IIB 

112TH CONGRESS 

1ST SESSION H. R. 2074 

IN THE SENATE OF THE UNITED STATES 

OCTOBER 12, 2011 

Received; read twice and referred to the Committee on Veterans’ Affairs 

AN ACT 

To amend title 38, United States Code, to require a comprehensive policy on reporting and tracking sexual assault incidents and other safety incidents that occur at 

medical facilities of the Department of Veterans Affairs, 

to improve rehabilitative services for veterans with traumatic brain injury, and for other purposes. 


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

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Veterans Sexual As5 sault Prevention and Health Care Enhancement Act’’. 

6 SEC. 2. COMPREHENSIVE POLICY ON REPORTING AND 

7 TRACKING SEXUAL ASSAULT INCIDENTS AND 

8 OTHER SAFETY INCIDENTS. 

9 (a) POLICY.—Subchapter I of chapter 17 of title 38, 

10 United States Code, is amended by adding at the end the 

11 following: 

12 ‘‘§ 1709. Comprehensive policy on reporting and 

13 tracking sexual assault incidents and 

14 other safety incidents 

15 ‘‘(a) POLICY REQUIRED.—Not later than March 1, 

16 2012, the Secretary of Veterans Affairs shall develop and 

17 implement a centralized and comprehensive policy on the 

18 reporting and tracking of sexual assault incidents and 

19 other safety incidents that occur at each medical facility 

20 of the Department, including— 

21 ‘‘(1) suspected, alleged, attempted, or confirmed 

22 cases of sexual assault, regardless of whether such 

23 assaults lead to prosecution or conviction; 

24 ‘‘(2) criminal and purposefully unsafe acts; 


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1 ‘‘(3) alcohol or substance abuse related acts (in2 cluding by employees of the Department); and 

3 ‘‘(4) any kind of event involving alleged or sus4 pected abuse of a patient. 

5 ‘‘(b) SCOPE.—The policy required by subsection (a) 

6 shall cover each of the following: 

7 ‘‘(1) For purposes of reporting and tracking 

8 sexual assault incidents and other safety incidents, 

9 definitions of the terms— 

10 ‘‘(A) ‘safety incident’; 

11 ‘‘(B) ‘sexual assault’; and 

12 ‘‘(C) ‘sexual assault incident’. 

13 ‘‘(2) The development and use of specific risk14 assessment tools to examine any risks related to sex15 ual assault that a veteran may pose while being 

16 treated at a medical facility of the Department, in17 cluding clear and consistent guidance on the collec18 tion of information related to— 

19 ‘‘(A) the legal history of the veteran; and 

20 ‘‘(B) the medical record of the veteran. 

21 ‘‘(3) The mandatory training of employees of 

22 the Department on security issues, including aware23 ness, preparedness, precautions, and police assist24 ance. 


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1 ‘‘(4) The mandatory implementation, use, and 

2 regular testing of appropriate physical security pre3 cautions and equipment, including surveillance cam4 era systems, computer-based panic alarm systems, 

5 stationary panic alarms, and electronic portable per6 sonal panic alarms. 

7 ‘‘(5) Clear, consistent, and comprehensive cri8 teria and guidance with respect to an employee of 

9 the Department communicating and reporting sexual 

10 assault incidents and other safety incidents to— 

11 ‘‘(A) supervisory personnel of the employee 

12 at— 

13 ‘‘(i) a medical facility of the Depart14 ment; 

15 ‘‘(ii) an office of a Veterans Inte16 grated Service Network; and 

17 ‘‘(iii) the central office of the Veterans 

18 Health Administration; and 

19 ‘‘(B) a law enforcement official of the De20 partment. 

21 ‘‘(6) Clear and consistent criteria and guide22 lines with respect to an employee of the Department 

23 referring and reporting to the Office of Inspector 

24 General of the Department sexual assault incidents 

25 and other safety incidents that meet the regulatory 


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1 criminal threshold in accordance with section 1.201 

2 and 1.204 of title 38, Code of Federal Regulations. 

3 ‘‘(7) An accountable oversight system within 

4 the Veterans Health Administration that includes— 

5 ‘‘(A) systematic information sharing of re6 ported sexual assault incidents and other safety 

7 incidents among officials of the Administration 

8 who have programmatic responsibility; and 

9 ‘‘(B) a centralized reporting, tracking, and 

10 monitoring system for such incidents. 

11 ‘‘(8) Consistent procedures and systems for law 

12 enforcement officials of the Department with respect 

13 to investigating, tracking, and closing reported sex14 ual assault incidents and other safety incidents. 

15 ‘‘(9) Clear and consistent guidance for the clin16 ical management of the treatment of sexual assaults 

17 that are reported more than 72 hours after the as18 sault. 

19 ‘‘(c) UPDATES TO POLICY.—The Secretary shall re20 view and revise the policy required by subsection (a) on 

21 a periodic basis as the Secretary considers appropriate and 

22 in accordance with best practices. 

23 ‘‘(d) ANNUAL REPORT.—(1) Not later than 60 days 

24 after the date on which the Secretary develops the policy 

25 required by subsection (a), and by not later than October 


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1 1 of each year thereafter, the Secretary shall submit to 

2 the Committee on Veterans’ Affairs of the House of Rep3 resentatives and the Committee on Veterans’ Affairs of 

4 the Senate a report on the implementation of the policy. 

5 ‘‘(2) The report under paragraph (1) shall include— 

6 ‘‘(A) the number and type of sexual assault in7 cidents and other safety incidents reported by each 

8 medical facility of the Department; 

9 ‘‘(B) a detailed description of the implementa10 tion of the policy required by subsection (a), includ11 ing any revisions made to such policy from the pre12 vious year; and 

13 ‘‘(C) the effectiveness of such policy on improv14 ing the safety and security of the medical facilities 

15 of the Department, including the performance meas16 ures used to evaluate such effectiveness. 

17 ‘‘(e) REGULATIONS.—The Secretary shall prescribe 

18 regulations to carry out this section.’’. 

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

20 at the beginning of such chapter is amended by adding 

21 after the item relating to section 1708 the following: 

‘‘1709. Comprehensive policy on reporting and tracking sexual assault incidents 

and other safety incidents.’’. 

22 (c) INTERIM REPORT.—Not later than 30 days after 

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

24 Veterans Affairs shall submit to the Committee on VetVerDate Mar 15 2010 02:06 Oct 13, 2011 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H2074.RFS H2074

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1 erans’ Affairs of the House of Representatives and the 

2 Committee on Veterans’ Affairs of the Senate a report on 

3 the development of the performance measures described 

4 in section 1709(d)(2)(C) of title 38, United States Code, 

5 as added by subsection (a). 

6 SEC. 3. INCREASED FLEXIBILITY IN ESTABLISHING PAY7 MENT RATES FOR NURSING HOME CARE PRO8 VIDED BY STATE HOMES. 

9 (a) IN GENERAL.— 

10 (1) CONTRACTS AND AGREEMENTS FOR NURS11 ING HOME CARE.—Section 1745(a) of title 38, 

12 United States Code, is amended— 

13 (A) in paragraph (1), by striking ‘‘The 

14 Secretary shall pay each State home for nursing 

15 home care at the rate determined under para16 graph (2)’’ and inserting ‘‘The Secretary shall 

17 enter into a contract (or agreement under sec18 tion 1720(c)(1) of this title) with each State 

19 home for payment by the Secretary for nursing 

20 home care provided in the home’’; and 

21 (B) by striking paragraph (2) and insert22 ing the following new paragraph (2): 

23 ‘‘(2) Payment under each contract (or agreement) be24 tween the Secretary and a State home under paragraph 

25 (1) shall be based on a methodology, developed by the SecVerDate Mar 15 2010 02:06 Oct 13, 2011 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H2074.RFS H2074

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1 retary in consultation with the State home, to adequately 

2 reimburse the State home for the care provided by the 

3 State home under the contract (or agreement).’’. 

4 (2) STATE NURSING HOMES.—Section 

5 1720(c)(1)(A) of such title is amended— 

6 (A) in clause (i), by striking ‘‘; and’’ and 

7 inserting a semicolon; 

8 (B) in clause (ii), by striking the period at 

9 the end and inserting ‘‘; and’’; and 

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

11 clause: 

12 ‘‘(iii) a provider of services eligible to enter into 

13 a contract pursuant to section 1745(a) of this title 

14 who is not otherwise described in clause (i) or (ii).’’. 

15 (b) EFFECTIVE DATE.—The amendment made by 

16 subsection (a) shall apply to care provided on or after Jan17 uary 1, 2012. 

18 SEC. 4. REHABILITATIVE SERVICES FOR VETERANS WITH 

19 TRAUMATIC BRAIN INJURY. 

20 (a) REHABILITATION PLANS AND SERVICES.—Sec21 tion 1710C of title 38, United States Code, is amended— 

22 (1) in subsection (a)(1), by inserting before the 

23 semicolon the following: ‘‘with the goal of maxi24 mizing the individual’s independence’’; 

25 (2) in subsection (b)— 


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1 (A) in paragraph (1)— 

2 (i) by inserting ‘‘(and sustaining im3 provement in)’’ after ‘‘improving’’; 

4 (ii) by inserting ‘‘behavioral,’’ after 

5 ‘‘cognitive’’; 

6 (B) in paragraph (2), by inserting ‘‘reha7 bilitative services and’’ before ‘‘rehabilitative 

8 components’’; and 

9 (C) in paragraph (3)— 

10 (i) by striking ‘‘treatments’’ the first 

11 place it appears and inserting ‘‘services’’; 

12 and 

13 (ii) by striking ‘‘treatments and’’ the 

14 second place it appears; and 

15 (3) by adding at the end the following new sub16 section: 

17 ‘‘(h) REHABILITATIVE SERVICES DEFINED.—For 

18 purposes of this section, and sections 1710D and 1710E 

19 of this title, the term ‘rehabilitative services’ includes— 

20 ‘‘(1) rehabilitative services, as defined in section 

21 1701 of this title; 

22 ‘‘(2) treatment and services (which may be of 

23 ongoing duration) to sustain, and prevent loss of, 

24 functional gains that have been achieved; and 


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1 ‘‘(3) any other rehabilitative services or sup2 ports that may contribute to maximizing an individ3 ual’s independence.’’. 

4 (b) REHABILITATION SERVICES IN COMPREHENSIVE

5 PROGRAM FOR LONG-TERM REHABILITATION.—Section 

6 1710D(a) of title 38, United States Code, is amended— 

7 (1) by inserting ‘‘and rehabilitative services (as 

8 defined in section 1710C of this title)’’ after ‘‘long9 term care’’; and 

10 (2) by striking ‘‘treatment’’. 

11 (c) REHABILITATION SERVICES IN AUTHORITY FOR

12 COOPERATIVE AGREEMENTS FOR USE OF NON-DEPART13 MENT FACILITIES FOR REHABILITATION.—Section 

14 1710E(a) of title 38, United States Code, is amended by 

15 inserting ‘‘, including rehabilitative services (as defined in 

16 section 1710C of this title),’’ after ‘‘medical services’’. 

17 (d) TECHNICAL AMENDMENT.—Section 

18 1710C(c)(2)(S) of title 38, United States Code, is amend19 ed by striking ‘‘opthamologist’’ and inserting ‘‘ophthalmol20 ogist’’. 

21 SEC. 5. USE OF SERVICE DOGS ON PROPERTY OF THE DE22 PARTMENT OF VETERANS AFFAIRS. 

23 Section 901 of title 38, United States Code, is 

24 amended by adding at the end the following new sub25 section: 


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1 ‘‘(f) The Secretary may not prohibit the use of service 

2 dogs in any facility or on any property of the Department 

3 or in any facility or on any property that receives funding 

4 from the Secretary.’’. 

5 SEC. 6. DEPARTMENT OF VETERANS AFFAIRS PILOT PRO6 GRAM ON DOG TRAINING THERAPY. 

7 (a) IN GENERAL.—Commencing not later than 120 

8 days after the date of the enactment of this Act, the Sec9 retary of Veterans Affairs shall implement a three-year 

10 pilot program for the purpose of assessing the effective11 ness of using dog training activities as a component of 

12 integrated post-deployment mental health and post-trau13 matic stress disorder rehabilitation programs at Depart14 ment of Veterans Affairs medical centers to positively af15 fect veterans with post-deployment mental health condi16 tions and post-traumatic stress disorder symptoms and, 

17 through such activities, to produce specially trained dogs 

18 that meet criteria for becoming service dogs for veterans 

19 with disabilities. 

20 (b) LOCATION OF PILOT PROGRAM.—The pilot pro21 gram shall be carried out at one Department of Veterans 

22 Affairs medical center selected by the Secretary for such 

23 purpose at a location other than in the Department of Vet24 erans Affairs Palo Alto health care system in Palo Alto, 


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1 California. In selecting a medical center for the pilot pro2 gram, the Secretary shall— 

3 (1) ensure that the medical center selected— 

4 (A) has an established mental health reha5 bilitation program that includes a clinical focus 

6 on rehabilitation treatment of post-deployment 

7 mental health conditions and post-traumatic 

8 stress disorder; and 

9 (B) has a demonstrated capability and ca10 pacity to incorporate service dog training activi11 ties into the rehabilitation program; and 

12 (2) shall review and consider using rec13 ommendations published by Assistance Dogs Inter14 national, International Guide Dog Federation, or 

15 comparably recognized experts in the art and science 

16 of basic dog training with regard to space, equip17 ments, and methodologies. 

18 (c) DESIGN OF PILOT PROGRAM.—In carrying out 

19 the pilot program, the Secretary shall— 

20 (1) administer the program through the De21 partment of Veterans Affairs Patient Care Services 

22 Office as a collaborative effort between the Rehabili23 tation Office and the Office of Mental Health Serv24 ices; 


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1 (2) ensure that the national pilot program lead 

2 of the Patient Care Services Office has sufficient ad3 ministrative experience to oversee the pilot program; 

4 (3) establish partnerships through memoran5 dums of understanding with Assistance Dogs Inter6 national organizations, International Guide Dog 

7 Federation organizations, academic affiliates, or or8 ganizations with equivalent credentials with experi9 ence in teaching others to train service dogs for the 

10 purpose of advising the Department of Veterans Af11 fairs regarding the design, development, and imple12 mentation of pilot program; 

13 (4) ensure that the pilot program site has a 

14 service dog training instructor; 

15 (5) ensure that dogs selected for use in the pro16 gram meet all health clearance, age, and tempera17 ment criteria as outlined by Assistance Dogs Inter18 national, International Guide Dog Federation, or an 

19 organization with equivalent credentials and the 

20 Centers for Disease Control and Prevention; 

21 (6) consider dogs residing in animal shelters or 

22 foster homes for participation in the program if such 

23 dogs meet the selection criteria under this sub24 section; and 


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1 (7) ensure that each dog selected for the pro2 gram is taught all basic commands and behaviors es3 sential to being accepted by an accredited service 

4 dog training organization to be partnered with a dis5 abled veteran for final individualized service dog 

6 training tailored to meet the needs of the veteran. 

7 (d) VETERAN PARTICIPATION.—A veteran who is en8 rolled in the health care system established under section 

9 1705(a) of title 38, United States Code, and is diagnosed 

10 with post-traumatic stress disorder or another post-de11 ployment mental health condition may volunteer to partici12 pate in the pilot program required by subsection (a) of 

13 this section and may participate in the program if the Sec14 retary determines that adequate program resources are 

15 available for such veteran to participate at the pilot pro16 gram site. 

17 (e) HIRING PREFERENCE.—In hiring service dog 

18 training instructors for the pilot program required by sub19 section (a), the Secretary shall give a preference to vet20 erans in accordance with section 2108 and 3309 of title 

21 5, United States Code. 

22 (f) COLLECTION OF DATA.—The Secretary shall col23 lect data on the pilot program required by subsection (a) 

24 to determine the effectiveness of the program in positively 

25 affecting veterans with post-traumatic stress disorder or 


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1 other post-deployment mental health condition symptoms 

2 and the potential for expanding the program to additional 

3 Department of Veterans Affairs medical centers. Such 

4 data shall be collected and analyzed using valid and reli5 able methodologies and instruments. 

6 (g) REPORTS TO CONGRESS.— 

7 (1) ANNUAL REPORTS.—Not later than one 

8 year after the date of the commencement of the pilot 

9 program, and annually thereafter for the duration of 

10 the pilot program, the Secretary shall submit to 

11 Congress a report on the pilot program. Each such 

12 report shall include— 

13 (A) the number of veterans participating in 

14 the pilot program; 

15 (B) a description of the services carried 

16 out by the Secretary under the pilot program; 

17 and 

18 (C) the effects that participating in the 

19 pilot program has on veterans with post-trau20 matic stress disorder and post-deployment men21 tal health conditions. 

22 (2) FINAL REPORT.—At the conclusion of pilot 

23 program, the Secretary shall submit to Congress a 

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1 spect to the extension or expansion of the pilot pro2 gram. 

3 (h) DEFINITION.—For the purposes of this section, 

4 the term ‘‘service dog training instructor’’ means an in5 structor recognized by an accredited dog organization 

6 training program who provides hands-on training in the 

7 art and science of service dog training and handling. 

8 SEC. 7. ELIMINATION OF ANNUAL REPORT ON STAFFING 

9 FOR NURSE POSITIONS. 

10 Section 7451(e) of title 38, United States Code, is 

11 amended— 

12 (1) by striking paragraph (5); and 

13 (2) by redesignating paragraph (6) as para14 graph (5). 

Passed the House of Representatives October 11, 

2011. 

Attest: KAREN L. HAAS, 

Clerk. 


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