January 15, 2009 CONGRESSIONAL RECORD — SENATE S599 

S. 98

At the request of Mr. VITTER, the 

name of the Senator from Kansas (Mr. 

BROWNBACK) was added as a cosponsor 

of S. 98, a bill to impose admitting 

privilege requirements with respect to 

physicians who perform abortions. 

S. 154

At the request of Mr. ENSIGN, the 

name of the Senator from Mississippi 

(Mr. WICKER) was added as a cosponsor 

of S. 154, a bill to require the Congressional Budget Office and the Joint 

Committee on Taxation to use dynamic 

economic modeling in addition to static economic modeling in the preparation of budgetary estimates of proposed 

changes in Federal revenue law. 

S. 162

At the request of Mr. FEINGOLD, the 

name of the Senator from North Carolina (Mr. BURR) was added as a cosponsor of S. 162, a bill to provide greater 

accountability of taxpayers’ dollars by 

curtailing congressional earmarking, 

and for other purposes. 

S. 166

At the request of Mrs. HUTCHISON, the 

names of the Senator from Tennessee 

(Mr. CORKER), the Senator from Florida 

(Mr. MARTINEZ) and the Senator from 

Iowa (Mr. GRASSLEY) were added as cosponsors of S. 166, a bill to amend title 

VII of the Civil Rights Act of 1964 to 

clarify the filing period applicable to 

charges of discrimination, and for 

other purposes. 

S. 211

At the request of Mrs. CLINTON, the 

name of the Senator from California 

(Mrs. BOXER) was added as a cosponsor 

of S. 211, a bill to facilitate nationwide 

availability of 2-1-1 telephone service 

for information and referral on human 

services and volunteer services, and for 

other purposes. 

S. 225

At the request of Mr. BAYH, the name 

of the Senator from Illinois (Mr. DURBIN) was added as a cosponsor of S. 225, 

a bill to amend title XIX of the Social 

Security Act to establish programs to 

improve the quality, performance, and 

delivery of pediatric care. 

S. 238

At the request of Mr. WYDEN, the 

name of the Senator from Mississippi 

(Mr. WICKER) was added as a cosponsor 

of S. 238, a bill to provide $50,000,000,000 

in new transportation infrastructure 

funding through bonding to empower 

States and local governments to complete significant infrastructure 

projects across all modes of transportation, including roads, bridges, rail 

and transit systems, ports, and inland 

waterways, and for other purposes. 

S. 247

At the request of Mrs. FEINSTEIN, the 

name of the Senator from Maryland 

(Ms. MIKULSKI) was added as a cosponsor of S. 247, a bill to accelerate motor 

fuel savings nationwide and provide incentives to registered owners of high 

fuel consumption automobiles to replace such automobiles with fuel efficient automobiles or public transportation. 

S. 250

At the request of Mr. SCHUMER, the 

names of the Senator from Wisconsin 

(Mr. KOHL), the Senator from New Jersey (Mr. MENENDEZ) and the Senator 

from Maryland (Mr. CARDIN) were 

added as cosponsors of S. 250, a bill to 

amend the Internal Revenue Code of 

1986 to provide a higher education opportunity credit in place of existing 

education tax incentives. 

f 

STATEMENTS ON INTRODUCED 

BILLS AND JOINT RESOLUTIONS 

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, cuttingedge 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 healthplan 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. 


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S600 CONGRESSIONAL RECORD — SENATE January 15, 2009 

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. 


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January 15, 2009 CONGRESSIONAL RECORD — SENATE 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,’’. 


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S602 CONGRESSIONAL RECORD — SENATE January 15, 2009 

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: 

‘‘§ 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: 

‘‘§ 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. 


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‘‘(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: 

‘‘§ 1709. Disclosure to Secretary of health-plan 

contract information and social security 

number of certain veterans receiving care 

‘‘(a) REQUIRED DISCLOSURE OF HEALTHPLAN CONTRACTS.—(1) Any individual who 


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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: 

‘‘§ 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. 


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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. 


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(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 twoyear 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-serviceconnected 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: 


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‘‘§ 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 threeyear 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 


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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, 


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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 faithbased 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 faithbased 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 


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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 faithbased 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 


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(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: 

‘‘§ 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 


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S612 CONGRESSIONAL RECORD — SENATE January 15, 2009 

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 Departmentissued 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.’’. 

By Mrs. LINCOLN (for herself, 

Ms. SNOWE, and Mr. ISAKSON): 

S. 254. A bill to amend title XVIII of 

the Social Security Act to provide for 

the coverage of home infusion therapy 

under the Medicare Program; to the 

Committee on Finance. 

Ms. SNOWE. Mr. President, today I 

am pleased to join my colleague, Senator LINCOLN of Arkansas, to introduce 

the Medicare Home Infusion Coverage 

Act. As we do so, we recognize that 

Medicare has serious fiscal challenges. 

Currently, the Part A, Hospital, Trust 

Fund faces insolvency in 2019, when expenditures will exceed projected contributions and require additional taxpayer support to maintain the care required by our seniors and so many disabled Americans. At the same time, 

today Medicare beneficiaries struggle 

under the burden of paying nearly half 

of their health care costs. So the legislation we are re-introducing is vital to 

addressing the fiscal issues affecting 

Medicare. 

Many serious conditions—including 

some cancers and drug-resistant infections—require the use of infusion therapy. Such treatment involves the administration of medication directly 

into the bloodstream via a needle or 

catheter. Specialized equipment, supplies, and professional services—such 

as sterile drug compounding, care coordination, and patient education and 

monitoring—are components of such 

therapy. Infusion treatment is an extensive medical treatment often lasting for several hours per day over a 6- 

to-8 week period. 

The unfortunate fact is that under 

current Medicare rules, patients requiring infusion therapy must either 

bear that cost themselves or endure 

costly and unnecessary hospitalization 

in order to receive coverage—raising 

costs for both beneficiaries and Medicare alike. Current Medicare regulations authorize payment for infusion 

drugs, but do not pay for the services, 

equipment, and supplies necessary to 

safely provide infusion therapy in the 

home. Not surprisingly, even though 

home infusion therapy may cost as little as $100 a day, too few seniors can 

bear that cost. 

The result is that patients are excessively hospitalized, producing costs of 

treatment as much as 10–20 times higher than treatment in the home. The 

process may even place the patient’s 

health in jeopardy because unnecessary 

hospitalization places individuals at 

risk of exposure to a health care-acquired infection—which may be drug 

resistant and life-threatening. 

Private health plans have long understood that home infusion therapy is 

not only less costly, but safer as well. 

Thus, private insurance coverage for 

home infusion therapy is common. Private plans also recognize that patients 

benefit from avoiding hospitalization. 

At home they have a familiar, comfortable environment with their family 

conveniently at hand—no small concerns when fighting a serious illness. 

It is clear we must change the status 

quo, and achieve safer, more cost-effective treatment. By extending coverage 

of infusion therapy to the home, we 

will correct this inappropriate and unnecessary gap in Medicare coverage 

and take a significant step in reducing 

Medicare costs. This legislation offers 

an alternative to allowing our Medicare beneficiaries to be overcome with 

health care costs that are rising faster 

than inflation by reforming care delivery to emphasize high quality, lower 

cost services. 

I hope my colleagues will join us in 

support of this legislation so we may 

further the goals of improving patient 

safety and reducing our escalating 

health care costs. 

Mr. President, I ask unanimous consent that the text of the bill to be 

printed in the RECORD. 


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