```

[Congressional Record Volume 155, Number 9 (Thursday, January 15, 2009)]
[Senate]
[Pages S599-S612]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. AKAKA (for himself, Mr. Durbin, and Mrs. Murray):
  S. 252. a bill to amend title 38, United States Code, to enhance the 
capacity of the Department of Veterans Affairs to recruit and retain 
nurses and other critical health-care professionals, to improve the 
provision of health care veterans, and for other purposes; to the 
Committee on Veterans' Affairs.
  Mr. AKAKA. Mr. President, today I am introducing legislation which is 
drawn in large measure from S. 2969, the proposed Veterans' Health Care 
Authorization Act, as reported by the Committee on Veterans' Affairs 
last Congress.
  VA faces a looming shortage of health care personnel. Without 
concerted and timely action, this situation will only worsen in the 
years ahead. This is especially true as more Iraq and Afghanistan 
veterans return home injured and in need of new and specialized care. 
In order to avert this problem, VA must be able to offer competitive 
salaries, work schedules, and benefits. The provisions in the bill I am 
introducing will allow VA to recruit and retain nurses, home health 
aides, and specialty care providers.
  This bill also contains measures that would improve the efficiency of 
health care delivery to veterans, including a number of pilot programs 
designed to help VA find new and innovative ways to deliver better, 
faster, and more comprehensive treatment.
  Women make up an ever growing percentage of the Armed Forces. As 
such, they are also making up an ever growing percentage of the veteran 
population. While there have been efforts over the years to address the 
unique needs of women veterans, there is much more that VA might do. To 
that end, there are provisions in this bill to address current 
shortcomings and help VA better respond to the increased demand for 
care from women veterans. I particularly thank Senator Murray for her 
leadership on this issue.
  One of the most troubling and difficult challenges of warfare, which 
can be seen particularly in the current conflicts in Iraq and 
Afghanistan, is diagnosing and treating those who suffer from the 
invisible wounds of war. The lack of understanding of these injuries, 
the stigma associated with them, and many other factors make effective 
treatment difficult. Last Congress, legislation I authored, the 
Veterans Mental Health and Other Care Improvements Act, was enacted as 
Public Law 110-387. This Congress, I seek to improve upon those 
advances, and to continue to provide accessible, cutting-edge care for 
those afflicted with invisible wounds. This bill would expand 
eligibility and authority for the Vet Centers to provide needed 
services, and would commission a comprehensive study on suicides among 
veterans so that we can improve efforts to prevent such tragedies.
  This bill will also provide support for homeless veterans through a 
proposed series of innovative pilot programs. These programs are 
designed to significantly improve VA outreach to these veterans, in 
order to help them access the benefits and services provided by VA.
  I look forward to working with all of our colleagues to bring this 
legislation to the full Senate for consideration early in this Session. 
Mr. President, I ask unanimous consent that the text of this bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 252

       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 ``Veterans 
     Health Care Authorization Act of 2009''.
       (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--DEPARTMENT PERSONNEL MATTERS

Sec. 101. Enhancement of authorities for retention of medical 
              professionals.
Sec. 102. Limitations on overtime duty, weekend duty, and alternative 
              work schedules for nurses.
Sec. 103. Improvements to certain educational assistance programs.
Sec. 104. Standards for appointment and practice of physicians in 
              Department of Veterans Affairs medical facilities.

                     TITLE II--HEALTH CARE MATTERS

Sec. 201. Repeal of certain annual reporting requirements.
Sec. 202. Modifications to annual Gulf War research report.
Sec. 203. Payment for care furnished to CHAMPVA beneficiaries.
Sec. 204. Payor provisions for care furnished to certain children of 
              Vietnam veterans.
Sec. 205. Disclosures from certain medical records.
Sec. 206. Disclosure to Secretary of health-plan contract information 
              and social security number of certain veterans receiving 
              care.
Sec. 207. Enhancement of quality management.
Sec. 208. Reports on improvements to Department health care quality 
              management.

[[Page S600]]

Sec. 209. Pilot program on training and certification for family 
              caregiver personal care attendants for veterans and 
              members of the Armed Forces with traumatic brain injury.
Sec. 210. Pilot program on provision of respite care to members of the 
              Armed Forces and veterans with traumatic brain injury by 
              students in graduate programs of education related to 
              mental health or rehabilitation.
Sec. 211. 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. 212. Specialized residential care and rehabilitation for certain 
              veterans.
Sec. 213. Authority to disclose medical records to third party for 
              collection of charges for provision of certain care.
Sec. 214. Expanded study on the health impact of Project Shipboard 
              Hazard and Defense.
Sec. 215. Use of non-Department facilities for rehabilitation of 
              individuals with traumatic brain injury.
Sec. 216. Inclusion of federally recognized tribal organizations in 
              certain programs for State veterans homes.
Sec. 217. Pilot program on provision of dental insurance plans to 
              veterans and survivors and dependents of veterans.

                 TITLE III--WOMEN VETERANS HEALTH CARE

Sec. 301. Report on barriers to receipt of health care for women 
              veterans.
Sec. 302. Plan to improve provision of health care services to women 
              veterans.
Sec. 303. Independent study on health consequences of women veterans of 
              military service in Operation Iraqi Freedom and Operation 
              Enduring Freedom.
Sec. 304. Training and certification for mental health care providers 
              on care for veterans suffering from sexual trauma.
Sec. 305. Pilot program on counseling in retreat settings for women 
              veterans newly separated from service in the Armed 
              Forces.
Sec. 306. Report on full-time women veterans program managers at 
              medical centers.
Sec. 307. Service on certain advisory committees of women recently 
              separated from service in the Armed Forces.
Sec. 308. Pilot program on subsidies for child care for certain 
              veterans receiving health care.
Sec. 309. Care for newborn children of women veterans receiving 
              maternity care.

                      TITLE IV--MENTAL HEALTH CARE

Sec. 401. Eligibility of members of the Armed Forces who serve in 
              Operation Iraqi Freedom or Operation Enduring 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.
Sec. 404. Transfer of funds to Secretary of Health and Human Services 
              for Graduate Psychology Education program.

                       TITLE V--HOMELESS VETERANS

Sec. 501. Pilot program on financial support for entities that 
              coordinate the provision of supportive services to 
              formerly homeless veterans residing on certain military 
              property.
Sec. 502. Pilot program on financial support of entities that 
              coordinate the provision of supportive services to 
              formerly homeless veterans residing in permanent housing.
Sec. 503. Pilot program on financial support of entities that provide 
              outreach to inform certain veterans about pension 
              benefits.
Sec. 504. Pilot program on financial support of entities that provide 
              transportation assistance, child care assistance, and 
              clothing assistance to veterans entitled to a 
              rehabilitation program.
Sec. 505. Assessment of pilot programs.

        TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

Sec. 601. General authorities on establishment of corporations.
Sec. 602. Clarification of purposes of corporations.
Sec. 603. Modification of requirements for boards of directors of 
              corporations.
Sec. 604. Clarification of powers of corporations.
Sec. 605. Redesignation of section 7364A of title 38, United States 
              Code.
Sec. 606. Improved accountability and oversight of corporations.

                  TITLE VII--MISCELLANEOUS PROVISIONS

Sec. 701. Expansion of authority for Department of Veterans Affairs 
              police officers.
Sec. 702. Uniform allowance for Department of Veterans Affairs police 
              officers.

     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 or repeal to 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--DEPARTMENT PERSONNEL MATTERS

     SEC. 101. 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) 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.
       ``(B) Before submitting notice under subparagraph (A), 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) An appointment of a registered nurse under this 
     chapter, whether on a full-time basis or a part-time basis, 
     shall be for a probationary period ending upon the completion 
     by the person so appointed of a number of hours of work 
     pursuant to such appointment that the Secretary considers 
     appropriate for such appointment but not more than 4,180 
     hours.
       ``(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 4,180 Hours.--Section 7405 is 
     amended by adding at the end the following new subsection:
       ``(g)(1) Employment of a registered nurse on a temporary 
     part-time basis under subsection (a)(1) shall be for a 
     probationary period ending upon the completion by the person 
     so employed of a number of hours of work pursuant to such 
     employment that the Secretary considers appropriate for such 
     employment but not more than 4,180 hours.
       ``(2) 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).''.
       (d) Waiver of Offset From Pay for Certain Reemployed 
     Annuitants.--
       (1) In general.--Section 7405, as amended by subsection 
     (c), is further amended by adding at the end the following 
     new subsection:
       ``(h)(1) The Secretary may waive the application of 
     sections 8344 and 8468 of title 5 (relating to annuities and 
     pay on reemployment) or any other similar provision of law 
     under a Government retirement system on a case-by-case basis 
     for an annuitant reemployed on a temporary basis under the 
     authority of subsection (a) in a position described under 
     paragraph (1) of that subsection.
       ``(2) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall not be considered an employee for purposes of 
     any Government retirement system.
       ``(3) An annuitant to whom a waiver under paragraph (1) is 
     in effect shall be subject to the provisions of chapter 71 of 
     title 5 (including all labor authority and labor 
     representative collective bargaining agreements) applicable 
     to the position to which appointed.
       ``(4) In this subsection:
       ``(A) The term `annuitant' means an annuitant under a 
     Government retirement system.
       ``(B) The term `employee' has the meaning under section 
     2105 of title 5.

[[Page S601]]

       ``(C) The term `Government retirement system' means a 
     retirement system established by law for employees of the 
     Government of the United States.''.
       (2) Effective date.--The amendment made by paragraph (1) 
     shall take effect on the date that is six months after the 
     date of the enactment of this Act, and shall apply to pay 
     periods beginning on or after such effective date.
       (e) 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) 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).''.
       (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.
       (f) Comparability Pay Program for Appointees to the Office 
     of the Under Secretary for Health.--Section 7410 is amended--
       (1) by striking ``The Secretary may'' and inserting ``(a) 
     In General.--The Secretary may''; and
       (2) by adding at the end the following new subsection:
       ``(b) Comparability Pay for Appointees to the Office of the 
     Under Secretary for Health.--(1) The Secretary may authorize 
     the Under Secretary for Health to provide comparability pay 
     of not more than $100,000 per year to individuals of the 
     Veterans Health Administration appointed under section 7306 
     of this title who are not physicians or dentists and to 
     individuals who are appointed to Senior Executive Service 
     positions (as such term is defined in section 3132(a) of 
     title 5) to achieve annual pay levels for such individuals 
     that are comparable with annual pay levels of individuals 
     with similar positions in the private sector.
       ``(2) Comparability pay under paragraph (1) for an 
     individual is in addition to all other pay, awards, and 
     performance bonuses paid to such individual under this title.
       ``(3) Except as provided in paragraph (4), comparability 
     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.
       ``(4) Comparability pay under paragraph (1) for an 
     individual shall not be considered basic pay for purposes of 
     adverse actions under subchapter V of this chapter.
       ``(5) Comparability 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.''.
       (g) Special Incentive Pay for Department Pharmacist 
     Executives.--Section 7410, as amended by subsection (f) of 
     this section, is further amended by adding at the end the 
     following new subsection:
       ``(c) 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.''.
       (h) 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.''.
       (i) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) 
     is amended by striking ``level V'' and inserting ``level 
     IV''.
       (j) 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.''.
       (k) 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.''.
       (l) Increased Limitation on Special Pay for Nurse 
     Executives.--Section 7452(g)(2) is amended by striking 
     ``$25,000'' and inserting ``$100,000''.
       (m) 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.''.
       (n) Exemption of Additional Nurse Positions From Limitation 
     on Increase in Rates of Basic Pay.--Section 7455(c)(1) is 
     amended by inserting after ``nurse anesthetists,'' the 
     following: ``licensed practical nurses, licensed vocational 
     nurses, and nursing positions otherwise covered by title 
     5,''.

[[Page S602]]

     SEC. 102. 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 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, dismissal 
     or discharge of the staff, or 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 periods of service within a pay 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)--
       (i) in subparagraph (A), by striking ``40-hour basic work 
     week'' and inserting ``80-hour pay period'';
       (ii) in subparagraph (B), by striking ``regularly scheduled 
     36-hour tour of duty within the work week'' and inserting 
     ``scheduled 72-hour period of service within the bi-weekly 
     pay period'';
       (iii) in subparagraph (C)--

       (I) in clause (i), by striking ``regularly scheduled 36-
     hour tour of duty within an administrative work week'' and 
     inserting ``scheduled 72-hour period of service within an 
     administrative pay period'';
       (II) in clause (ii), by striking ``regularly scheduled 12-
     hour tour of duty'' and inserting ``scheduled 12-hour period 
     of service''; and
       (III) in clause (iii), by striking ``regularly scheduled 
     36-hour tour of duty work week'' and inserting ``scheduled 
     72-hour period of service pay period''; and

       (iv) in subparagraph (D), by striking ``regularly scheduled 
     12-hour tour of duty'' and inserting ``scheduled 12-hour 
     period of service''; and
       (C) in paragraph (3), by striking ``regularly scheduled 12-
     hour tour of duty'' and inserting ``scheduled 12-hour period 
     of service''.

     SEC. 103. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE 
                   PROGRAMS.

       (a) Reinstatement of Health Professionals Educational 
     Assistance Scholarship Program.--
       (1) In general.--Section 7618 is amended by striking 
     ``December 31, 1998'' and inserting ``December 31, 2014''.
       (2) 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.''.
       (b) Improvements to Education Debt Reduction Program.--
       (1) 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.
       (2) Eligibility.--Section 7682 is amended--
       (A) in subsection (a)(1), by striking ``a recently 
     appointed'' and inserting ``an''; and
       (B) by striking subsection (c).
       (3) Maximum amounts of assistance.--Section 7683(d)(1) is 
     amended--
       (A) by striking ``$44,000'' and inserting ``$60,000''; and
       (B) by striking ``$10,000'' and inserting ``$12,000''.
       (c) Loan Repayment Program for Clinical Researchers From 
     Disadvantaged Backgrounds.--
       (1) In general.--The Secretary of Veterans Affairs may, in 
     consultation with the Secretary of Health and Human Services, 
     utilize 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.
       (2) Limitations.--The exercise by the Secretary of Veterans 
     Affairs of the authorities referred to in paragraph (1) 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)).
       (3) Funding.--Amounts for the repayment of principal and 
     interest of educational loans under this subsection shall be 
     derived from amounts available to the Secretary of Veterans 
     Affairs for the Veterans Health Administration for Medical 
     Services.

     SEC. 104. STANDARDS FOR APPOINTMENT AND PRACTICE OF 
                   PHYSICIANS IN DEPARTMENT OF VETERANS AFFAIRS 
                   MEDICAL FACILITIES.

       (a) Standards.--
       (1) In general.--Subchapter I of chapter 74 is amended by 
     inserting after section 7402 the following new section:

     ``Sec. 7402A. Appointment and practice of physicians: 
       standards

       ``(a) In General.--The Secretary shall, acting through the 
     Under Secretary for Health, prescribe standards to be met by 
     individuals in order to qualify for appointment in the 
     Veterans Health Administration in the position of physician 
     and to practice as a physician in medical facilities of the 
     Administration. The standards shall incorporate the 
     requirements of this section.
       ``(b) Disclosure of Certain Information Before 
     Appointment.--Each individual seeking appointment in the 
     Veterans Health Administration in the position of physician 
     shall do the following:
       ``(1) Provide the Secretary a full and complete explanation 
     of the following:
       ``(A) Each lawsuit, civil action, or other claim (whether 
     open or closed) brought against the individual for medical 
     malpractice or negligence (other than a lawsuit, action, or 
     claim closed without any judgment against or payment by or on 
     behalf of the individual).
       ``(B) Each payment made by or on behalf of the individual 
     to settle any lawsuit, action, or claim covered by 
     subparagraph (A).
       ``(C) Each investigation or disciplinary action taken 
     against the individual relating to the individual's 
     performance as a physician.
       ``(2) Submit a written request and authorization to the 
     State licensing board of each State in which the individual 
     holds or has held a license to practice medicine to disclose 
     to the Secretary any information in the records of such State 
     on the following:
       ``(A) Each lawsuit, civil action, or other claim brought 
     against the individual for medical malpractice or negligence 
     covered by paragraph (1)(A) that occurred in such State.
       ``(B) Each payment made by or on behalf of the individual 
     to settle any lawsuit, action, or claim covered by 
     subparagraph (A).
       ``(C) Each medical malpractice judgment against the 
     individual by the courts or administrative agencies or bodies 
     of such State.
       ``(D) Each disciplinary action taken or under consideration 
     against the individual by an administrative agency or body of 
     such State.
       ``(E) Any change in the status of the license to practice 
     medicine issued the individual by such State, including any 
     voluntary or nondisciplinary surrendering of such license by 
     the individual.
       ``(F) Any open investigation of the individual by an 
     administrative agency or body of such State, or any 
     outstanding allegation against the individual before such an 
     administrative agency or body.
       ``(G) Any written notification by the State to the 
     individual of potential termination of a license for cause or 
     otherwise.
       ``(c) Disclosure of Certain Information Following 
     Appointment.--(1) Each individual appointed in the Veterans 
     Health Administration in the position of physician after the 
     date of the enactment of this section shall, as a condition 
     of service under the appointment, disclose to the Secretary, 
     not later than 30 days after the occurrence of such event, 
     the following:
       ``(A) A judgment against the individual for medical 
     malpractice or negligence.

[[Page S603]]

       ``(B) A payment made by or on behalf of the individual to 
     settle any lawsuit, action, or claim disclosed under 
     paragraph (1) or (2) of subsection (b).
       ``(C) Any disposition of or material change in a matter 
     disclosed under paragraph (1) or (2) of subsection (b).
       ``(2) Each individual appointed in the Veterans Health 
     Administration in the position of physician as of the date of 
     the enactment of this section shall do the following:
       ``(A) Not later than the end of the 60-day period beginning 
     on the date of the enactment of this section and as a 
     condition of service under the appointment after the end of 
     that period, submit the request and authorization described 
     in subsection (b)(2).
       ``(B) Agree, as a condition of service under the 
     appointment, to disclose to the Secretary, not later than 30 
     days after the occurrence of such event, the following:
       ``(i) A judgment against the individual for medical 
     malpractice or negligence.
       ``(ii) A payment made by or on behalf of the individual to 
     settle any lawsuit, action, or claim disclosed pursuant to 
     subparagraph (A) or under this subparagraph.
       ``(iii) Any disposition of or material change in a matter 
     disclosed pursuant to subparagraph (A) or under this 
     subparagraph.
       ``(3) Each individual appointed in the Veterans Health 
     Administration in the position of physician shall, as part of 
     the biennial review of the performance of the physician under 
     the appointment, submit the request and authorization 
     described in subsection (b)(2). The requirement of this 
     paragraph is in addition to the requirements of paragraph (1) 
     or (2), as applicable.
       ``(d) Investigation of Disclosed Matters.--(1) The Director 
     of the Veterans Integrated Services Network (VISN) in which 
     an individual is seeking appointment in the Veterans Health 
     Administration in the position of physician shall perform an 
     investigation (in such manner as the standards required by 
     this section shall specify) of each matter disclosed under 
     subsection (b) with respect to the individual.
       ``(2) The Director of the Veterans Integrated Services 
     Network in which an individual is appointed in the Veterans 
     Health Administration in the position of physician shall 
     perform an investigation (in a manner so specified) of each 
     matter disclosed under subsection (c) with respect to the 
     individual.
       ``(3) The results of each investigation performed under 
     this subsection shall be fully documented.
       ``(e) Approval of Appointments by Directors of VISNs.--(1) 
     An individual may not be appointed in the Veterans Health 
     Administration in the position of physician without the 
     approval of the Director of the Veterans Integrated Services 
     Network in which the individual will first serve under the 
     appointment.
       ``(2) In approving the appointment under this subsection of 
     an individual for whom any matters have been disclosed under 
     subsection (b), a Director shall--
       ``(A) certify in writing the completion of the performance 
     of the investigation under subsection (d)(1) of each such 
     matter, including the results of such investigation; and
       ``(B) provide a written justification why any matters 
     raised in the course of such investigation do not disqualify 
     the individual from appointment.
       ``(f) Enrollment of Physicians With Practice Privileges in 
     Proactive Disclosure Service.--Each medical facility of the 
     Department at which physicians are extended the privileges of 
     practice shall enroll each physician extended such privileges 
     in the Proactive Disclosure Service of the National 
     Practitioner Data Bank.
       ``(g) Encouraging Hiring of Physicians With Board 
     Certification.--(1) The Secretary shall, for each performance 
     contract with a Director of a Veterans Integrated Services 
     Network (VISN), include in such contract a provision that 
     encourages such director to hire physicians who are board 
     eligible or board certified in the specialty in which the 
     physicians will practice.
       ``(2) The Secretary may determine the nature and manner of 
     the provision described in paragraph (1).''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 74 is amended by inserting after the 
     item relating to section 7402 the following new item:

``7402A. Appointment and practice of physicians: standards.''.
       (b) Effective Date and Applicability.--
       (1) Effective date.--Except as provided in paragraphs (2) 
     and (3), the amendments made by subsection (a) shall take 
     effect on the date of the enactment of this Act.
       (2) Applicability of certain requirements to physicians 
     practicing on effective date.--In the case of an individual 
     appointed to the Veterans Health Administration in the 
     position of physician as of the date of the enactment of this 
     Act, the requirements of section 7402A(f) of title 38, United 
     States Code, as added by subsection (a) of this section, 
     shall take effect on the date that is 60 days after the date 
     of the enactment of this Act.
       (3) Applicability of requirements related to hiring of 
     physicians with board certification.--The requirement of 
     section 7402A(g) of such title, as added by subsection (a), 
     shall begin with the first cycle of performance contracts for 
     directors of Veterans Integrated Services Networks beginning 
     after the date of the enactment of this Act.

                     TITLE II--HEALTH CARE MATTERS

     SEC. 201. 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. 202. MODIFICATIONS TO ANNUAL GULF WAR RESEARCH REPORT.

       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, 2008, and July 
     1 of each of the five following years''.

     SEC. 203. PAYMENT FOR CARE FURNISHED TO CHAMPVA 
                   BENEFICIARIES.

       Section 1781 is amended at the end by adding 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. 204. PAYOR PROVISIONS FOR CARE FURNISHED TO CERTAIN 
                   CHILDREN OF VIETNAM VETERANS.

       (a) Children of Vietnam Veterans Born With Spina Bifida.--
     Section 1803 is amended--
       (1) by redesignating subsection (c) as subsection (d); and
       (2) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c) Where payment by the Secretary under this section is 
     less than the amount of the charges billed, the health care 
     provider or agent of the health care provider may seek 
     payment for the difference between the amount billed and the 
     amount paid by the Secretary from a responsible third party 
     to the extent that the provider or agent thereof would be 
     eligible to receive payment for such care or services from 
     such third party, but--
       ``(1) the health care provider or agent for the health care 
     provider may not impose any additional charge on the 
     beneficiary who received the medical care, or the family of 
     such beneficiary, for any service or item for which the 
     Secretary has made payment under this section;
       ``(2) the total amount of payment a provider or agent of 
     the provider may receive for care and services furnished 
     under this section may not exceed the amount billed to the 
     Secretary; and
       ``(3) the Secretary, upon request, shall disclose to such 
     third party information received for the purposes of carrying 
     out this section.''.
       (b) Children of Women Vietnam Veterans Born With Birth 
     Defects.--Section 1813 is amended--
       (1) by redesignating subsection (c) as subsection (d); and
       (2) by inserting after subsection (b) the following new 
     subsection (c):
       ``(c) Seeking Payment From Third Parties.--Where payment by 
     the Secretary under this section is less than the amount of 
     the charges billed, the health care provider or agent of the 
     health care provider may seek payment for the difference 
     between the amount billed and the amount paid by the 
     Secretary from a responsible third party to the extent that 
     the health care provider or agent thereof would be eligible 
     to receive payment for such care or services from such third 
     party, but--
       ``(1) the health care provider or agent for the health care 
     provider may not impose any additional charge on the 
     beneficiary who received medical care, or the family of such 
     beneficiary, for any service or item for which the Secretary 
     has made payment under this section;
       ``(2) the total amount of payment a provider or agent of 
     the provider may receive for care and services furnished 
     under this section may not exceed the amount billed to the 
     Secretary; and
       ``(3) the Secretary, upon request, shall disclose to such 
     third party information received for the purposes of carrying 
     out this section.''.

     SEC. 205. DISCLOSURES FROM CERTAIN MEDICAL RECORDS.

       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. 206. DISCLOSURE TO SECRETARY OF HEALTH-PLAN CONTRACT 
                   INFORMATION AND SOCIAL SECURITY NUMBER OF 
                   CERTAIN VETERANS RECEIVING CARE.

       (a) In General.--Subchapter I of chapter 17 is amended by 
     adding at the end the following new section:

     ``Sec. 1709. Disclosure to Secretary of health-plan contract 
       information and social security number of certain veterans 
       receiving care

       ``(a) Required Disclosure of Health-Plan Contracts.--(1) 
     Any individual who

[[Page S604]]

     applies for or is in receipt of care described in paragraph 
     (2) shall, at the time of such application, or otherwise when 
     requested by the Secretary, submit to the Secretary such 
     current information as the Secretary may require to identify 
     any health-plan contract (as defined in section 1729(i) of 
     this title) under which such individual is covered, to 
     include, as applicable--
       ``(A) the name, address, and telephone number of such 
     health-plan contract;
       ``(B) the name of the individual's spouse, if the 
     individual's coverage is under the spouse's health-plan 
     contract;
       ``(C) the plan number; and
       ``(D) the plan's group code.
       ``(2) The care described in this paragraph is--
       ``(A) hospital, nursing home, or domiciliary care;
       ``(B) medical, rehabilitative, or preventive health 
     services; or
       ``(C) other medical care under laws administered by the 
     Secretary.
       ``(b) Required Disclosure of Social Security Number.--(1) 
     Any individual who applies for or is in receipt of care 
     described in paragraph (2) shall, at the time of such 
     application, or otherwise when requested by the Secretary, 
     submit to the Secretary--
       ``(A) the individual's social security number; and
       ``(B) the social security number of any dependent or 
     Department beneficiary on whose behalf, or based upon whom, 
     such individual applies for or is in receipt of such care.
       ``(2) The care described in this paragraph is--
       ``(A) hospital, nursing home, or domiciliary care;
       ``(B) medical, rehabilitative, or preventive health 
     services; or
       ``(C) other medical care under laws administered by the 
     Secretary.
       ``(3) This subsection does not require an individual to 
     furnish the Secretary with a social security number for any 
     individual to whom a social security number has not been 
     assigned.
       ``(c) Failure to Disclose Social Security Number.--(1) The 
     Secretary shall deny an individual's application for, or may 
     terminate an individual's enrollment in, the system of 
     patient enrollment established by the Secretary under section 
     1705 of this title, if such individual does not provide the 
     social security number required or requested to be submitted 
     pursuant to subsection (b).
       ``(2) Following a denial or termination under paragraph (1) 
     with respect to an individual, the Secretary may, upon 
     receipt of the information required or requested under 
     subsection (b), approve such individual's application or 
     reinstate such individual's enrollment (if otherwise in 
     order), for such medical care and services provided on and 
     after the date of such receipt of information.
       ``(d) Construction.--Nothing in this section shall be 
     construed as authority to deny medical care and treatment to 
     an individual in a medical emergency.''.
       (b) Clerical Amendment.--The table of sections at the 
     beginning of such chapter 17 is amended by inserting after 
     the item relating to section 1708 the following new item:

``1709. Disclosure to Secretary of health-plan contract information and 
              social security number of certain veterans receiving 
              care.''.

     SEC. 207. 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 
     of the American College of Surgeons, 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 (VISN) 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 are 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(b) 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 (NSQIP), 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.

[[Page S605]]

     SEC. 208. REPORTS ON IMPROVEMENTS TO DEPARTMENT HEALTH CARE 
                   QUALITY MANAGEMENT.

       (a) Report.--Not later than December 15, 2009, and each 
     year thereafter through 2012, the Secretary of Veterans 
     Affairs shall submit to the congressional veterans affairs 
     committees a report on the implementation of sections 104 and 
     207 of this Act and the amendments made by such sections 
     during the preceding fiscal year. Each report shall include, 
     for the fiscal year covered by such report, the following:
       (1) A comprehensive description of the implementation of 
     sections 104 and 207 of this Act and the amendments made by 
     such sections.
       (2) Such recommendations as the Secretary considers 
     appropriate for legislative or administrative action to 
     improve the authorities and requirements in such sections and 
     the amendments made by such sections or to otherwise improve 
     the quality of health care and the quality of the physicians 
     in the Veterans Health Administration.
       (b) Congressional Veterans Affairs Committees Defined.--In 
     this section, the term ``congressional veterans affairs 
     committees'' means--
       (1) the Committees on Veterans' Affairs and Appropriations 
     of the Senate; and
       (2) the Committees on Veterans' Affairs and Appropriations 
     of the House of Representatives.

     SEC. 209. PILOT PROGRAM ON TRAINING AND CERTIFICATION FOR 
                   FAMILY CAREGIVER PERSONAL CARE ATTENDANTS FOR 
                   VETERANS AND MEMBERS OF THE ARMED FORCES WITH 
                   TRAUMATIC BRAIN INJURY.

       (a) Pilot Program Authorized.--The Secretary of Veterans 
     Affairs shall, in collaboration with the Secretary of 
     Defense, carry out a pilot program to assess the feasibility 
     and advisability of providing training and certification for 
     family caregivers of veterans and members of the Armed Forces 
     with traumatic brain injury as personal care attendants of 
     such veterans and members.
       (b) Duration of Program.--The pilot program required by 
     subsection (a) shall be carried out during the three-year 
     period beginning on the date of the commencement of the pilot 
     program.
       (c) Locations.--
       (1) In general.--The pilot program under this section shall 
     be carried out--
       (A) in three medical facilities of the Department of 
     Veterans Affairs; and
       (B) if determined appropriate by the Secretary of Veterans 
     Affairs and the Secretary of Defense, one medical facility of 
     the Department of Defense.
       (2) Emphasis on polytrauma centers.--In selecting the 
     locations of the pilot program at facilities of the 
     Department of Veterans Affairs, the Secretary of Veterans 
     Affairs shall give special emphasis to the polytrauma centers 
     of the Department of Veterans Affairs designated as Tier I 
     polytrauma centers.
       (d) Training Curricula.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     develop curricula for the training of personal care 
     attendants under the pilot program under this section. Such 
     curricula shall incorporate--
       (A) applicable standards and protocols utilized by 
     certification programs of national brain injury care 
     specialist organizations; and
       (B) best practices recognized by caregiving organizations.
       (2) Use of existing curricula.--In developing the curricula 
     required by paragraph (1), the Secretary of Veterans Affairs 
     shall, to the extent practicable, utilize and expand upon 
     training curricula developed pursuant to section 744(b) of 
     the John Warner National Defense Authorization Act for Fiscal 
     Year 2007 (Public Law 109-364; 120 Stat. 2308).
       (e) Participation in Programs.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     determine the eligibility of a family member of a veteran or 
     member of the Armed Forces for participation in the pilot 
     program under this section.
       (2) Basis for determination.--A determination made under 
     paragraph (1) shall be based on the needs of the veteran or 
     member of the Armed Forces concerned, as determined by the 
     physician of such veteran or member.
       (f) Eligibility for Compensation.--A family caregiver of a 
     veteran or member of the Armed Forces who receives 
     certification as a personal care attendant under the pilot 
     program under this section shall be eligible for compensation 
     from the Department of Veterans Affairs for care provided to 
     such veteran or member.
       (g) Costs of Training.--
       (1) Training of families of veterans.--Any costs of 
     training provided under the pilot program under this section 
     for family members of veterans shall be borne by the 
     Secretary of Veterans Affairs.
       (2) Training of families of members of the armed forces.--
     The Secretary of Defense shall reimburse the Secretary of 
     Veterans Affairs for any costs of training provided under the 
     pilot program for family members of members of the Armed 
     Forces.
       (h) Assessment of Family Caregiver Needs.--
       (1) In general.--The Secretary of Veterans Affairs may 
     provide to a family caregiver who receives training under the 
     pilot program under this section--
       (A) an assessment of their needs with respect to their role 
     as a family caregiver; and
       (B) a referral to services and support that--
       (i) are relevant to any needs identified in such 
     assessment; and
       (ii) are provided in the community where the family 
     caregiver resides, including such services and support 
     provided by community-based organizations, publicly-funded 
     programs, and the Department of Veterans Affairs.
       (2) Use of existing tools.--In developing and administering 
     an assessment under paragraph (1), the Secretary shall, to 
     the extent practicable, use and expand upon caregiver 
     assessment tools already developed and in use by the 
     Department.
       (i) Report.--Not later than 2 years after the date of the 
     enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to Congress a report on the pilot program 
     carried out under this section, including the recommendations 
     of the Secretary with respect to expansion or modification of 
     the pilot program.
       (j) Construction.--Nothing in this section shall be 
     construed--
       (1) to establish a mandate or right for a family caregiver 
     to be trained and certified under this section; and
       (2) to prohibit the Secretary from considering or adopting 
     the preference of a veteran or member of the Armed Forces for 
     services provided by a personal care attendant who is not a 
     family caregiver.
       (k) Family Caregiver Defined.--In this section, with 
     respect to member of the Armed Forces or a veteran with 
     traumatic brain injury, the term ``family caregiver'' means a 
     family member of such member or veteran, or such other 
     individual of similar affinity to such member or veteran as 
     the Secretary proscribes, who is providing care to such 
     member or veteran for such traumatic brain injury.

     SEC. 210. PILOT PROGRAM ON PROVISION OF RESPITE CARE TO 
                   MEMBERS OF THE ARMED FORCES AND VETERANS WITH 
                   TRAUMATIC BRAIN INJURY BY STUDENTS IN GRADUATE 
                   PROGRAMS OF EDUCATION RELATED TO MENTAL HEALTH 
                   OR REHABILITATION.

       (a) Pilot Program Authorized.--The Secretary of Veterans 
     Affairs shall, in collaboration with the Secretary of 
     Defense, carry out a pilot program to assess the feasibility 
     and advisability of providing respite care to members of the 
     Armed Forces and veterans described in subsection (c) through 
     students enrolled in graduate programs of education described 
     in subsection (d)(1) to provide--
       (1) relief to the family caregivers of such members and 
     veterans from the responsibilities associated with providing 
     care to such members and veterans; and
       (2) socialization and cognitive skill development to such 
     members and veterans.
       (b) Duration of Program.--The pilot program required by 
     subsection (a) shall be carried out during the three-year 
     period beginning on the date of the commencement of the pilot 
     program.
       (c) Covered Members and Veterans.--The members of the Armed 
     Forces and veterans described in this subsection are the 
     individuals as follows:
       (1) Members of the Armed Forces who have been diagnosed 
     with traumatic brain injury, including limitations of 
     ambulatory mobility, cognition, and verbal abilities.
       (2) Veterans who have been so diagnosed.
       (d) Program Locations.--
       (1) In general.--The pilot program shall be carried out at 
     not more than 10 locations selected by the Secretary of 
     Veterans Affairs for purposes of the pilot program. Each 
     location so selected shall be a medical facility of the 
     Department of Veterans Affairs that is in close proximity to, 
     or that has a relationship, affiliation, or established 
     partnership with, an institution of higher education that has 
     a graduate program in an appropriate mental health or 
     rehabilitation related field, such as social work, nursing, 
     psychology, occupational therapy, physical therapy, or 
     interdisciplinary training programs.
       (2) Considerations.--In selecting medical facilities of the 
     Department for the pilot program, the Secretary shall give 
     special consideration to the following:
       (A) The polytrauma centers of the Department designated as 
     Tier I polytrauma centers.
       (B) Facilities of the Department in regions with a high 
     concentration of veterans with traumatic brain injury.
       (e) Scope of Assistance.--
       (1) Use of graduate students.--In carrying out the pilot 
     program, the Secretary shall--
       (A) recruit students enrolled in a graduate program of 
     education selected by the Secretary under subsection (d)(1) 
     to provide respite care to the members of the Armed Forces 
     and veterans described in subsection (c);
       (B) train such students to provide respite care to such 
     members and veterans; and
       (C) match such students with such members and veterans in 
     the student's local area for the provision of individualized 
     respite care to such members and veterans.
       (2) Determinations in conjunction with heads of graduate 
     programs of education.--The Secretary shall determine, in 
     collaboration with the head of the graduate program of 
     education chosen to participate in the pilot program under 
     subsection (d)(1), the following:
       (A) The amount of training that a student shall complete 
     before providing respite care under the pilot program.

[[Page S606]]

       (B) The number of hours of respite care to be provided by 
     the students who participate in the pilot program.
       (C) The requirements for successful participation by a 
     student in the pilot program.
       (f) Training Standards and Best Practices.--In providing 
     training under subsection (e)(1)(B), the Secretary shall 
     use--
       (1) applicable standards and protocols used by 
     certification programs of national brain injury care 
     specialist organizations in the provision of respite care 
     training; and
       (2) best practices recognized by caregiving organizations.
       (g) Definitions.--In this section:
       (1) Family caregiver.--With respect to member of the Armed 
     Forces or a veteran with traumatic brain injury, the term 
     ``family caregiver'' means a relative, partner, or friend of 
     such member or veteran who is providing care to such member 
     or veteran for such traumatic brain injury.
       (2) Respite care.--The term ``respite care'' means the 
     temporary provision of care to an individual to provide 
     relief to the regular caregiver of the individual from the 
     ongoing responsibility of providing care to such individual.

     SEC. 211. 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 two-year period beginning on 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 of Veterans Affairs 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 how the proposal was developed in 
     consultation with the Department of Veterans Affairs.
       (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 increase 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. 212. 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. 213. AUTHORITY TO DISCLOSE MEDICAL RECORDS TO THIRD 
                   PARTY FOR COLLECTION OF CHARGES FOR PROVISION 
                   OF CERTAIN CARE.

       (a) Limited Exception to Confidentiality of Medical 
     Records.--Section 5701 is amended by adding at the end the 
     following new subsection:
       ``(l) Under regulations that the Secretary shall prescribe, 
     the Secretary may disclose the name or address, or both, of 
     any individual who is a present or former member of the Armed 
     Forces, or who is a dependent of a present or former member 
     of the Armed Forces, to a third party, as defined in section 
     1729(i)(3)(D) of this title, in order to enable the Secretary 
     to collect reasonable charges under section 1729(a)(2)(E) of 
     this title for care or services provided for a non-service-
     connected disability.''.
       (b) Disclosures From Certain Medical Records.--Section 
     7332(b)(2), as amended by section 205 of this Act, is further 
     amended by adding at the end the following new subparagraph:
       ``(G) To a third party, as defined in section 1729(i)(3)(D) 
     of this title, to collect reasonable charges under section 
     1729(a)(2)(E) of this title for care or services provided for 
     a non-service-connected disability.''.

     SEC. 214. 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) Utilization of Existing Studies.--The study required by 
     subsection (a) may use results from the study covered in the 
     report entitled ``Long-Term Health Effects of Participation 
     in Project SHAD'' of the Institute of Medicine of the 
     National Academies.

     SEC. 215. 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. 216. INCLUSION OF FEDERALLY RECOGNIZED TRIBAL 
                   ORGANIZATIONS IN CERTAIN PROGRAMS FOR STATE 
                   VETERANS HOMES.

       (a) Treatment of Tribal Organization Health Facilities as 
     State Homes.--Section 8138 is amended--
       (1) by redesignating subsection (e) as subsection (f); and
       (2) by inserting after subsection (d) the following new 
     subsection (e):
       ``(e)(1) A health facility (or certain beds in a health 
     facility) of a tribal organization is treatable as a State 
     home under subsection (a) in accordance with the provisions 
     of that subsection.
       ``(2) Except as provided in paragraph (3), the provisions 
     of this section shall apply to a health facility (or certain 
     beds in such facility) treated as a State home under 
     subsection (a) by reason of this subsection to the same 
     extent as health facilities (or beds) treated as a State home 
     under subsection (a).
       ``(3) Subsection (f) shall not apply to the treatment of 
     health facilities (or certain beds in such facilities) of 
     tribal organizations as a State home under subsection (a).''.
       (b) State Home Facilities for Domiciliary, Nursing, and 
     Other Care.--
       (1) In general.--Chapter 81 is further amended--
       (A) in section 8131, by adding at the end the following new 
     paragraph:
       ``(5) The term `tribal organization' has the meaning given 
     such term in section 3765 of this title.'';
       (B) in section 8132, by inserting ``and tribal 
     organizations'' after ``the several States''; and
       (C) by inserting after section 8133 the following new 
     section:

[[Page S607]]

     ``Sec. 8133A. Tribal organizations

       ``(a) Authority to Award Grants.--The Secretary may award a 
     grant to a tribal organization under this subchapter in order 
     to carry out the purposes of this subchapter.
       ``(b) Manner and Condition of Grant Awards.--(1) Grants to 
     tribal organizations under this section shall be awarded in 
     the same manner, and under the same conditions, as grants 
     awarded to the several States under the provisions of this 
     subchapter, subject to such exceptions as the Secretary shall 
     prescribe for purposes of this subchapter to take into 
     account the unique circumstances of tribal organizations.
       ``(2) For purposes of according priority under subsection 
     (c)(2) of section 8135 of this title to an application 
     submitted under subsection (a) of such section, an 
     application submitted under such subsection (a) by a tribal 
     organization of a State that has previously applied for award 
     of a grant under this subchapter for construction or 
     acquisition of a State nursing home shall be considered under 
     subparagraph (C) of such subsection (c)(2) an application 
     from a tribal organization that has not previously applied 
     for such a grant.''.
       (2) Clerical amendment.--The table of sections at the 
     beginning of chapter 81 is amended by inserting after the 
     item relating to section 8133 the following new item:

``8133A. Tribal organizations.''.

     SEC. 217. 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 this title.
       (2) Any survivor or dependent of a veteran who is eligible 
     for medical care under section 1781 of this title.
       (c) Duration of Program.--The pilot program shall be 
     carried out during the three-year period beginning on the 
     date of the enactment of this Act.
       (d) Pilot Program Locations.--The pilot program shall be 
     carried out in not less than two and not more than four 
     Veterans Integrated Services Networks (VISNs) selected by the 
     Secretary of Veterans Affairs for purposes of the pilot 
     program.
       (e) Administration.--The Secretary of Veterans Affairs 
     shall contract with a dental insurer to administer the dental 
     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 this section 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 of Veterans Affairs 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 utilization 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.

                 TITLE III--WOMEN VETERANS HEALTH CARE

     SEC. 301. REPORT ON BARRIERS TO RECEIPT OF HEALTH CARE FOR 
                   WOMEN VETERANS.

       (a) Report.--Not later than June 1, 2010, 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 barriers to 
     the receipt of comprehensive health care through the 
     Department of Veterans Affairs that are encountered by women 
     veterans, especially veterans of Operation Iraqi Freedom and 
     Operation Enduring Freedom.
       (b) Elements.--The report required by subsection (a) shall 
     include the following:
       (1) An identification and assessment of the following:
       (A) Any stigma perceived or associated with seeking mental 
     health care services through the Department of Veterans 
     Affairs.
       (B) The effect on access to care through the Department of 
     driving distance or availability of other forms of 
     transportation to the nearest appropriate facility of the 
     Department.
       (C) The availability of child care.
       (D) The receipt of health care through women's health 
     clinics, integrated primary care clinics, or both.
       (E) The extent of comprehension of eligibility requirements 
     for health care through the Department, and the scope of 
     health care services available through the Department.
       (F) The quality and nature of the reception of women 
     veterans by Department health care providers and other staff.
       (G) The perception of personal safety and comfort of women 
     veterans in inpatient, outpatient, and behavioral health 
     facilities of the Department.
       (H) The sensitivity of Department health care providers and 
     other staff to issues that particularly affect women.
       (I) The effectiveness of outreach on health care services 
     of the Department that are available to women veterans.
       (J) Such other matters as the Secretary identifies for 
     purposes of the assessment.
       (2) Such recommendations for administrative and legislative 
     action as the Secretary considers appropriate in light of the 
     report.
       (c) Facility of the Department Defined.--In this section, 
     the term ``facility of the Department'' has the meaning given 
     that term in section 1701 of title 38, United States Code.

     SEC. 302. PLAN TO IMPROVE PROVISION OF HEALTH CARE SERVICES 
                   TO WOMEN VETERANS.

       (a) Plan To Improve Services.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     develop a plan--
       (A) to improve the provision of health care services to 
     women veterans; and
       (B) to plan appropriately for the future health care needs, 
     including mental health care needs, of women serving on 
     active duty in the Armed Forces in the combat theaters of 
     Operation Iraqi Freedom and Operation Enduring Freedom.
       (2) Required actions.--In developing the plan required by 
     this subsection, the Secretary of Veterans Affairs shall--
       (A) identify the types of health care services to be 
     available to women veterans at each Department of Veterans 
     Affairs medical center; and
       (B) identify the personnel and other resources required to 
     provide such services to women veterans under the plan at 
     each such medical center.
       (b) Submittal of Plan to Congress.--Not later than 18 
     months after the date of the enactment of this Act, 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 the plan 
     required by this section, along with such recommendations for 
     administrative and legislative action as the Secretary 
     considers appropriate in light of the plan.

     SEC. 303. INDEPENDENT STUDY ON HEALTH CONSEQUENCES OF WOMEN 
                   VETERANS OF MILITARY SERVICE IN OPERATION IRAQI 
                   FREEDOM AND OPERATION ENDURING FREEDOM.

       (a) Study Required.--The Secretary of Veterans Affairs 
     shall enter into an agreement with a non-Department of 
     Veterans Affairs entity for the purpose of conducting a study 
     on health consequences for women veterans of service on 
     active duty in the Armed

[[Page S608]]

     Forces in deployment in Operation Iraqi Freedom and Operation 
     Enduring Freedom.
       (b) Specific Matters Studied.--The study under subsection 
     (a) shall include the following:
       (1) A determination of any association of environmental and 
     occupational exposures and combat in Operation Iraqi Freedom 
     or Operation Enduring Freedom with the general health, mental 
     health, or reproductive health of women who served on active 
     duty in the Armed Forces in Operation Iraqi Freedom or 
     Operation Enduring Freedom.
       (2) A review and analysis of published literature on 
     environmental and occupational exposures of women while 
     serving in the Armed Forces, including combat trauma, 
     military sexual trauma, and exposure to potential teratogens 
     associated with reproductive problems and birth defects.
       (c) Report.--
       (1) In general.--Not later than 18 months after entering 
     into the agreement for the study under subsection (a), the 
     entity described in subsection (a) shall submit to the 
     Secretary of Veterans Affairs and to Congress a report on the 
     study containing such findings and determinations as the 
     entity considers appropriate.
       (2) Responsive report.--Not later than 90 days after the 
     receipt of the report under paragraph (1), the Secretary 
     shall submit to Congress a report setting forth the response 
     of the Secretary to the findings and determinations of the 
     entity described in subsection (a) in the report under 
     paragraph (1).

     SEC. 304. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE 
                   PROVIDERS ON CARE FOR VETERANS SUFFERING FROM 
                   SEXUAL TRAUMA.

       (a) Program Required.--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 implement a program for 
     education, training, certification, and continuing medical 
     education for mental health professionals to specialize in 
     the provision of counseling and care to veterans eligible for 
     services under subsection (a). In carrying out the program, 
     the Secretary shall ensure that all such mental health 
     professionals have been trained in a consistent manner and 
     that such training includes principles of evidence-based 
     treatment and care for sexual trauma.
       ``(2) The Secretary shall determine the minimum 
     qualifications necessary for mental health professionals 
     certified by the program under paragraph (1) to provide 
     evidence-based treatment and therapy to veterans eligible for 
     services under subsection (a) in facilities of the 
     Department.
       ``(e) The Secretary shall submit to Congress each year a 
     report on the counseling, care, and services provided to 
     veterans under this section. Each report shall include data 
     for the preceding year with respect to the following:
       ``(1) The number of mental health professionals and primary 
     care providers who have been certified under the program 
     under subsection (d), and the amount and nature of continuing 
     medical education provided under such program to 
     professionals and providers who have been so certified.
       ``(2) The number of women veterans who received counseling, 
     care, and services under subsection (a) from professionals 
     and providers who have been trained or certified under the 
     program under subsection (d).
       ``(3) The number of training, certification, and continuing 
     medical education programs operating under 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.
       ``(5) Such other information as the Secretary considers 
     appropriate.''.
       (b) Standards for Personnel Providing Treatment for Sexual 
     Trauma.--The Secretary of Veterans Affairs shall establish 
     education, training, certification, and staffing standards 
     for Department of Veterans Affairs health-care facilities for 
     full-time equivalent employees who are trained to provide 
     treatment and care to veterans for sexual trauma.

     SEC. 305. 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 and 
     community.
       (c) Locations.--The Secretary shall carry out the pilot 
     program at not fewer than five locations selected by the 
     Secretary for purposes of the pilot program.
       (d) Duration.--The pilot program shall be carried out 
     during the two-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 are 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. 306. REPORT ON FULL-TIME WOMEN VETERANS PROGRAM MANAGERS 
                   AT MEDICAL CENTERS.

       The Secretary shall, acting through the Under Secretary for 
     Health, submit to Congress a report on employment of full-
     time women veterans program managers at Department of 
     Veterans Affairs medical centers to ensure that health care 
     needs of women veterans are met. Such report should include 
     an assessment of whether there is at least one full-time 
     employee at each Department medical center who is a full-time 
     women veterans program manager.

     SEC. 307. 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) Effective Date.--The amendments made by this section 
     shall apply to appointments made on or after the date of the 
     enactment of this Act.

     SEC. 308. PILOT PROGRAM ON SUBSIDIES 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), subsidies to qualified veterans described in 
     subsection (c) to obtain child care so that such veterans can 
     receive health care services described in such subsection.
       (b) Limitation on Period of Payments.--A subsidy 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 referred to 
     in subsection (c) at a facility of the Department; and
       (2) requires to travel to and return from such facility for 
     the receipt of such health care services.
       (c) Qualified Veterans.--In this section, the term 
     ``qualified veteran'' means a veteran who is the primary 
     caretaker of a child or children and who is receiving from 
     the Department one or more of the following health care 
     services:
       (1) Regular mental health care services.
       (2) Intensive mental health care services.
       (3) Such other intensive health care services that the 
     Secretary determines that payment to the veteran for the 
     provision of child care would improve access to those health 
     care services by the veteran.
       (d) Locations.--The Secretary shall carry out the pilot 
     program in no fewer than three Veterans Integrated Service 
     Networks (VISNs) selected by the Secretary for purposes of 
     the pilot program.
       (e) Duration.--The pilot program shall be carried out 
     during the two-year period beginning on the date of the 
     commencement of the pilot program.
       (f) Existing Model.--To the extent practicable, the 
     Secretary shall model the pilot program after the Department 
     of Veterans Affairs Child Care Subsidy Program that was 
     established pursuant to section 630 of the Treasury and 
     General Government Appropriations Act, 2002 (Public Law 107-
     67; 115 Stat. 552), using the same income eligibility 
     standards and payment structure.
       (g) Report.--Not later than six 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,

[[Page S609]]

     and shall include such recommendations for the continuation 
     or expansion of the pilot program as the Secretary considers 
     appropriate.
       (h) Authorization of Appropriations.--There are authorized 
     to be appropriated to the Secretary of Veterans Affairs for 
     each of fiscal years 2010 and 2011, $1,500,000 to carry out 
     the pilot program.

     SEC. 309. 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 7 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 
     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 IV--MENTAL HEALTH CARE

     SEC. 401. ELIGIBILITY OF MEMBERS OF THE ARMED FORCES WHO 
                   SERVE IN OPERATION IRAQI FREEDOM OR OPERATION 
                   ENDURING 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 Iraqi Freedom or 
     Operation Enduring 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, 1997, and the date of the 
     enactment of this Act.
       (b) Coordination.--In carrying out the study under 
     subsection (b) 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 (b) and the findings of the Secretary.
       (d) Authorization of Appropriations.--There are authorized 
     to be appropriated such sums as may be necessary to carry out 
     this section.

     SEC. 404. TRANSFER OF FUNDS TO SECRETARY OF HEALTH AND HUMAN 
                   SERVICES FOR GRADUATE PSYCHOLOGY EDUCATION 
                   PROGRAM.

       (a) Transfer of Funds.--Not later than September 30, 2010, 
     the Secretary of Veterans Affairs shall transfer $5,000,000 
     from accounts of the Veterans Health Administration to the 
     Secretary of Health and Human Services for the Graduate 
     Psychology Education program established under section 
     755(b)(1)(J) of the Public Health Service Act (42 U.S.C. 
     294e(b)(1)(J)).
       (b) Use of Funds Transferred.--Funds transferred under 
     subsection (a) shall be used to award grants to support the 
     training of psychologists in the treatment of veterans with 
     post traumatic stress disorder, traumatic brain injury, and 
     other combat-related disorders.
       (c) Preference for Department of Veterans Affairs Health 
     Care Facilities.--In the awarding of grants under subsection 
     (b), the Graduate Psychology Education program shall give 
     preference to health care facilities of the Department of 
     Veterans Affairs and graduate programs of education that are 
     affiliated with such facilities.

                       TITLE V--HOMELESS VETERANS

     SEC. 501. PILOT PROGRAM ON FINANCIAL SUPPORT FOR ENTITIES 
                   THAT COORDINATE THE PROVISION OF SUPPORTIVE 
                   SERVICES TO FORMERLY HOMELESS VETERANS RESIDING 
                   ON CERTAIN MILITARY PROPERTY.

       (a) Establishment.--
       (1) In general.--Subject to the availability of 
     appropriations for such purpose, the Secretary of Veterans 
     Affairs may carry out a pilot program to make grants to 
     public and nonprofit organizations (including faith-based and 
     community organizations) to coordinate the provision of 
     supportive services available in the local community to very 
     low income, formerly homeless veterans residing in permanent 
     housing that is located on qualifying property described in 
     subsection (b).
       (2) Number of grants.--The Secretary may make grants at up 
     to 10 qualifying properties under the pilot program.
       (b) Qualifying Property.--Qualifying property under the 
     pilot program is property that--
       (1) was part of a military installation that was closed in 
     accordance with--
       (A) decisions made as part of the 2005 round of defense 
     base closure and realignment under the Defense Base Closure 
     and Realignment Act of 1990 (part A of title XXIX of Public 
     Law 101-510; 10 U.S.C. 2687 note); and
       (B) subchapter III of chapter 5 of title 40, United States 
     Code; and
       (2) the Secretary of Defense determines, after considering 
     any redevelopment plans of any local redevelopment authority 
     relating to such property, may be used to assist the homeless 
     in accordance with such redevelopment plan.
       (c) Criteria for Grants.--The Secretary shall prescribe 
     criteria and requirements for grants under this section and 
     shall publish such criteria and requirements in the Federal 
     Register.
       (d) Duration of Program.--The authority of the Secretary to 
     provide grants under a pilot program under this section shall 
     cease on the date that is five years after the date of the 
     commencement of the pilot program.
       (e) Very Low Income Defined.--In this section, the term 
     ``very low income'' has the meaning given that term in the 
     Resident Characteristics Report issued annually by the 
     Department of Housing and Urban Development.
       (f) Authorization of Appropriations.--There is authorized 
     to be appropriated from amounts made available under the 
     heading ``General Operating Expenses'', not more than 
     $3,000,000 in each of fiscal years 2010 through 2014 to carry 
     out the purposes of this section.

     SEC. 502. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT 
                   COORDINATE THE PROVISION OF SUPPORTIVE SERVICES 
                   TO FORMERLY HOMELESS VETERANS RESIDING IN 
                   PERMANENT HOUSING.

       (a) Establishment of Pilot Program.--
       (1) In general.--Subject to the availability of 
     appropriations for such purpose, the Secretary of Veterans 
     Affairs may carry out a pilot program to make grants to 
     public and nonprofit organizations (including faith-based and 
     community organizations) to coordinate the provision of 
     supportive services available in the local community to very 
     low income, formerly homeless veterans residing in permanent 
     housing.
       (2) Number of grants.--The Secretary may make grants at up 
     to 10 qualifying properties under the pilot program.
       (b) Qualifying Property.--Qualifying property under the 
     pilot program is any property in the United States on which 
     permanent housing is provided or afforded to formerly 
     homeless veterans, as determined by the Secretary.
       (c) Criteria for Grants.--The Secretary shall prescribe 
     criteria and requirements for grants under this section and 
     shall publish such criteria and requirements in the Federal 
     Register.
       (d) Duration of Pilot Program.--The authority of the 
     Secretary to provide grants under a pilot program under this 
     section shall cease on the date that is five years

[[Page S610]]

     after the date of the commencement of the pilot program.
       (e) Very Low Income Defined.--In this section, the term 
     ``very low income'' has the meaning given that term in the 
     Resident Characteristics Report issued annually by the 
     Department of Housing and Urban Development.
       (f) Authorization of Appropriations.--There is authorized 
     to be appropriated from amounts made available under the 
     heading ``General Operating Expenses'', not more than 
     $3,000,000 in each of fiscal years 2010 through 2014 to carry 
     out the purposes of this section.

     SEC. 503. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT 
                   PROVIDE OUTREACH TO INFORM CERTAIN VETERANS 
                   ABOUT PENSION BENEFITS.

       (a) Authority To Make Grants.--In addition to the outreach 
     authority provided to the Secretary of Veterans Affairs by 
     section 6303 of title 38, United States Code, the Secretary 
     may carry out a pilot program to make grants to public and 
     nonprofit organizations (including faith-based and community 
     organizations) for services to provide outreach to inform 
     low-income and elderly veterans and their spouses who reside 
     in rural areas of benefits for which they may be eligible 
     under chapter 15 of such title.
       (b) Criteria for Grants.--The Secretary shall prescribe 
     criteria and requirements for grants under this section and 
     shall publish such criteria and requirements in the Federal 
     Register.
       (c) Duration of Pilot Program.--The authority of the 
     Secretary to provide grants under a pilot program under this 
     section shall cease on the date that is five years after the 
     date of the commencement of the pilot program.
       (d) Authorization of Appropriations.--There is authorized 
     to be appropriated from amounts made available under the 
     heading ``General Operating Expenses'', not more than 
     $1,275,000 in each of fiscal years 2010 through 2014 to carry 
     out the purposes of this section.

     SEC. 504. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT 
                   PROVIDE TRANSPORTATION ASSISTANCE, CHILD CARE 
                   ASSISTANCE, AND CLOTHING ASSISTANCE TO VETERANS 
                   ENTITLED TO A REHABILITATION PROGRAM.

       (a) Pilot Program Authorized.--
       (1) In general.--Subject to the availability of 
     appropriations authorized under subsection (g), the Secretary 
     of Veterans Affairs may carry out a pilot program to assess 
     the feasibility and advisability of providing financial 
     assistance to eligible entities to establish new programs or 
     activities, or expand or modify existing programs or 
     activities, to provide to each eligible transitioning 
     individual who is entitled and eligible for a rehabilitation 
     program under chapter 31 of title 38, United States Code, the 
     following assistance:
       (A) Transportation assistance to facilitate such eligible 
     transitioning individual's participation in such 
     rehabilitation program or related activity. Such assistance 
     may include--
       (i) providing transportation;
       (ii) paying for or reimbursing transportation costs; and
       (iii) paying for or reimbursing other transportation-
     related expenses (including orientation on the use of 
     transportation) .
       (B) Child care assistance to facilitate such eligible 
     transitioning individual's participation in such 
     rehabilitation program or related activity. Such assistance 
     may include--
       (i) child care services; or
       (ii) reimbursement of expenses related to child care.
       (C) Clothing assistance, which may include personal 
     services in selecting, and payment of a monetary allowance to 
     cover the cost of purchasing, clothing and accessories 
     suitable for a job interview or related activity consistent 
     with such eligible transitioning individual's participation 
     in such rehabilitation program or related activity.
       (2) Eligible transitioning individual.--For purposes of 
     this section, an eligible transitioning individual is a 
     person--
       (A) described in section 3102 of title 38, United States 
     Code; or
       (B) who was separated or released from active duty in the 
     Armed Forces on or after October 1, 2006, because of a 
     service-connected disability.
       (b) Duration of Program.--The authority of the Secretary to 
     provide grants under a pilot program established under 
     subsection (a)(1) shall cease on the date that is three years 
     after the date of the commencement of the pilot program.
       (c) Grants.--
       (1) In general.--The Secretary of Veterans Affairs shall 
     carry out the pilot program through the award of grants to 
     eligible entities to establish new programs or activities, or 
     to expand or modify existing programs or activities, as 
     described in subsection (a)(1).
       (2) Grant criteria.--
       (A) In general.--The Secretary shall establish criteria and 
     requirements for grants under the pilot program, including 
     criteria for eligible entities to receive such grants. The 
     criteria established under this subparagraph shall include 
     the following:
       (i) Specification as to the kinds of projects or activities 
     for which grants are available.
       (ii) Specification as to the number of projects or 
     activities for which grants are available.
       (iii) Provisions to ensure that grants awarded under the 
     pilot program do not result in duplication of ongoing 
     services.
       (B) Publication of criteria in federal register.--The 
     Secretary shall publish the criteria and requirements 
     established under subparagraph (A) in the Federal Register.
       (3) Funding limitation.--A grant under the pilot program 
     may not be used to support the operational costs of an 
     eligible entity.
       (d) Eligible Entities.--For purposes of this section, an 
     eligible entity is a public or nonprofit organization 
     (including a faith-based or community organization) that--
       (1) has the capacity to administer effectively a grant 
     under the pilot program, as determined by the Secretary of 
     Veterans Affairs;
       (2) demonstrates that adequate financial support will be 
     available to establish new programs or activities, or to 
     expand or modify existing programs or activities, as 
     described in subsection (a)(1) consistent with the plans, 
     specifications, and schedule submitted by the applicant to 
     the Secretary under subsection (e)(2);
       (3) agrees to meet the applicable criteria and requirements 
     established under subsection (c)(2) and described in 
     subsection (e)(2)(C); and
       (4) has the capacity, as determined by the Secretary, to 
     meet the criteria and requirements described in paragraph 
     (3).
       (e) Selection of Grant Recipients.--
       (1) Application.--An eligible entity seeking a grant under 
     the pilot program shall submit to the Secretary of Veterans 
     Affairs 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) The amount of the grant sought for the project or 
     activity.
       (B) Plans, specifications, and the schedule for 
     implementation of the project or activity in accordance with 
     criteria and requirements prescribed by the Secretary under 
     subsection (c)(2).
       (C) An agreement--
       (i) to provide the services for which the grant is sought 
     at locations accessible to eligible transitioning 
     individuals;
       (ii) to ensure the confidentiality of records maintained on 
     eligible transitioning individuals receiving services through 
     the pilot program; and
       (iii) to establish such procedures for fiscal control and 
     fund accounting as may be necessary to ensure proper 
     disbursement and accounting with respect to the grant and to 
     such payments as may be made under this section.
       (3) Applicant agreement.--The Secretary may not select an 
     eligible entity for a grant under the pilot program unless 
     the eligible entity agrees to the provisions listed in 
     paragraph (2)(C).
       (f) Recovery of Unused Grant Amounts.--
       (1) In general.--The United States shall be entitled to 
     recover from a grant recipient under this section the total 
     of all unused grant amounts made under this section to such 
     recipient in connection with such program if such grant 
     recipient--
       (A) does not establish a program or activity in accordance 
     with this section; or
       (B) ceases to furnish services under such a program for 
     which the grant was made.
       (2) Obligation.--Any amount recovered by the United States 
     under paragraph (1) may be obligated by the Secretary of 
     Veterans Affairs without fiscal year limitation to carry out 
     provisions of this section.
       (3) Limitation on recovery.--An amount may not be recovered 
     under paragraph (1)(A) as an unused grant amount before the 
     end of the three-year period beginning on the date on which 
     the grant is made.
       (g) Authorization of Appropriations.--There is authorized 
     to be appropriated from amounts made available under the 
     heading ``General Operating Expenses'', not more than 
     $5,000,000 in each of fiscal years 2010 through 2012 to carry 
     out this section.

     SEC. 505. ASSESSMENT OF PILOT PROGRAMS.

       (a) Progress Reports.--Not less than one year before the 
     expiration of the authority to carry out a pilot program 
     authorized by sections 501 through 504, the Secretary of 
     Veterans Affairs shall submit to Congress a progress report 
     on such pilot program.
       (b) Contents.--Each progress report submitted for a pilot 
     program under subsection (a) shall include the following:
       (1) The lessons learned by the Secretary of Veterans 
     Affairs with respect to such pilot program that can be 
     applied to other programs with similar purposes.
       (2) The recommendations of the Secretary on whether to 
     continue such pilot program.
       (3) The number of veterans and dependents served by such 
     pilot program.
       (4) An assessment of the quality of service provided to 
     veterans and dependents under such pilot program.
       (5) The amount of funds provided to grant recipients under 
     such pilot program.
       (6) The names of organizations that have received grants 
     under such pilot program.

        TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

     SEC. 601. 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

[[Page S611]]

       (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) of this section, is further 
     amended by inserting ``section 501(c)(3) of'' after ``exempt 
     from taxation under''.

     SEC. 602. CLARIFICATION OF PURPOSES OF CORPORATIONS.

       (a) Clarification of Purposes.--Subsection (a) of section 
     7362 is amended--
       (1) in the first sentence--
       (A) 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
       (B) by inserting before the period at the end the 
     following: ``or centers''; and
       (2) in the second sentence, by inserting ``or centers'' 
     after ``at the medical center''.
       (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. 603. 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. 604. 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 under 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

[[Page S612]]

     under section 501(c)(3) of the Internal Revenue Code of 
     1986.''.
       (b) Conforming Amendment.--Section 7362(a), as amended by 
     section 602(a)(1) of this Act, is further amended by striking 
     the last sentence.

     SEC. 605. 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. 606. 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 $300,000 
     for any year shall obtain an audit of the corporation for 
     that year.
       ``(B) A corporation with annual revenues between $10,000 
     and $300,000 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) Confirmation of Application of Conflict of Interest 
     Regulations to Appropriate Corporation Positions.--Subsection 
     (c) of such section is amended--
       (1) by striking ``laws and'' each place it appears;
       (2) in paragraph (1)--
       (A) by inserting ``each officer and'' after ``under this 
     subchapter,''; and
       (B) by striking ``, and each employee of the Department'' 
     and all that follows through ``during any year''; and
       (3) in paragraph (2)--
       (A) by inserting ``, officer,'' after ``verifying that each 
     director''; and
       (B) by striking ``in the same manner'' and all that follows 
     before the period at the end.
       (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 VII--MISCELLANEOUS PROVISIONS

     SEC. 701. 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 local, State, or Federal law enforcement agencies; 
     and
       ``(F) carry out, as needed and appropriate, the duties 
     described in subparagraphs (A) through (E) of this paragraph 
     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. 702. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS 
                   AFFAIRS POLICE OFFICERS.

       Section 903 is amended--
       (1) by amending subsection (b) to read as follows:
       ``(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, 2008. 
     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.''.
                                 ______
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