II 

111TH CONGRESS 

1ST SESSION S. 252 

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 

to veterans, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 15, 2009 

Mr. AKAKA (for himself, Mr. DURBIN, and Mrs. MURRAY) introduced the following bill; which was read twice and referred to the Committee on Veterans’ Affairs 

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 to veterans, and for other purposes. 

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

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Veterans Health Care Authorization Act of 2009’’. 

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

7 this Act is as follows: 


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Sec. 1. Short title; table of contents. 

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

TITLE I—DEPARTMENT PERSONNEL MATTERS 

Sec. 101. Enhancement of authorities for retention of medical professionals. 

Sec. 102. Limitations on overtime duty, weekend duty, and alternative work 

schedules for nurses. 

Sec. 103. Improvements to certain educational assistance programs. 

Sec. 104. Standards for appointment and practice of physicians in Department 

of Veterans Affairs medical facilities. 

TITLE II—HEALTH CARE MATTERS 

Sec. 201. Repeal of certain annual reporting requirements. 

Sec. 202. Modifications to annual Gulf War research report. 

Sec. 203. Payment for care furnished to CHAMPVA beneficiaries. 

Sec. 204. Payor provisions for care furnished to certain children of Vietnam 

veterans. 

Sec. 205. Disclosures from certain medical records. 

Sec. 206. Disclosure to Secretary of health-plan contract information and social 

security number of certain veterans receiving care. 

Sec. 207. Enhancement of quality management. 

Sec. 208. Reports on improvements to Department health care quality management. 

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. 


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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. 


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1 SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE. 

2 Except as otherwise expressly provided, whenever in 

3 this Act an amendment or repeal is expressed in terms 

4 of an amendment or repeal to a section or other provision, 

5 the reference shall be considered to be made to a section 

6 or other provision of title 38, United States Code. 

7 TITLE I—DEPARTMENT 

8 PERSONNEL MATTERS 

9 SEC. 101. ENHANCEMENT OF AUTHORITIES FOR RETEN10 TION OF MEDICAL PROFESSIONALS. 

11 (a) SECRETARIAL AUTHORITY TO EXTEND TITLE 38 

12 STATUS TO ADDITIONAL POSITIONS.— 

13 (1) IN GENERAL.—Paragraph (3) of section 

14 7401 is amended by striking ‘‘and blind rehabilita15 tion outpatient specialists.’’ and inserting the fol16 lowing: ‘‘blind rehabilitation outpatient specialists, 

17 and such other classes of health care occupations as 

18 the Secretary considers necessary for the recruit19 ment and retention needs of the Department subject 

20 to the following requirements: 

21 ‘‘(A) Not later than 45 days before the 

22 Secretary appoints any personnel for a class of 

23 health care occupations that is not specifically 

24 listed in this paragraph, the Secretary shall 

25 submit to the Committee on Veterans’ Affairs 

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1 fairs of the House of Representatives, and the 

2 Office of Management and Budget notice of 

3 such appointment. 

4 ‘‘(B) Before submitting notice under sub5 paragraph (A), the Secretary shall solicit com6 ments from any labor organization representing 

7 employees in such class and include such com8 ments in such notice.’’. 

9 (2) APPOINTMENT OF NURSE ASSISTANTS.— 

10 Such paragraph is further amended by inserting 

11 ‘‘nurse assistants,’’ after ‘‘licensed practical or voca12 tional nurses,’’. 

13 (b) PROBATIONARY PERIODS FOR REGISTERED

14 NURSES.—Section 7403(b) is amended— 

15 (1) in paragraph (1), by striking ‘‘Appoint16 ments’’ and inserting ‘‘Except as otherwise provided 

17 in this subsection, appointments’’; 

18 (2) by redesignating paragraph (2) as para19 graph (4); and 

20 (3) by inserting after paragraph (1) the fol21 lowing new paragraphs: 

22 ‘‘(2) An appointment of a registered nurse under this 

23 chapter, whether on a full-time basis or a part-time basis, 

24 shall be for a probationary period ending upon the comple25 tion by the person so appointed of a number of hours of 


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1 work pursuant to such appointment that the Secretary 

2 considers appropriate for such appointment but not more 

3 than 4,180 hours. 

4 ‘‘(3) An appointment described in subsection (a) on 

5 a part-time basis of a person who has previously served 

6 on a full-time basis for the probationary period for the 

7 position concerned shall be without a probationary pe8 riod.’’. 

9 (c) PROHIBITION ON TEMPORARY PART-TIME REG10 ISTERED NURSE APPOINTMENTS IN EXCESS OF 4,180 

11 HOURS.—Section 7405 is amended by adding at the end 

12 the following new subsection: 

13 ‘‘(g)(1) Employment of a registered nurse on a tem14 porary part-time basis under subsection (a)(1) shall be for 

15 a probationary period ending upon the completion by the 

16 person so employed of a number of hours of work pursuant 

17 to such employment that the Secretary considers appro18 priate for such employment but not more than 4,180 

19 hours. 

20 ‘‘(2) Upon completion by a registered nurse of the 

21 probationary period described in paragraph (1)— 

22 ‘‘(A) the employment of such nurse shall— 

23 ‘‘(i) no longer be considered temporary; 

24 and 


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1 ‘‘(ii) be considered an appointment de2 scribed in section 7403(a) of this title; and 

3 ‘‘(B) the nurse shall be considered to have 

4 served the probationary period required by section 

5 7403(b).’’. 

6 (d) WAIVER OF OFFSET FROM PAY FOR CERTAIN

7 REEMPLOYED ANNUITANTS.— 

8 (1) IN GENERAL.—Section 7405, as amended 

9 by subsection (c), is further amended by adding at 

10 the end the following new subsection: 

11 ‘‘(h)(1) The Secretary may waive the application of 

12 sections 8344 and 8468 of title 5 (relating to annuities 

13 and pay on reemployment) or any other similar provision 

14 of law under a Government retirement system on a case15 by-case basis for an annuitant reemployed on a temporary 

16 basis under the authority of subsection (a) in a position 

17 described under paragraph (1) of that subsection. 

18 ‘‘(2) An annuitant to whom a waiver under para19 graph (1) is in effect shall not be considered an employee 

20 for purposes of any Government retirement system. 

21 ‘‘(3) An annuitant to whom a waiver under para22 graph (1) is in effect shall be subject to the provisions 

23 of chapter 71 of title 5 (including all labor authority and 

24 labor representative collective bargaining agreements) ap25 plicable to the position to which appointed. 


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1 ‘‘(4) In this subsection: 

2 ‘‘(A) The term ‘annuitant’ means an annuitant 

3 under a Government retirement system. 

4 ‘‘(B) The term ‘employee’ has the meaning 

5 under section 2105 of title 5. 

6 ‘‘(C) The term ‘Government retirement system’ 

7 means a retirement system established by law for 

8 employees of the Government of the United States.’’. 

9 (2) EFFECTIVE DATE.—The amendment made 

10 by paragraph (1) shall take effect on the date that 

11 is six months after the date of the enactment of this 

12 Act, and shall apply to pay periods beginning on or 

13 after such effective date. 

14 (e) RATE OF BASIC PAY FOR APPOINTEES TO THE

15 OFFICE OF THE UNDER SECRETARY FOR HEALTH SET

16 TO RATE OF BASIC PAY FOR SENIOR EXECUTIVE SERV17 ICE POSITIONS.— 

18 (1) IN GENERAL.—Section 7404(a) is amend19 ed— 

20 (A) by striking ‘‘The annual’’ and insert21 ing ‘‘(1) The annual’’; 

22 (B) by striking ‘‘The pay’’ and inserting 

23 the following: 

24 ‘‘(2) The pay’’; 


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1 (C) by striking ‘‘under the preceding sen2 tence’’ and inserting ‘‘under paragraph (1)’’; 

3 and 

4 (D) by adding at the end the following new 

5 paragraph: 

6 ‘‘(3) The rate of basic pay for a position to which 

7 an Executive order applies under paragraph (1) and is not 

8 described by paragraph (2) shall be set in accordance with 

9 section 5382 of title 5 as if such position were a Senior 

10 Executive Service position (as such term is defined in sec11 tion 3132(a) of title 5).’’. 

12 (2) EFFECTIVE DATE.—The amendments made 

13 by paragraph (1) shall take effect on the first day 

14 of the first pay period beginning after the day that 

15 is 180 days after the date of the enactment of this 

16 Act. 

17 (f) COMPARABILITY PAY PROGRAM FOR APPOINTEES

18 TO THE OFFICE OF THE UNDER SECRETARY FOR

19 HEALTH.—Section 7410 is amended— 

20 (1) by striking ‘‘The Secretary may’’ and in21 serting ‘‘(a) IN GENERAL.—The Secretary may’’; 

22 and 

23 (2) by adding at the end the following new sub24 section: 


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1 ‘‘(b) COMPARABILITY PAY FOR APPOINTEES TO THE

2 OFFICE OF THE UNDER SECRETARY FOR HEALTH.—(1) 

3 The Secretary may authorize the Under Secretary for 

4 Health to provide comparability pay of not more than 

5 $100,000 per year to individuals of the Veterans Health 

6 Administration appointed under section 7306 of this title 

7 who are not physicians or dentists and to individuals who 

8 are appointed to Senior Executive Service positions (as 

9 such term is defined in section 3132(a) of title 5) to 

10 achieve annual pay levels for such individuals that are 

11 comparable with annual pay levels of individuals with simi12 lar positions in the private sector. 

13 ‘‘(2) Comparability pay under paragraph (1) for an 

14 individual is in addition to all other pay, awards, and per15 formance bonuses paid to such individual under this title. 

16 ‘‘(3) Except as provided in paragraph (4), com17 parability pay under paragraph (1) for an individual shall 

18 be considered basic pay for all purposes, including retire19 ment benefits under chapters 83 and 84 of title 5, and 

20 other benefits. 

21 ‘‘(4) Comparability pay under paragraph (1) for an 

22 individual shall not be considered basic pay for purposes 

23 of adverse actions under subchapter V of this chapter. 

24 ‘‘(5) Comparability pay under paragraph (1) may not 

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1 sult in an aggregate amount of pay (including bonuses and 

2 awards) received by such individual in a year under this 

3 title that is greater than the annual pay of the Presi4 dent.’’. 

5 (g) SPECIAL INCENTIVE PAY FOR DEPARTMENT

6 PHARMACIST EXECUTIVES.—Section 7410, as amended 

7 by subsection (f) of this section, is further amended by 

8 adding at the end the following new subsection: 

9 ‘‘(c) SPECIAL INCENTIVE PAY FOR DEPARTMENT

10 PHARMACIST EXECUTIVES.—(1) In order to recruit and 

11 retain highly qualified Department pharmacist executives, 

12 the Secretary may authorize the Under Secretary for 

13 Health to pay special incentive pay of not more than 

14 $40,000 per year to an individual of the Veterans Health 

15 Administration who is a pharmacist executive. 

16 ‘‘(2) In determining whether and how much special 

17 pay to provide to such individual, the Under Secretary 

18 shall consider the following: 

19 ‘‘(A) The grade and step of the position of the 

20 individual. 

21 ‘‘(B) The scope and complexity of the position 

22 of the individual. 

23 ‘‘(C) The personal qualifications of the indi24 vidual. 


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1 ‘‘(D) The characteristics of the labor market 

2 concerned. 

3 ‘‘(E) Such other factors as the Secretary con4 siders appropriate. 

5 ‘‘(3) Special incentive pay under paragraph (1) for 

6 an individual is in addition to all other pay (including 

7 basic pay) and allowances to which the individual is enti8 tled. 

9 ‘‘(4) Except as provided in paragraph (5), special in10 centive pay under paragraph (1) for an individual shall 

11 be considered basic pay for all purposes, including retire12 ment benefits under chapters 83 and 84 of title 5, and 

13 other benefits. 

14 ‘‘(5) Special incentive pay under paragraph (1) for 

15 an individual shall not be considered basic pay for pur16 poses of adverse actions under subchapter V of this chap17 ter. 

18 ‘‘(6) Special incentive pay under paragraph (1) may 

19 not be awarded to an individual in an amount that would 

20 result in an aggregate amount of pay (including bonuses 

21 and awards) received by such individual in a year under 

22 this title that is greater than the annual pay of the Presi23 dent.’’. 

24 (h) PAY FOR PHYSICIANS AND DENTISTS.— 


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1 (1) NON-FOREIGN COST OF LIVING ADJUST2 MENT ALLOWANCE.—Section 7431(b) is amended by 

3 adding at the end the following new paragraph: 

4 ‘‘(5) The non-foreign cost of living adjustment 

5 allowance authorized under section 5941 of title 5 

6 for physicians and dentists whose pay is set under 

7 this section shall be determined as a percentage of 

8 base pay only.’’. 

9 (2) MARKET PAY DETERMINATIONS FOR PHYSI10 CIANS AND DENTISTS IN ADMINISTRATIVE OR EXEC11 UTIVE LEADERSHIP POSITIONS.—Section 

12 7431(c)(4)(B)(i) is amended by adding at the end 

13 the following: ‘‘The Secretary may exempt physi14 cians and dentists occupying administrative or exec15 utive leadership positions from the requirements of 

16 the previous sentence.’’. 

17 (3) EXCEPTION TO PROHIBITION ON REDUC18 TION OF MARKET PAY.—Section 7431(c)(7) is 

19 amended by striking ‘‘concerned.’’ and inserting 

20 ‘‘concerned, unless there is a change in board certifi21 cation or reduction of privileges.’’. 

22 (i) ADJUSTMENT OF PAY CAP FOR NURSES.—Sec23 tion 7451(c)(2) is amended by striking ‘‘level V’’ and in24 serting ‘‘level IV’’. 


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1 (j) EXEMPTION FOR CERTIFIED REGISTERED NURSE

2 ANESTHETISTS FROM LIMITATION ON AUTHORIZED COM3 PETITIVE PAY.—Section 7451(c)(2) is further amended 

4 by adding at the end the following new sentence: ‘‘The 

5 maximum rate of basic pay for a grade for the position 

6 of certified registered nurse anesthetist pursuant to an ad7 justment under subsection (d) may exceed the maximum 

8 rate otherwise provided in the preceding sentence.’’. 

9 (k) LOCALITY PAY SCALE COMPUTATIONS.— 

10 (1) EDUCATION, TRAINING, AND SUPPORT FOR

11 FACILITY DIRECTORS IN WAGE SURVEYS.—Section 

12 7451(d)(3) is amended by adding at the end the fol13 lowing new subparagraph: 

14 ‘‘(F) The Under Secretary for Health shall provide 

15 appropriate education, training, and support to directors 

16 of Department health care facilities in the conduct and 

17 use of surveys, including the use of third-party surveys, 

18 under this paragraph.’’. 

19 (2) INFORMATION ON METHODOLOGY USED IN

20 WAGE SURVEYS.—Section 7451(e)(4) is amended— 

21 (A) by redesignating subparagraph (D) as 

22 subparagraph (E); and 

23 (B) by inserting after subparagraph (C) 

24 the following new subparagraph (D): 


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1 ‘‘(D) In any case in which the director conducts 

2 such a wage survey during the period covered by the 

3 report and makes adjustment in rates of basic pay 

4 applicable to one or more covered positions at the fa5 cility, information on the methodology used in mak6 ing such adjustment or adjustments.’’. 

7 (3) DISCLOSURE OF INFORMATION TO PERSONS

8 IN COVERED POSITIONS.—Section 7451(e), as 

9 amended by paragraph (2) of this subsection, is fur10 ther amended by adding at the end the following 

11 new paragraph: 

12 ‘‘(6)(A) Upon the request of an individual described 

13 in subparagraph (B) for a report provided under para14 graph (4) with respect to a Department health-care facil15 ity, the Under Secretary for Health or the director of such 

16 facility shall provide to the individual the most current re17 port for such facility provided under such paragraph. 

18 ‘‘(B) An individual described in this subparagraph 

19 is— 

20 ‘‘(i) an individual in a covered position at a De21 partment health-care facility; or 

22 ‘‘(ii) a representative of the labor organization 

23 representing that individual who is designated by 

24 that individual to make the request.’’. 


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1 (l) INCREASED LIMITATION ON SPECIAL PAY FOR

2 NURSE EXECUTIVES.—Section 7452(g)(2) is amended by 

3 striking ‘‘$25,000’’ and inserting ‘‘$100,000’’. 

4 (m) ELIGIBILITY OF PART-TIME NURSES FOR ADDI5 TIONAL NURSE PAY.— 

6 (1) IN GENERAL.—Section 7453 is amended— 

7 (A) in subsection (a), by striking ‘‘a 

8 nurse’’ and inserting ‘‘a full-time nurse or part9 time nurse’’; 

10 (B) in subsection (b)— 

11 (i) in the first sentence— 

12 (I) by striking ‘‘on a tour of 

13 duty’’; 

14 (II) by striking ‘‘service on such 

15 tour’’ and inserting ‘‘such service’’; 

16 and 

17 (III) by striking ‘‘of such tour’’ 

18 and inserting ‘‘of such service’’; and 

19 (ii) in the second sentence, by striking 

20 ‘‘of such tour’’ and inserting ‘‘of such serv21 ice’’; 

22 (C) in subsection (c)— 

23 (i) by striking ‘‘on a tour of duty’’; 

24 and 


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1 (ii) by striking ‘‘service on such tour’’ 

2 and inserting ‘‘such service’’; and 

3 (D) in subsection (e)— 

4 (i) in paragraph (1), by striking 

5 ‘‘eight hours in a day’’ and inserting 

6 ‘‘eight consecutive hours’’; and 

7 (ii) in paragraph (5)(A), by striking 

8 ‘‘tour of duty’’ and inserting ‘‘period of 

9 service’’. 

10 (2) EXCLUSION OF APPLICATION OF ADDI11 TIONAL NURSE PAY PROVISIONS TO CERTAIN ADDI12 TIONAL EMPLOYEES.—Paragraph (3) of section 

13 7454(b) is amended to read as follows: 

14 ‘‘(3) Employees appointed under section 7408 of this 

15 title performing service on a tour of duty, any part of 

16 which is within the period commencing at midnight Friday 

17 and ending at midnight Sunday, shall receive additional 

18 pay in addition to the rate of basic pay provided such em19 ployees for each hour of service on such tour at a rate 

20 equal to 25 percent of such employee’s hourly rate of basic 

21 pay.’’. 

22 (n) EXEMPTION OF ADDITIONAL NURSE POSITIONS

23 FROM LIMITATION ON INCREASE IN RATES OF BASIC

24 PAY.—Section 7455(c)(1) is amended by inserting after 

25 ‘‘nurse anesthetists,’’ the following: ‘‘licensed practical 


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1 nurses, licensed vocational nurses, and nursing positions 

2 otherwise covered by title 5,’’. 

3 SEC. 102. LIMITATIONS ON OVERTIME DUTY, WEEKEND 

4 DUTY, AND ALTERNATIVE WORK SCHEDULES 

5 FOR NURSES. 

6 (a) OVERTIME DUTY.— 

7 (1) IN GENERAL.—Subchapter IV of chapter 74 

8 is amended by adding at the end the following new 

9 section: 

10 ‘‘§ 7459. Nursing staff: special rules for overtime duty 

11 ‘‘(a) LIMITATION.—Except as provided in subsection 

12 (c), the Secretary may not require nursing staff to work 

13 more than 40 hours (or 24 hours if such staff is covered 

14 under section 7456 of this title) in an administrative work 

15 week or more than eight consecutive hours (or 12 hours 

16 if such staff is covered under section 7456 or 7456A of 

17 this title). 

18 ‘‘(b) VOLUNTARY OVERTIME.—(1) Nursing staff may 

19 on a voluntary basis elect to work hours otherwise prohib20 ited by subsection (a). 

21 ‘‘(2) The refusal of nursing staff to work hours pro22 hibited by subsection (a) shall not be grounds to discrimi23 nate (within the meaning of section 704(a) of the Civil 

24 Rights Act of 1964 (42 U.S.C. 2000e–3(a))) against the 


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1 staff, dismissal or discharge of the staff, or any other ad2 verse personnel action against the staff. 

3 ‘‘(c) OVERTIME UNDER EMERGENCY CIR4 CUMSTANCES.—(1) Subject to paragraph (2), the Sec5 retary may require nursing staff to work hours otherwise 

6 prohibited by subsection (a) if— 

7 ‘‘(A) the work is a consequence of an emer8 gency that could not have been reasonably antici9 pated; 

10 ‘‘(B) the emergency is non-recurring and is not 

11 caused by or aggravated by the inattention of the 

12 Secretary or lack of reasonable contingency planning 

13 by the Secretary; 

14 ‘‘(C) the Secretary has exhausted all good faith, 

15 reasonable attempts to obtain voluntary workers; 

16 ‘‘(D) the nurse staff have critical skills and ex17 pertise that are required for the work; and 

18 ‘‘(E) the work involves work for which the 

19 standard of care for a patient assignment requires 

20 continuity of care through completion of a case, 

21 treatment, or procedure. 

22 ‘‘(2) Nursing staff may not be required to work hours 

23 under this subsection after the requirement for a direct 

24 role by the staff in responding to medical needs resulting 

25 from the emergency ends. 


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1 ‘‘(d) NURSING STAFF DEFINED.—In this section, the 

2 term ‘nursing staff’ includes the following; 

3 ‘‘(1) A registered nurse. 

4 ‘‘(2) A licensed practical or vocational nurse. 

5 ‘‘(3) A nurse assistant appointed under this 

6 chapter or title 5. 

7 ‘‘(4) Any other nurse position designated by the 

8 Secretary for purposes of this section.’’. 

9 (2) CLERICAL AMENDMENT.—The table of sec10 tions at the beginning of chapter 74 is amended by 

11 inserting after the item relating to section 7458 the 

12 following new item: 

‘‘7459. Nursing staff: special rules for overtime duty.’’. 

13 (b) WEEKEND DUTY.—Section 7456 is amended— 

14 (1) by striking subsection (c); and 

15 (2) by redesignating subsection (d) as sub16 section (c). 

17 (c) ALTERNATE WORK SCHEDULES.— 

18 (1) IN GENERAL.—Section 7456A(b)(1)(A) is 

19 amended by striking ‘‘three regularly scheduled’’ and 

20 all that follows through the period at the end and 

21 inserting ‘‘six regularly scheduled 12-hour periods of 

22 service within a pay period shall be considered for all 

23 purposes to have worked a full 80-hour pay period.’’. 

24 (2) CONFORMING AMENDMENTS.—Section 

25 7456A(b) is amended— 


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1 (A) in the subsection heading, by striking 

2 ‘‘36/40’’ and inserting ‘‘72/80’’; 

3 (B) in paragraph (2)— 

4 (i) in subparagraph (A), by striking 

5 ‘‘40-hour basic work week’’ and inserting 

6 ‘‘80-hour pay period’’; 

7 (ii) in subparagraph (B), by striking 

8 ‘‘regularly scheduled 36-hour tour of duty 

9 within the work week’’ and inserting 

10 ‘‘scheduled 72-hour period of service within 

11 the bi-weekly pay period’’; 

12 (iii) in subparagraph (C)— 

13 (I) in clause (i), by striking ‘‘reg14 ularly scheduled 36-hour tour of duty 

15 within an administrative work week’’ 

16 and inserting ‘‘scheduled 72-hour pe17 riod of service within an administra18 tive pay period’’; 

19 (II) in clause (ii), by striking 

20 ‘‘regularly scheduled 12-hour tour of 

21 duty’’ and inserting ‘‘scheduled 12- 

22 hour period of service’’; and 

23 (III) in clause (iii), by striking 

24 ‘‘regularly scheduled 36-hour tour of 

25 duty work week’’ and inserting 


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1 ‘‘scheduled 72-hour period of service 

2 pay period’’; and 

3 (iv) in subparagraph (D), by striking 

4 ‘‘regularly scheduled 12-hour tour of duty’’ 

5 and inserting ‘‘scheduled 12-hour period of 

6 service’’; and 

7 (C) in paragraph (3), by striking ‘‘regu8 larly scheduled 12-hour tour of duty’’ and in9 serting ‘‘scheduled 12-hour period of service’’. 

10 SEC. 103. IMPROVEMENTS TO CERTAIN EDUCATIONAL AS11 SISTANCE PROGRAMS. 

12 (a) REINSTATEMENT OF HEALTH PROFESSIONALS

13 EDUCATIONAL ASSISTANCE SCHOLARSHIP PROGRAM.— 

14 (1) IN GENERAL.—Section 7618 is amended by 

15 striking ‘‘December 31, 1998’’ and inserting ‘‘De16 cember 31, 2014’’. 

17 (2) EXPANSION OF ELIGIBILITY REQUIRE18 MENTS.—Section 7612(b)(2) is amended by striking 

19 ‘‘(under section’’ and all that follows through ‘‘or vo20 cational nurse.’’ and inserting the following: ‘‘as an 

21 appointee under paragraph (1) or (3) of section 

22 7401 of this title.’’. 

23 (b) IMPROVEMENTS TO EDUCATION DEBT REDUC24 TION PROGRAM.— 


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1 (1) INCLUSION OF EMPLOYEE RETENTION AS

2 PURPOSE OF PROGRAM.—Section 7681(a)(2) is 

3 amended by inserting ‘‘and retention’’ after ‘‘recruit4 ment’’ the first time it appears. 

5 (2) ELIGIBILITY.—Section 7682 is amended— 

6 (A) in subsection (a)(1), by striking ‘‘a re7 cently appointed’’ and inserting ‘‘an’’; and 

8 (B) by striking subsection (c). 

9 (3) MAXIMUM AMOUNTS OF ASSISTANCE.—Sec10 tion 7683(d)(1) is amended— 

11 (A) by striking ‘‘$44,000’’ and inserting 

12 ‘‘$60,000’’; and 

13 (B) by striking ‘‘$10,000’’ and inserting 

14 ‘‘$12,000’’. 

15 (c) LOAN REPAYMENT PROGRAM FOR CLINICAL RE16 SEARCHERS FROM DISADVANTAGED BACKGROUNDS.— 

17 (1) IN GENERAL.—The Secretary of Veterans 

18 Affairs may, in consultation with the Secretary of 

19 Health and Human Services, utilize the authorities 

20 available in section 487E of the Public Health Serv21 ice Act (42 U.S.C. 288–5) for the repayment of the 

22 principal and interest of educational loans of appro23 priately qualified health professionals who are from 

24 disadvantaged backgrounds in order to secure clinVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00023 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 ical research by such professionals for the Veterans 

2 Health Administration. 

3 (2) LIMITATIONS.—The exercise by the Sec4 retary of Veterans Affairs of the authorities referred 

5 to in paragraph (1) shall be subject to the conditions 

6 and limitations specified in paragraphs (2) and (3) 

7 of section 487E(a) of the Public Health Service Act 

8 (42 U.S.C. 288–5(a)(2) and (3)). 

9 (3) FUNDING.—Amounts for the repayment of 

10 principal and interest of educational loans under this 

11 subsection shall be derived from amounts available 

12 to the Secretary of Veterans Affairs for the Veterans 

13 Health Administration for Medical Services. 

14 SEC. 104. STANDARDS FOR APPOINTMENT AND PRACTICE 

15 OF PHYSICIANS IN DEPARTMENT OF VET16 ERANS AFFAIRS MEDICAL FACILITIES. 

17 (a) STANDARDS.— 

18 (1) IN GENERAL.—Subchapter I of chapter 74 

19 is amended by inserting after section 7402 the fol20 lowing new section: 

21 ‘‘§ 7402A. Appointment and practice of physicians: 

22 standards 

23 ‘‘(a) IN GENERAL.—The Secretary shall, acting 

24 through the Under Secretary for Health, prescribe stand25 ards to be met by individuals in order to qualify for apVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00024 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 pointment in the Veterans Health Administration in the 

2 position of physician and to practice as a physician in 

3 medical facilities of the Administration. The standards 

4 shall incorporate the requirements of this section. 

5 ‘‘(b) DISCLOSURE OF CERTAIN INFORMATION BE6 FORE APPOINTMENT.—Each individual seeking appoint7 ment in the Veterans Health Administration in the posi8 tion of physician shall do the following: 

9 ‘‘(1) Provide the Secretary a full and complete 

10 explanation of the following: 

11 ‘‘(A) Each lawsuit, civil action, or other 

12 claim (whether open or closed) brought against 

13 the individual for medical malpractice or neg14 ligence (other than a lawsuit, action, or claim 

15 closed without any judgment against or pay16 ment by or on behalf of the individual). 

17 ‘‘(B) Each payment made by or on behalf 

18 of the individual to settle any lawsuit, action, or 

19 claim covered by subparagraph (A). 

20 ‘‘(C) Each investigation or disciplinary ac21 tion taken against the individual relating to the 

22 individual’s performance as a physician. 

23 ‘‘(2) Submit a written request and authoriza24 tion to the State licensing board of each State in 

25 which the individual holds or has held a license to 


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1 practice medicine to disclose to the Secretary any in2 formation in the records of such State on the fol3 lowing: 

4 ‘‘(A) Each lawsuit, civil action, or other 

5 claim brought against the individual for medical 

6 malpractice or negligence covered by paragraph 

7 (1)(A) that occurred in such State. 

8 ‘‘(B) Each payment made by or on behalf 

9 of the individual to settle any lawsuit, action, or 

10 claim covered by subparagraph (A). 

11 ‘‘(C) Each medical malpractice judgment 

12 against the individual by the courts or adminis13 trative agencies or bodies of such State. 

14 ‘‘(D) Each disciplinary action taken or 

15 under consideration against the individual by 

16 an administrative agency or body of such State. 

17 ‘‘(E) Any change in the status of the li18 cense to practice medicine issued the individual 

19 by such State, including any voluntary or non20 disciplinary surrendering of such license by the 

21 individual. 

22 ‘‘(F) Any open investigation of the indi23 vidual by an administrative agency or body of 

24 such State, or any outstanding allegation 


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1 against the individual before such an adminis2 trative agency or body. 

3 ‘‘(G) Any written notification by the State 

4 to the individual of potential termination of a li5 cense for cause or otherwise. 

6 ‘‘(c) DISCLOSURE OF CERTAIN INFORMATION FOL7 LOWING APPOINTMENT.—(1) Each individual appointed 

8 in the Veterans Health Administration in the position of 

9 physician after the date of the enactment of this section 

10 shall, as a condition of service under the appointment, dis11 close to the Secretary, not later than 30 days after the 

12 occurrence of such event, the following: 

13 ‘‘(A) A judgment against the individual for 

14 medical malpractice or negligence. 

15 ‘‘(B) A payment made by or on behalf of the 

16 individual to settle any lawsuit, action, or claim dis17 closed under paragraph (1) or (2) of subsection (b). 

18 ‘‘(C) Any disposition of or material change in a 

19 matter disclosed under paragraph (1) or (2) of sub20 section (b). 

21 ‘‘(2) Each individual appointed in the Veterans 

22 Health Administration in the position of physician as of 

23 the date of the enactment of this section shall do the fol24 lowing: 


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1 ‘‘(A) Not later than the end of the 60-day pe2 riod beginning on the date of the enactment of this 

3 section and as a condition of service under the ap4 pointment after the end of that period, submit the 

5 request and authorization described in subsection 

6 (b)(2). 

7 ‘‘(B) Agree, as a condition of service under the 

8 appointment, to disclose to the Secretary, not later 

9 than 30 days after the occurrence of such event, the 

10 following: 

11 ‘‘(i) A judgment against the individual for 

12 medical malpractice or negligence. 

13 ‘‘(ii) A payment made by or on behalf of 

14 the individual to settle any lawsuit, action, or 

15 claim disclosed pursuant to subparagraph (A) 

16 or under this subparagraph. 

17 ‘‘(iii) Any disposition of or material change 

18 in a matter disclosed pursuant to subparagraph 

19 (A) or under this subparagraph. 

20 ‘‘(3) Each individual appointed in the Veterans 

21 Health Administration in the position of physician shall, 

22 as part of the biennial review of the performance of the 

23 physician under the appointment, submit the request and 

24 authorization described in subsection (b)(2). The requireVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 ment of this paragraph is in addition to the requirements 

2 of paragraph (1) or (2), as applicable. 

3 ‘‘(d) INVESTIGATION OF DISCLOSED MATTERS.—(1) 

4 The Director of the Veterans Integrated Services Network 

5 (VISN) in which an individual is seeking appointment in 

6 the Veterans Health Administration in the position of phy7 sician shall perform an investigation (in such manner as 

8 the standards required by this section shall specify) of 

9 each matter disclosed under subsection (b) with respect 

10 to the individual. 

11 ‘‘(2) The Director of the Veterans Integrated Serv12 ices Network in which an individual is appointed in the 

13 Veterans Health Administration in the position of physi14 cian shall perform an investigation (in a manner so speci15 fied) of each matter disclosed under subsection (c) with 

16 respect to the individual. 

17 ‘‘(3) The results of each investigation performed 

18 under this subsection shall be fully documented. 

19 ‘‘(e) APPROVAL OF APPOINTMENTS BY DIRECTORS

20 OF VISNS.—(1) An individual may not be appointed in 

21 the Veterans Health Administration in the position of phy22 sician without the approval of the Director of the Veterans 

23 Integrated Services Network in which the individual will 

24 first serve under the appointment. 


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1 ‘‘(2) In approving the appointment under this sub2 section of an individual for whom any matters have been 

3 disclosed under subsection (b), a Director shall— 

4 ‘‘(A) certify in writing the completion of the 

5 performance of the investigation under subsection 

6 (d)(1) of each such matter, including the results of 

7 such investigation; and 

8 ‘‘(B) provide a written justification why any 

9 matters raised in the course of such investigation do 

10 not disqualify the individual from appointment. 

11 ‘‘(f) ENROLLMENT OF PHYSICIANS WITH PRACTICE

12 PRIVILEGES IN PROACTIVE DISCLOSURE SERVICE.—Each 

13 medical facility of the Department at which physicians are 

14 extended the privileges of practice shall enroll each physi15 cian extended such privileges in the Proactive Disclosure 

16 Service of the National Practitioner Data Bank. 

17 ‘‘(g) ENCOURAGING HIRING OF PHYSICIANS WITH

18 BOARD CERTIFICATION.—(1) The Secretary shall, for 

19 each performance contract with a Director of a Veterans 

20 Integrated Services Network (VISN), include in such con21 tract a provision that encourages such director to hire 

22 physicians who are board eligible or board certified in the 

23 specialty in which the physicians will practice. 

24 ‘‘(2) The Secretary may determine the nature and 

25 manner of the provision described in paragraph (1).’’. 


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1 (2) CLERICAL AMENDMENT.—The table of sec2 tions at the beginning of chapter 74 is amended by 

3 inserting after the item relating to section 7402 the 

4 following new item: 

‘‘7402A. Appointment and practice of physicians: standards.’’. 

5 (b) EFFECTIVE DATE AND APPLICABILITY.— 

6 (1) EFFECTIVE DATE.—Except as provided in 

7 paragraphs (2) and (3), the amendments made by 

8 subsection (a) shall take effect on the date of the en9 actment of this Act. 

10 (2) APPLICABILITY OF CERTAIN REQUIRE11 MENTS TO PHYSICIANS PRACTICING ON EFFECTIVE

12 DATE.—In the case of an individual appointed to the 

13 Veterans Health Administration in the position of 

14 physician as of the date of the enactment of this 

15 Act, the requirements of section 7402A(f) of title 

16 38, United States Code, as added by subsection (a) 

17 of this section, shall take effect on the date that is 

18 60 days after the date of the enactment of this Act. 

19 (3) APPLICABILITY OF REQUIREMENTS RE20 LATED TO HIRING OF PHYSICIANS WITH BOARD CER21 TIFICATION.—The requirement of section 7402A(g) 

22 of such title, as added by subsection (a), shall begin 

23 with the first cycle of performance contracts for di24 rectors of Veterans Integrated Services Networks be25 ginning after the date of the enactment of this Act. 


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1 TITLE II—HEALTH CARE 

2 MATTERS 

3 SEC. 201. REPEAL OF CERTAIN ANNUAL REPORTING RE4 QUIREMENTS. 

5 (a) NURSE PAY REPORT.—Section 7451 is amend6 ed— 

7 (1) by striking subsection (f); and 

8 (2) by redesignating subsection (g) as sub9 section (f). 

10 (b) LONG-TERM PLANNING REPORT.— 

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

12 (2) CONFORMING AMENDMENT.—The table of 

13 sections at the beginning of chapter 81 is amended 

14 by striking the item relating to section 8107. 

15 SEC. 202. MODIFICATIONS TO ANNUAL GULF WAR RE16 SEARCH REPORT. 

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

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

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

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

21 1, 2008, and July 1 of each of the five following years’’. 

22 SEC. 203. PAYMENT FOR CARE FURNISHED TO CHAMPVA 

23 BENEFICIARIES. 

24 Section 1781 is amended at the end by adding the 

25 following new subsection: 


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

2 behalf of a covered beneficiary for medical care shall con3 stitute payment in full and extinguish any liability on the 

4 part of the beneficiary for that care.’’. 

5 SEC. 204. PAYOR PROVISIONS FOR CARE FURNISHED TO 

6 CERTAIN CHILDREN OF VIETNAM VETERANS. 

7 (a) CHILDREN OF VIETNAM VETERANS BORN WITH

8 SPINA BIFIDA.—Section 1803 is amended— 

9 (1) by redesignating subsection (c) as sub10 section (d); and 

11 (2) by inserting after subsection (b) the fol12 lowing new subsection (c): 

13 ‘‘(c) Where payment by the Secretary under this sec14 tion is less than the amount of the charges billed, the 

15 health care provider or agent of the health care provider 

16 may seek payment for the difference between the amount 

17 billed and the amount paid by the Secretary from a re18 sponsible third party to the extent that the provider or 

19 agent thereof would be eligible to receive payment for such 

20 care or services from such third party, but— 

21 ‘‘(1) the health care provider or agent for the 

22 health care provider may not impose any additional 

23 charge on the beneficiary who received the medical 

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1 ice or item for which the Secretary has made pay2 ment under this section; 

3 ‘‘(2) the total amount of payment a provider or 

4 agent of the provider may receive for care and serv5 ices furnished under this section may not exceed the 

6 amount billed to the Secretary; and 

7 ‘‘(3) the Secretary, upon request, shall disclose 

8 to such third party information received for the pur9 poses of carrying out this section.’’. 

10 (b) CHILDREN OF WOMEN VIETNAM VETERANS

11 BORN WITH BIRTH DEFECTS.—Section 1813 is amend12 ed— 

13 (1) by redesignating subsection (c) as sub14 section (d); and 

15 (2) by inserting after subsection (b) the fol16 lowing new subsection (c): 

17 ‘‘(c) SEEKING PAYMENT FROM THIRD PARTIES.— 

18 Where payment by the Secretary under this section is less 

19 than the amount of the charges billed, the health care pro20 vider or agent of the health care provider may seek pay21 ment for the difference between the amount billed and the 

22 amount paid by the Secretary from a responsible third 

23 party to the extent that the health care provider or agent 

24 thereof would be eligible to receive payment for such care 

25 or services from such third party, but— 


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1 ‘‘(1) the health care provider or agent for the 

2 health care provider may not impose any additional 

3 charge on the beneficiary who received medical care, 

4 or the family of such beneficiary, for any service or 

5 item for which the Secretary has made payment 

6 under this section; 

7 ‘‘(2) the total amount of payment a provider or 

8 agent of the provider may receive for care and serv9 ices furnished under this section may not exceed the 

10 amount billed to the Secretary; and 

11 ‘‘(3) the Secretary, upon request, shall disclose 

12 to such third party information received for the pur13 poses of carrying out this section.’’. 

14 SEC. 205. DISCLOSURES FROM CERTAIN MEDICAL 

15 RECORDS. 

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

17 the following new subparagraph: 

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

19 lacks decision-making capacity, when a practitioner 

20 deems the content of the given record necessary for 

21 that representative to make an informed decision re22 garding the patient’s treatment. 

23 ‘‘(ii) In this subparagraph, the term ‘represent24 ative’ means an individual, organization, or other 

25 body authorized under section 7331 of this title and 


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1 its implementing regulations to give informed con2 sent on behalf of a patient who lacks decision-mak3 ing capacity.’’. 

4 SEC. 206. DISCLOSURE TO SECRETARY OF HEALTH-PLAN 

5 CONTRACT INFORMATION AND SOCIAL SECU6 RITY NUMBER OF CERTAIN VETERANS RE7 CEIVING CARE. 

8 (a) IN GENERAL.—Subchapter I of chapter 17 is 

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

10 ‘‘§ 1709. Disclosure to Secretary of health-plan con11 tract information and social security 

12 number of certain veterans receiving 

13 care 

14 ‘‘(a) REQUIRED DISCLOSURE OF HEALTH-PLAN

15 CONTRACTS.—(1) Any individual who applies for or is in 

16 receipt of care described in paragraph (2) shall, at the 

17 time of such application, or otherwise when requested by 

18 the Secretary, submit to the Secretary such current infor19 mation as the Secretary may require to identify any 

20 health-plan contract (as defined in section 1729(i) of this 

21 title) under which such individual is covered, to include, 

22 as applicable— 

23 ‘‘(A) the name, address, and telephone number 

24 of such health-plan contract; 


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1 ‘‘(B) the name of the individual’s spouse, if the 

2 individual’s coverage is under the spouse’s health3 plan contract; 

4 ‘‘(C) the plan number; and 

5 ‘‘(D) the plan’s group code. 

6 ‘‘(2) The care described in this paragraph is— 

7 ‘‘(A) hospital, nursing home, or domiciliary 

8 care; 

9 ‘‘(B) medical, rehabilitative, or preventive 

10 health services; or 

11 ‘‘(C) other medical care under laws adminis12 tered by the Secretary. 

13 ‘‘(b) REQUIRED DISCLOSURE OF SOCIAL SECURITY

14 NUMBER.—(1) Any individual who applies for or is in re15 ceipt of care described in paragraph (2) shall, at the time 

16 of such application, or otherwise when requested by the 

17 Secretary, submit to the Secretary— 

18 ‘‘(A) the individual’s social security number; 

19 and 

20 ‘‘(B) the social security number of any depend21 ent or Department beneficiary on whose behalf, or 

22 based upon whom, such individual applies for or is 

23 in receipt of such care. 

24 ‘‘(2) The care described in this paragraph is— 


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1 ‘‘(A) hospital, nursing home, or domiciliary 

2 care; 

3 ‘‘(B) medical, rehabilitative, or preventive 

4 health services; or 

5 ‘‘(C) other medical care under laws adminis6 tered by the Secretary. 

7 ‘‘(3) This subsection does not require an individual 

8 to furnish the Secretary with a social security number for 

9 any individual to whom a social security number has not 

10 been assigned. 

11 ‘‘(c) FAILURE TO DISCLOSE SOCIAL SECURITY NUM12 BER.—(1) The Secretary shall deny an individual’s appli13 cation for, or may terminate an individual’s enrollment in, 

14 the system of patient enrollment established by the Sec15 retary under section 1705 of this title, if such individual 

16 does not provide the social security number required or 

17 requested to be submitted pursuant to subsection (b). 

18 ‘‘(2) Following a denial or termination under para19 graph (1) with respect to an individual, the Secretary may, 

20 upon receipt of the information required or requested 

21 under subsection (b), approve such individual’s application 

22 or reinstate such individual’s enrollment (if otherwise in 

23 order), for such medical care and services provided on and 

24 after the date of such receipt of information. 


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1 ‘‘(d) CONSTRUCTION.—Nothing in this section shall 

2 be construed as authority to deny medical care and treat3 ment to an individual in a medical emergency.’’. 

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

5 at the beginning of such chapter 17 is amended by insert6 ing after the item relating to section 1708 the following 

7 new item: 

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

8 SEC. 207. ENHANCEMENT OF QUALITY MANAGEMENT. 

9 (a) ENHANCEMENT OF QUALITY MANAGEMENT

10 THROUGH QUALITY MANAGEMENT OFFICERS.— 

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

12 is amended by inserting after section 7311 the fol13 lowing new section: 

14 ‘‘§ 7311A. Quality management officers 

15 ‘‘(a) NATIONAL QUALITY MANAGEMENT OFFICER.— 

16 (1) The Under Secretary for Health shall designate an of17 ficial of the Veterans Health Administration to act as the 

18 principal quality management officer for the quality-assur19 ance program required by section 7311 of this title. The 

20 official so designated may be known as the ‘National Qual21 ity Management Officer of the Veterans Health Adminis22 tration’ (in this section referred to as the ‘National Qual23 ity Management Officer’). 


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

2 report directly to the Under Secretary for Health in the 

3 discharge of responsibilities and duties of the Officer 

4 under this section. 

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

6 be the official within the Veterans Health Administration 

7 who is principally responsible for the quality-assurance 

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

9 responsibility, the Officer shall be responsible for the fol10 lowing: 

11 ‘‘(A) Establishing and enforcing the require12 ments of the program referred to in paragraph (1). 

13 ‘‘(B) Developing an aggregate quality metric 

14 from existing data sources, such as the Inpatient 

15 Evaluation Center of the Department, the National 

16 Surgical Quality Improvement Program of the 

17 American College of Surgeons, and the External 

18 Peer Review Program of the Veterans Health Ad19 ministration, that could be used to assess reliably 

20 the quality of care provided at individual Depart21 ment medical centers and associated community 

22 based outpatient clinics. 

23 ‘‘(C) Ensuring that existing measures of qual24 ity, including measures from the Inpatient Evalua25 tion Center, the National Surgical Quality ImproveVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00040 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 ment Program, System-Wide Ongoing Assessment 

2 and Review reports of the Department, and Com3 bined Assessment Program reviews of the Office of 

4 Inspector General of the Department, are monitored 

5 routinely and analyzed in a manner that ensures the 

6 timely detection of quality of care issues. 

7 ‘‘(D) Encouraging research and development in 

8 the area of quality metrics for the purposes of im9 proving how the Department measures quality in in10 dividual facilities. 

11 ‘‘(E) Carrying out such other responsibilities 

12 and duties relating to quality management in the 

13 Veterans Health Administration as the Under Sec14 retary for Health shall specify. 

15 ‘‘(4) The requirements under paragraph (3) shall in16 clude requirements regarding the following: 

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

18 reports by Veterans Health Administration per19 sonnel regarding quality management at Department 

20 facilities. 

21 ‘‘(B) Mechanisms for the peer review of the ac22 tions of individuals appointed in the Veterans Health 

23 Administration in the position of physician. 

24 ‘‘(b) QUALITY MANAGEMENT OFFICERS FOR

25 VISNS.—(1) The Regional Director of each Veterans InVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00041 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 tegrated Services Network (VISN) shall appoint an official 

2 of the Network to act as the quality management officer 

3 of the Network. 

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

5 Integrated Services Network shall report to the Regional 

6 Director of the Veterans Integrated Services Network, and 

7 to the National Quality Management Officer, regarding 

8 the discharge of the responsibilities and duties of the offi9 cer under this section. 

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

11 Integrated Services Network shall— 

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

13 the Network; and 

14 ‘‘(B) coordinate, monitor, and oversee the qual15 ity management programs and activities of the Ad16 ministration medical facilities in the Network in 

17 order to ensure the thorough and uniform discharge 

18 of quality management requirements under such 

19 programs and activities throughout such facilities. 

20 ‘‘(c) QUALITY MANAGEMENT OFFICERS FOR MED21 ICAL FACILITIES.—(1) The director of each Veterans 

22 Health Administration medical facility shall appoint a 

23 quality management officer for that facility. 

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

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


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1 the quality management officer of the Veterans Integrated 

2 Services Network in which the facility is located, regarding 

3 the discharge of the responsibilities and duties of the qual4 ity management officer under this section. 

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

6 shall be responsible for designing, disseminating, and im7 plementing quality management programs and activities 

8 for the facility that meet the requirements established by 

9 the National Quality Management Officer under sub10 section (a). 

11 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—(1) Ex12 cept as provided in paragraph (2), there are authorized 

13 to be appropriated such sums as may be necessary to carry 

14 out this section. 

15 ‘‘(2) There are authorized to be appropriated to carry 

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

17 subsection (a)(3), $25,000,000 for the two-year period of 

18 fiscal years beginning after the date of the enactment of 

19 this section.’’. 

20 (2) CLERICAL AMENDMENT.—The table of sec21 tions at the beginning of chapter 73 is amended by 

22 inserting after the item relating to section 7311 the 

23 following new item: 

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


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1 (b) REPORTS ON QUALITY CONCERNS UNDER QUAL2 ITY-ASSURANCE PROGRAM.—Section 7311(b) is amended 

3 by adding at the end the following new paragraph: 

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

5 Under Secretary for Health shall establish mechanisms 

6 through which employees of Veterans Health Administra7 tion facilities may submit reports, on a confidential basis, 

8 on matters relating to quality of care in Veterans Health 

9 Administration facilities to the quality management offi10 cers of such facilities under section 7311A(b) of this title. 

11 The mechanisms shall provide for the prompt and thor12 ough review of any reports so submitted by the receiving 

13 officials.’’. 

14 (c) REVIEW OF CURRENT HEALTH CARE QUALITY

15 SAFEGUARDS.— 

16 (1) IN GENERAL.—The Secretary of Veterans 

17 Affairs shall conduct a comprehensive review of all 

18 current policies and protocols of the Department of 

19 Veterans Affairs for maintaining health care quality 

20 and patient safety at Department medical facilities. 

21 The review shall include a review and assessment of 

22 the National Surgical Quality Improvement Program 

23 (NSQIP), including an assessment of— 

24 (A) the efficacy of the quality indicators 

25 under the program; 


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1 (B) the efficacy of the data collection 

2 methods under the program; 

3 (C) the efficacy of the frequency with 

4 which regular data analyses are performed 

5 under the program; and 

6 (D) the extent to which the resources allo7 cated to the program are adequate to fulfill the 

8 stated function of the program. 

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

10 date of the enactment of this Act, the Secretary 

11 shall submit to Congress a report on the review con12 ducted under paragraph (1), including the findings 

13 of the Secretary as a result of the review and such 

14 recommendations as the Secretary considers appro15 priate in light of the review. 

16 SEC. 208. REPORTS ON IMPROVEMENTS TO DEPARTMENT 

17 HEALTH CARE QUALITY MANAGEMENT. 

18 (a) REPORT.—Not later than December 15, 2009, 

19 and each year thereafter through 2012, the Secretary of 

20 Veterans Affairs shall submit to the congressional vet21 erans affairs committees a report on the implementation 

22 of sections 104 and 207 of this Act and the amendments 

23 made by such sections during the preceding fiscal year. 

24 Each report shall include, for the fiscal year covered by 

25 such report, the following: 


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1 (1) A comprehensive description of the imple2 mentation of sections 104 and 207 of this Act and 

3 the amendments made by such sections. 

4 (2) Such recommendations as the Secretary 

5 considers appropriate for legislative or administra6 tive action to improve the authorities and require7 ments in such sections and the amendments made 

8 by such sections or to otherwise improve the quality 

9 of health care and the quality of the physicians in 

10 the Veterans Health Administration. 

11 (b) CONGRESSIONAL VETERANS AFFAIRS COMMIT12 TEES DEFINED.—In this section, the term ‘‘congressional 

13 veterans affairs committees’’ means— 

14 (1) the Committees on Veterans’ Affairs and 

15 Appropriations of the Senate; and 

16 (2) the Committees on Veterans’ Affairs and 

17 Appropriations of the House of Representatives. 

18 SEC. 209. PILOT PROGRAM ON TRAINING AND CERTIFI19 CATION FOR FAMILY CAREGIVER PERSONAL 

20 CARE ATTENDANTS FOR VETERANS AND 

21 MEMBERS OF THE ARMED FORCES WITH 

22 TRAUMATIC BRAIN INJURY. 

23 (a) PILOT PROGRAM AUTHORIZED.—The Secretary 

24 of Veterans Affairs shall, in collaboration with the Sec25 retary of Defense, carry out a pilot program to assess the 


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1 feasibility and advisability of providing training and cer2 tification for family caregivers of veterans and members 

3 of the Armed Forces with traumatic brain injury as per4 sonal care attendants of such veterans and members. 

5 (b) DURATION OF PROGRAM.—The pilot program re6 quired by subsection (a) shall be carried out during the 

7 three-year period beginning on the date of the commence8 ment of the pilot program. 

9 (c) LOCATIONS.— 

10 (1) IN GENERAL.—The pilot program under 

11 this section shall be carried out— 

12 (A) in three medical facilities of the De13 partment of Veterans Affairs; and 

14 (B) if determined appropriate by the Sec15 retary of Veterans Affairs and the Secretary of 

16 Defense, one medical facility of the Department 

17 of Defense. 

18 (2) EMPHASIS ON POLYTRAUMA CENTERS.—In 

19 selecting the locations of the pilot program at facili20 ties of the Department of Veterans Affairs, the Sec21 retary of Veterans Affairs shall give special empha22 sis to the polytrauma centers of the Department of 

23 Veterans Affairs designated as Tier I polytrauma 

24 centers. 

25 (d) TRAINING CURRICULA.— 


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1 (1) IN GENERAL.—The Secretary of Veterans 

2 Affairs shall develop curricula for the training of 

3 personal care attendants under the pilot program 

4 under this section. Such curricula shall incor5 porate— 

6 (A) applicable standards and protocols uti7 lized by certification programs of national brain 

8 injury care specialist organizations; and 

9 (B) best practices recognized by caregiving 

10 organizations. 

11 (2) USE OF EXISTING CURRICULA.—In devel12 oping the curricula required by paragraph (1), the 

13 Secretary of Veterans Affairs shall, to the extent 

14 practicable, utilize and expand upon training cur15 ricula developed pursuant to section 744(b) of the 

16 John Warner National Defense Authorization Act 

17 for Fiscal Year 2007 (Public Law 109–364; 120 

18 Stat. 2308). 

19 (e) PARTICIPATION IN PROGRAMS.— 

20 (1) IN GENERAL.—The Secretary of Veterans 

21 Affairs shall determine the eligibility of a family 

22 member of a veteran or member of the Armed 

23 Forces for participation in the pilot program under 

24 this section. 


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1 (2) BASIS FOR DETERMINATION.—A determina2 tion made under paragraph (1) shall be based on the 

3 needs of the veteran or member of the Armed Forces 

4 concerned, as determined by the physician of such 

5 veteran or member. 

6 (f) ELIGIBILITY FOR COMPENSATION.—A family 

7 caregiver of a veteran or member of the Armed Forces 

8 who receives certification as a personal care attendant 

9 under the pilot program under this section shall be eligible 

10 for compensation from the Department of Veterans Af11 fairs for care provided to such veteran or member. 

12 (g) COSTS OF TRAINING.— 

13 (1) TRAINING OF FAMILIES OF VETERANS.— 

14 Any costs of training provided under the pilot pro15 gram under this section for family members of vet16 erans shall be borne by the Secretary of Veterans 

17 Affairs. 

18 (2) TRAINING OF FAMILIES OF MEMBERS OF

19 THE ARMED FORCES.—The Secretary of Defense 

20 shall reimburse the Secretary of Veterans Affairs for 

21 any costs of training provided under the pilot pro22 gram for family members of members of the Armed 

23 Forces. 

24 (h) ASSESSMENT OF FAMILY CAREGIVER NEEDS.— 


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1 (1) IN GENERAL.—The Secretary of Veterans 

2 Affairs may provide to a family caregiver who re3 ceives training under the pilot program under this 

4 section— 

5 (A) an assessment of their needs with re6 spect to their role as a family caregiver; and 

7 (B) a referral to services and support 

8 that— 

9 (i) are relevant to any needs identified 

10 in such assessment; and 

11 (ii) are provided in the community 

12 where the family caregiver resides, includ13 ing such services and support provided by 

14 community-based organizations, publicly 

15 funded programs, and the Department of 

16 Veterans Affairs. 

17 (2) USE OF EXISTING TOOLS.—In developing 

18 and administering an assessment under paragraph 

19 (1), the Secretary shall, to the extent practicable, 

20 use and expand upon caregiver assessment tools al21 ready developed and in use by the Department. 

22 (i) REPORT.—Not later than 2 years after the date 

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

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1 ommendations of the Secretary with respect to expansion 

2 or modification of the pilot program. 

3 (j) CONSTRUCTION.—Nothing in this section shall be 

4 construed— 

5 (1) to establish a mandate or right for a family 

6 caregiver to be trained and certified under this sec7 tion; and 

8 (2) to prohibit the Secretary from considering 

9 or adopting the preference of a veteran or member 

10 of the Armed Forces for services provided by a per11 sonal care attendant who is not a family caregiver. 

12 (k) FAMILY CAREGIVER DEFINED.—In this section, 

13 with respect to member of the Armed Forces or a veteran 

14 with traumatic brain injury, the term ‘‘family caregiver’’ 

15 means a family member of such member or veteran, or 

16 such other individual of similar affinity to such member 

17 or veteran as the Secretary proscribes, who is providing 

18 care to such member or veteran for such traumatic brain 

19 injury. 


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1 SEC. 210. PILOT PROGRAM ON PROVISION OF RESPITE 

2 CARE TO MEMBERS OF THE ARMED FORCES 

3 AND VETERANS WITH TRAUMATIC BRAIN IN4 JURY BY STUDENTS IN GRADUATE PRO5 GRAMS OF EDUCATION RELATED TO MENTAL 

6 HEALTH OR REHABILITATION. 

7 (a) PILOT PROGRAM AUTHORIZED.—The Secretary 

8 of Veterans Affairs shall, in collaboration with the Sec9 retary of Defense, carry out a pilot program to assess the 

10 feasibility and advisability of providing respite care to 

11 members of the Armed Forces and veterans described in 

12 subsection (c) through students enrolled in graduate pro13 grams of education described in subsection (d)(1) to pro14 vide— 

15 (1) relief to the family caregivers of such mem16 bers and veterans from the responsibilities associ17 ated with providing care to such members and vet18 erans; and 

19 (2) socialization and cognitive skill development 

20 to such members and veterans. 

21 (b) DURATION OF PROGRAM.—The pilot program re22 quired by subsection (a) shall be carried out during the 

23 three-year period beginning on the date of the commence24 ment of the pilot program. 


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1 (c) COVERED MEMBERS AND VETERANS.—The mem2 bers of the Armed Forces and veterans described in this 

3 subsection are the individuals as follows: 

4 (1) Members of the Armed Forces who have 

5 been diagnosed with traumatic brain injury, includ6 ing limitations of ambulatory mobility, cognition, 

7 and verbal abilities. 

8 (2) Veterans who have been so diagnosed. 

9 (d) PROGRAM LOCATIONS.— 

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

11 carried out at not more than 10 locations selected by 

12 the Secretary of Veterans Affairs for purposes of the 

13 pilot program. Each location so selected shall be a 

14 medical facility of the Department of Veterans Af15 fairs that is in close proximity to, or that has a rela16 tionship, affiliation, or established partnership with, 

17 an institution of higher education that has a grad18 uate program in an appropriate mental health or re19 habilitation related field, such as social work, nurs20 ing, psychology, occupational therapy, physical ther21 apy, or interdisciplinary training programs. 

22 (2) CONSIDERATIONS.—In selecting medical fa23 cilities of the Department for the pilot program, the 

24 Secretary shall give special consideration to the fol25 lowing: 


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1 (A) The polytrauma centers of the Depart2 ment designated as Tier I polytrauma centers. 

3 (B) Facilities of the Department in regions 

4 with a high concentration of veterans with trau5 matic brain injury. 

6 (e) SCOPE OF ASSISTANCE.— 

7 (1) USE OF GRADUATE STUDENTS.—In car8 rying out the pilot program, the Secretary shall— 

9 (A) recruit students enrolled in a graduate 

10 program of education selected by the Secretary 

11 under subsection (d)(1) to provide respite care 

12 to the members of the Armed Forces and vet13 erans described in subsection (c); 

14 (B) train such students to provide respite 

15 care to such members and veterans; and 

16 (C) match such students with such mem17 bers and veterans in the student’s local area for 

18 the provision of individualized respite care to 

19 such members and veterans. 

20 (2) DETERMINATIONS IN CONJUNCTION WITH

21 HEADS OF GRADUATE PROGRAMS OF EDUCATION.— 

22 The Secretary shall determine, in collaboration with 

23 the head of the graduate program of education cho24 sen to participate in the pilot program under sub25 section (d)(1), the following: 


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1 (A) The amount of training that a student 

2 shall complete before providing respite care 

3 under the pilot program. 

4 (B) The number of hours of respite care to 

5 be provided by the students who participate in 

6 the pilot program. 

7 (C) The requirements for successful par8 ticipation by a student in the pilot program. 

9 (f) TRAINING STANDARDS AND BEST PRACTICES.— 

10 In providing training under subsection (e)(1)(B), the Sec11 retary shall use— 

12 (1) applicable standards and protocols used by 

13 certification programs of national brain injury care 

14 specialist organizations in the provision of respite 

15 care training; and 

16 (2) best practices recognized by caregiving or17 ganizations. 

18 (g) DEFINITIONS.—In this section: 

19 (1) FAMILY CAREGIVER.—With respect to mem20 ber of the Armed Forces or a veteran with traumatic 

21 brain injury, the term ‘‘family caregiver’’ means a 

22 relative, partner, or friend of such member or vet23 eran who is providing care to such member or vet24 eran for such traumatic brain injury. 


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1 (2) RESPITE CARE.—The term ‘‘respite care’’ 

2 means the temporary provision of care to an indi3 vidual to provide relief to the regular caregiver of 

4 the individual from the ongoing responsibility of pro5 viding care to such individual. 

6 SEC. 211. PILOT PROGRAM ON USE OF COMMUNITY-BASED 

7 ORGANIZATIONS AND LOCAL AND STATE 

8 GOVERNMENT ENTITIES TO ENSURE THAT 

9 VETERANS RECEIVE CARE AND BENEFITS 

10 FOR WHICH THEY ARE ELIGIBLE. 

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

12 Veterans Affairs shall carry out a pilot program to assess 

13 the feasibility and advisability of using community-based 

14 organizations and local and State government entities— 

15 (1) to increase the coordination of community, 

16 local, State, and Federal providers of health care 

17 and benefits for veterans to assist veterans who are 

18 transitioning from military service to civilian life in 

19 such transition; 

20 (2) to increase the availability of high quality 

21 medical and mental health services to veterans 

22 transitioning from military service to civilian life; 

23 (3) to provide assistance to families of veterans 

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1 ian life to help such families adjust to such transi2 tion; and 

3 (4) to provide outreach to veterans and their 

4 families to inform them about the availability of ben5 efits and connect them with appropriate care and 

6 benefit programs. 

7 (b) DURATION OF PROGRAM.—The pilot program 

8 shall be carried out during the two-year period beginning 

9 on the date of the enactment of this Act. 

10 (c) PROGRAM LOCATIONS.— 

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

12 carried out at five locations selected by the Secretary 

13 for purposes of the pilot program. 

14 (2) CONSIDERATIONS.—In selecting locations 

15 for the pilot program, the Secretary shall consider 

16 the advisability of selecting locations in— 

17 (A) rural areas; 

18 (B) areas with populations that have a 

19 high proportion of minority group representa20 tion; 

21 (C) areas with populations that have a 

22 high proportion of individuals who have limited 

23 access to health care; and 

24 (D) areas that are not in close proximity 

25 to an active duty military installation. 


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

2 program through the award of grants to community-based 

3 organizations and local and State government entities. 

4 (e) SELECTION OF GRANT RECIPIENTS.— 

5 (1) IN GENERAL.—A community-based organi6 zation or local or State government entity seeking a 

7 grant under the pilot program shall submit to the 

8 Secretary of Veterans Affairs an application therefor 

9 in such form and in such manner as the Secretary 

10 considers appropriate. 

11 (2) ELEMENTS.—Each application submitted 

12 under paragraph (1) shall include the following: 

13 (A) A description of how the proposal was 

14 developed in consultation with the Department 

15 of Veterans Affairs. 

16 (B) A plan to coordinate activities under 

17 the pilot program, to the greatest extent pos18 sible, with the local, State, and Federal pro19 viders of services for veterans to reduce duplica20 tion of services and to increase the effect of 

21 such services. 

22 (f) USE OF GRANT FUNDS.—The Secretary shall pre23 scribe appropriate uses of grant funds received under the 

24 pilot program. 

25 (g) REPORT ON PROGRAM.— 


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

2 after the completion of the pilot program, the Sec3 retary shall submit to Congress a report on the pilot 

4 program. 

5 (2) ELEMENTS.—The report required by para6 graph (1) shall include the following: 

7 (A) The findings and conclusions of the 

8 Secretary with respect to the pilot program. 

9 (B) An assessment of the benefits to vet10 erans of the pilot program. 

11 (C) The recommendations of the Secretary 

12 as to the advisability of continuing the pilot 

13 program. 

14 SEC. 212. SPECIALIZED RESIDENTIAL CARE AND REHABILI15 TATION FOR CERTAIN VETERANS. 

16 Section 1720 is amended by adding at the end the 

17 following new subsection: 

18 ‘‘(g) The Secretary may contract with appropriate en19 tities to provide specialized residential care and rehabilita20 tion services to a veteran of Operation Enduring Freedom 

21 or Operation Iraqi Freedom who the Secretary determines 

22 suffers from a traumatic brain injury, has an accumula23 tion of deficits in activities of daily living and instrumental 

24 activities of daily living, and because of these deficits, 

25 would otherwise require admission to a nursing home even 


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1 though such care would generally exceed the veteran’s 

2 nursing needs.’’. 

3 SEC. 213. AUTHORITY TO DISCLOSE MEDICAL RECORDS TO 

4 THIRD PARTY FOR COLLECTION OF CHARGES 

5 FOR PROVISION OF CERTAIN CARE. 

6 (a) LIMITED EXCEPTION TO CONFIDENTIALITY OF

7 MEDICAL RECORDS.—Section 5701 is amended by adding 

8 at the end the following new subsection: 

9 ‘‘(l) Under regulations that the Secretary shall pre10 scribe, the Secretary may disclose the name or address, 

11 or both, of any individual who is a present or former mem12 ber of the Armed Forces, or who is a dependent of a 

13 present or former member of the Armed Forces, to a third 

14 party, as defined in section 1729(i)(3)(D) of this title, in 

15 order to enable the Secretary to collect reasonable charges 

16 under section 1729(a)(2)(E) of this title for care or serv17 ices provided for a non-service-connected disability.’’. 

18 (b) DISCLOSURES FROM CERTAIN MEDICAL

19 RECORDS.—Section 7332(b)(2), as amended by section 

20 205 of this Act, is further amended by adding at the end 

21 the following new subparagraph: 

22 ‘‘(G) To a third party, as defined in section 

23 1729(i)(3)(D) of this title, to collect reasonable 

24 charges under section 1729(a)(2)(E) of this title for 


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1 care or services provided for a non-service-connected 

2 disability.’’. 

3 SEC. 214. EXPANDED STUDY ON THE HEALTH IMPACT OF 

4 PROJECT SHIPBOARD HAZARD AND DE5 FENSE. 

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

7 date of the enactment of this Act, the Secretary of Vet8 erans Affairs shall enter into a contract with the Institute 

9 of Medicine of the National Academies to conduct an ex10 panded study on the health impact of Project Shipboard 

11 Hazard and Defense (Project SHAD). 

12 (b) COVERED VETERANS.—The study required by 

13 subsection (a) shall include, to the extent practicable, all 

14 veterans who participated in Project Shipboard Hazard 

15 and Defense. 

16 (c) UTILIZATION OF EXISTING STUDIES.—The study 

17 required by subsection (a) may use results from the study 

18 covered in the report entitled ‘‘Long-Term Health Effects 

19 of Participation in Project SHAD’’ of the Institute of 

20 Medicine of the National Academies. 

21 SEC. 215. USE OF NON-DEPARTMENT FACILITIES FOR RE22 HABILITATION OF INDIVIDUALS WITH TRAU23 MATIC BRAIN INJURY. 

24 Section 1710E is amended— 


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1 (1) by redesignating subsection (b) as sub2 section (c); 

3 (2) by inserting after subsection (a) the fol4 lowing new subsection (b): 

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

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

7 an individual— 

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

9 this title; and 

10 ‘‘(2)(A) to whom the Secretary is unable to pro11 vide such treatment or services at the frequency or 

12 for the duration prescribed in such plan; or 

13 ‘‘(B) for whom the Secretary determines that it 

14 is optimal with respect to the recovery and rehabili15 tation for such individual.’’; and 

16 (3) by adding at the end the following new sub17 section: 

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

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

20 non-Department facility under such subsection unless 

21 such facility maintains standards for the provision of such 

22 treatment or services established by an independent, peer23 reviewed organization that accredits specialized rehabilita24 tion programs for adults with traumatic brain injury.’’. 


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1 SEC. 216. INCLUSION OF FEDERALLY RECOGNIZED TRIBAL 

2 ORGANIZATIONS IN CERTAIN PROGRAMS FOR 

3 STATE VETERANS HOMES. 

4 (a) TREATMENT OF TRIBAL ORGANIZATION HEALTH

5 FACILITIES AS STATE HOMES.—Section 8138 is amend6 ed— 

7 (1) by redesignating subsection (e) as sub8 section (f); and 

9 (2) by inserting after subsection (d) the fol10 lowing new subsection (e): 

11 ‘‘(e)(1) A health facility (or certain beds in a health 

12 facility) of a tribal organization is treatable as a State 

13 home under subsection (a) in accordance with the provi14 sions of that subsection. 

15 ‘‘(2) Except as provided in paragraph (3), the provi16 sions of this section shall apply to a health facility (or cer17 tain beds in such facility) treated as a State home under 

18 subsection (a) by reason of this subsection to the same 

19 extent as health facilities (or beds) treated as a State 

20 home under subsection (a). 

21 ‘‘(3) Subsection (f) shall not apply to the treatment 

22 of health facilities (or certain beds in such facilities) of 

23 tribal organizations as a State home under subsection 

24 (a).’’. 

25 (b) STATE HOME FACILITIES FOR DOMICILIARY, 

26 NURSING, AND OTHER CARE.— 


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1 (1) IN GENERAL.—Chapter 81 is further 

2 amended— 

3 (A) in section 8131, by adding at the end 

4 the following new paragraph: 

5 ‘‘(5) The term ‘tribal organization’ has the 

6 meaning given such term in section 3765 of this 

7 title.’’; 

8 (B) in section 8132, by inserting ‘‘and 

9 tribal organizations’’ after ‘‘the several States’’; 

10 and 

11 (C) by inserting after section 8133 the fol12 lowing new section: 

13 ‘‘§ 8133A. Tribal organizations 

14 ‘‘(a) AUTHORITY TO AWARD GRANTS.—The Sec15 retary may award a grant to a tribal organization under 

16 this subchapter in order to carry out the purposes of this 

17 subchapter. 

18 ‘‘(b) MANNER AND CONDITION OF GRANT

19 AWARDS.—(1) Grants to tribal organizations under this 

20 section shall be awarded in the same manner, and under 

21 the same conditions, as grants awarded to the several 

22 States under the provisions of this subchapter, subject to 

23 such exceptions as the Secretary shall prescribe for pur24 poses of this subchapter to take into account the unique 

25 circumstances of tribal organizations. 


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1 ‘‘(2) For purposes of according priority under sub2 section (c)(2) of section 8135 of this title to an application 

3 submitted under subsection (a) of such section, an applica4 tion submitted under such subsection (a) by a tribal orga5 nization of a State that has previously applied for award 

6 of a grant under this subchapter for construction or acqui7 sition of a State nursing home shall be considered under 

8 subparagraph (C) of such subsection (c)(2) an application 

9 from a tribal organization that has not previously applied 

10 for such a grant.’’. 

11 (2) CLERICAL AMENDMENT.—The table of sec12 tions at the beginning of chapter 81 is amended by 

13 inserting after the item relating to section 8133 the 

14 following new item: 

‘‘8133A. Tribal organizations.’’. 

15 SEC. 217. PILOT PROGRAM ON PROVISION OF DENTAL IN16 SURANCE PLANS TO VETERANS AND SUR17 VIVORS AND DEPENDENTS OF VETERANS. 

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

19 Veterans Affairs shall carry out a pilot program to assess 

20 the feasibility and advisability of providing a dental insur21 ance plan to veterans and survivors and dependents of vet22 erans described in subsection (b). 

23 (b) COVERED VETERANS AND SURVIVORS AND DE24 PENDENTS.—The veterans and survivors and dependents 

25 of veterans described in this subsection are as follows: 


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1 (1) Any veteran who is enrolled in the system 

2 of annual patient enrollment under section 1705 of 

3 this title. 

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

5 is eligible for medical care under section 1781 of 

6 this title. 

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

8 shall be carried out during the three-year period beginning 

9 on the date of the enactment of this Act. 

10 (d) PILOT PROGRAM LOCATIONS.—The pilot pro11 gram shall be carried out in not less than two and not 

12 more than four Veterans Integrated Services Networks 

13 (VISNs) selected by the Secretary of Veterans Affairs for 

14 purposes of the pilot program. 

15 (e) ADMINISTRATION.—The Secretary of Veterans 

16 Affairs shall contract with a dental insurer to administer 

17 the dental plan provided under the pilot program. 

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

19 pilot program shall provide such benefits for dental care 

20 and treatment as the Secretary considers appropriate for 

21 the dental insurance plan, including diagnostic services, 

22 preventative services, endodontics and other restorative 

23 services, surgical services, and emergency services. 

24 (g) ENROLLMENT.— 


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1 (1) VOLUNTARY.—Enrollment in the dental in2 surance plan under this section shall be voluntary. 

3 (2) MINIMUM PERIOD.—Enrollment in the den4 tal insurance plan shall be for such minimum period 

5 as the Secretary shall prescribe for purposes of this 

6 section. 

7 (h) PREMIUMS.— 

8 (1) IN GENERAL.—Premiums for coverage 

9 under the dental insurance plan under the pilot pro10 gram shall be in such amount or amounts as the 

11 Secretary of Veterans Affairs shall prescribe to cover 

12 all costs associated with the pilot program. 

13 (2) ANNUAL ADJUSTMENT.—The Secretary 

14 shall adjust the premiums payable under the pilot 

15 program for coverage under the dental insurance 

16 plan on an annual basis. Each individual covered by 

17 the dental insurance plan at the time of such an ad18 justment shall be notified of the amount and effec19 tive date of such adjustment. 

20 (3) RESPONSIBILITY FOR PAYMENT.—Each in21 dividual covered by the dental insurance plan shall 

22 pay the entire premium for coverage under the den23 tal insurance plan, in addition to the full cost of any 

24 copayments. 

25 (i) VOLUNTARY DISENROLLMENT.— 


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

2 in the dental insurance plan under the pilot pro3 gram, the Secretary shall— 

4 (A) permit the voluntary disenrollment of 

5 an individual in the dental insurance plan if the 

6 disenrollment occurs during the 30-day period 

7 beginning on the date of the enrollment of the 

8 individual in the dental insurance plan; and 

9 (B) permit the voluntary disenrollment of 

10 an individual in the dental insurance plan for 

11 such circumstances as the Secretary shall pre12 scribe for purposes of this subsection, but only 

13 to the extent such disenrollment does not jeop14 ardize the fiscal integrity of the dental insur15 ance plan. 

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

18 include the following: 

19 (A) If an individual enrolled in the dental 

20 insurance plan relocates to a location outside 

21 the jurisdiction of the dental insurance plan 

22 that prevents utilization of the benefits under 

23 the dental insurance plan. 

24 (B) If an individual enrolled in the dental 

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1 ical condition from being able to obtain benefits 

2 under the dental insurance plan. 

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

6 (3) ESTABLISHMENT OF PROCEDURES.—The 

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

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

12 (j) RELATIONSHIP TO DENTAL CARE PROVIDED BY

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

15 section 1712 of title 38, United States Code, and the par16 ticipation of an individual in the dental insurance plan 

17 under the pilot program shall not affect the individual’s 

18 entitlement to outpatient dental services and treatment, 

19 and related dental appliances, under that section. 

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

21 the pilot program shall be administered under such regula22 tions as the Secretary shall prescribe. 


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1 TITLE III—WOMEN VETERANS 

2 HEALTH CARE 

3 SEC. 301. REPORT ON BARRIERS TO RECEIPT OF HEALTH 

4 CARE FOR WOMEN VETERANS. 

5 (a) REPORT.—Not later than June 1, 2010, the Sec6 retary of Veterans Affairs shall submit to the Committee 

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

8 Veterans’ Affairs of the House of Representatives a report 

9 on the barriers to the receipt of comprehensive health care 

10 through the Department of Veterans Affairs that are en11 countered by women veterans, especially veterans of Oper12 ation Iraqi Freedom and Operation Enduring Freedom. 

13 (b) ELEMENTS.—The report required by subsection 

14 (a) shall include the following: 

15 (1) An identification and assessment of the fol16 lowing: 

17 (A) Any stigma perceived or associated 

18 with seeking mental health care services 

19 through the Department of Veterans Affairs. 

20 (B) The effect on access to care through 

21 the Department of driving distance or avail22 ability of other forms of transportation to the 

23 nearest appropriate facility of the Department. 

24 (C) The availability of child care. 


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1 (D) The receipt of health care through 

2 women’s health clinics, integrated primary care 

3 clinics, or both. 

4 (E) The extent of comprehension of eligi5 bility requirements for health care through the 

6 Department, and the scope of health care serv7 ices available through the Department. 

8 (F) The quality and nature of the recep9 tion of women veterans by Department health 

10 care providers and other staff. 

11 (G) The perception of personal safety and 

12 comfort of women veterans in inpatient, out13 patient, and behavioral health facilities of the 

14 Department. 

15 (H) The sensitivity of Department health 

16 care providers and other staff to issues that 

17 particularly affect women. 

18 (I) The effectiveness of outreach on health 

19 care services of the Department that are avail20 able to women veterans. 

21 (J) Such other matters as the Secretary 

22 identifies for purposes of the assessment. 

23 (2) Such recommendations for administrative 

24 and legislative action as the Secretary considers ap25 propriate in light of the report. 


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1 (c) FACILITY OF THE DEPARTMENT DEFINED.—In 

2 this section, the term ‘‘facility of the Department’’ has the 

3 meaning given that term in section 1701 of title 38, 

4 United States Code. 

5 SEC. 302. PLAN TO IMPROVE PROVISION OF HEALTH CARE 

6 SERVICES TO WOMEN VETERANS. 

7 (a) PLAN TO IMPROVE SERVICES.— 

8 (1) IN GENERAL.—The Secretary of Veterans 

9 Affairs shall develop a plan— 

10 (A) to improve the provision of health care 

11 services to women veterans; and 

12 (B) to plan appropriately for the future 

13 health care needs, including mental health care 

14 needs, of women serving on active duty in the 

15 Armed Forces in the combat theaters of Oper16 ation Iraqi Freedom and Operation Enduring 

17 Freedom. 

18 (2) REQUIRED ACTIONS.—In developing the 

19 plan required by this subsection, the Secretary of 

20 Veterans Affairs shall— 

21 (A) identify the types of health care serv22 ices to be available to women veterans at each 

23 Department of Veterans Affairs medical center; 

24 and 


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1 (B) identify the personnel and other re2 sources required to provide such services to 

3 women veterans under the plan at each such 

4 medical center. 

5 (b) SUBMITTAL OF PLAN TO CONGRESS.—Not later 

6 than 18 months after the date of the enactment of this 

7 Act, the Secretary of Veterans Affairs shall submit to the 

8 Committee on Veterans’ Affairs of the Senate and the 

9 Committee on Veterans’ Affairs of the House of Rep10 resentatives the plan required by this section, along with 

11 such recommendations for administrative and legislative 

12 action as the Secretary considers appropriate in light of 

13 the plan. 

14 SEC. 303. INDEPENDENT STUDY ON HEALTH CON15 SEQUENCES OF WOMEN VETERANS OF MILI16 TARY SERVICE IN OPERATION IRAQI FREE17 DOM AND OPERATION ENDURING FREEDOM. 

18 (a) STUDY REQUIRED.—The Secretary of Veterans 

19 Affairs shall enter into an agreement with a non-Depart20 ment of Veterans Affairs entity for the purpose of con21 ducting a study on health consequences for women vet22 erans of service on active duty in the Armed Forces in 

23 deployment in Operation Iraqi Freedom and Operation 

24 Enduring Freedom. 


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1 (b) SPECIFIC MATTERS STUDIED.—The study under 

2 subsection (a) shall include the following: 

3 (1) A determination of any association of envi4 ronmental and occupational exposures and combat in 

5 Operation Iraqi Freedom or Operation Enduring 

6 Freedom with the general health, mental health, or 

7 reproductive health of women who served on active 

8 duty in the Armed Forces in Operation Iraqi Free9 dom or Operation Enduring Freedom. 

10 (2) A review and analysis of published lit11 erature on environmental and occupational exposures 

12 of women while serving in the Armed Forces, includ13 ing combat trauma, military sexual trauma, and ex14 posure to potential teratogens associated with repro15 ductive problems and birth defects. 

16 (c) REPORT.— 

17 (1) IN GENERAL.—Not later than 18 months 

18 after entering into the agreement for the study 

19 under subsection (a), the entity described in sub20 section (a) shall submit to the Secretary of Veterans 

21 Affairs and to Congress a report on the study con22 taining such findings and determinations as the enti23 ty considers appropriate. 

24 (2) RESPONSIVE REPORT.—Not later than 90 

25 days after the receipt of the report under paragraph 


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1 (1), the Secretary shall submit to Congress a report 

2 setting forth the response of the Secretary to the 

3 findings and determinations of the entity described 

4 in subsection (a) in the report under paragraph (1). 

5 SEC. 304. TRAINING AND CERTIFICATION FOR MENTAL 

6 HEALTH CARE PROVIDERS ON CARE FOR 

7 VETERANS SUFFERING FROM SEXUAL TRAU8 MA. 

9 (a) PROGRAM REQUIRED.—Section 1720D is amend10 ed— 

11 (1) by redesignating subsection (d) as sub12 section (f); and 

13 (2) by inserting after subsection (c) the fol14 lowing new subsections: 

15 ‘‘(d)(1) The Secretary shall implement a program for 

16 education, training, certification, and continuing medical 

17 education for mental health professionals to specialize in 

18 the provision of counseling and care to veterans eligible 

19 for services under subsection (a). In carrying out the pro20 gram, the Secretary shall ensure that all such mental 

21 health professionals have been trained in a consistent 

22 manner and that such training includes principles of evi23 dence-based treatment and care for sexual trauma. 

24 ‘‘(2) The Secretary shall determine the minimum 

25 qualifications necessary for mental health professionals 


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1 certified by the program under paragraph (1) to provide 

2 evidence-based treatment and therapy to veterans eligible 

3 for services under subsection (a) in facilities of the De4 partment. 

5 ‘‘(e) The Secretary shall submit to Congress each 

6 year a report on the counseling, care, and services pro7 vided to veterans under this section. Each report shall in8 clude data for the preceding year with respect to the fol9 lowing: 

10 ‘‘(1) The number of mental health professionals 

11 and primary care providers who have been certified 

12 under the program under subsection (d), and the 

13 amount and nature of continuing medical education 

14 provided under such program to professionals and 

15 providers who have been so certified. 

16 ‘‘(2) The number of women veterans who re17 ceived counseling, care, and services under sub18 section (a) from professionals and providers who 

19 have been trained or certified under the program 

20 under subsection (d). 

21 ‘‘(3) The number of training, certification, and 

22 continuing medical education programs operating 

23 under subsection (d). 

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

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1 ment to meet the needs of veterans requiring treat2 ment and care for sexual trauma. 

3 ‘‘(5) Such other information as the Secretary 

4 considers appropriate.’’. 

5 (b) STANDARDS FOR PERSONNEL PROVIDING

6 TREATMENT FOR SEXUAL TRAUMA.—The Secretary of 

7 Veterans Affairs shall establish education, training, cer8 tification, and staffing standards for Department of Vet9 erans Affairs health-care facilities for full-time equivalent 

10 employees who are trained to provide treatment and care 

11 to veterans for sexual trauma. 

12 SEC. 305. PILOT PROGRAM ON COUNSELING IN RETREAT 

13 SETTINGS FOR WOMEN VETERANS NEWLY 

14 SEPARATED FROM SERVICE IN THE ARMED 

15 FORCES. 

16 (a) PILOT PROGRAM REQUIRED.— 

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

18 180 days after the date of the enactment of this Act, 

19 the Secretary of Veterans Affairs shall carry out, 

20 through the Readjustment Counseling Service of the 

21 Veterans Health Administration, a pilot program to 

22 evaluate the feasibility and advisability of providing 

23 reintegration and readjustment services described in 

24 subsection (b) in group retreat settings to women 


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1 veterans who are recently separated from service in 

2 the Armed Forces after a prolonged deployment. 

3 (2) PARTICIPATION AT ELECTION OF VET4 ERAN.—The participation of a veteran in the pilot 

5 program under this section shall be at the election 

6 of the veteran. 

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

8 woman veteran under the pilot program shall include the 

9 following: 

10 (1) Information on reintegration into the vet11 eran’s family, employment, and community. 

12 (2) Financial counseling. 

13 (3) Occupational counseling. 

14 (4) Information and counseling on stress reduc15 tion. 

16 (5) Information and counseling on conflict reso17 lution. 

18 (6) Such other information and counseling as 

19 the Secretary considers appropriate to assist a 

20 woman veteran under the pilot program in reintegra21 tion into the veteran’s family and community. 

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

23 pilot program at not fewer than five locations selected by 

24 the Secretary for purposes of the pilot program. 


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

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

3 the commencement of the pilot program. 

4 (e) REPORT.—Not later than 180 days after the com5 pletion of the pilot program, the Secretary shall submit 

6 to Congress a report on the pilot program. The report 

7 shall contain the findings and conclusions of the Secretary 

8 as a result of the pilot program, and shall include such 

9 recommendations for the continuation or expansion of the 

10 pilot program as the Secretary considers appropriate. 

11 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

12 are authorized to be appropriated to the Secretary of Vet13 erans Affairs for each of fiscal years 2010 and 2011, 

14 $2,000,000 to carry out the pilot program. 

15 SEC. 306. REPORT ON FULL-TIME WOMEN VETERANS PRO16 GRAM MANAGERS AT MEDICAL CENTERS. 

17 The Secretary shall, acting through the Under Sec18 retary for Health, submit to Congress a report on employ19 ment of full-time women veterans program managers at 

20 Department of Veterans Affairs medical centers to ensure 

21 that health care needs of women veterans are met. Such 

22 report should include an assessment of whether there is 

23 at least one full-time employee at each Department med24 ical center who is a full-time women veterans program 

25 manager. 


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1 SEC. 307. SERVICE ON CERTAIN ADVISORY COMMITTEES OF 

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

4 (a) ADVISORY COMMITTEE ON WOMEN VETERANS.— 

5 Section 542(a)(2)(A) is amended— 

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

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

8 end and inserting ‘‘; and’’; and 

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

10 new clause: 

11 ‘‘(iv) women veterans who are recently sepa12 rated from service in the Armed Forces.’’. 

13 (b) ADVISORY COMMITTEE ON MINORITY VET14 ERANS.—Section 544(a)(2)(A) is amended— 

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

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

17 end and inserting ‘‘; and’’; and 

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

19 new clause: 

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

21 members and are recently separated from service in 

22 the Armed Forces.’’. 

23 (c) EFFECTIVE DATE.—The amendments made by 

24 this section shall apply to appointments made on or after 

25 the date of the enactment of this Act. 


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1 SEC. 308. PILOT PROGRAM ON SUBSIDIES FOR CHILD CARE 

2 FOR CERTAIN VETERANS RECEIVING HEALTH 

3 CARE. 

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

5 Veterans Affairs shall carry out a pilot program to assess 

6 the feasibility and advisability of providing, subject to sub7 section (b), subsidies to qualified veterans described in 

8 subsection (c) to obtain child care so that such veterans 

9 can receive health care services described in such sub10 section. 

11 (b) LIMITATION ON PERIOD OF PAYMENTS.—A sub12 sidy may only be provided to a qualified veteran under 

13 the pilot program for receipt of child care during the pe14 riod that the qualified veteran— 

15 (1) receives the types of health care services re16 ferred to in subsection (c) at a facility of the De17 partment; and 

18 (2) requires to travel to and return from such 

19 facility for the receipt of such health care services. 

20 (c) QUALIFIED VETERANS.—In this section, the term 

21 ‘‘qualified veteran’’ means a veteran who is the primary 

22 caretaker of a child or children and who is receiving from 

23 the Department one or more of the following health care 

24 services: 

25 (1) Regular mental health care services. 

26 (2) Intensive mental health care services. 


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1 (3) Such other intensive health care services 

2 that the Secretary determines that payment to the 

3 veteran for the provision of child care would improve 

4 access to those health care services by the veteran. 

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

6 pilot program in no fewer than three Veterans Integrated 

7 Service Networks (VISNs) selected by the Secretary for 

8 purposes of the pilot program. 

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

10 out during the two-year period beginning on the date of 

11 the commencement of the pilot program. 

12 (f) EXISTING MODEL.—To the extent practicable, the 

13 Secretary shall model the pilot program after the Depart14 ment of Veterans Affairs Child Care Subsidy Program 

15 that was established pursuant to section 630 of the Treas16 ury and General Government Appropriations Act, 2002 

17 (Public Law 107–67; 115 Stat. 552), using the same in18 come eligibility standards and payment structure. 

19 (g) REPORT.—Not later than six months after the 

20 completion of the pilot program, the Secretary shall sub21 mit to Congress a report on the pilot program. The report 

22 shall include the findings and conclusions of the Secretary 

23 as a result of the pilot program, and shall include such 

24 recommendations for the continuation or expansion of the 

25 pilot program as the Secretary considers appropriate. 


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1 (h) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to the Secretary of Vet3 erans Affairs for each of fiscal years 2010 and 2011, 

4 $1,500,000 to carry out the pilot program. 

5 SEC. 309. CARE FOR NEWBORN CHILDREN OF WOMEN VET6 ERANS RECEIVING MATERNITY CARE. 

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

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

9 ‘‘SEC. 1786. CARE FOR NEWBORN CHILDREN OF WOMEN 

10 VETERANS RECEIVING MATERNITY CARE. 

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

12 health care services described in subsection (b) to a new13 born child of a woman veteran who is receiving maternity 

14 care furnished by the Department for not more than 7 

15 days after the birth of the child if the veteran delivered 

16 the child in— 

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

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

19 contract for services relating to such delivery. 

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

21 care services described in this subsection are all post-deliv22 ery care services, including routine care services, that a 

23 newborn requires.’’. 

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

25 at the beginning of chapter 17 is amended by inserting 


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1 after the item relating to section 1785 the following new 

2 item: 

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

3 TITLE IV—MENTAL HEALTH 

4 CARE 

5 SEC. 401. ELIGIBILITY OF MEMBERS OF THE ARMED 

6 FORCES WHO SERVE IN OPERATION IRAQI 

7 FREEDOM OR OPERATION ENDURING FREE8 DOM FOR COUNSELING AND SERVICES 

9 THROUGH READJUSTMENT COUNSELING 

10 SERVICE. 

11 (a) IN GENERAL.—Any member of the Armed 

12 Forces, including a member of the National Guard or Re13 serve, who serves on active duty in the Armed Forces in 

14 Operation Iraqi Freedom or Operation Enduring Freedom 

15 is eligible for readjustment counseling and related mental 

16 health services under section 1712A of title 38, United 

17 States Code, through the Readjustment Counseling Serv18 ice of the Veterans Health Administration. 

19 (b) NO REQUIREMENT FOR CURRENT ACTIVE DUTY

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

21 requirements for eligibility for counseling and services 

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

23 under that subsection regardless of whether or not the 

24 member is currently on active duty in the Armed Forces 


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1 at the time of receipt of counseling and services under that 

2 subsection. 

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

4 Armed Forces for counseling and services under sub5 section (a) shall be subject to such regulations as the Sec6 retary of Defense and the Secretary of Veterans Affairs 

7 shall jointly prescribe for purposes of this section. 

8 (d) SUBJECT TO AVAILABILITY OF APPROPRIA9 TIONS.—The provision of counseling and services under 

10 subsection (a) shall be subject to the availability of appro11 priations for such purpose. 

12 SEC. 402. RESTORATION OF AUTHORITY OF READJUST13 MENT COUNSELING SERVICE TO PROVIDE 

14 REFERRAL AND OTHER ASSISTANCE UPON 

15 REQUEST TO FORMER MEMBERS OF THE 

16 ARMED FORCES NOT AUTHORIZED COUN17 SELING. 

18 Section 1712A is amended— 

19 (1) by redesignating subsections (c) through (f) 

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

21 (2) by inserting after subsection (b) the fol22 lowing new subsection (c): 

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

24 this section from any individual who has been discharged 

25 or released from active military, naval, or air service but 


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1 who is not otherwise eligible for such counseling, the Sec2 retary shall— 

3 ‘‘(1) provide referral services to assist such in4 dividual, to the maximum extent practicable, in ob5 taining mental health care and services from sources 

6 outside the Department; and 

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

8 individual’s rights to apply to the appropriate mili9 tary, naval, or air service, and to the Department, 

10 for review of such individual’s discharge or release 

11 from such service.’’. 

12 SEC. 403. STUDY ON SUICIDES AMONG VETERANS. 

13 (a) STUDY REQUIRED.—The Secretary of Veterans 

14 Affairs shall conduct a study to determine the number of 

15 veterans who died by suicide between January 1, 1997, 

16 and the date of the enactment of this Act. 

17 (b) COORDINATION.—In carrying out the study under 

18 subsection (b) the Secretary of Veterans Affairs shall co19 ordinate with— 

20 (1) the Secretary of Defense; 

21 (2) Veterans Service Organizations; 

22 (3) the Centers for Disease Control and Preven23 tion; and 

24 (4) State public health offices and veterans 

25 agencies. 


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1 (c) REPORT TO CONGRESS.—The Secretary of Vet2 erans Affairs shall submit to the Committee on Veterans’ 

3 Affairs of the Senate and the Committee on Veterans’ Af4 fairs of the House of Representatives a report on the study 

5 required under subsection (b) and the findings of the Sec6 retary. 

7 (d) AUTHORIZATION OF APPROPRIATIONS.—There 

8 are authorized to be appropriated such sums as may be 

9 necessary to carry out this section. 

10 SEC. 404. TRANSFER OF FUNDS TO SECRETARY OF HEALTH 

11 AND HUMAN SERVICES FOR GRADUATE PSY12 CHOLOGY EDUCATION PROGRAM. 

13 (a) TRANSFER OF FUNDS.—Not later than Sep14 tember 30, 2010, the Secretary of Veterans Affairs shall 

15 transfer $5,000,000 from accounts of the Veterans Health 

16 Administration to the Secretary of Health and Human 

17 Services for the Graduate Psychology Education program 

18 established under section 755(b)(1)(J) of the Public 

19 Health Service Act (42 U.S.C. 294e(b)(1)(J)). 

20 (b) USE OF FUNDS TRANSFERRED.—Funds trans21 ferred under subsection (a) shall be used to award grants 

22 to support the training of psychologists in the treatment 

23 of veterans with post traumatic stress disorder, traumatic 

24 brain injury, and other combat-related disorders. 


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1 (c) PREFERENCE FOR DEPARTMENT OF VETERANS

2 AFFAIRS HEALTH CARE FACILITIES.—In the awarding of 

3 grants under subsection (b), the Graduate Psychology 

4 Education program shall give preference to health care fa5 cilities of the Department of Veterans Affairs and grad6 uate programs of education that are affiliated with such 

7 facilities. 

8 TITLE V—HOMELESS VETERANS 

9 SEC. 501. PILOT PROGRAM ON FINANCIAL SUPPORT FOR 

10 ENTITIES THAT COORDINATE THE PROVI11 SION OF SUPPORTIVE SERVICES TO FOR12 MERLY HOMELESS VETERANS RESIDING ON 

13 CERTAIN MILITARY PROPERTY. 

14 (a) ESTABLISHMENT.— 

15 (1) IN GENERAL.—Subject to the availability of 

16 appropriations for such purpose, the Secretary of 

17 Veterans Affairs may carry out a pilot program to 

18 make grants to public and nonprofit organizations 

19 (including faith-based and community organizations) 

20 to coordinate the provision of supportive services 

21 available in the local community to very low income, 

22 formerly homeless veterans residing in permanent 

23 housing that is located on qualifying property de24 scribed in subsection (b). 


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1 (2) NUMBER OF GRANTS.—The Secretary may 

2 make grants at up to 10 qualifying properties under 

3 the pilot program. 

4 (b) QUALIFYING PROPERTY.—Qualifying property 

5 under the pilot program is property that— 

6 (1) was part of a military installation that was 

7 closed in accordance with— 

8 (A) decisions made as part of the 2005 

9 round of defense base closure and realignment 

10 under the Defense Base Closure and Realign11 ment Act of 1990 (part A of title XXIX of 

12 Public Law 101–510; 10 U.S.C. 2687 note); 

13 and 

14 (B) subchapter III of chapter 5 of title 40, 

15 United States Code; and 

16 (2) the Secretary of Defense determines, after 

17 considering any redevelopment plans of any local re18 development authority relating to such property, 

19 may be used to assist the homeless in accordance 

20 with such redevelopment plan. 

21 (c) CRITERIA FOR GRANTS.—The Secretary shall 

22 prescribe criteria and requirements for grants under this 

23 section and shall publish such criteria and requirements 

24 in the Federal Register. 


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1 (d) DURATION OF PROGRAM.—The authority of the 

2 Secretary to provide grants under a pilot program under 

3 this section shall cease on the date that is five years after 

4 the date of the commencement of the pilot program. 

5 (e) VERY LOW INCOME DEFINED.—In this section, 

6 the term ‘‘very low income’’ has the meaning given that 

7 term in the Resident Characteristics Report issued annu8 ally by the Department of Housing and Urban Develop9 ment. 

10 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

11 authorized to be appropriated from amounts made avail12 able under the heading ‘‘General Operating Expenses’’, 

13 not more than $3,000,000 in each of fiscal years 2010 

14 through 2014 to carry out the purposes of this section. 

15 SEC. 502. PILOT PROGRAM ON FINANCIAL SUPPORT OF EN16 TITIES THAT COORDINATE THE PROVISION 

17 OF SUPPORTIVE SERVICES TO FORMERLY 

18 HOMELESS VETERANS RESIDING IN PERMA19 NENT HOUSING. 

20 (a) ESTABLISHMENT OF PILOT PROGRAM.— 

21 (1) IN GENERAL.—Subject to the availability of 

22 appropriations for such purpose, the Secretary of 

23 Veterans Affairs may carry out a pilot program to 

24 make grants to public and nonprofit organizations 

25 (including faith-based and community organizations) 


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1 to coordinate the provision of supportive services 

2 available in the local community to very low income, 

3 formerly homeless veterans residing in permanent 

4 housing. 

5 (2) NUMBER OF GRANTS.—The Secretary may 

6 make grants at up to 10 qualifying properties under 

7 the pilot program. 

8 (b) QUALIFYING PROPERTY.—Qualifying property 

9 under the pilot program is any property in the United 

10 States on which permanent housing is provided or af11 forded to formerly homeless veterans, as determined by 

12 the Secretary. 

13 (c) CRITERIA FOR GRANTS.—The Secretary shall 

14 prescribe criteria and requirements for grants under this 

15 section and shall publish such criteria and requirements 

16 in the Federal Register. 

17 (d) DURATION OF PILOT PROGRAM.—The authority 

18 of the Secretary to provide grants under a pilot program 

19 under this section shall cease on the date that is five years 

20 after the date of the commencement of the pilot program. 

21 (e) VERY LOW INCOME DEFINED.—In this section, 

22 the term ‘‘very low income’’ has the meaning given that 

23 term in the Resident Characteristics Report issued annu24 ally by the Department of Housing and Urban Develop25 ment. 


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1 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated from amounts made avail3 able under the heading ‘‘General Operating Expenses’’, 

4 not more than $3,000,000 in each of fiscal years 2010 

5 through 2014 to carry out the purposes of this section. 

6 SEC. 503. PILOT PROGRAM ON FINANCIAL SUPPORT OF EN7 TITIES THAT PROVIDE OUTREACH TO IN8 FORM CERTAIN VETERANS ABOUT PENSION 

9 BENEFITS. 

10 (a) AUTHORITY TO MAKE GRANTS.—In addition to 

11 the outreach authority provided to the Secretary of Vet12 erans Affairs by section 6303 of title 38, United States 

13 Code, the Secretary may carry out a pilot program to 

14 make grants to public and nonprofit organizations (includ15 ing faith-based and community organizations) for services 

16 to provide outreach to inform low-income and elderly vet17 erans and their spouses who reside in rural areas of bene18 fits for which they may be eligible under chapter 15 of 

19 such title. 

20 (b) CRITERIA FOR GRANTS.—The Secretary shall 

21 prescribe criteria and requirements for grants under this 

22 section and shall publish such criteria and requirements 

23 in the Federal Register. 

24 (c) DURATION OF PILOT PROGRAM.—The authority 

25 of the Secretary to provide grants under a pilot program 


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1 under this section shall cease on the date that is five years 

2 after the date of the commencement of the pilot program. 

3 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

4 authorized to be appropriated from amounts made avail5 able under the heading ‘‘General Operating Expenses’’, 

6 not more than $1,275,000 in each of fiscal years 2010 

7 through 2014 to carry out the purposes of this section. 

8 SEC. 504. PILOT PROGRAM ON FINANCIAL SUPPORT OF EN9 TITIES THAT PROVIDE TRANSPORTATION AS10 SISTANCE, CHILD CARE ASSISTANCE, AND 

11 CLOTHING ASSISTANCE TO VETERANS ENTI12 TLED TO A REHABILITATION PROGRAM. 

13 (a) PILOT PROGRAM AUTHORIZED.— 

14 (1) IN GENERAL.—Subject to the availability of 

15 appropriations authorized under subsection (g), the 

16 Secretary of Veterans Affairs may carry out a pilot 

17 program to assess the feasibility and advisability of 

18 providing financial assistance to eligible entities to 

19 establish new programs or activities, or expand or 

20 modify existing programs or activities, to provide to 

21 each eligible transitioning individual who is entitled 

22 and eligible for a rehabilitation program under chap23 ter 31 of title 38, United States Code, the following 

24 assistance: 


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1 (A) Transportation assistance to facilitate 

2 such eligible transitioning individual’s participa3 tion in such rehabilitation program or related 

4 activity. Such assistance may include— 

5 (i) providing transportation; 

6 (ii) paying for or reimbursing trans7 portation costs; and 

8 (iii) paying for or reimbursing other 

9 transportation-related expenses (including 

10 orientation on the use of transportation). 

11 (B) Child care assistance to facilitate such 

12 eligible transitioning individual’s participation 

13 in such rehabilitation program or related activ14 ity. Such assistance may include— 

15 (i) child care services; or 

16 (ii) reimbursement of expenses related 

17 to child care. 

18 (C) Clothing assistance, which may include 

19 personal services in selecting, and payment of a 

20 monetary allowance to cover the cost of pur21 chasing, clothing and accessories suitable for a 

22 job interview or related activity consistent with 

23 such eligible transitioning individual’s participa24 tion in such rehabilitation program or related 

25 activity. 


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1 (2) ELIGIBLE TRANSITIONING INDIVIDUAL.— 

2 For purposes of this section, an eligible transitioning 

3 individual is a person— 

4 (A) described in section 3102 of title 38, 

5 United States Code; or 

6 (B) who was separated or released from 

7 active duty in the Armed Forces on or after Oc8 tober 1, 2006, because of a service-connected 

9 disability. 

10 (b) DURATION OF PROGRAM.—The authority of the 

11 Secretary to provide grants under a pilot program estab12 lished under subsection (a)(1) shall cease on the date that 

13 is three years after the date of the commencement of the 

14 pilot program. 

15 (c) GRANTS.— 

16 (1) IN GENERAL.—The Secretary of Veterans 

17 Affairs shall carry out the pilot program through the 

18 award of grants to eligible entities to establish new 

19 programs or activities, or to expand or modify exist20 ing programs or activities, as described in subsection 

21 (a)(1). 

22 (2) GRANT CRITERIA.— 

23 (A) IN GENERAL.—The Secretary shall es24 tablish criteria and requirements for grants 

25 under the pilot program, including criteria for 


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1 eligible entities to receive such grants. The cri2 teria established under this subparagraph shall 

3 include the following: 

4 (i) Specification as to the kinds of 

5 projects or activities for which grants are 

6 available. 

7 (ii) Specification as to the number of 

8 projects or activities for which grants are 

9 available. 

10 (iii) Provisions to ensure that grants 

11 awarded under the pilot program do not 

12 result in duplication of ongoing services. 

13 (B) PUBLICATION OF CRITERIA IN FED14 ERAL REGISTER.—The Secretary shall publish 

15 the criteria and requirements established under 

16 subparagraph (A) in the Federal Register. 

17 (3) FUNDING LIMITATION.—A grant under the 

18 pilot program may not be used to support the oper19 ational costs of an eligible entity. 

20 (d) ELIGIBLE ENTITIES.—For purposes of this sec21 tion, an eligible entity is a public or nonprofit organization 

22 (including a faith-based or community organization) 

23 that— 


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1 (1) has the capacity to administer effectively a 

2 grant under the pilot program, as determined by the 

3 Secretary of Veterans Affairs; 

4 (2) demonstrates that adequate financial sup5 port will be available to establish new programs or 

6 activities, or to expand or modify existing programs 

7 or activities, as described in subsection (a)(1) con8 sistent with the plans, specifications, and schedule 

9 submitted by the applicant to the Secretary under 

10 subsection (e)(2); 

11 (3) agrees to meet the applicable criteria and 

12 requirements established under subsection (c)(2) and 

13 described in subsection (e)(2)(C); and 

14 (4) has the capacity, as determined by the Sec15 retary, to meet the criteria and requirements de16 scribed in paragraph (3). 

17 (e) SELECTION OF GRANT RECIPIENTS.— 

18 (1) APPLICATION.—An eligible entity seeking a 

19 grant under the pilot program shall submit to the 

20 Secretary of Veterans Affairs an application therefor 

21 in such form and in such manner as the Secretary 

22 considers appropriate. 

23 (2) ELEMENTS.—Each application submitted 

24 under paragraph (1) shall include the following: 


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1 (A) The amount of the grant sought for 

2 the project or activity. 

3 (B) Plans, specifications, and the schedule 

4 for implementation of the project or activity in 

5 accordance with criteria and requirements pre6 scribed by the Secretary under subsection 

7 (c)(2). 

8 (C) An agreement— 

9 (i) to provide the services for which 

10 the grant is sought at locations accessible 

11 to eligible transitioning individuals; 

12 (ii) to ensure the confidentiality of 

13 records maintained on eligible transitioning 

14 individuals receiving services through the 

15 pilot program; and 

16 (iii) to establish such procedures for 

17 fiscal control and fund accounting as may 

18 be necessary to ensure proper disburse19 ment and accounting with respect to the 

20 grant and to such payments as may be 

21 made under this section. 

22 (3) APPLICANT AGREEMENT.—The Secretary 

23 may not select an eligible entity for a grant under 

24 the pilot program unless the eligible entity agrees to 

25 the provisions listed in paragraph (2)(C). 


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1 (f) RECOVERY OF UNUSED GRANT AMOUNTS.— 

2 (1) IN GENERAL.—The United States shall be 

3 entitled to recover from a grant recipient under this 

4 section the total of all unused grant amounts made 

5 under this section to such recipient in connection 

6 with such program if such grant recipient— 

7 (A) does not establish a program or activ8 ity in accordance with this section; or 

9 (B) ceases to furnish services under such 

10 a program for which the grant was made. 

11 (2) OBLIGATION.—Any amount recovered by 

12 the United States under paragraph (1) may be obli13 gated by the Secretary of Veterans Affairs without 

14 fiscal year limitation to carry out provisions of this 

15 section. 

16 (3) LIMITATION ON RECOVERY.—An amount 

17 may not be recovered under paragraph (1)(A) as an 

18 unused grant amount before the end of the three19 year period beginning on the date on which the 

20 grant is made. 

21 (g) AUTHORIZATION OF APPROPRIATIONS.—There is 

22 authorized to be appropriated from amounts made avail23 able under the heading ‘‘General Operating Expenses’’, 

24 not more than $5,000,000 in each of fiscal years 2010 

25 through 2012 to carry out this section. 


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1 SEC. 505. ASSESSMENT OF PILOT PROGRAMS. 

2 (a) PROGRESS REPORTS.—Not less than one year be3 fore the expiration of the authority to carry out a pilot 

4 program authorized by sections 501 through 504, the Sec5 retary of Veterans Affairs shall submit to Congress a 

6 progress report on such pilot program. 

7 (b) CONTENTS.—Each progress report submitted for 

8 a pilot program under subsection (a) shall include the fol9 lowing: 

10 (1) The lessons learned by the Secretary of Vet11 erans Affairs with respect to such pilot program that 

12 can be applied to other programs with similar pur13 poses. 

14 (2) The recommendations of the Secretary on 

15 whether to continue such pilot program. 

16 (3) The number of veterans and dependents 

17 served by such pilot program. 

18 (4) An assessment of the quality of service pro19 vided to veterans and dependents under such pilot 

20 program. 

21 (5) The amount of funds provided to grant re22 cipients under such pilot program. 

23 (6) The names of organizations that have re24 ceived grants under such pilot program. 


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1 TITLE VI—NONPROFIT RE2 SEARCH AND EDUCATION 

3 CORPORATIONS 

4 SEC. 601. GENERAL AUTHORITIES ON ESTABLISHMENT OF 

5 CORPORATIONS. 

6 (a) AUTHORIZATION OF MULTI-MEDICAL CENTER

7 RESEARCH CORPORATIONS.— 

8 (1) IN GENERAL.—Section 7361 is amended— 

9 (A) by redesignating subsection (b) as sub10 section (e); and 

11 (B) by inserting after subsection (a) the 

12 following new subsection (b): 

13 ‘‘(b)(1) Subject to paragraph (2), a corporation es14 tablished under this subchapter may facilitate the conduct 

15 of research, education, or both at more than one medical 

16 center. Such a corporation shall be known as a ‘multi-med17 ical center research corporation’. 

18 ‘‘(2) The board of directors of a multi-medical center 

19 research corporation under this subsection shall include 

20 the official at each Department medical center concerned 

21 who is, or who carries out the responsibilities of, the med22 ical center director of such center as specified in section 

23 7363(a)(1)(A)(i) of this title. 

24 ‘‘(3) In facilitating the conduct of research, edu25 cation, or both at more than one Department medical cenVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00101 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 ter under this subchapter, a multi-medical center research 

2 corporation may administer receipts and expenditures re3 lating to such research, education, or both, as applicable, 

4 performed at the Department medical centers concerned.’’. 

5 (2) EXPANSION OF EXISTING CORPORATIONS TO

6 MULTI-MEDICAL CENTER RESEARCH CORPORA7 TIONS.—Such section is further amended by adding 

8 at the end the following new subsection: 

9 ‘‘(f) A corporation established under this subchapter 

10 may act as a multi-medical center research corporation 

11 under this subchapter in accordance with subsection (b) 

12 if— 

13 ‘‘(1) the board of directors of the corporation 

14 approves a resolution permitting facilitation by the 

15 corporation of the conduct of research, education, or 

16 both at the other Department medical center or 

17 medical centers concerned; and 

18 ‘‘(2) the Secretary approves the resolution of 

19 the corporation under paragraph (1).’’. 

20 (b) RESTATEMENT AND MODIFICATION OF AUTHORI21 TIES ON APPLICABILITY OF STATE LAW.— 

22 (1) IN GENERAL.—Section 7361, as amended 

23 by subsection (a) of this section, is further amended 

24 by inserting after subsection (b) the following new 

25 subsection (c): 


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1 ‘‘(c) Any corporation established under this sub2 chapter shall be established in accordance with the non3 profit corporation laws of the State in which the applicable 

4 Department medical center is located and shall, to the ex5 tent not inconsistent with any Federal law, be subject to 

6 the laws of such State. In the case of any multi-medical 

7 center research corporation that facilitates the conduct of 

8 research, education, or both at Department medical cen9 ters located in different States, the corporation shall be 

10 established in accordance with the nonprofit corporation 

11 laws of the State in which one of such Department medical 

12 centers is located.’’. 

13 (2) CONFORMING AMENDMENT.—Section 7365 

14 is repealed. 

15 (c) CLARIFICATION OF STATUS OF CORPORATIONS.— 

16 Section 7361, as amended by this section, is further 

17 amended— 

18 (1) in subsection (a), by striking the second 

19 sentence; and 

20 (2) by inserting after subsection (c) the fol21 lowing new subsection (d): 

22 ‘‘(d)(1) Except as otherwise provided in this sub23 chapter or under regulations prescribed by the Secretary, 

24 any corporation established under this subchapter, and its 

25 officers, directors, and employees, shall be required to 


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1 comply only with those Federal laws, regulations, and ex2 ecutive orders and directives that apply generally to pri3 vate nonprofit corporations. 

4 ‘‘(2) A corporation under this subchapter is not— 

5 ‘‘(A) owned or controlled by the United States; 

6 or 

7 ‘‘(B) an agency or instrumentality of the 

8 United States.’’. 

9 (d) REINSTATEMENT OF REQUIREMENT FOR

10 501(C)(3) STATUS OF CORPORATIONS.—Subsection (e) of 

11 section 7361, as redesignated by subsection (a)(1) of this 

12 section, is further amended by inserting ‘‘section 

13 501(c)(3) of’’ after ‘‘exempt from taxation under’’. 

14 SEC. 602. CLARIFICATION OF PURPOSES OF CORPORA15 TIONS. 

16 (a) CLARIFICATION OF PURPOSES.—Subsection (a) 

17 of section 7362 is amended— 

18 (1) in the first sentence— 

19 (A) by striking ‘‘Any corporation’’ and all 

20 that follows through ‘‘facilitate’’ and inserting 

21 ‘‘A corporation established under this sub22 chapter shall be established to provide a flexible 

23 funding mechanism for the conduct of approved 

24 research and education at one or more DepartVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00104 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 ment medical centers and to facilitate functions 

2 related to the conduct of’’; and 

3 (B) by inserting before the period at the 

4 end the following: ‘‘or centers’’; and 

5 (2) in the second sentence, by inserting ‘‘or cen6 ters’’ after ‘‘at the medical center’’. 

7 (b) MODIFICATION OF DEFINED TERM RELATING TO

8 EDUCATION AND TRAINING.—Subsection (b) of such sec9 tion is amended in the matter preceding paragraph (1) 

10 by striking ‘‘the term ‘education and training’ ’’ and in11 serting ‘‘the term ‘education’ includes education and train12 ing and’’. 

13 (c) REPEAL OF ROLE OF CORPORATIONS WITH RE14 SPECT TO FELLOWSHIPS.—Paragraph (1) of subsection 

15 (b) of such section is amended by striking the flush matter 

16 following subparagraph (C). 

17 (d) AVAILABILITY OF EDUCATION FOR FAMILIES OF

18 VETERAN PATIENTS.—Paragraph (2) of subsection (b) of 

19 such section is amended by striking ‘‘to patients and to 

20 the families’’ and inserting ‘‘and includes education and 

21 training for patients and families’’. 


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1 SEC. 603. MODIFICATION OF REQUIREMENTS FOR BOARDS 

2 OF DIRECTORS OF CORPORATIONS. 

3 (a) REQUIREMENTS FOR DEPARTMENT BOARD MEM4 BERS.—Paragraph (1) of section 7363(a) is amended to 

5 read as follows: 

6 ‘‘(1) with respect to the Department medical 

7 center— 

8 ‘‘(A)(i) the director (or directors of each 

9 Department medical center, in the case of a 

10 multi-medical center research corporation); 

11 ‘‘(ii) the chief of staff; and 

12 ‘‘(iii) as appropriate for the activities of 

13 such corporation, the associate chief of staff for 

14 research and the associate chief of staff for 

15 education; or 

16 ‘‘(B) in the case of a Department medical 

17 center at which one or more of the positions re18 ferred to in subparagraph (A) do not exist, the 

19 official or officials who are responsible for car20 rying out the responsibilities of such position or 

21 positions at the Department medical center; 

22 and’’. 

23 (b) REQUIREMENTS FOR NON-DEPARTMENT BOARD

24 MEMBERS.—Paragraph (2) of such section is amended— 

25 (1) by inserting ‘‘not less than two’’ before 

26 ‘‘members’’; and 


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1 (2) by striking ‘‘and who’’ and all that follows 

2 through the period at the end and inserting ‘‘and 

3 who have backgrounds, or business, legal, financial, 

4 medical, or scientific expertise, of benefit to the op5 erations of the corporation.’’. 

6 (c) CONFLICTS OF INTEREST.—Subsection (c) of sec7 tion 7363 is amended by striking ‘‘, employed by, or have 

8 any other financial relationship with’’ and inserting ‘‘or 

9 employed by’’. 

10 SEC. 604. CLARIFICATION OF POWERS OF CORPORATIONS. 

11 (a) IN GENERAL.—Section 7364 is amended to read 

12 as follows: 

13 ‘‘§ 7364. General powers 

14 ‘‘(a) IN GENERAL.—(1) A corporation established 

15 under this subchapter may, solely to carry out the pur16 poses of this subchapter— 

17 ‘‘(A) accept, administer, retain, and spend 

18 funds derived from gifts, contributions, grants, fees, 

19 reimbursements, and bequests from individuals and 

20 public and private entities; 

21 ‘‘(B) enter into contracts and agreements with 

22 individuals and public and private entities; 

23 ‘‘(C) subject to paragraph (2), set fees for edu24 cation and training facilitated under section 7362 of 


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1 this title, and receive, retain, administer, and spend 

2 funds in furtherance of such education and training; 

3 ‘‘(D) reimburse amounts to the applicable ap4 propriation account of the Department for the Office 

5 of General Counsel for any expenses of that Office 

6 in providing legal services attributable to research 

7 and education agreements under this subchapter; 

8 and 

9 ‘‘(E) employ such employees as the corporation 

10 considers necessary for such purposes and fix the 

11 compensation of such employees. 

12 ‘‘(2) Fees charged under paragraph (1)(C) for edu13 cation and training described in that paragraph to individ14 uals who are officers or employees of the Department may 

15 not be paid for by any funds appropriated to the Depart16 ment. 

17 ‘‘(3) Amounts reimbursed to the Office of General 

18 Counsel under paragraph (1)(D) shall be available for use 

19 by the Office of the General Counsel only for staff and 

20 training, and related travel, for the provision of legal serv21 ices described in that paragraph and shall remain available 

22 for such use without fiscal year limitation. 

23 ‘‘(b) TRANSFER AND ADMINISTRATION OF FUNDS.— 

24 (1) Except as provided in paragraph (2), any funds re25 ceived by the Secretary for the conduct of research or eduVerDate Nov 24 2008 02:09 Jan 17, 2009 Jkt 079200 PO 00000 Frm 00108 Fmt 6652 Sfmt 6201 E:\BILLS\S252.IS S252

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1 cation at a Department medical center or centers, other 

2 than funds appropriated to the Department, may be trans3 ferred to and administered by a corporation established 

4 under this subchapter for such purposes. 

5 ‘‘(2) A Department medical center may reimburse the 

6 corporation for all or a portion of the pay, benefits, or 

7 both of an employee of the corporation who is assigned 

8 to the Department medical center if the assignment is car9 ried out pursuant to subchapter VI of chapter 33 of title 

10 5. 

11 ‘‘(3) A Department medical center may retain and 

12 use funds provided to it by a corporation established under 

13 this subchapter. Such funds shall be credited to the appli14 cable appropriation account of the Department and shall 

15 be available, without fiscal year limitation, for the pur16 poses of that account. 

17 ‘‘(c) RESEARCH PROJECTS.—Except for reasonable 

18 and usual preliminary costs for project planning before its 

19 approval, a corporation established under this subchapter 

20 may not spend funds for a research project unless the 

21 project is approved in accordance with procedures pre22 scribed by the Under Secretary for Health for research 

23 carried out with Department funds. Such procedures shall 

24 include a scientific review process. 


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1 ‘‘(d) EDUCATION ACTIVITIES.—Except for reason2 able and usual preliminary costs for activity planning be3 fore its approval, a corporation established under this sub4 chapter may not spend funds for an education activity un5 less the activity is approved in accordance with procedures 

6 prescribed by the Under Secretary for Health. 

7 ‘‘(e) POLICIES AND PROCEDURES.—The Under Sec8 retary for Health may prescribe policies and procedures 

9 to guide the spending of funds by corporations established 

10 under this subchapter that are consistent with the purpose 

11 of such corporations as flexible funding mechanisms and 

12 with Federal and State laws and regulations, and execu13 tive orders, circulars, and directives that apply generally 

14 to the receipt and expenditure of funds by nonprofit orga15 nizations exempt from taxation under section 501(c)(3) of 

16 the Internal Revenue Code of 1986.’’. 

17 (b) CONFORMING AMENDMENT.—Section 7362(a), as 

18 amended by section 602(a)(1) of this Act, is further 

19 amended by striking the last sentence. 

20 SEC. 605. REDESIGNATION OF SECTION 7364A OF TITLE 38, 

21 UNITED STATES CODE. 

22 (a) REDESIGNATION.—Section 7364A is redesignated 

23 as section 7365. 

24 (b) CLERICAL AMENDMENTS.—The table of sections 

25 at the beginning of chapter 73 is amended— 


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1 (1) by striking the item relating to section 

2 7364A; and 

3 (2) by striking the item relating to section 7365 

4 and inserting the following new item: 

‘‘7365. Coverage of employees under certain Federal tort claims laws.’’. 

5 SEC. 606. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF 

6 CORPORATIONS. 

7 (a) ADDITIONAL INFORMATION IN ANNUAL RE8 PORTS.—Subsection (b) of section 7366 is amended to 

9 read as follows: 

10 ‘‘(b)(1) Each corporation shall submit to the Sec11 retary each year a report providing a detailed statement 

12 of the operations, activities, and accomplishments of the 

13 corporation during that year. 

14 ‘‘(2)(A) A corporation with revenues in excess of 

15 $300,000 for any year shall obtain an audit of the cor16 poration for that year. 

17 ‘‘(B) A corporation with annual revenues between 

18 $10,000 and $300,000 shall obtain an audit of the cor19 poration at least once every three years. 

20 ‘‘(C) Any audit under this paragraph shall be per21 formed by an independent auditor. 

22 ‘‘(3) The corporation shall include in each report to 

23 the Secretary under paragraph (1) the following: 

24 ‘‘(A) The most recent audit of the corporation 

25 under paragraph (2). 


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1 ‘‘(B) The most recent Internal Revenue Service 

2 Form 990 ‘Return of Organization Exempt from In3 come Tax’ or equivalent and the applicable schedules 

4 under such form.’’. 

5 (b) CONFIRMATION OF APPLICATION OF CONFLICT

6 OF INTEREST REGULATIONS TO APPROPRIATE CORPORA7 TION POSITIONS.—Subsection (c) of such section is 

8 amended— 

9 (1) by striking ‘‘laws and’’ each place it ap10 pears; 

11 (2) in paragraph (1)— 

12 (A) by inserting ‘‘each officer and’’ after 

13 ‘‘under this subchapter,’’; and 

14 (B) by striking ‘‘, and each employee of 

15 the Department’’ and all that follows through 

16 ‘‘during any year’’; and 

17 (3) in paragraph (2)— 

18 (A) by inserting ‘‘, officer,’’ after 

19 ‘‘verifying that each director’’; and 

20 (B) by striking ‘‘in the same manner’’ and 

21 all that follows before the period at the end. 

22 (c) ESTABLISHMENT OF APPROPRIATE PAYEE RE23 PORTING THRESHOLD.—Subsection (d)(3)(C) of such sec24 tion is amended by striking ‘‘$35,000’’ and inserting 

25 ‘‘$50,000’’. 


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1 TITLE VII—MISCELLANEOUS 

2 PROVISIONS 

3 SEC. 701. EXPANSION OF AUTHORITY FOR DEPARTMENT OF 

4 VETERANS AFFAIRS POLICE OFFICERS. 

5 Section 902 is amended— 

6 (1) in subsection (a)— 

7 (A) by amending paragraph (1) to read as 

8 follows: 

9 ‘‘(1) Employees of the Department who are De10 partment police officers shall, with respect to acts 

11 occurring on Department property— 

12 ‘‘(A) enforce Federal laws; 

13 ‘‘(B) enforce the rules prescribed under 

14 section 901 of this title; 

15 ‘‘(C) enforce traffic and motor vehicle laws 

16 of a State or local government (by issuance of 

17 a citation for violation of such laws) within the 

18 jurisdiction of which such Department property 

19 is located as authorized by an express grant of 

20 authority under applicable State or local law; 

21 ‘‘(D) carry the appropriate Department22 issued weapons, including firearms, while off 

23 Department property in an official capacity or 

24 while in an official travel status; 


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1 ‘‘(E) conduct investigations, on and off 

2 Department property, of offenses that may have 

3 been committed on property under the original 

4 jurisdiction of Department, consistent with 

5 agreements or other consultation with affected 

6 local, State, or Federal law enforcement agen7 cies; and 

8 ‘‘(F) carry out, as needed and appropriate, 

9 the duties described in subparagraphs (A) 

10 through (E) of this paragraph when engaged in 

11 duties authorized by other Federal statutes.’’; 

12 (B) by striking paragraph (2) and redesig13 nating paragraph (3) as paragraph (2); and 

14 (C) in paragraph (2), as redesignated by 

15 subparagraph (B) of this paragraph, by insert16 ing ‘‘, and on any arrest warrant issued by 

17 competent judicial authority’’ before the period; 

18 and 

19 (2) by amending subsection (c) to read as fol20 lows: 

21 ‘‘(c) The powers granted to Department police offi22 cers designated under this section shall be exercised in ac23 cordance with guidelines approved by the Secretary and 

24 the Attorney General.’’. 


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1 SEC. 702. UNIFORM ALLOWANCE FOR DEPARTMENT OF 

2 VETERANS AFFAIRS POLICE OFFICERS. 

3 Section 903 is amended— 

4 (1) by amending subsection (b) to read as fol5 lows: 

6 ‘‘(b)(1) The amount of the allowance that the Sec7 retary may pay under this section is the lesser of— 

8 ‘‘(A) the amount currently allowed as pre9 scribed by the Office of Personnel Management; or 

10 ‘‘(B) estimated costs or actual costs as deter11 mined by periodic surveys conducted by the Depart12 ment. 

13 ‘‘(2) During any fiscal year no officer shall receive 

14 more for the purchase of a uniform described in subsection 

15 (a) than the amount established under this subsection.’’; 

16 and 

17 (2) by striking subsection (c) and inserting the 

18 following new subsection (c): 

19 ‘‘(c) The allowance established under subsection (b) 

20 shall be paid at the beginning of a Department police offi21 cer’s employment for those appointed on or after October 

22 1, 2008. In the case of any other Department police offi23 cer, an allowance in the amount established under sub24 section (b) shall be paid upon the request of the officer.’’. 

Æ 


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