated Service Network; and
        (3) ensure that the sample of women veterans surveyed is of 
    sufficient size for the study results to be statistically 
    significant and is a larger sample than that of the study referred 
    to in subsection (b).
    (b) Use of Previous Study.--In conducting the study required by 
subsection (a), the Secretary shall build on the work of the study of 
the Department of Veterans Affairs titled ``National Survey of Women 
Veterans in Fiscal Year 2007-2008''.
    (c) Elements of Study.--In conducting the study required by 
subsection (a), the Secretary shall conduct research on the effects of 
the following on the women veterans surveyed in the study:
        (1) The perceived stigma associated with seeking mental health 
    care services.
        (2) The effect of driving distance or availability of other 
    forms of transportation to the nearest medical facility on access 
    to care.
        (3) The availability of child care.
        (4) The acceptability of integrated primary care, women's 
    health clinics, or both.
        (5) The comprehension of eligibility requirements for, and the 
    scope of services available under, hospital care and medical 
    services.
        (6) The perception of personal safety and comfort in inpatient, 
    outpatient, and behavioral health facilities.
        (7) The gender sensitivity of health care providers and staff 
    to issues that particularly affect women.
        (8) The effectiveness of outreach for health care services 
    available to women veterans.
        (9) The location and operating hours of health care facilities 
    that provide services to women veterans.
        (10) Such other significant barriers as the Secretary considers 
    appropriate.
    (d) Discharge by Contract.--The Secretary shall enter into a 
contract with a qualified independent entity or organization to carry 
out the study and research required under this section.
    (e) Mandatory Review of Data by Certain Department Divisions.--
        (1) In general.--The Secretary shall ensure that the head of 
    each division of the Department of Veterans Affairs specified in 
    paragraph (2) reviews the results of the study conducted under this 
    section. The head of each such division shall submit findings with 
    respect to the study to the Under Secretary for Health and to other 
    pertinent program offices within the Department of Veterans Affairs 
    with responsibilities relating to health care services for women 
    veterans.
        (2) Specified divisions.--The divisions of the Department of 
    Veterans Affairs specified in this paragraph are the following:
            (A) The Center for Women Veterans established under section 
        318 of title 38, United States Code.
            (B) The Advisory Committee on Women Veterans established 
        under section 542 of such title.
    (f) Reports.--
        (1) Report on implementation.--Not later than 6 months after 
    the date on which the Department of Veterans Affairs publishes a 
    final report on the study titled ``National Survey of Women 
    Veterans in Fiscal Year 2007-2008'', the Secretary shall submit to 
    Congress a report on the status of the implementation of this 
    section.
        (2) Report on study.--Not later than 30 months after the date 
    on which the Department publishes such final report, the Secretary 
    shall submit to Congress a report on the study required under this 
    section. The report shall include recommendations for such 
    administrative and legislative action as the Secretary considers 
    appropriate. The report shall also include the findings of the head 
    of each division of the Department specified under subsection 
    (e)(2) and of the Under Secretary for Health.
    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs $4,000,000 to carry 
out this section.
    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.
    Section 1720D is amended--
        (1) by redesignating subsection (d) as subsection (f); and
        (2) by inserting after subsection (c) the following new 
    subsections:
    ``(d)(1) The Secretary shall carry out a program to provide 
graduate medical education, training, certification, and continuing 
medical education for mental health professionals who provide 
counseling, care, and services under subsection (a).
    ``(2) In carrying out the program required by paragraph (1), the 
Secretary shall ensure that--
        ``(A) all mental health professionals described in such 
    paragraph have been trained in a consistent manner; and
        ``(B) training described in such paragraph includes principles 
    of evidence-based treatment and care for sexual trauma and post-
    traumatic stress disorder.
    ``(e) Each year, the Secretary shall submit to Congress an annual 
report on the counseling, care, and services provided to veterans 
pursuant to this section. Each report shall include data for the year 
covered by the report with respect to each of the following:
        ``(1) The number of mental health professionals, graduate 
    medical education trainees, and primary care providers who have 
    been certified under the program required by subsection (d) and the 
    amount and nature of continuing medical education provided under 
    such program to such professionals, trainees, and providers who are 
    so certified.
        ``(2) The number of women veterans who received counseling and 
    care and services under subsection (a) from professionals and 
    providers who received training under subsection (d).
        ``(3) The number of graduate medical education, training, 
    certification, and continuing medical education courses provided by 
    reason of subsection (d).
        ``(4) The number of trained full-time equivalent employees 
    required in each facility of the Department to meet the needs of 
    veterans requiring treatment and care for sexual trauma and post-
    traumatic stress disorder.
        ``(5) Such recommendations for improvements in the treatment of 
    women veterans with sexual trauma and post-traumatic stress 
    disorder as the Secretary considers appropriate.
        ``(6) Such other information as the Secretary considers 
    appropriate.''.
    SEC. 203. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR WOMEN 
      VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED FORCES.
    (a) Pilot Program Required.--
        (1) In general.--Commencing not later than 180 days after the 
    date of the enactment of this Act, the Secretary of Veterans 
    Affairs shall carry out, through the Readjustment Counseling 
    Service of the Veterans Health Administration, a pilot program to 
    evaluate the feasibility and advisability of providing 
    reintegration and readjustment services described in subsection (b) 
    in group retreat settings to women veterans who are recently 
    separated from service in the Armed Forces after a prolonged 
    deployment.
        (2) Participation at election of veteran.--The participation of 
    a veteran in the pilot program under this section shall be at the 
    election of the veteran.
    (b) Covered Services.--The services provided to a woman veteran 
under the pilot program shall include the following:
        (1) Information on reintegration into the veteran's family, 
    employment, and community.
        (2) Financial counseling.
        (3) Occupational counseling.
        (4) Information and counseling on stress reduction.
        (5) Information and counseling on conflict resolution.
        (6) Such other information and counseling as the Secretary 
    considers appropriate to assist a woman veteran under the pilot 
    program in reintegration into the veteran's family, employment, and 
    community.
    (c) Locations.--The Secretary shall carry out the pilot program at 
not fewer than three locations selected by the Secretary for purposes 
of the pilot program.
    (d) Duration.--The pilot program shall be carried out during the 2-
year period beginning on the date of the commencement of the pilot 
program.
    (e) Report.--Not later than 180 days after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program. The report shall contain the findings and conclusions of 
the Secretary as a result of the pilot program, and shall include such 
recommendations for the continuation or expansion of the pilot program 
as the Secretary considers appropriate.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs for each of fiscal 
years 2010 and 2011, $2,000,000 to carry out the pilot program.
    SEC. 204. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN RECENTLY 
      SEPARATED FROM SERVICE IN THE ARMED FORCES.
    (a) Advisory Committee on Women Veterans.--Section 542(a)(2)(A) is 
amended--
        (1) in clause (ii), by striking ``and'' at the end;
        (2) in clause (iii), by striking the period at the end and 
    inserting ``; and''; and
        (3) by inserting after clause (iii) the following new clause:
        ``(iv) women veterans who are recently separated from service 
    in the Armed Forces.''.
    (b) Advisory Committee on Minority Veterans.--Section 544(a)(2)(A) 
is amended--
        (1) in clause (iii), by striking ``and'' at the end;
        (2) in clause (iv), by striking the period at the end and 
    inserting ``; and''; and
        (3) by inserting after clause (iv) the following new clause:
        ``(v) women veterans who are minority group members and are 
    recently separated from service in the Armed Forces.''.
    (c) Applicability.--The amendments made by this section shall apply 
to appointments made on or after the date of the enactment of this Act.
    SEC. 205. PILOT PROGRAM ON ASSISTANCE FOR CHILD CARE FOR CERTAIN 
      VETERANS RECEIVING HEALTH CARE.
    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasibility and 
advisability of providing, subject to subsection (b), assistance to 
qualified veterans described in subsection (c) to obtain child care so 
that such veterans can receive health care services described in 
subsection (c).
    (b) Limitation on Period of Payments.--Assistance may only be 
provided to a qualified veteran under the pilot program for receipt of 
child care during the period that the qualified veteran--
        (1) receives the types of health care services described in 
    subsection (c) at a facility of the Department; and
        (2) requires travel to and return from such facility for the 
    receipt of such health care services.
    (c) Qualified Veterans.--For purposes of this section, a qualified 
veteran is a veteran who is--
        (1) the primary caretaker of a child or children; and
        (2)(A) receiving from the Department--
            (i) regular mental health care services;
            (ii) intensive mental health care services; or
            (iii) such other intensive health care services that the 
        Secretary determines that provision of assistance to the 
        veteran to obtain child care would improve access to such 
        health care services by the veteran; or
        (B) in need of regular or intensive mental health care services 
    from the Department, and but for lack of child care services, would 
    receive such health care services from the Department.
    (d) Locations.--The Secretary shall carry out the pilot program in 
no fewer than three Veterans Integrated Service Networks selected by 
the Secretary for purposes of the pilot program.
    (e) Duration.--The pilot program shall be carried out during the 2-
year period beginning on the date of the commencement of the pilot 
program.
    (f) Forms of Child Care Assistance.--
        (1) In general.--Child care assistance under this section may 
    include the following:
            (A) Stipends for the payment of child care offered by 
        licensed child care centers (either directly or through a 
        voucher program) which shall be, to the extent practicable, 
        modeled after the Department of Veterans Affairs Child Care 
        Subsidy Program established pursuant to section 630 of the 
        Treasury and General Government Appropriations Act, 2002 
        (Public Law 107-67; 115 Stat. 552).
            (B) Direct provision of child care at an on-site facility 
        of the Department of Veterans Affairs.
            (C) Payments to private child care agencies.
            (D) Collaboration with facilities or programs of other 
        Federal departments or agencies.
            (E) Such other forms of assistance as the Secretary 
        considers appropriate.
        (2) Amounts of stipends.--In the case that child care 
    assistance under this section is provided as a stipend under 
    paragraph (1)(A), such stipend shall cover the full cost of such 
    child care.
    (g) Report.--Not later than 6 months after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program. The report shall include the findings and conclusions of 
the Secretary as a result of the pilot program, and shall include such 
recommendations for the continuation or expansion of the pilot program 
as the Secretary considers appropriate.
    (h) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs to carry out the 
pilot program $1,500,000 for each of fiscal years 2010 and 2011.
    SEC. 206. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING 
      MATERNITY CARE.
    (a) In General.--Subchapter VIII of chapter 17 is amended by adding 
at the end the following new section:
``Sec. 1786. Care for newborn children of women veterans receiving 
    maternity care
    ``(a) In General.--The Secretary may furnish health care services 
described in subsection (b) to a newborn child of a woman veteran who 
is receiving maternity care furnished by the Department for not more 
than seven days after the birth of the child if the veteran delivered 
the child in--
        ``(1) a facility of the Department; or
        ``(2) another facility pursuant to a Department contract for 
    services relating to such delivery.
    ``(b) Covered Health Care Services.--Health care services described 
in this subsection are all post-delivery care services, including 
routine care services, that a newborn child requires.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1785 the following new item:

``1786. Care for newborn children of women veterans receiving maternity 
          care.''.

                  TITLE III--RURAL HEALTH IMPROVEMENTS

    SEC. 301. IMPROVEMENTS TO THE EDUCATION DEBT REDUCTION PROGRAM.
    (a) Inclusion of Employee Retention as Purpose of Program.--Section 
7681(a)(2) is amended by inserting ``and retention'' after 
``recruitment'' the first time it appears.
    (b) Expansion of Eligibility.--Section 7682 is amended--
        (1) in subsection (a)(1), by striking ``a recently appointed'' 
    and inserting ``an''; and
        (2) by striking subsection (c).
    (c) Increase in Maximum Annual Amount of Payments.--Paragraph (1) 
of subsection (d) of section 7683 is amended--
        (1) by striking ``$44,000'' and inserting ``$60,000''; and
        (2) by striking ``$10,000'' and inserting ``$12,000''.
    (d) Exception to Limitation on Amount for Certain Participants.--
Such subsection is further amended by adding at the end the following 
new paragraph:
    ``(3)(A) The Secretary may waive the limitations under paragraphs 
(1) and (2) in the case of a participant described in subparagraph (B). 
In the case of such a waiver, the total amount of education debt 
repayments payable to that participant is the total amount of the 
principal and the interest on the participant's loans referred to in 
subsection (a).
    ``(B) A participant described in this subparagraph is a participant 
in the Program who the Secretary determines serves in a position for 
which there is a shortage of qualified employees by reason of either 
the location or the requirements of the position.''.
    SEC. 302. VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY 
      PROFESSIONALS EDUCATION ASSISTANCE PROGRAM.
    (a) Establishment of Program.--Part V is amended by inserting after 
chapter 74 the following new chapter:

     ``CHAPTER 75--VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY 
              PROFESSIONALS EDUCATIONAL ASSISTANCE 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.

``Sec. 7501. Establishment of scholarship program; purpose
    ``(a) Establishment.--Subject to the availability of 
appropriations, the Secretary shall establish and carry out a 
scholarship program to provide financial assistance in accordance with 
this chapter to individuals who--
        ``(1) are accepted for enrollment or currently enrolled in a 
    program of study leading to a degree or certificate in visual 
    impairment or orientation and mobility, or a dual degree or 
    certification in both such areas, at an accredited (as determined 
    by the Secretary) educational institution that is in a State; and
        ``(2) enter into an agreement with the Secretary as described 
    in section 7504 of this title.
    ``(b) Purpose.--The purpose of the scholarship program is to 
increase the supply of qualified blind rehabilitation specialists for 
the Department and the Nation.
    ``(c) Outreach.--The Secretary shall publicize the scholarship 
program to educational institutions throughout the United States, with 
an emphasis on disseminating information to such institutions with high 
numbers of Hispanic students and to Historically Black Colleges and 
Universities.
``Sec. 7502. Application and acceptance
    ``(a) Application.--(1) To apply and participate in the scholarship 
program under this chapter, an individual shall submit to the Secretary 
an application for such participation together with an agreement 
described in section 7504 of this title under which the participant 
agrees to serve a period of obligated service in the Department as 
provided in the agreement in return for payment of educational 
assistance as provided in the agreement.
    ``(2) In distributing application forms and agreement forms to 
individuals desiring to participate in the scholarship program, the 
Secretary shall include with such forms the following:
        ``(A) A fair summary of the rights and liabilities of an 
    individual whose application is approved (and whose agreement is 
    accepted) by the Secretary.
        ``(B) A full description of the terms and conditions that apply 
    to participation in the scholarship program and service in the 
    Department.
    ``(b) Approval.--(1) Upon the Secretary's approval of an 
individual's participation in the scholarship program, the Secretary 
shall, in writing, promptly notify the individual of that acceptance.
    ``(2) An individual becomes a participant in the scholarship 
program upon such approval by the Secretary.
``Sec. 7503. Amount of assistance; duration
    ``(a) Amount of Assistance.--The amount of the financial assistance 
provided an individual under the scholarship program under this chapter 
shall be the amount determined by the Secretary as being necessary to 
pay the tuition and fees of the individual. In the case of an 
individual enrolled in a program of study leading to a dual degree or 
certification in both the areas of study described in section 
7501(a)(1) of this title, the tuition and fees shall not exceed the 
amounts necessary for the minimum number of credit hours to achieve 
such dual degree or certification.
    ``(b) Relationship to Other Assistance.--Financial assistance may 
be provided to an individual under the scholarship program to 
supplement other educational assistance to the extent that the total 
amount of educational assistance received by the individual during an 
academic year does not exceed the total tuition and fees for such 
academic year.
    ``(c) Maximum Amount of Assistance.--(1) The total amount of 
assistance provided under the scholarship program for an academic year 
to an individual who is a full-time student may not exceed $15,000.
    ``(2) In the case of an individual who is a part-time student, the 
total amount of assistance provided under the scholarship program shall 
bear the same ratio to the amount that would be paid under paragraph 
(1) if the participant were a full-time student in the program of study 
being pursued by the individual as the coursework carried by the 
individual to full-time coursework in that program of study.
    ``(3) The total amount of assistance provided to an individual 
under the scholarship program may not exceed $45,000.
    ``(d) Maximum Duration of Assistance.--Financial assistance may not 
be provided to an individual under the scholarship program for more 
than six academic years.
``Sec. 7504. Agreement
    ``An agreement between the Secretary and a participant in the 
scholarship program under this chapter shall be in writing, shall be 
signed by the participant, and shall include--
        ``(1) the Secretary's agreement to provide the participant with 
    financial assistance as authorized under this chapter;
        ``(2) the participant's agreement--
            ``(A) to accept such financial assistance;
            ``(B) to maintain enrollment and attendance in the program 
        of study described in section 7501(a)(1) of this title;
            ``(C) while enrolled in such program, to maintain an 
        acceptable level of academic standing (as determined by the 
        educational institution offering such program under regulations 
        prescribed by the Secretary); and
            ``(D) after completion of the program, to serve as a full-
        time employee in the Department for a period of three years, to 
        be served within the first six years after the participant has 
        completed such program and received a degree or certificate 
        described in section 7501(a)(1) of this title; and
        ``(3) any other terms and conditions that the Secretary 
    considers appropriate for carrying out this chapter.
``Sec. 7505. Repayment for failure to satisfy requirements of agreement
    ``(a) In General.--An individual who receives educational 
assistance under the scholarship program under this chapter shall repay 
to the Secretary an amount equal to the unearned portion of such 
assistance if the individual fails to satisfy the requirements of the 
agreement entered into under section 7504 of this title, except in 
circumstances authorized by the Secretary.
    ``(b) Amount of Repayment.--The Secretary shall establish, by 
regulations, procedures for determining the amount of the repayment 
required under this section and the circumstances under which an 
exception to the required repayment may be granted.
    ``(c) Waiver or Suspension of Compliance.--The Secretary shall 
prescribe regulations providing for the waiver or suspension of any 
obligation of an individual for service or payment under this chapter 
(or an agreement under this chapter) whenever--
        ``(1) noncompliance by the individual is due to circumstances 
    beyond the control of the individual; or
        ``(2) the Secretary determines that the waiver or suspension of 
    compliance is in the best interest of the United States.
    ``(d) Obligation as Debt to United States.--An obligation to repay 
the Secretary under this section is, for all purposes, a debt owed the 
United States. A discharge in bankruptcy under title 11 does not 
discharge a person from such debt if the discharge order is entered 
less than five years after the date of the termination of the agreement 
or contract on which the debt is based.''.
    (b) Clerical Amendments.--The tables of chapters at the beginning 
of title 38, and of part V, are each amended by inserting after the 
item relating to chapter 74 the following new item:

``75. Visual Impairment and Orientation and Mobility Professionals 
Educational Assistance Program...................................7501''.

    (c) Implementation.--The Secretary of Veterans Affairs shall 
implement chapter 75 of title 38, United States Code, as added by 
subsection (a), not later than 6 months after the date of the enactment 
of this Act.
    SEC. 303. DEMONSTRATION PROJECTS ON ALTERNATIVES FOR EXPANDING CARE 
      FOR VETERANS IN RURAL AREAS.
    (a) In General.--The Secretary of Veterans Affairs may, through the 
Director of the Office of Rural Health, carry out demonstration 
projects to examine the feasibility and advisability of alternatives 
for expanding care for veterans in rural areas, which may include the 
following:
        (1) Establishing a partnership between the Department of 
    Veterans Affairs and the Centers for Medicare and Medicaid Services 
    of the Department of Health and Human Services to coordinate care 
    for veterans in rural areas at critical access hospitals (as 
    designated or certified under section 1820 of the Social Security 
    Act (42 U.S.C. 1395i-4)).
        (2) Establishing a partnership between the Department of 
    Veterans Affairs and the Department of Health and Human Services to 
    coordinate care for veterans in rural areas at community health 
    centers.
        (3) Expanding coordination between the Department of Veterans 
    Affairs and the Indian Health Service to expand care for Indian 
    veterans.
    (b) Geographic Distribution.--The Secretary shall ensure that the 
demonstration projects carried out under subsection (a) are located at 
facilities that are geographically distributed throughout the United 
States.
    (c) Report.--Not later than 2 years after the date of the enactment 
of this Act, the Secretary shall submit a report on the results of the 
demonstration projects carried out under subsection (a) to--
        (1) the Committee on Veterans' Affairs and the Committee on 
    Appropriations of the Senate; and
        (2) the Committee on Veterans' Affairs and the Committee on 
    Appropriations of the House of Representatives.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for fiscal year 2010 
and each fiscal year thereafter.
    SEC. 304. PROGRAM ON READJUSTMENT AND MENTAL HEALTH CARE SERVICES 
      FOR VETERANS WHO SERVED IN OPERATION ENDURING FREEDOM AND 
      OPERATION IRAQI FREEDOM.
    (a) Program Required.--Not later than 180 days after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall 
establish a program to provide--
        (1) to veterans of Operation Enduring Freedom and Operation 
    Iraqi Freedom, particularly veterans who served in such operations 
    while in the National Guard and the Reserves--
            (A) peer outreach services;
            (B) peer support services;
            (C) readjustment counseling and services described in 
        section 1712A of title 38, United States Code; and
            (D) mental health services; and
        (2) to members of the immediate family of veterans described in 
    paragraph (1), during the 3-year period beginning on the date of 
    the return of such veterans from deployment in Operation Enduring 
    Freedom or Operation Iraqi Freedom, education, support, counseling, 
    and mental health services to assist in--
            (A) the readjustment of such veterans to civilian life;
            (B) in the case such veterans have an injury or illness 
        incurred during such deployment, the recovery of such veterans 
        from such injury or illness; and
            (C) the readjustment of the family following the return of 
        such veterans.
    (b) Contracts With Community Mental Health Centers and Other 
Qualified Entities.--In carrying out the program required by subsection 
(a), the Secretary may contract with community mental health centers 
and other qualified entities to provide the services required by such 
subsection only in areas the Secretary determines are not adequately 
served by other health care facilities or vet centers of the Department 
of Veterans Affairs. Such contracts shall require each contracting 
community health center or entity--
        (1) to the extent practicable, to use telehealth services for 
    the delivery of services required by subsection (a);
        (2) to the extent practicable, to employ veterans trained under 
    subsection (c) in the provision of services covered by that 
    subsection;
        (3) to participate in the training program conducted in 
    accordance with subsection (d);
        (4) to comply with applicable protocols of the Department 
    before incurring any liability on behalf of the Department for the 
    provision of services required by subsection (a);
        (5) for each veteran for whom a community mental health center 
    or other qualified entity provides mental health services under 
    such contract, to provide the Department with such clinical summary 
    information as the Secretary shall require;
        (6) to submit annual reports to the Secretary containing, with 
    respect to the program required by subsection (a) and for the last 
    full calendar year ending before the submittal of such report--
            (A) the number of the veterans served, veterans diagnosed, 
        and courses of treatment provided to veterans as part of the 
        program required by subsection (a); and
            (B) demographic information for such services, diagnoses, 
        and courses of treatment; and
        (7) to meet such other requirements as the Secretary shall 
    require.
    (c) Training of Veterans for Provision of Peer-outreach and Peer-
support Services.--In carrying out the program required by subsection 
(a), the Secretary shall contract with a national not-for-profit mental 
health organization to carry out a national program of training for 
veterans described in subsection (a) to provide the services described 
in subparagraphs (A) and (B) of paragraph (1) of such subsection.
    (d) Training of Clinicians for Provision of Services.--The 
Secretary shall conduct a training program for clinicians of community 
mental health centers or entities that have contracts with the 
Secretary under subsection (b) to ensure that such clinicians can 
provide the services required by subsection (a) in a manner that--
        (1) recognizes factors that are unique to the experience of 
    veterans who served on active duty in Operation Enduring Freedom or 
    Operation Iraqi Freedom (including their combat and military 
    training experiences); and
        (2) uses best practices and technologies.
    (e) Vet Center Defined.--In this section, the term ``vet center'' 
means a center for readjustment counseling and related mental health 
services for veterans under section 1712A of title 38, United States 
Code.
    SEC. 305. TRAVEL REIMBURSEMENT FOR VETERANS RECEIVING TREATMENT AT 
      FACILITIES OF THE DEPARTMENT OF VETERANS AFFAIRS.
    (a) Enhancement of Allowance Based Upon Mileage Traveled.--Section 
111 is amended--
        (1) in subsection (a), by striking ``traveled,'' and inserting 
    ``(at a rate of 41.5 cents per mile),''; and
        (2) by amending subsection (g) to read as follows:
    ``(g)(1) Beginning one year after the date of the enactment of the 
Caregivers and Veterans Omnibus Health Services Act of 2010, the 
Secretary may adjust the mileage rate described in subsection (a) to be 
equal to the mileage reimbursement rate for the use of privately owned 
vehicles by Government employees on official business (when a 
Government vehicle is available), as prescribed by the Administrator of 
General Services under section 5707(b) of title 5.
    ``(2) If an adjustment in the mileage rate under paragraph (1) 
results in a lower mileage rate than the mileage rate otherwise 
specified in subsection (a), the Secretary shall, not later than 60 
days before the date of the implementation of the mileage rate as so 
adjusted, submit to Congress a written report setting forth the 
adjustment in the mileage rate under this subsection, together with a 
justification for the decision to make the adjustment in the mileage 
rate under this subsection.''.
    (b) Coverage of Cost of Transportation by Air.--Subsection (a) of 
section 111, as amended by subsection (a)(1), is further amended by 
inserting after the first sentence the following new sentence: ``Actual 
necessary expense of travel includes the reasonable costs of airfare if 
travel by air is the only practical way to reach a Department 
facility.''.
    (c) Elimination of Limitation Based on Maximum Annual Rate of 
Pension.--Subsection (b)(1)(D)(i) of such section is amended by 
inserting ``who is not traveling by air and'' before ``whose annual''.
    (d) Determination of Practicality.--Subsection (b) of such section 
is amended by adding at the end the following new paragraph:
    ``(4) In determining for purposes of subsection (a) whether travel 
by air is the only practical way for a veteran to reach a Department 
facility, the Secretary shall consider the medical condition of the 
veteran and any other impediments to the use of ground transportation 
by the veteran.''.
    (e) No Expansion of Eligibility for Beneficiary Travel.--The 
amendments made by subsections (b) and (d) of this section may not be 
construed as expanding or otherwise modifying eligibility for payments 
or allowances for beneficiary travel under section 111 of title 38, 
United States Code, as in effect on the day before the date of the 
enactment of this Act.
    (f) Clarification of Relation to Public Transportation in Veterans 
Health Administration Handbook.--Not later than 30 days after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
revise the Veterans Health Administration Handbook to clarify that an 
allowance for travel based on mileage paid under section 111(a) of 
title 38, United States Code, may exceed the cost of such travel by 
public transportation regardless of medical necessity.
    SEC. 306. PILOT PROGRAM ON INCENTIVES FOR PHYSICIANS WHO ASSUME 
      INPATIENT RESPONSIBILITIES AT COMMUNITY HOSPITALS IN HEALTH 
      PROFESSIONAL SHORTAGE AREAS.
    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasability and 
advisability of each of the following:
        (1) The provision of financial incentives to eligible 
    physicians who obtain and maintain inpatient privileges at 
    community hospitals in health professional shortage areas in order 
    to facilitate the provision by such physicians of primary care and 
    mental health services to veterans at such hospitals.
        (2) The collection of payments from third-party providers for 
    care provided by eligible physicians to nonveterans while 
    discharging inpatient responsibilities at community hospitals in 
    the course of exercising the privileges described in paragraph (1).
    (b) Eligible Physicians.--For purposes of this section, an eligible 
physician is a primary care or mental health physician employed by the 
Department of Veterans Affairs on a full-time basis.
    (c) Duration of Program.--The pilot program shall be carried out 
during the 3-year period beginning on the date of the commencement of 
the pilot program.
    (d) Locations.--
        (1) In general.--The pilot program shall be carried out at not 
    less than five community hospitals in each of not less than two 
    Veterans Integrated Services Networks. The hospitals shall be 
    selected by the Secretary using the results of the survey required 
    under subsection (e).
        (2) Qualifying community hospitals.--A community hospital may 
    be selected by the Secretary as a location for the pilot program 
    if--
            (A) the hospital is located in a health professional 
        shortage area; and
            (B) the number of eligible physicians willing to assume 
        inpatient responsibilities at the hospital (as determined using 
        the result of the survey) is sufficient for purposes of the 
        pilot program.
    (e) Survey of Physician Interest in Participation.--
        (1) In general.--Not later than 120 days after the date of the 
    enactment of this Act, the Secretary shall conduct a survey of 
    eligible physicians to determine the extent of the interest of such 
    physicians in participating in the pilot program.
        (2) Elements.--The survey shall disclose the type, amount, and 
    nature of the financial incentives to be provided under subsection 
    (h) to physicians participating in the pilot program.
    (f) Physician Participation.--
        (1) In general.--The Secretary shall select physicians for 
    participation in the pilot program from among eligible physicians 
    who--
            (A) express interest in participating in the pilot program 
        in the survey conducted under subsection (e);
            (B) are in good standing with the Department; and
            (C) primarily have clinical responsibilities with the 
        Department.
        (2) Voluntary participation.--Participation in the pilot 
    program shall be voluntary. Nothing in this section shall be 
    construed to require a physician working for the Department to 
    assume inpatient responsibilities at a community hospital unless 
    otherwise required as a term or condition of employment with the 
    Department.
    (g) Assumption of Inpatient Physician Responsibilities.--
        (1) In general.--Each eligible physician selected for 
    participation in the pilot program shall assume and maintain 
    inpatient responsibilities, including inpatient responsibilities 
    with respect to nonveterans, at one or more community hospitals 
    selected by the Secretary for participation in the pilot program 
    under subsection (d).
        (2) Coverage under federal tort claims act.--If an eligible 
    physician participating in the pilot program carries out on-call 
    responsibilities at a community hospital where privileges to 
    practice at such hospital are conditioned upon the provision of 
    services to individuals who are not veterans while the physician is 
    on call for such hospital, the provision of such services by the 
    physician shall be considered an action within the scope of the 
    physician's office or employment for purposes of chapter 171 of 
    title 28, United States Code (commonly referred to as the ``Federal 
    Tort Claims Act'').
    (h) Compensation.--
        (1) In general.--The Secretary shall provide each eligible 
    physician participating in the pilot program with such compensation 
    (including pay and other appropriate compensation) as the Secretary 
    considers appropriate to compensate such physician for the 
    discharge of any inpatient responsibilities by such physician at a 
    community hospital for which such physician would not otherwise be 
    compensated by the Department as a full-time employee of the 
    Department.
        (2) Written agreement.--The amount of any compensation to be 
    provided a physician under the pilot program shall be specified in 
    a written agreement entered into by the Secretary and the physician 
    for purposes of the pilot program.
        (3) Treatment of compensation.--The Secretary shall consult 
    with the Director of the Office of Personnel Management on the 
    inclusion of a provision in the written agreement required under 
    paragraph (2) that describes the treatment under Federal law of any 
    compensation provided a physician under the pilot program, 
    including treatment for purposes of retirement under the civil 
    service laws.
    (i) Collections From Third Parties.--In carrying out the pilot 
program for the purpose described in subsection (a)(2), the Secretary 
shall implement a variety and range of requirements and mechanisms for 
the collection from third-party payors of amounts to reimburse the 
Department for health care services provided to nonveterans under the 
pilot program by eligible physicians discharging inpatient 
responsibilities under the pilot program.
    (j) Report.--Not later than 1 year after the date of the enactment 
of this Act and annually thereafter, the Secretary shall submit to 
Congress a report on the pilot program, including the following:
        (1) The findings of the Secretary with respect to the pilot 
    program.
        (2) The number of veterans and nonveterans provided inpatient 
    care by physicians participating in the pilot program.
        (3) The amounts payable and collected under subsection (i).
    (k) Definitions.--In this section:
        (1) Health professional shortage area.--The term ``health 
    professional shortage area'' has the meaning given the term in 
    section 332(a) of the Public Health Service Act (42 U.S.C. 
    254e(a)).
        (2) Inpatient responsibilities.--The term ``inpatient 
    responsibilities'' means on-call responsibilities customarily 
    required of a physician by a community hospital as a condition of 
    granting privileges to the physician to practice in the hospital.
    SEC. 307. GRANTS FOR VETERANS SERVICE ORGANIZATIONS FOR 
      TRANSPORTATION OF HIGHLY RURAL VETERANS.
    (a) Grants Authorized.--
        (1) In general.--The Secretary of Veterans Affairs shall 
    establish a grant program to provide innovative transportation 
    options to veterans in highly rural areas.
        (2) Eligible recipients.--The following may be awarded a grant 
    under this section:
            (A) State veterans service agencies.
            (B) Veterans service organizations.
        (3) Use of funds.--A State veterans service agency or veterans 
    service organization awarded a grant under this section may use the 
    grant amount to--
            (A) assist veterans in highly rural areas to travel to 
        Department of Veterans Affairs medical centers; and
            (B) otherwise assist in providing transportation in 
        connection with the provision of medical care to veterans in 
        highly rural areas.
        (4) Maximum amount.--The amount of a grant under this section 
    may not exceed $50,000.
        (5) No matching requirement.--The recipient of a grant under 
    this section shall not be required to provide matching funds as a 
    condition for receiving such grant.
    (b) Regulations.--The Secretary shall prescribe regulations for--
        (1) evaluating grant applications under this section; and
        (2) otherwise administering the program established by this 
    section.
    (c) Definitions.--In this section:
        (1) Highly rural.--The term ``highly rural'', in the case of an 
    area, means that the area consists of a county or counties having a 
    population of less than seven persons per square mile.
        (2) Veterans service organization.--The term ``veterans service 
    organization'' means any organization recognized by the Secretary 
    of Veterans Affairs for the representation of veterans under 
    section 5902 of title 38, United States Code.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated $3,000,000 for each of fiscal years 2010 through 2014 to 
carry out this section.
    SEC. 308. MODIFICATION OF ELIGIBILITY FOR PARTICIPATION IN PILOT 
      PROGRAM OF ENHANCED CONTRACT CARE AUTHORITY FOR HEALTH CARE NEEDS 
      OF CERTAIN VETERANS.
    Subsection (b) of section 403 of the Veterans' Mental Health and 
other Care Improvements Act of 2008 (Public Law 110-387; 122 Stat. 
4125; 38 U.S.C. 1703 note) is amended to read as follows:
    ``(b) Covered Veterans.--For purposes of the pilot program under 
this section, a covered veteran is any veteran who--
        ``(1) is--
            ``(A) enrolled in the system of patient enrollment 
        established under section 1705(a) of title 38, United States 
        Code, as of the date of the commencement of the pilot program 
        under subsection (a)(2); or
            ``(B) eligible for health care under section 1710(e)(3) of 
        such title; and
        ``(2) resides in a location that is--
            ``(A) more than 60 minutes driving distance from the 
        nearest Department health care facility providing primary care 
        services, if the veteran is seeking such services;
            ``(B) more than 120 minutes driving distance from the 
        nearest Department health care facility providing acute 
        hospital care, if the veteran is seeking such care; or
            ``(C) more than 240 minutes driving distance from the 
        nearest Department health care facility providing tertiary 
        care, if the veteran is seeking such care.''.

                  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.
    (a) In General.--Any member of the Armed Forces, including a member 
of the National Guard or Reserve, who serves on active duty in the 
Armed Forces in Operation Enduring Freedom or Operation Iraqi Freedom 
is eligible for readjustment counseling and related mental health 
services under section 1712A of title 38, United States Code, through 
the Readjustment Counseling Service of the Veterans Health 
Administration.
    (b) No Requirement for Current Active Duty Service.--A member of 
the Armed Forces who meets the requirements for eligibility for 
counseling and services under subsection (a) is entitled to counseling 
and services under that subsection regardless of whether or not the 
member is currently on active duty in the Armed Forces at the time of 
receipt of counseling and services under that subsection.
    (c) Regulations.--The eligibility of members of the Armed Forces 
for counseling and services under subsection (a) shall be subject to 
such regulations as the Secretary of Defense and the Secretary of 
Veterans Affairs shall jointly prescribe for purposes of this section.
    (d) Subject to Availability of Appropriations.--The provision of 
counseling and services under subsection (a) shall be subject to the 
availability of appropriations for such purpose.
    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.
    Section 1712A is amended--
        (1) by redesignating subsections (c) through (f) as subsections 
    (d) through (g), respectively; and
        (2) by inserting after subsection (b) the following new 
    subsection (c):
    ``(c) Upon receipt of a request for counseling under this section 
from any individual who has been discharged or released from active 
military, naval, or air service but who is not otherwise eligible for 
such counseling, the Secretary shall--
        ``(1) provide referral services to assist such individual, to 
    the maximum extent practicable, in obtaining mental health care and 
    services from sources outside the Department; and
        ``(2) if pertinent, advise such individual of such individual's 
    rights to apply to the appropriate military, naval, or air service, 
    and to the Department, for review of such individual's discharge or 
    release from such service.''.
    SEC. 403. STUDY ON SUICIDES AMONG VETERANS.
    (a) Study Required.--The Secretary of Veterans Affairs shall 
conduct a study to determine the number of veterans who died by suicide 
between January 1, 1999, and the date of the enactment of this Act.
    (b) Coordination.--In carrying out the study under subsection (a) 
the Secretary of Veterans Affairs shall coordinate with--
        (1) the Secretary of Defense;
        (2) veterans service organizations;
        (3) the Centers for Disease Control and Prevention; and
        (4) State public health offices and veterans agencies.
    (c) Report to Congress.--The Secretary of Veterans Affairs shall 
submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
on the study required under subsection (a) and the findings of the 
Secretary.
    (d) Veterans Service Organization Defined.--In this section, the 
term ``veterans service organization'' means any organization 
recognized by the Secretary for the representation of veterans under 
section 5902 of title 38, United States Code.

                   TITLE V--OTHER HEALTH CARE MATTERS

    SEC. 501. REPEAL OF CERTAIN ANNUAL REPORTING REQUIREMENTS.
    (a) Nurse Pay Report.--Section 7451 is amended--
        (1) by striking subsection (f); and
        (2) by redesignating subsection (g) as subsection (f).
    (b) Long-term Planning Report.--
        (1) In general.--Section 8107 is repealed.
        (2) Conforming amendment.--The table of sections at the 
    beginning of chapter 81 is amended by striking the item relating to 
    section 8107.
    SEC. 502. SUBMITTAL DATE OF ANNUAL REPORT ON GULF WAR RESEARCH.
    Section 707(c)(1) of the Persian Gulf War Veterans' Health Status 
Act (title VII of Public Law 102-585; 38 U.S.C. 527 note) is amended by 
striking ``Not later than March 1 of each year'' and inserting ``Not 
later than July 1, 2010, and July 1 of each of the five following 
years''.
    SEC. 503. PAYMENT FOR CARE FURNISHED TO CHAMPVA BENEFICIARIES.
    Section 1781 is amended by adding at the end the following new 
subsection:
    ``(e) Payment by the Secretary under this section on behalf of a 
covered beneficiary for medical care shall constitute payment in full 
and extinguish any liability on the part of the beneficiary for that 
care.''.
    SEC. 504. DISCLOSURE OF PATIENT TREATMENT INFORMATION FROM MEDICAL 
      RECORDS OF PATIENTS LACKING DECISIONMAKING CAPACITY.
    Section 7332(b)(2) is amended by adding at the end the following 
new subparagraph:
        ``(F)(i) To a representative of a patient who lacks decision-
    making capacity, when a practitioner deems the content of the given 
    record necessary for that representative to make an informed 
    decision regarding the patient's treatment.
        ``(ii) In this subparagraph, the term `representative' means an 
    individual, organization, or other body authorized under section 
    7331 of this title and its implementing regulations to give 
    informed consent on behalf of a patient who lacks decision-making 
    capacity.''.
    SEC. 505. ENHANCEMENT OF QUALITY MANAGEMENT.
    (a) Enhancement of Quality Management Through Quality Management 
Officers.--
        (1) In general.--Subchapter II of chapter 73 is amended by 
    inserting after section 7311 the following new section:
``Sec. 7311A. Quality management officers
    ``(a) National Quality Management Officer.--(1) The Under Secretary 
for Health shall designate an official of the Veterans Health 
Administration to act as the principal quality management officer for 
the quality-assurance program required by section 7311 of this title. 
The official so designated may be known as the `National Quality 
Management Officer of the Veterans Health Administration' (in this 
section referred to as the `National Quality Management Officer').
    ``(2) The National Quality Management Officer shall report directly 
to the Under Secretary for Health in the discharge of responsibilities 
and duties of the Officer under this section.
    ``(3) The National Quality Management Officer shall be the official 
within the Veterans Health Administration who is principally 
responsible for the quality-assurance program referred to in paragraph 
(1). In carrying out that responsibility, the Officer shall be 
responsible for the following:
        ``(A) Establishing and enforcing the requirements of the 
    program referred to in paragraph (1).
        ``(B) Developing an aggregate quality metric from existing data 
    sources, such as the Inpatient Evaluation Center of the Department, 
    the National Surgical Quality Improvement Program, and the External 
    Peer Review Program of the Veterans Health Administration, that 
    could be used to assess reliably the quality of care provided at 
    individual Department medical centers and associated community 
    based outpatient clinics.
        ``(C) Ensuring that existing measures of quality, including 
    measures from the Inpatient Evaluation Center, the National 
    Surgical Quality Improvement Program, System-Wide Ongoing 
    Assessment and Review reports of the Department, and Combined 
    Assessment Program reviews of the Office of Inspector General of 
    the Department, are monitored routinely and analyzed in a manner 
    that ensures the timely detection of quality of care issues.
        ``(D) Encouraging research and development in the area of 
    quality metrics for the purposes of improving how the Department 
    measures quality in individual facilities.
        ``(E) Carrying out such other responsibilities and duties 
    relating to quality management in the Veterans Health 
    Administration as the Under Secretary for Health shall specify.
    ``(4) The requirements under paragraph (3) shall include 
requirements regarding the following:
        ``(A) A confidential system for the submittal of reports by 
    Veterans Health Administration personnel regarding quality 
    management at Department facilities.
        ``(B) Mechanisms for the peer review of the actions of 
    individuals appointed in the Veterans Health Administration in the 
    position of physician.
    ``(b) Quality Management Officers for VISNs.--(1) The Regional 
Director of each Veterans Integrated Services Network shall appoint an 
official of the Network to act as the quality management officer of the 
Network.
    ``(2) The quality management officer for a Veterans Integrated 
Services Network shall report to the Regional Director of the Veterans 
Integrated Services Network, and to the National Quality Management 
Officer, regarding the discharge of the responsibilities and duties of 
the officer under this section.
    ``(3) The quality management officer for a Veterans Integrated 
Services Network shall--
        ``(A) direct the quality management office in the Network; and
        ``(B) coordinate, monitor, and oversee the quality management 
    programs and activities of the Administration medical facilities in 
    the Network in order to ensure the thorough and uniform discharge 
    of quality management requirements under such programs and 
    activities throughout such facilities.
    ``(c) Quality Management Officers for Medical Facilities.--(1) The 
director of each Veterans Health Administration medical facility shall 
appoint a quality management officer for that facility.
    ``(2) The quality management officer for a facility shall report 
directly to the director of the facility, and to the quality management 
officer of the Veterans Integrated Services Network in which the 
facility is located, regarding the discharge of the responsibilities 
and duties of the quality management officer under this section.
    ``(3) The quality management officer for a facility shall be 
responsible for designing, disseminating, and implementing quality 
management programs and activities for the facility that meet the 
requirements established by the National Quality Management Officer 
under subsection (a).
    ``(d) Authorization of Appropriations.--(1) Except as provided in 
paragraph (2), there are authorized to be appropriated such sums as may 
be necessary to carry out this section.
    ``(2) There is authorized to be appropriated to carry out the 
provisions of subparagraphs (B), (C), and (D) of subsection (a)(3), 
$25,000,000 for the two-year period of fiscal years beginning after the 
date of the enactment of this section.''.
        (2) Clerical amendment.--The table of sections at the beginning 
    of chapter 73 is amended by inserting after the item relating to 
    section 7311 the following new item:

``7311A. Quality management officers.''.

    (b) Reports on Quality Concerns Under Quality-assurance Program.--
Section 7311(b) is amended by adding at the end the following new 
paragraph:
    ``(4) As part of the quality-assurance program, the Under Secretary 
for Health shall establish mechanisms through which employees of 
Veterans Health Administration facilities may submit reports, on a 
confidential basis, on matters relating to quality of care in Veterans 
Health Administration facilities to the quality management officers of 
such facilities under section 7311A(c) of this title. The mechanisms 
shall provide for the prompt and thorough review of any reports so 
submitted by the receiving officials.''.
    (c) Review of Current Health Care Quality Safeguards.--
        (1) In general.--The Secretary of Veterans Affairs shall 
    conduct a comprehensive review of all current policies and 
    protocols of the Department of Veterans Affairs for maintaining 
    health care quality and patient safety at Department medical 
    facilities. The review shall include a review and assessment of the 
    National Surgical Quality Improvement Program, including an 
    assessment of--
            (A) the efficacy of the quality indicators under the 
        program;
            (B) the efficacy of the data collection methods under the 
        program;
            (C) the efficacy of the frequency with which regular data 
        analyses are performed under the program; and
            (D) the extent to which the resources allocated to the 
        program are adequate to fulfill the stated function of the 
        program.
        (2) Report.--Not later than 60 days after the date of the 
    enactment of this Act, the Secretary shall submit to Congress a 
    report on the review conducted under paragraph (1), including the 
    findings of the Secretary as a result of the review and such 
    recommendations as the Secretary considers appropriate in light of 
    the review.
    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.
    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasibility and 
advisability of using community-based organizations and local and State 
government entities--
        (1) to increase the coordination of community, local, State, 
    and Federal providers of health care and benefits for veterans to 
    assist veterans who are transitioning from military service to 
    civilian life in such transition;
        (2) to increase the availability of high quality medical and 
    mental health services to veterans transitioning from military 
    service to civilian life;
        (3) to provide assistance to families of veterans who are 
    transitioning from military service to civilian life to help such 
    families adjust to such transition; and
        (4) to provide outreach to veterans and their families to 
    inform them about the availability of benefits and connect them 
    with appropriate care and benefit programs.
    (b) Duration of Program.--The pilot program shall be carried out 
during the 2-year period beginning on the date that is 180 days after 
the date of the enactment of this Act.
    (c) Program Locations.--
        (1) In general.--The pilot program shall be carried out at five 
    locations selected by the Secretary for purposes of the pilot 
    program.
        (2) Considerations.--In selecting locations for the pilot 
    program, the Secretary shall consider the advisability of selecting 
    locations in--
            (A) rural areas;
            (B) areas with populations that have a high proportion of 
        minority group representation;
            (C) areas with populations that have a high proportion of 
        individuals who have limited access to health care; and
            (D) areas that are not in close proximity to an active duty 
        military installation.
    (d) Grants.--The Secretary shall carry out the pilot program 
through the award of grants to community-based organizations and local 
and State government entities.
    (e) Selection of Grant Recipients.--
        (1) In general.--A community-based organization or local or 
    State government entity seeking a grant under the pilot program 
    shall submit to the Secretary an application therefor in such form 
    and in such manner as the Secretary considers appropriate.
        (2) Elements.--Each application submitted under paragraph (1) 
    shall include the following:
            (A) A description of the consultations, if any, with the 
        Department of Veterans Affairs in the development of the 
        proposal under the application.
            (B) A plan to coordinate activities under the pilot 
        program, to the greatest extent possible, with the local, 
        State, and Federal providers of services for veterans to reduce 
        duplication of services and to enhance the effect of such 
        services.
    (f) Use of Grant Funds.--The Secretary shall prescribe appropriate 
uses of grant funds received under the pilot program.
    (g) Report on Program.--
        (1) In general.--Not later than 180 days after the completion 
    of the pilot program, the Secretary shall submit to Congress a 
    report on the pilot program.
        (2) Elements.--The report required by paragraph (1) shall 
    include the following:
            (A) The findings and conclusions of the Secretary with 
        respect to the pilot program.
            (B) An assessment of the benefits to veterans of the pilot 
        program.
            (C) The recommendations of the Secretary as to the 
        advisability of continuing the pilot program.
    SEC. 507. SPECIALIZED RESIDENTIAL CARE AND REHABILITATION FOR 
      CERTAIN VETERANS.
    Section 1720 is amended by adding at the end the following new 
subsection:
    ``(g) The Secretary may contract with appropriate entities to 
provide specialized residential care and rehabilitation services to a 
veteran of Operation Enduring Freedom or Operation Iraqi Freedom who 
the Secretary determines suffers from a traumatic brain injury, has an 
accumulation of deficits in activities of daily living and instrumental 
activities of daily living, and because of these deficits, would 
otherwise require admission to a nursing home even though such care 
would generally exceed the veteran's nursing needs.''.
    SEC. 508. EXPANDED STUDY ON THE HEALTH IMPACT OF PROJECT SHIPBOARD 
      HAZARD AND DEFENSE.
    (a) In General.--Not later than 90 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall enter 
into a contract with the Institute of Medicine of the National 
Academies to conduct an expanded study on the health impact of Project 
Shipboard Hazard and Defense (Project SHAD).
    (b) Covered Veterans.--The study required by subsection (a) shall 
include, to the extent practicable, all veterans who participated in 
Project Shipboard Hazard and Defense.
    (c) Use of Existing Studies.--The study required by subsection (a) 
may use results from the study covered in the report titled ``Long-Term 
Health Effects of Participation in Project SHAD'' of the Institute of 
Medicine of the National Academies.
    SEC. 509. USE OF NON-DEPARTMENT FACILITIES FOR REHABILITATION OF 
      INDIVIDUALS WITH TRAUMATIC BRAIN INJURY.
    Section 1710E is amended--
        (1) by redesignating subsection (b) as subsection (c);
        (2) by inserting after subsection (a) the following new 
    subsection (b):
    ``(b) Covered Individuals.--The care and services provided under 
subsection (a) shall be made available to an individual--
        ``(1) who is described in section 1710C(a) of this title; and
        ``(2)(A) to whom the Secretary is unable to provide such 
    treatment or services at the frequency or for the duration 
    prescribed in such plan; or
        ``(B) for whom the Secretary determines that it is optimal with 
    respect to the recovery and rehabilitation for such individual.''; 
    and
        (3) by adding at the end the following new subsection:
    ``(d) Standards.--The Secretary may not provide treatment or 
services as described in subsection (a) at a non-Department facility 
under such subsection unless such facility maintains standards for the 
provision of such treatment or services established by an independent, 
peer-reviewed organization that accredits specialized rehabilitation 
programs for adults with traumatic brain injury.''.
    SEC. 510. PILOT PROGRAM ON PROVISION OF DENTAL INSURANCE PLANS TO 
      VETERANS AND SURVIVORS AND DEPENDENTS OF VETERANS.
    (a) Pilot Program Required.--The Secretary of Veterans Affairs 
shall carry out a pilot program to assess the feasibility and 
advisability of providing a dental insurance plan to veterans and 
survivors and dependents of veterans described in subsection (b).
    (b) Covered Veterans and Survivors and Dependents.--The veterans 
and survivors and dependents of veterans described in this subsection 
are as follows:
        (1) Any veteran who is enrolled in the system of annual patient 
    enrollment under section 1705 of title 38, United States Code.
        (2) Any survivor or dependent of a veteran who is eligible for 
    medical care under section 1781 of such title.
    (c) Duration of Program.--The pilot program shall be carried out 
during the 3-year period beginning on the date that is 270 days after 
the date of the enactment of this Act.
    (d) Locations.--The pilot program shall be carried out in such 
Veterans Integrated Services Networks as the Secretary considers 
appropriate for purposes of the pilot program.
    (e) Administration.--The Secretary shall contract with a dental 
insurer to administer the dental insurance plan provided under the 
pilot program.
    (f) Benefits.--The dental insurance plan under the pilot program 
shall provide such benefits for dental care and treatment as the 
Secretary considers appropriate for the dental insurance plan, 
including diagnostic services, preventative services, endodontics and 
other restorative services, surgical services, and emergency services.
    (g) Enrollment.--
        (1) Voluntary.--Enrollment in the dental insurance plan under 
    the pilot program shall be voluntary.
        (2) Minimum period.--Enrollment in the dental insurance plan 
    shall be for such minimum period as the Secretary shall prescribe 
    for purposes of this section.
    (h) Premiums.--
        (1) In general.--Premiums for coverage under the dental 
    insurance plan under the pilot program shall be in such amount or 
    amounts as the Secretary shall prescribe to cover all costs 
    associated with the pilot program.
        (2) Annual adjustment.--The Secretary shall adjust the premiums 
    payable under the pilot program for coverage under the dental 
    insurance plan on an annual basis. Each individual covered by the 
    dental insurance plan at the time of such an adjustment shall be 
    notified of the amount and effective date of such adjustment.
        (3) Responsibility for payment.--Each individual covered by the 
    dental insurance plan shall pay the entire premium for coverage 
    under the dental insurance plan, in addition to the full cost of 
    any copayments.
    (i) Voluntary Disenrollment.--
        (1) In general.--With respect to enrollment in the dental 
    insurance plan under the pilot program, the Secretary shall--
            (A) permit the voluntary disenrollment of an individual in 
        the dental insurance plan if the disenrollment occurs during 
        the 30-day period beginning on the date of the enrollment of 
        the individual in the dental insurance plan; and
            (B) permit the voluntary disenrollment of an individual in 
        the dental insurance plan for such circumstances as the 
        Secretary shall prescribe for purposes of this subsection, but 
        only to the extent such disenrollment does not jeopardize the 
        fiscal integrity of the dental insurance plan.
        (2) Allowable circumstances.--The circumstances prescribed 
    under paragraph (1)(B) shall include the following:
            (A) If an individual enrolled in the dental insurance plan 
        relocates to a location outside the jurisdiction of the dental 
        insurance plan that prevents use of the benefits under the 
        dental insurance plan.
            (B) If an individual enrolled in the dental insurance plan 
        is prevented by a serious medical condition from being able to 
        obtain benefits under the dental insurance plan.
            (C) Such other circumstances as the Secretary shall 
        prescribe for purposes of this subsection.
        (3) Establishment of procedures.--The Secretary shall establish 
    procedures for determinations on the permissibility of voluntary 
    disenrollments under paragraph (1)(B). Such procedures shall ensure 
    timely determinations on the permissibility of such disenrollments.
    (j) Relationship to Dental Care Provided by Secretary.--Nothing in 
this section shall affect the responsibility of the Secretary to 
provide dental care under section 1712 of title 38, United States Code, 
and the participation of an individual in the dental insurance plan 
under the pilot program shall not affect the individual's entitlement 
to outpatient dental services and treatment, and related dental 
appliances, under that section.
    (k) Regulations.--The dental insurance plan under the pilot program 
shall be administered under such regulations as the Secretary shall 
prescribe.
    SEC. 511. PROHIBITION ON COLLECTION OF COPAYMENTS FROM VETERANS WHO 
      ARE CATASTROPHICALLY DISABLED.
    (a) In General.--Subchapter III of chapter 17 is amended by adding 
at the end the following new section:
``Sec. 1730A. Prohibition on collection of copayments from 
     catastrophically disabled veterans
    ``Notwithstanding subsections (f) and (g) of section 1710 and 
section 1722A(a) of this title or any other provision of law, the 
Secretary may not require a veteran who is catastrophically disabled, 
as defined by the Secretary, to make any copayment for the receipt of 
hospital care or medical services under the laws administered by the 
Secretary.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1730 the following new item:

``1730A. Prohibition on collection of copayments from catastrophically 
          disabled veterans.''.
    SEC. 512. HIGHER PRIORITY STATUS FOR CERTAIN VETERANS WHO ARE MEDAL 
      OF HONOR RECIPIENTS.
    Section 1705(a)(3) is amended by inserting ``veterans who were 
awarded the medal of honor under section 3741, 6241, or 8741 of title 
10 or section 491 of title 14,'' after ``the Purple Heart,''.
    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.
    Section 1710(e) is amended--
        (1) in paragraph (3)--
            (A) by striking ``subsection (a)(2)(F)--'' and all that 
        follows through ``(C) in the case'' and inserting ``subsection 
        (a)(2)(F) in the case''; and
            (B) by redesignating clauses (i) and (ii) of the former 
        subparagraph (C) as subparagraphs (A) and (B) of such paragraph 
        (3) and by realigning the margin of such new subparagraphs two 
        ems to the left; and
        (2) in paragraph (1)(C)--
            (A) by striking ``paragraphs (2) and (3)'' and inserting 
        ``paragraph (2)''; and
            (B) by inserting after ``on active duty'' the following: 
        ``between August 2, 1990, and November 11, 1998,''.
    SEC. 514. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN ASSISTANT SERVICES 
      IN VETERANS HEALTH ADMINISTRATION.
    (a) In General.--Section 7306(a) is amended by striking paragraph 
(9) and inserting the following new paragraph (9):
        ``(9) The Director of Physician Assistant Services, who shall--
            ``(A) serve in a full-time capacity at the Central Office 
        of the Department;
            ``(B) be a qualified physician assistant; and
            ``(C) be responsible and report directly to the Chief 
        Patient Care Services Officer of the Veterans Health 
        Administration on all matters relating to the education and 
        training, employment, appropriate use, and optimal 
        participation of physician assistants within the programs and 
        initiatives of the Administration.''.
    (b) Deadline for Implementation.--The Secretary of Veterans Affairs 
shall ensure that an individual is serving as the Director of Physician 
Assistant Services under paragraph (9) of section 7306(a) of title 38, 
United States Code, as amended by subsection (a), by not later than 120 
days after the date of the enactment of this Act.
    SEC. 515. COMMITTEE ON CARE OF VETERANS WITH TRAUMATIC BRAIN 
      INJURY.
    (a) Establishment of Committee.--Subchapter II of chapter 73 is 
amended by inserting after section 7321 the following new section:
``Sec. 7321A. Committee on Care of Veterans with Traumatic Brain Injury
    ``(a) Establishment.--The Secretary shall establish in the Veterans 
Health Administration a committee to be known as the `Committee on Care 
of Veterans with Traumatic Brain Injury'. The Under Secretary for 
Health shall appoint employees of the Department with expertise in the 
care of veterans with traumatic brain injury to serve on the committee.
    ``(b) Responsibilities of Committee.--The committee shall assess, 
and carry out a continuing assessment of, the capability of the 
Veterans Health Administration to meet effectively the treatment and 
rehabilitation needs of veterans with traumatic brain injury. In 
carrying out that responsibility, the committee shall--
        ``(1) evaluate the care provided to such veterans through the 
    Veterans Health Administration;
        ``(2) identify systemwide problems in caring for such veterans 
    in facilities of the Veterans Health Administration;
        ``(3) identify specific facilities within the Veterans Health 
    Administration at which program enrichment is needed to improve 
    treatment and rehabilitation of such veterans; and
        ``(4) identify model programs which the committee considers to 
    have been successful in the treatment and rehabilitation of such 
    veterans and which should be implemented more widely in or through 
    facilities of the Veterans Health Administration.
    ``(c) Advice and Recommendations.--The committee shall--
        ``(1) advise the Under Secretary regarding the development of 
    policies for the care and rehabilitation of veterans with traumatic 
    brain injury; and
        ``(2) make recommendations to the Under Secretary--
            ``(A) for improving programs of care of such veterans at 
        specific facilities and throughout the Veterans Health 
        Administration;
            ``(B) for establishing special programs of education and 
        training relevant to the care of such veterans for employees of 
        the Veterans Health Administration;
            ``(C) regarding research needs and priorities relevant to 
        the care of such veterans; and
            ``(D) regarding the appropriate allocation of resources for 
        all such activities.
    ``(d) Annual Report.--Not later than June 1, 2010, and each year 
thereafter, the Secretary shall submit to the Committee on Veterans' 
Affairs of the Senate and the Committee on Veterans' Affairs of the 
House of Representatives a report on the implementation of this 
section. Each such report shall include the following for the calendar 
year preceding the year in which the report is submitted:
        ``(1) A list of the members of the committee.
        ``(2) The assessment of the Under Secretary for Health, after 
    review of the findings of the committee, regarding the capability 
    of the Veterans Health Administration, on a systemwide and 
    facility-by-facility basis, to meet effectively the treatment and 
    rehabilitation needs of veterans with traumatic brain injury.
        ``(3) The plans of the committee for further assessments.
        ``(4) The findings and recommendations made by the committee to 
    the Under Secretary for Health and the views of the Under Secretary 
    on such findings and recommendations.
        ``(5) A description of the steps taken, plans made (and a 
    timetable for the execution of such plans), and resources to be 
    applied toward improving the capability of the Veterans Health 
    Administration to meet effectively the treatment and rehabilitation 
    needs of veterans with traumatic brain injury.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 is amended by inserting after the item relating to section 
7321 the following new item:

``7321A. 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.
    (a) Increase.--Section 1717(a)(2) is amended by striking 
subparagraphs (A) and (B) and inserting the following:
        ``(A) in the case of medical services furnished under section 
    1710(a)(1) of this title, or for a disability described in section 
    1710(a)(2)(C) of this title--
            ``(i) in the case of a veteran who first applies for 
        benefits under this paragraph before the date of the Caregivers 
        and Veterans Omnibus Health Services Act of 2010, $4,100; or
            ``(ii) in the case of a veteran who first applies for 
        benefits under this paragraph on or after the date of the 
        Caregivers and Veterans Omnibus Health Services Act of 2010, 
        $6,800; and
        ``(B) in the case of medical services furnished under any other 
    provision of section 1710(a) of this title--
            ``(i) in the case of a veteran who first applies for 
        benefits under this paragraph before the date of the Caregivers 
        and Veterans Omnibus Health Services Act of 2010, $1,200; or
            ``(ii) in the case of a veteran who first applies for 
        benefits under this paragraph on or after the date of the 
        Caregivers and Veterans Omnibus Health Services Act of 2010, 
        $2,000.''.
    (b) Construction.--A veteran who exhausts such veteran's 
eligibility for benefits under section 1717(a)(2) of such title before 
the date of the enactment of this Act, is not entitled to additional 
benefits under such section by reason of the amendments made by 
subsection (a).
    SEC. 517. EXTENSION OF STATUTORILY DEFINED COPAYMENTS FOR CERTAIN 
      VETERANS FOR HOSPITAL CARE AND NURSING HOME CARE.
    Subparagraph (B) of section 1710(f)(2) is amended to read as 
follows:
            ``(B) before September 30, 2012, an amount equal to $10 for 
        every day the veteran receives hospital care and $5 for every 
        day the veteran receives nursing home care.''.
    SEC. 518. EXTENSION OF AUTHORITY TO RECOVER COST OF CERTAIN CARE 
      AND SERVICES FROM DISABLED VETERANS WITH HEALTH-PLAN CONTRACTS.
    Subparagraph (E) of section 1729(a)(2) is amended to read as 
follows:
            ``(E) for which care and services are furnished before 
        October 1, 2012, under this chapter to a veteran who--
                ``(i) has a service-connected disability; and
                ``(ii) is entitled to care (or payment of the expenses 
            of care) under a health-plan contract.''.

                 TITLE VI--DEPARTMENT PERSONNEL MATTERS

    SEC. 601. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL 
      PROFESSIONALS.
    (a) Secretarial Authority To Extend Title 38 Status to Additional 
Positions.--
        (1) In general.--Paragraph (3) of section 7401 is amended by 
    striking ``and blind rehabilitation outpatient specialists.'' and 
    inserting the following: ``blind rehabilitation outpatient 
    specialists, and such other classes of health care occupations as 
    the Secretary considers necessary for the recruitment and retention 
    needs of the Department subject to the following requirements:
            ``(A) Such other classes of health care occupations--
                ``(i) are not occupations relating to administrative, 
            clerical, or physical plant maintenance and protective 
            services;
                ``(ii) that would otherwise receive basic pay in 
            accordance with the General Schedule under section 5332 of 
            title 5;
                ``(iii) provide, as determined by the Secretary, direct 
            patient care services or services incident to direct 
            patient services; and
                ``(iv) would not otherwise be available to provide 
            medical care or treatment for veterans.
            ``(B) Not later than 45 days before the Secretary appoints 
        any personnel for a class of health care occupations that is 
        not specifically listed in this paragraph, the Secretary shall 
        submit to the Committee on Veterans' Affairs of the Senate, the 
        Committee on Veterans' Affairs of the House of Representatives, 
        and the Office of Management and Budget notice of such 
        appointment.
            ``(C) Before submitting notice under subparagraph (B), the 
        Secretary shall solicit comments from any labor organization 
        representing employees in such class and include such comments 
        in such notice.''.
        (2) Appointment of nurse assistants.--Such paragraph is further 
    amended by inserting ``nurse assistants,'' after ``licensed 
    practical or vocational nurses,''.
    (b) Probationary Periods for Registered Nurses.--Section 7403(b) is 
amended--
        (1) in paragraph (1), by striking ``Appointments'' and 
    inserting ``Except as otherwise provided in this subsection, 
    appointments'';
        (2) by redesignating paragraph (2) as paragraph (4); and
        (3) by inserting after paragraph (1) the following new 
    paragraphs:
    ``(2) With respect to the appointment of a registered nurse under 
this chapter, paragraph (1) shall apply with respect to such 
appointment regardless of whether such appointment is on a full-time 
basis or a part-time basis.
    ``(3) An appointment described in subsection (a) on a part-time 
basis of a person who has previously served on a full-time basis for 
the probationary period for the position concerned shall be without a 
probationary period.''.
    (c) Prohibition on Temporary Part-time Registered Nurse 
Appointments in Excess of 2 Years.--Section 7405 is amended by adding 
at the end the following new subsection:
    ``(g)(1) Except as provided in paragraph (3), employment of a 
registered nurse on a temporary part-time basis under subsection (a)(1) 
shall be for a probationary period of two years.
    ``(2) Except as provided in paragraph (3), upon completion by a 
registered nurse of the probationary period described in paragraph 
(1)--
        ``(A) the employment of such nurse shall--
            ``(i) no longer be considered temporary; and
            ``(ii) be considered an appointment described in section 
        7403(a) of this title; and
        ``(B) the nurse shall be considered to have served the 
    probationary period required by section 7403(b).
    ``(3) This subsection shall not apply to appointments made on a 
term limited basis of less than or equal to three years of--
        ``(A) nurses with a part-time appointment resulting from an 
    academic affiliation or teaching position in a nursing academy of 
    the Department;
        ``(B) nurses appointed as a result of a specific research 
    proposal or grant; or
        ``(C) nurses who are not citizens of the United States and 
    appointed under section 7407(a) of this title.''.
    (d) Rate of Basic Pay for Appointees to the Office of the Under 
Secretary for Health Set to Rate of Basic Pay for Senior Executive 
Service Positions.--
        (1) In general.--Section 7404(a) is amended--
            (A) by striking ``The annual'' and inserting ``(1) The 
        annual'';
            (B) by striking ``The pay'' and inserting the following:
    ``(2) The pay'';
            (C) by striking ``under the preceding sentence'' and 
        inserting ``under paragraph (1)''; and
            (D) by adding at the end the following new paragraph:
    ``(3)(A) The rate of basic pay for a position to which an Executive 
order applies under paragraph (1) and is not described by paragraph (2) 
shall be set in accordance with section 5382 of title 5 as if such 
position were a Senior Executive Service position (as such term is 
defined in section 3132(a) of title 5).
    ``(B) A rate of basic pay for a position may not be set under 
subparagraph (A) in excess of--
        ``(i) in the case the position is not described in clause (ii), 
    the rate of basic pay payable for level III of the Executive 
    Schedule; or
        ``(ii) in the case that the position is covered by a 
    performance appraisal system that meets the certification criteria 
    established by regulation under section 5307(d) of title 5, the 
    rate of basic pay payable for level II of the Executive Schedule.
    ``(C) Notwithstanding the provisions of subsection (d) of section 
5307 of title 5, the Secretary may make any certification under that 
subsection instead of the Office of Personnel Management and without 
concurrence of the Office of Management and Budget.''.
        (2) Effective date.--The amendments made by paragraph (1) shall 
    take effect on the first day of the first pay period beginning 
    after the day that is 180 days after the date of the enactment of 
    this Act.
    (e) Special Incentive Pay for Department Pharmacist Executives.--
Section 7410 is amended--
        (1) by striking ``The Secretary may'' and inserting the 
    following:
    ``(a) In General.--The Secretary may''; and
        (2) by adding at the end the following new subsection:
    ``(b) Special Incentive Pay for Department Pharmacist Executives.--
(1) In order to recruit and retain highly qualified Department 
pharmacist executives, the Secretary may authorize the Under Secretary 
for Health to pay special incentive pay of not more than $40,000 per 
year to an individual of the Veterans Health Administration who is a 
pharmacist executive.
    ``(2) In determining whether and how much special pay to provide to 
such individual, the Under Secretary shall consider the following:
        ``(A) The grade and step of the position of the individual.
        ``(B) The scope and complexity of the position of the 
    individual.
        ``(C) The personal qualifications of the individual.
        ``(D) The characteristics of the labor market concerned.
        ``(E) Such other factors as the Secretary considers 
    appropriate.
    ``(3) Special incentive pay under paragraph (1) for an individual 
is in addition to all other pay (including basic pay) and allowances to 
which the individual is entitled.
    ``(4) Except as provided in paragraph (5), special incentive pay 
under paragraph (1) for an individual shall be considered basic pay for 
all purposes, including retirement benefits under chapters 83 and 84 of 
title 5, and other benefits.
    ``(5) Special incentive pay under paragraph (1) for an individual 
shall not be considered basic pay for purposes of adverse actions under 
subchapter V of this chapter.
    ``(6) Special incentive pay under paragraph (1) may not be awarded 
to an individual in an amount that would result in an aggregate amount 
of pay (including bonuses and awards) received by such individual in a 
year under this title that is greater than the annual pay of the 
President.''.
    (f) Pay for Physicians and Dentists.--
        (1) Non-foreign cost of living adjustment allowance.--Section 
    7431(b) is amended by adding at the end the following new 
    paragraph:
        ``(5) The non-foreign cost of living adjustment allowance 
    authorized under section 5941 of title 5 for physicians and 
    dentists whose pay is set under this section shall be determined as 
    a percentage of base pay only.''.
        (2) Market pay determinations for physicians and dentists in 
    administrative or executive leadership positions.--Section 
    7431(c)(4)(B)(i) is amended by adding at the end the following: 
    ``The Secretary may exempt physicians and dentists occupying 
    administrative or executive leadership positions from the 
    requirements of the previous sentence.''.
        (3) Exception to prohibition on reduction of market pay.--
    Section 7431(c)(7) is amended by striking ``concerned.'' and 
    inserting ``concerned, unless there is a change in board 
    certification or reduction of privileges.''.
    (g) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) is 
amended by striking ``level V'' and inserting ``level IV''.
    (h) Exemption for Certified Registered Nurse Anesthetists From 
Limitation on Authorized Competitive Pay.--Section 7451(c)(2) is 
further amended by adding at the end the following new sentence: ``The 
maximum rate of basic pay for a grade for the position of certified 
registered nurse anesthetist pursuant to an adjustment under subsection 
(d) may exceed the maximum rate otherwise provided in the preceding 
sentence.''.
    (i) Increased Limitation on Special Pay for Nurse Executives.--
Section 7452(g)(2) is amended by striking ``$25,000'' and inserting 
``$100,000''.
    (j) Locality Pay Scale Computations.--
        (1) Education, training, and support for facility directors in 
    wage surveys.--Section 7451(d)(3) is amended by adding at the end 
    the following new subparagraph:
    ``(F) The Under Secretary for Health shall provide appropriate 
education, training, and support to directors of Department health care 
facilities in the conduct and use of surveys, including the use of 
third-party surveys, under this paragraph.''.
        (2) Information on methodology used in wage surveys.--Section 
    7451(e)(4) is amended--
            (A) by redesignating subparagraph (D) as subparagraph (E); 
        and
            (B) by inserting after subparagraph (C) the following new 
        subparagraph (D):
        ``(D) In any case in which the director conducts such a wage 
    survey during the period covered by the report and makes adjustment 
    in rates of basic pay applicable to one or more covered positions 
    at the facility, information on the methodology used in making such 
    adjustment or adjustments.''.
        (3) Disclosure of information to persons in covered 
    positions.--Section 7451(e), as amended by paragraph (2) of this 
    subsection, is further amended by adding at the end the following 
    new paragraph:
    ``(6)(A) Upon the request of an individual described in 
subparagraph (B) for a report provided under paragraph (4) with respect 
to a Department health-care facility, the Under Secretary for Health or 
the director of such facility shall provide to the individual the most 
current report for such facility provided under such paragraph.
    ``(B) An individual described in this subparagraph is--
        ``(i) an individual in a covered position at a Department 
    health-care facility; or
        ``(ii) a representative of the labor organization representing 
    that individual who is designated by that individual to make the 
    request.''.
    (k) Eligibility of Part-Time Nurses for Additional Nurse Pay.--
        (1) In general.--Section 7453 is amended--
            (A) in subsection (a), by striking ``a nurse'' and 
        inserting ``a full-time nurse or part-time nurse'';
            (B) in subsection (b)--
                (i) in the first sentence--

                    (I) by striking ``on a tour of duty'';
                    (II) by striking ``service on such tour'' and 
                inserting ``such service''; and
                    (III) by striking ``of such tour'' and inserting 
                ``of such service''; and

                (ii) in the second sentence, by striking ``of such 
            tour'' and inserting ``of such service'';
            (C) in subsection (c)--
                (i) by striking ``on a tour of duty''; and
                (ii) by striking ``service on such tour'' and inserting 
            ``such service''; and
            (D) in subsection (e)--
                (i) in paragraph (1), by striking ``eight hours in a 
            day'' and inserting ``eight consecutive hours''; and
                (ii) in paragraph (5)(A), by striking ``tour of duty'' 
            and inserting ``period of service''.
        (2) Exclusion of application of additional nurse pay provisions 
    to certain additional employees.--Paragraph (3) of section 7454(b) 
    is amended to read as follows:
    ``(3) Employees appointed under section 7408 of this title 
performing service on a tour of duty, any part of which is within the 
period commencing at midnight Friday and ending at midnight Sunday, 
shall receive additional pay in addition to the rate of basic pay 
provided such employees for each hour of service on such tour at a rate 
equal to 25 percent of such employee's hourly rate of basic pay.''.
    (l) Enhanced Authority To Increase Rates of Basic Pay To Obtain or 
Retain Services of Certain Persons.--Section 7455(c) is amended to read 
as follows:
    ``(c)(1) Subject to paragraph (2), the amount of any increase under 
subsection (a) in the minimum rate for any grade may not (except in the 
case of nurse anesthetists, licensed practical nurses, licensed 
vocational nurses, nursing positions otherwise covered by title 5, 
pharmacists, and licensed physical therapists) exceed the maximum rate 
of basic pay (excluding any locality-based comparability payment under 
section 5304 of title 5 or similar provision of law) for the grade or 
level by more than 30 percent.
    ``(2) No rate may be established under this section in excess of 
the rate of basic pay payable for level IV of the Executive 
Schedule.''.
    SEC. 602. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND 
      ALTERNATIVE WORK SCHEDULES FOR NURSES.
    (a) Overtime Duty.--
        (1) In general.--Subchapter IV of chapter 74 is amended by 
    adding at the end the following new section:
``Sec. 7459. Nursing staff: special rules for overtime duty
    ``(a) Limitation.--Except as provided in subsection (c), the 
Secretary may not require nursing staff to work more than 40 hours (or 
24 hours if such staff is covered under section 7456 of this title) in 
an administrative work week or more than eight consecutive hours (or 12 
hours if such staff is covered under section 7456 or 7456A of this 
title).
    ``(b) Voluntary Overtime.--(1) Nursing staff may on a voluntary 
basis elect to work hours otherwise prohibited by subsection (a).
    ``(2) The refusal of nursing staff to work hours prohibited by 
subsection (a) shall not be grounds--
        ``(A) to discriminate (within the meaning of section 704(a) of 
    the Civil Rights Act of 1964 (42 U.S.C. 2000e-3(a))) against the 
    staff;
        ``(B) to dismiss or discharge the staff; or
        ``(C) for any other adverse personnel action against the staff.
    ``(c) Overtime Under Emergency Circumstances.--(1) Subject to 
paragraph (2), the Secretary may require nursing staff to work hours 
otherwise prohibited by subsection (a) if--
        ``(A) the work is a consequence of an emergency that could not 
    have been reasonably anticipated;
        ``(B) the emergency is non-recurring and is not caused by or 
    aggravated by the inattention of the Secretary or lack of 
    reasonable contingency planning by the Secretary;
        ``(C) the Secretary has exhausted all good faith, reasonable 
    attempts to obtain voluntary workers;
        ``(D) the nurse staff have critical skills and expertise that 
    are required for the work; and
        ``(E) the work involves work for which the standard of care for 
    a patient assignment requires continuity of care through completion 
    of a case, treatment, or procedure.
    ``(2) Nursing staff may not be required to work hours under this 
subsection after the requirement for a direct role by the staff in 
responding to medical needs resulting from the emergency ends.
    ``(d) Nursing Staff Defined.--In this section, the term `nursing 
staff' includes the following:
        ``(1) A registered nurse.
        ``(2) A licensed practical or vocational nurse.
        ``(3) A nurse assistant appointed under this chapter or title 
    5.
        ``(4) Any other nurse position designated by the Secretary for 
    purposes of this section.''.
        (2) Clerical amendment.--The table of sections at the beginning 
    of chapter 74 is amended by inserting after the item relating to 
    section 7458 the following new item:

``7459. Nursing staff: special rules for overtime duty.''.

    (b) Weekend Duty.--Section 7456 is amended--
        (1) by striking subsection (c); and
        (2) by redesignating subsection (d) as subsection (c).
    (c) Alternate Work Schedules.--
        (1) In general.--Section 7456A(b)(1)(A) is amended by striking 
    ``three regularly scheduled'' and all that follows through the 
    period at the end and inserting ``six regularly scheduled 12-hour 
    tours of duty within a 14-day period shall be considered for all 
    purposes to have worked a full 80-hour pay period.''.
        (2) Conforming amendments.--Section 7456A(b) is amended--
            (A) in the subsection heading, by striking ``36/40'' and 
        inserting ``72/80'';
            (B) in paragraph (2)(A), by striking ``40-hour basic work 
        week'' and inserting ``80-hour pay period''; and
            (C) in paragraph (3), by striking ``regularly''.
    SEC. 603. REAUTHORIZATION OF HEALTH PROFESSIONALS EDUCATIONAL 
      ASSISTANCE SCHOLARSHIP PROGRAM.
    (a) In General.--Section 7618 is amended by striking ``December 31, 
1998'' and inserting ``December 31, 2014''.
    (b) Expansion of Eligibility Requirements.--Section 7612(b)(2) is 
amended by striking ``(under section'' and all that follows through 
``or vocational nurse.'' and inserting the following: ``as an appointee 
under paragraph (1) or (3) of section 7401 of this title.''.
    (c) Additional Program Requirements.--Subchapter II of chapter 76, 
as amended by subsections (a) and (b), is further amended--
        (1) by redesignating section 7618 as section 7619; and
        (2) by inserting after section 7617 the following new section:
``Sec. 7618. Additional program requirements
    ``(a) Program Modification.--Notwithstanding any provision of this 
subchapter, the Secretary shall carry out this subchapter after the 
date of the enactment of this section by modifying the Scholarship 
Program in such a manner that the program and hiring processes are 
designed to fully employ Scholarship Program graduates as soon as 
possible, if not immediately, upon graduation and completion of 
necessary certifications, and to actively assist and monitor graduates 
to ensure certifications are obtained in a minimal amount of time 
following graduation.
    ``(b) Clinical Tours.--The Secretary shall require participants in 
the Scholarship Program to perform clinical tours in assignments or 
locations determined by the Secretary while the participants are 
enrolled in the course of education or training for which the 
scholarship is provided.
    ``(c) Mentors.--The Secretary shall ensure that at the commencement 
of the period of obligated service of a participant in the Scholarship 
Program, the participant is assigned to a mentor who is employed in the 
same facility where the participant performs such service.''.
    (d) Clerical Amendment.--The table of sections at the beginning of 
chapter 76 is amended by striking the item relating to section 7618 and 
inserting the following new items:

``7618. Additional program requirements.
``7619. Expiration of program.''.
    SEC. 604. LOAN REPAYMENT PROGRAM FOR CLINICAL RESEARCHERS FROM 
      DISADVANTAGED BACKGROUNDS.
    (a) In General.--The Secretary of Veterans Affairs may, in 
consultation with the Secretary of Health and Human Services, use the 
authorities available in section 487E of the Public Health Service Act 
(42 U.S.C. 288-5) for the repayment of the principal and interest of 
educational loans of appropriately qualified health professionals who 
are from disadvantaged backgrounds in order to secure clinical research 
by such professionals for the Veterans Health Administration.
    (b) Limitations.--The exercise by the Secretary of Veterans Affairs 
of the authorities referred to in subsection (a) shall be subject to 
the conditions and limitations specified in paragraphs (2) and (3) of 
section 487E(a) of the Public Health Service Act (42 U.S.C. 288-5(a)(2) 
and (3)).
    (c) Funding.--Amounts for the repayment of principal and interest 
of educational loans under this section shall be derived from amounts 
available to the Secretary of Veterans Affairs for the Veterans Health 
Administration for Medical Services.

                  TITLE VII--HOMELESS VETERANS MATTERS

    SEC. 701. PER DIEM GRANT PAYMENTS TO NONCONFORMING ENTITIES.
    Section 2012 is amended by adding at the end the following new 
subsection:
    ``(d) Per Diem Payments to Nonconforming Entities.--(1) The 
Secretary may make funds available for per diem payments under this 
section to the following grant recipients or eligible entities:
        ``(A) Grant recipients or eligible entities that--
            ``(i) meet each of the transitional and supportive services 
        criteria prescribed by the Secretary pursuant to subsection 
        (a)(1); and
            ``(ii) furnish services to homeless individuals, of which 
        less than 75 percent are veterans.
        ``(B) Grant recipients or eligible entities that--
            ``(i) meet at least one, but not all, of the transitional 
        and supportive services criteria prescribed by the Secretary 
        pursuant to subsection (a)(1); and
            ``(ii) furnish services to homeless individuals, of which 
        not less than 75 percent are veterans.
        ``(C) Grant recipients or eligible entities that--
            ``(i) meet at least one, but not all, of the transitional 
        and supportive services criteria prescribed by the Secretary 
        pursuant to subsection (a)(1); and
            ``(ii) furnish services to homeless individuals, of which 
        less than 75 percent are veterans.
    ``(2) Notwithstanding subsection (a)(2), in providing per diem 
payments under this subsection, the Secretary shall determine the rate 
of such per diem payments in accordance with the following order of 
priority:
        ``(A) Grant recipients or eligible entities described by 
    paragraph (1)(A).
        ``(B) Grant recipients or eligible entities described by 
    paragraph (1)(B).
        ``(C) Grant recipients or eligible entities described by 
    paragraph (1)(C).
    ``(3) For purposes of this subsection, an eligible entity is a 
nonprofit entity and may be an entity that is ineligible to receive a 
grant under section 2011 of this title, but whom the Secretary 
determines carries out the purposes described in that section.''.

       TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

    SEC. 801. GENERAL AUTHORITIES ON ESTABLISHMENT OF CORPORATIONS.
    (a) Authorization of Multi-medical Center Research Corporations.--
        (1) In general.--Section 7361 is amended--
            (A) by redesignating subsection (b) as subsection (e); and
            (B) by inserting after subsection (a) the following new 
        subsection (b):
    ``(b)(1) Subject to paragraph (2), a corporation established under 
this subchapter may facilitate the conduct of research, education, or 
both at more than one medical center. Such a corporation shall be known 
as a `multi-medical center research corporation'.
    ``(2) The board of directors of a multi-medical center research 
corporation under this subsection shall include the official at each 
Department medical center concerned who is, or who carries out the 
responsibilities of, the medical center director of such center as 
specified in section 7363(a)(1)(A)(i) of this title.
    ``(3) In facilitating the conduct of research, education, or both 
at more than one Department medical center under this subchapter, a 
multi-medical center research corporation may administer receipts and 
expenditures relating to such research, education, or both, as 
applicable, performed at the Department medical centers concerned.''.
        (2) Expansion of existing corporations to multi-medical center 
    research corporations.--Such section is further amended by adding 
    at the end the following new subsection:
    ``(f) A corporation established under this subchapter may act as a 
multi-medical center research corporation under this subchapter in 
accordance with subsection (b) if--
        ``(1) the board of directors of the corporation approves a 
    resolution permitting facilitation by the corporation of the 
    conduct of research, education, or both at the other Department 
    medical center or medical centers concerned; and
        ``(2) the Secretary approves the resolution of the corporation 
    under paragraph (1).''.
    (b) Restatement and Modification of Authorities on Applicability of 
State Law.--
        (1) In general.--Section 7361 as amended by subsection (a) of 
    this section, is further amended by inserting after subsection (b) 
    the following new subsection (c):
    ``(c) Any corporation established under this subchapter shall be 
established in accordance with the nonprofit corporation laws of the 
State in which the applicable Department medical center is located and 
shall, to the extent not inconsistent with any Federal law, be subject 
to the laws of such State. In the case of any multi-medical center 
research corporation that facilitates the conduct of research, 
education, or both at Department medical centers located in different 
States, the corporation shall be established in accordance with the 
nonprofit corporation laws of the State in which one of such Department 
medical centers is located.''.
        (2) Conforming amendment.--Section 7365 is repealed.
    (c) Clarification of Status of Corporations.--Section 7361, as 
amended by this section, is further amended--
        (1) in subsection (a), by striking the second sentence; and
        (2) by inserting after subsection (c) the following new 
    subsection (d):
    ``(d)(1) Except as otherwise provided in this subchapter or under 
regulations prescribed by the Secretary, any corporation established 
under this subchapter, and its officers, directors, and employees, 
shall be required to comply only with those Federal laws, regulations, 
and executive orders and directives that apply generally to private 
nonprofit corporations.
    ``(2) A corporation under this subchapter is not--
        ``(A) owned or controlled by the United States; or
        ``(B) an agency or instrumentality of the United States.''.
    (d) Reinstatement of Requirement for 501(c)(3) Status of 
Corporations.--Subsection (e) of section 7361, as redesignated by 
subsection (a)(1), is further amended by inserting ``section 501(c)(3) 
of'' after ``exempt from taxation under''.
    SEC. 802. CLARIFICATION OF PURPOSES OF CORPORATIONS.
    (a) Clarification of Purposes.--Subsection (a) of section 7362 is 
amended in the first sentence--
        (1) by striking ``Any corporation'' and all that follows 
    through ``facilitate'' and inserting ``A corporation established 
    under this subchapter shall be established to provide a flexible 
    funding mechanism for the conduct of approved research and 
    education at one or more Department medical centers and to 
    facilitate functions related to the conduct of''; and
        (2) by inserting before the period at the end the following: 
    ``or centers''.
    (b) Modification of Defined Term Relating to Education and 
Training.--Subsection (b) of such section is amended in the matter 
preceding paragraph (1) by striking ``the term `education and 
training''' and inserting ``the term `education' includes education and 
training and''.
    (c) Repeal of Role of Corporations With Respect to Fellowships.--
Paragraph (1) of subsection (b) of such section is amended by striking 
the flush matter following subparagraph (C).
    (d) Availability of Education for Families of Veteran Patients.--
Paragraph (2) of subsection (b) of such section is amended by striking 
``to patients and to the families'' and inserting ``and includes 
education and training for patients and families''.
    SEC. 803. MODIFICATION OF REQUIREMENTS FOR BOARDS OF DIRECTORS OF 
      CORPORATIONS.
    (a) Requirements for Department Board Members.--Paragraph (1) of 
section 7363(a) is amended to read as follows:
        ``(1) with respect to the Department medical center--
            ``(A)(i) the director (or directors of each Department 
        medical center, in the case of a multi-medical center research 
        corporation);
            ``(ii) the chief of staff; and
            ``(iii) as appropriate for the activities of such 
        corporation, the associate chief of staff for research and the 
        associate chief of staff for education; or
            ``(B) in the case of a Department medical center at which 
        one or more of the positions referred to in subparagraph (A) do 
        not exist, the official or officials who are responsible for 
        carrying out the responsibilities of such position or positions 
        at the Department medical center; and''.
    (b) Requirements for Non-department Board Members.--Paragraph (2) 
of such section is amended--
        (1) by inserting ``not less than two'' before ``members''; and
        (2) by striking ``and who'' and all that follows through the 
    period at the end and inserting ``and who have backgrounds, or 
    business, legal, financial, medical, or scientific expertise, of 
    benefit to the operations of the corporation.''.
    (c) Conflicts of Interest.--Subsection (c) of section 7363 is 
amended by striking ``, employed by, or have any other financial 
relationship with'' and inserting ``or employed by''.
    SEC. 804. CLARIFICATION OF POWERS OF CORPORATIONS.
    (a) In General.--Section 7364 is amended to read as follows:
``Sec. 7364. General powers
    ``(a) In General.--(1) A corporation established under this 
subchapter may, solely to carry out the purposes of this subchapter--
        ``(A) accept, administer, retain, and spend funds derived from 
    gifts, contributions, grants, fees, reimbursements, and bequests 
    from individuals and public and private entities;
        ``(B) enter into contracts and agreements with individuals and 
    public and private entities;
        ``(C) subject to paragraph (2), set fees for education and 
    training facilitated under section 7362 of this title, and receive, 
    retain, administer, and spend funds in furtherance of such 
    education and training;
        ``(D) reimburse amounts to the applicable appropriation account 
    of the Department for the Office of General Counsel for any 
    expenses of that Office in providing legal services attributable to 
    research and education agreements under this subchapter; and
        ``(E) employ such employees as the corporation considers 
    necessary for such purposes and fix the compensation of such 
    employees.
    ``(2) Fees charged pursuant to paragraph (1)(C) for education and 
training described in that paragraph to individuals who are officers or 
employees of the Department may not be paid for by any funds 
appropriated to the Department.
    ``(3) Amounts reimbursed to the Office of General Counsel under 
paragraph (1)(D) shall be available for use by the Office of the 
General Counsel only for staff and training, and related travel, for 
the provision of legal services described in that paragraph and shall 
remain available for such use without fiscal year limitation.
    ``(b) Transfer and Administration of Funds.--(1) Except as provided 
in paragraph (2), any funds received by the Secretary for the conduct 
of research or education at a Department medical center or centers, 
other than funds appropriated to the Department, may be transferred to 
and administered by a corporation established under this subchapter for 
such purposes.
    ``(2) A Department medical center may reimburse the corporation for 
all or a portion of the pay, benefits, or both of an employee of the 
corporation who is assigned to the Department medical center if the 
assignment is carried out pursuant to subchapter VI of chapter 33 of 
title 5.
    ``(3) A Department medical center may retain and use funds provided 
to it by a corporation established under this subchapter. Such funds 
shall be credited to the applicable appropriation account of the 
Department and shall be available, without fiscal year limitation, for 
the purposes of that account.
    ``(c) Research Projects.--Except for reasonable and usual 
preliminary costs for project planning before its approval, a 
corporation established under this subchapter may not spend funds for a 
research project unless the project is approved in accordance with 
procedures prescribed by the Under Secretary for Health for research 
carried out with Department funds. Such procedures shall include a 
scientific review process.
    ``(d) Education Activities.--Except for reasonable and usual 
preliminary costs for activity planning before its approval, a 
corporation established under this subchapter may not spend funds for 
an education activity unless the activity is approved in accordance 
with procedures prescribed by the Under Secretary for Health.
    ``(e) Policies and Procedures.--The Under Secretary for Health may 
prescribe policies and procedures to guide the spending of funds by 
corporations established under this subchapter that are consistent with 
the purpose of such corporations as flexible funding mechanisms and 
with Federal and State laws and regulations, and executive orders, 
circulars, and directives that apply generally to the receipt and 
expenditure of funds by nonprofit organizations exempt from taxation 
under section 501(c)(3) of the Internal Revenue Code of 1986.''.
    (b) Conforming Amendment.--Section 7362(a), as amended by section 
802(a)(1) of this Act, is further amended by striking the last 
sentence.
    SEC. 805. REDESIGNATION OF SECTION 7364A OF TITLE 38, UNITED STATES 
      CODE.
    (a) Redesignation.--Section 7364A is redesignated as section 7365.
    (b) Clerical Amendments.--The table of sections at the beginning of 
chapter 73 is amended--
        (1) by striking the item relating to section 7364A; and
        (2) by striking the item relating to section 7365 and inserting 
    the following new item:

``7365. Coverage of employees under certain Federal tort claims laws.''.
    SEC. 806. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF CORPORATIONS.
    (a) Additional Information in Annual Reports.--Subsection (b) of 
section 7366 is amended to read as follows:
    ``(b)(1) Each corporation shall submit to the Secretary each year a 
report providing a detailed statement of the operations, activities, 
and accomplishments of the corporation during that year.
    ``(2)(A) A corporation with revenues in excess of $500,000 for any 
year shall obtain an audit of the corporation for that year.
    ``(B) A corporation with annual revenues between $100,000 and 
$500,000 shall obtain an audit of the corporation at least once every 
three years.
    ``(C) Any audit under this paragraph shall be performed by an 
independent auditor.
    ``(3) The corporation shall include in each report to the Secretary 
under paragraph (1) the following:
        ``(A) The most recent audit of the corporation under paragraph 
    (2).
        ``(B) The most recent Internal Revenue Service Form 990 `Return 
    of Organization Exempt from Income Tax' or equivalent and the 
    applicable schedules under such form.''.
    (b) Conflict of Interest Policies.--Subsection (c) of such section 
is amended to read as follows:
    ``(c) Each director, officer, and employee of a corporation 
established under this subchapter shall be subject to a conflict of 
interest policy adopted by that corporation.''.
    (c) Establishment of Appropriate Payee Reporting Threshold.--
Subsection (d)(3)(C) of such section is amended by striking ``$35,000'' 
and inserting ``$50,000''.

               TITLE IX--CONSTRUCTION AND NAMING MATTERS

    SEC. 901. AUTHORIZATION OF MEDICAL FACILITY PROJECTS.
    (a) Authorization of Fiscal Year 2010 Major Medical Facility 
Projects.--The Secretary of Veterans Affairs may carry out the 
following major medical facility projects in fiscal year 2010, with 
each project to be carried out in the amount specified for such 
project:
        (1) Construction (including acquisition of land) for the 
    realignment of services and closure projects at the Department of 
    Veterans Affairs Medical Center in Livermore, California, in an 
    amount not to exceed $55,430,000.
        (2) Construction (including acquisition of land) for a new 
    medical facility at the Department of Veterans Affairs Medical 
    Center in Louisville, Kentucky, in an amount not to exceed 
    $75,000,000.
        (3) Construction (including acquisition of land) for a clinical 
    expansion for a Mental Health Facility at the Department of 
    Veterans Affairs Medical Center in Dallas, Texas, in an amount not 
    to exceed $15,640,000.
        (4) Construction (including acquisition of land) for a 
    replacement bed tower and clinical expansion at the Department of 
    Veterans Affairs Medical Center in St. Louis, Missouri, in an 
    amount not to exceed $43,340,000.
    (b) Extension of Authorization for Major Medical Facility 
Construction Projects Previously Authorized.--The Secretary of Veterans 
Affairs may carry out the following major medical facility projects in 
fiscal year 2010, as follows with each project to be carried out in the 
amount specified for such project:
        (1) Replacement of the existing Department of Veterans Affairs 
    Medical Center in Denver, Colorado, in an amount not to exceed 
    $800,000,000.
        (2) Construction of Outpatient and Inpatient Improvements in 
    Bay Pines, Florida, in an amount not to exceed $194,400,000.
    (c) Authorization of Appropriations.--
        (1) Authorization of appropriations for construction.--There is 
    authorized to be appropriated to the Secretary of Veterans Affairs 
    for fiscal year 2010, or the year in which funds are appropriated, 
    for the Construction, Major Projects account--
            (A) $189,410,000 for the projects authorized in subsection 
        (a); and
            (B) $994,400,000 for the projects authorized in subsection 
        (b).
        (2) Limitation.--The projects authorized in subsections (a) and 
    (b) may only be carried out using--
            (A) funds appropriated for fiscal year 2010 pursuant to the 
        authorization of appropriations in paragraph (1);
            (B) funds available for Construction, Major Projects for a 
        fiscal year before fiscal year 2010 that remain available for 
        obligation;
            (C) funds available for Construction, Major Projects for a 
        fiscal year after fiscal year 2010 that remain available for 
        obligation;
            (D) funds appropriated for Construction, Major Projects for 
        fiscal year 2010 for a category of activity not specific to a 
        project;
            (E) funds appropriated for Construction, Major Projects for 
        a fiscal year before 2010 for a category of activity not 
        specific to a project; and
            (F) funds appropriated for Construction, Major Projects for 
        a fiscal year after 2010 for a category of activity not 
        specific to a project.
    SEC. 902. DESIGNATION OF MERRIL LUNDMAN DEPARTMENT OF VETERANS 
      AFFAIRS OUTPATIENT CLINIC, HAVRE, MONTANA.
    (a) Designation.--The Department of Veterans Affairs outpatient 
clinic in Havre, Montana, shall after the date of the enactment of this 
Act be known and designated as the ``Merril Lundman Department of 
Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the outpatient 
clinic referred to in subsection (a) shall be considered to be a 
reference to the Merril Lundman Department of Veterans Affairs 
Outpatient Clinic.
    SEC. 903. DESIGNATION OF WILLIAM C. TALLENT DEPARTMENT OF VETERANS 
      AFFAIRS OUTPATIENT CLINIC, KNOXVILLE, TENNESSEE.
    (a) Designation.--The Department of Veterans Affairs Outpatient 
Clinic in Knoxville, Tennessee, shall after the date of the enactment 
of this Act be known and designated as the ``William C. Tallent 
Department of Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the outpatient 
clinic referred to in subsection (a) shall be considered to be a 
reference to the William C. Tallent Department of Veterans Affairs 
Outpatient Clinic.
    SEC. 904. DESIGNATION OF MAX J. BEILKE DEPARTMENT OF VETERANS 
      AFFAIRS OUTPATIENT CLINIC, ALEXANDRIA, MINNESOTA.
    (a) Designation.--The Department of Veterans Affairs outpatient 
clinic in Alexandria, Minnesota, shall after the date of the enactment 
of this Act be known and designated as the ``Max J. Beilke Department 
of Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the outpatient 
clinic referred to in subsection (a) shall be considered to be a 
reference to the Max J. Beilke Department of Veterans Affairs 
Outpatient Clinic.

                         TITLE X--OTHER MATTERS

SEC. 1001. EXPANSION OF AUTHORITY FOR DEPARTMENT OF VETERANS AFFAIRS 
POLICE OFFICERS.
    Section 902 is amended--
        (1) in subsection (a)--
            (A) by amending paragraph (1) to read as follows:
    ``(1) Employees of the Department who are Department police 
officers shall, with respect to acts occurring on Department property--
        ``(A) enforce Federal laws;
        ``(B) enforce the rules prescribed under section 901 of this 
    title;
        ``(C) enforce traffic and motor vehicle laws of a State or 
    local government (by issuance of a citation for violation of such 
    laws) within the jurisdiction of which such Department property is 
    located as authorized by an express grant of authority under 
    applicable State or local law;
        ``(D) carry the appropriate Department-issued weapons, 
    including firearms, while off Department property in an official 
    capacity or while in an official travel status;
        ``(E) conduct investigations, on and off Department property, 
    of offenses that may have been committed on property under the 
    original jurisdiction of Department, consistent with agreements or 
    other consultation with affected Federal, State, or local law 
    enforcement agencies; and
        ``(F) carry out, as needed and appropriate, the duties 
    described in subparagraphs (A) through (E) when engaged in duties 
    authorized by other Federal statutes.'';
            (B) by striking paragraph (2) and redesignating paragraph 
        (3) as paragraph (2); and
            (C) in paragraph (2), as redesignated by subparagraph (B) 
        of this paragraph, by inserting ``, and on any arrest warrant 
        issued by competent judicial authority'' before the period; and
        (2) by amending subsection (c) to read as follows:
    ``(c) The powers granted to Department police officers designated 
under this section shall be exercised in accordance with guidelines 
approved by the Secretary and the Attorney General.''.
SEC. 1002. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS AFFAIRS POLICE 
OFFICERS.
    Section 903 is amended--
        (1) by striking subsection (b) and inserting the following new 
    subsection (b):
    ``(b)(1) The amount of the allowance that the Secretary may pay 
under this section is the lesser of--
        ``(A) the amount currently allowed as prescribed by the Office 
    of Personnel Management; or
        ``(B) estimated costs or actual costs as determined by periodic 
    surveys conducted by the Department.
    ``(2) During any fiscal year no officer shall receive more for the 
purchase of a uniform described in subsection (a) than the amount 
established under this subsection.''; and
        (2) by striking subsection (c) and inserting the following new 
    subsection (c):
    ``(c) The allowance established under subsection (b) shall be paid 
at the beginning of a Department police officer's employment for those 
appointed on or after October 1, 2010. In the case of any other 
Department police officer, an allowance in the amount established under 
subsection (b) shall be paid upon the request of the officer.''.
SEC. 1003. SUBMISSION OF REPORTS TO CONGRESS BY SECRETARY OF VETERANS 
AFFAIRS IN ELECTRONIC FORM.
    (a) In General.--Chapter 1 is amended by adding at the end the 
following new section:
``Sec. 118. Submission of reports to Congress in electronic form
    ``(a) In General.--Whenever the Secretary or any other official of 
the Department is required by law to submit to Congress (or any 
committee of either chamber of Congress) a report, the Secretary or 
other official shall submit to Congress (or such committee) a copy of 
the report in an electronic format.
    ``(b) Treatment.--The submission of a copy of a report in 
accordance with this section shall be treated as meeting any 
requirement of law to submit such report to Congress (or any committee 
of either chamber of Congress).
    ``(c) Report Defined.--For purposes of this section, the term 
`report' includes any certification, notification, or other 
communication in writing.''.
    (b) Technical and Clerical Amendments.--The table of sections at 
the beginning of chapter 1 is amended--
        (1) by striking the item relating to section 117; and
        (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.''.
SEC. 1004. DETERMINATION OF BUDGETARY EFFECTS FOR PURPOSES OF 
COMPLIANCE WITH STATUTORY PAY-AS-YOU-GO ACT OF 2010.
    The budgetary effects of this Act, for the purpose of complying 
with the Statutory Pay-As-You-Go Act of 2010, shall be determined by 
reference to the latest statement titled ``Budgetary Effects of PAYGO 
Legislation'' for this Act, submitted for printing in the Congressional 
Record by the Chairman of the House Budget Committee, provided that 
such statement has been submitted prior to the vote on passage.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.
```