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SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Urban Medicare-Dependent Hospitals 
Preservation Act of 2011''.

SEC. 2. CRITERIA AND PAYMENT FOR CERTAIN URBAN MEDICARE-DEPENDENT 
              HOSPITALS.

    (a) In General.--Section 1886(d)(5) of the Social Security Act (42 
U.S.C. 1395ww(d)(5)) is amended by adding at the end the following new 
subparagraph:
                    ``(M)(i) For cost reporting periods beginning on or 
                after October 1, 2011, and before October 1, 2014, in 
                the case of a subsection (d) hospital which is an urban 
                Medicare-dependent hospital, payment under paragraph 
                (1)(A) shall be equal to the sum of the amount 
                determined under clause (ii) and the amount determined 
                under paragraph (1)(A)(iii).
                    ``(ii) The amount determined under this clause is, 
                for discharges occurring during a cost reporting period 
                that begins on or after October 1, 2011, and before 
                October 1, 2014, 50 percent of the amount by which the 
                hospital's target amount for the cost reporting period 
                (as defined in subsection (b)(3)(L)) exceeds the amount 
                determined under paragraph (1)(A)(iii).
                    ``(iii) For purposes of this subparagraph, the term 
                `urban Medicare-dependent hospital' means, with respect 
                to any cost reporting period to which clause (i) 
                applies, any hospital--
                            ``(I) located in an urban area or 
                        reclassified to an urban area for wage index 
                        purposes;
                            ``(II) that does not receive payment--
                                    ``(aa) under subparagraph (C) as a 
                                rural referral center;
                                    ``(bb) under subparagraph (D) as a 
                                sole community hospital;
                                    ``(cc) under subparagraph (B) or 
                                under subsection (h); or
                                    ``(dd) under subparagraph (F);
                            ``(III) that is not a physician-owned 
                        hospital, as defined in section 489.3 of title 
                        42, Code of Federal Regulations (as in effect 
                        as of the date of the enactment of this 
                        subparagraph); and
                            ``(IV) for which not less than 60 percent 
                        of its inpatient days or discharges during the 
                        cost reporting period beginning in fiscal year 
                        2006, or two of the three most recently audited 
                        cost reporting periods for which the Secretary 
                        has a settled cost report, were attributable to 
                        inpatients entitled to benefits under part A 
                        and not enrolled in a Medicare Advantage plan 
                        under part C.''.
    (b) Target Payment Amount.--Section 1886(b)(3) of the Social 
Security Act (42 U.S.C. 1395ww(b)(3)) is amended--
            (1) in subparagraph (B)(iv), by striking ``and (D)'' and 
        inserting ``, (D), and (M)''; and
            (2) by adding at the end the following new subparagraph:
                    ``(M) For cost reporting periods occurring on or 
                after October 1, 2011, and before October 1, 2014, in 
                the case of a hospital that is an urban Medicare-
                dependent hospital (as defined in subsection 
                (d)(5)(M)), the term `target amount' means--
                            ``(i) with respect to the first 12-month 
                        cost reporting period in which this 
                        subparagraph is applied to the hospital, the 
                        allowable operating costs of inpatient hospital 
                        services (as defined in subsection (a)(4)) 
                        recognized under this title for the hospital 
                        for the 12-month cost reporting period 
                        beginning during fiscal year 2002 or 2006 
                        (whichever results in a higher target amount), 
                        increased by the applicable percentage increase 
                        under subparagraph (B)(iv) for each of fiscal 
                        years 2003 through 2011 or 2007 through 2011, 
                        respectively; and
                            ``(ii) with respect to discharges occurring 
                        after the first 12-month cost reporting period 
                        in which this subparagraph is applied to the 
                        hospital, the target amount for the preceding 
                        year increased by the applicable percentage 
                        increase under subparagraph (B)(iv).''.
Urban Medicare-Dependent Hospitals Preservation Act of 2011 - Amends title XVIII (Medicare) of the Social Security Act, with respect to cost reporting periods beginning on or after October 1, 2011, and before October 1, 2014, to revise the criteria and payment formula for "subsection (d) hospitals" which are urban Medicare-dependent hospitals.

(Generally a subsection (d) hospital is an acute care hospital particularly one that receives payments under Medicare's inpatient prospective payment system when providing covered inpatient services to eligible beneficiaries.)

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``National Parks 
Capital Improvements Act of 1999''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
Sec. 3. Fundraising organization.
Sec. 4. Memorandum of agreement.
Sec. 5. National park surcharge or set-aside.
Sec. 6. Use of bond proceeds.
Sec. 7. Administration.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Fundraising organization.--The term ``fundraising 
        organization'' means an entity authorized to act as a 
        fundraising organization under section 3(a).
            (2) Memorandum of agreement.--The term ``memorandum of 
        agreement'' means a memorandum of agreement entered into by the 
        Secretary under section 3(a) that contains the terms specified 
        in section 4.
            (3) National park foundation.--The term ``National Park 
        Foundation'' means the foundation established under the Act 
        entitled ``An Act to establish the National Park Foundation'', 
        approved December 18, 1967 (16 U.S.C. 19e et seq.).
            (4) National park.--The term ``national park'' means--
                    (A) the Grand Canyon National Park; and
                    (B) any other national park designated by the 
                Secretary that has an approved general management plan 
                with capital needs in excess of $5,000,000.
            (5) Secretary.--The term ``Secretary'' means the Secretary 
        of the Interior.

SEC. 3. FUNDRAISING ORGANIZATION.

    (a) In General.--The Secretary may enter into a memorandum of 
agreement under section 4 with an entity to act as an authorized 
fundraising organization for the benefit of a national park.
    (b) Bonds.--The fundraising organization for a national park shall 
issue taxable bonds in return for the surcharge or set-aside for that 
national park collected under section 5.
    (c) Professional Standards.--The fundraising organization shall 
abide by all relevant professional standards regarding the issuance of 
securities and shall comply with all applicable Federal and State law.
    (d) Audit.--The fundraising organization shall be subject to an 
audit by the Secretary.
    (e) No Liability for Bonds.--
            (1) In general.--The United States shall not be liable for 
        the security of any bonds issued by the fundraising 
        organization.
            (2) Exception.--If the surcharge or set-aside described in 
        section 5(a) for a national park is not imposed for any reason, 
        or if the surcharge or set-aside is reduced or eliminated, the 
        full faith and credit of the United States is pledged to the 
        payment of--
                    (A) the bonds issued by a fundraising organization 
                under subsection (b) for that national park; and
                    (B) the interest accruing on the bonds.

SEC. 4. MEMORANDUM OF AGREEMENT.

    The fundraising organization shall enter into a memorandum of 
agreement that specifies--
            (1) the amount of the bond issue;
            (2) the maturity of the bonds, not to exceed 20 years;
            (3) the per capita amount required to amortize the bond 
        issue, provide for the reasonable costs of administration, and 
        maintain a sufficient reserve consistent with industry 
        standards;
            (4) the project or projects at the national park that will 
        be funded with the bond proceeds and the specific 
        responsibilities of the Secretary and the fundraising 
        organization with respect to each project; and
            (5) procedures for modifications of the agreement with the 
        consent of both parties based on changes in circumstances, 
        including modifications relating to project priorities.

SEC. 5. NATIONAL PARK SURCHARGE OR SET-ASIDE.

    (a) In General.--Notwithstanding any other provision of law, the 
Secretary may authorize the superintendent of a national park for which 
a memorandum of agreement is in effect--
            (1) to charge and collect a surcharge in an amount not to 
        exceed $2 for each individual otherwise subject to an entrance 
        fee for admission to the national park; or
            (2) to set aside not more than $2 for each individual 
        charged the entrance fee.
    (b) Surcharge in Addition to Entrance Fees.--A surcharge under 
subsection (a) shall be in addition to any entrance fee collected 
under--
            (1) section 4 of the Land and Water Conservation Fund Act 
        of 1965 (16 U.S.C. 460l-6a);
            (2) the recreational fee demonstration program authorized 
        by section 315 of the Department of the Interior and Related 
        Agencies Appropriations Act, 1996 (as contained in Public Law 
        104-134; 110 Stat. 1321-156; 1321-200; 16 U.S.C. 460l-6a note); 
        or
            (3) the national park passport program established under 
        title VI of the National Parks Omnibus Management Act of 1998 
        (Public Law 105-391; 112 Stat. 3518; 16 U.S.C. 5991 et seq.).
    (c) Limitation.--The total amount charged or set aside under 
subsection (a) may not exceed $2 for each individual charged an 
entrance fee.
    (d) Use.--A surcharge or set-aside under subsection (a) shall be 
used by the fundraising organization to--
            (1) amortize the bond issue;
            (2) provide for the reasonable costs of administration; and
            (3) maintain a sufficient reserve consistent with industry 
        standards, as determined by the bond underwriter.
    (e) Excess Funds.--Any funds collected in excess of the amount 
necessary to fund the uses in subsection (d) shall be remitted to the 
National Park Foundation to be used for the benefit of all units of the 
National Park System.

SEC. 6. USE OF BOND PROCEEDS.

    (a) Eligible Projects.--
            (1) In general.--Subject to paragraph (2), bond proceeds 
        under this Act may be used for a project for the design, 
        construction, operation, maintenance, repair, or replacement of 
        a facility in the national park for which the bond was issued.
            (2) Project limitations.--A project referred to in 
        paragraph (1) shall be consistent with--
                    (A) the laws governing the National Park System;
                    (B) any law governing the national park in which 
                the project is to be completed; and
                    (C) the general management plan for the national 
                park.
            (3) Prohibition on use for administration.--Other than 
        interest as provided in subsection (b), no part of the bond 
        proceeds may be used to defray administrative expenses.
    (b) Interest on Bond Proceeds.--
            (1) Authorized uses.--Any interest earned on bond proceeds 
        may be used by the fundraising organization to--
                    (A) meet reserve requirements; and
                    (B) defray reasonable administrative expenses 
                incurred in connection with the management and sale of 
                the bonds.
            (2) Excess interest.--All interest on bond proceeds not 
        used for purposes of paragraph (1) shall be remitted to the 
        National Park Foundation for the benefit of all units of the 
        National Park System.

SEC. 7. ADMINISTRATION.

    The Secretary, in consultation with the Secretary of Treasury, 
shall promulgate regulations to carry out this Act.
Exempts the United States from liability for such bonds unless the surcharge is not imposed for any reason or if it is reduced or eliminated in which case the full faith and credit of the United States is pledged to bond payment.
Authorizes the Secretary to: (1) permit the Superintendent of the park to charge and collect, in addition to the entrance fee, a surcharge of not to exceed $2; or (2) set aside not more than $2 for each entrance fee. Requires: (1) the surcharge or set-aside to be used by the organization to amortize the bond issue, to provide for the reasonable costs of administration, and to maintain a sufficient reserve consistent with industry standards; and (2) any excess funds to be remitted to the National Park Foundation (NPF) to be used for the benefit of all National Park System (NPS) units.
Allows bond proceeds to be used for a park facility project that is consistent with: (1) the laws governing the NPS and the park; and (2) the general management plan for the park.
Requires interest earned on bond proceeds to be: (1) used by the organization to meet reserve requirements and defray reasonable administrative expenses; and (2) remitted to the NPF for the benefit of all NPS units, to the extent funds are available in excess of the amount required for projects.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Veterans Combat Stress Healthcare 
Improvement Act''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) More than 1.6 million members of the Armed Forces have 
        been deployed in Afghanistan or Iraq for Operation Enduring 
        Freedom and Operation Iraqi Freedom.
            (2) The 2008 RAND Corporation report entitled ``Invisible 
        Wounds of War'' stated that ``With the possibility of more than 
        300,000 new cases of mental health conditions among OEF/OIF 
        veterans, a commensurate increase in treatment capacity is 
        needed.''.
            (3) Combat stress refers to the expected and predictable 
        emotional, intellectual, physical, or behavioral reactions of 
        members of the Armed Forces who have been exposed to stressful 
        events in war or other military operations, and combat stress 
        is often associated with post-traumatic stress disorder, 
        anxiety, depression, alcohol or drug abuse, and readjustment 
        difficulties.
            (4) Approximately 18.5 percent of the members of the Armed 
        Forces who have served in Afghanistan or Iraq are believed to 
        be suffering from post-traumatic stress disorder or depression, 
        and the rate of suicide among veterans suffering from post-
        traumatic stress disorder is a serious problem.
            (5) Approximately 19.5 percent of the members of the Armed 
        Forces who have served in Afghanistan or Iraq report that they 
        experienced a traumatic brain injury during their deployment.
            (6) It is estimated that only half of the veterans who need 
        treatment for post-traumatic stress disorder or traumatic brain 
        injury actually seek treatment, and, of the veterans who 
        receive treatment, only slightly more than half receive 
        minimally adequate or better care.
            (7) The Department of Veterans Affairs must be prepared to 
        provide lifetime care for veterans who were severely wounded 
        physically or psychologically in combat operations in 
        Afghanistan and Iraq.
            (8) The inadequate number of licensed mental health 
        professionals trained to treat combat stress may have a 
        negative long-term impact on the quality of mental health care 
        for veterans.
            (9) There are many challenges surrounding the hiring and 
        retention of trained mental health providers by the Department 
        of Veterans Affairs.
            (10) The Health Professionals Educational Assistance 
        Program under chapter 76 of title 38, United States Code, 
        contains a number of scholarship, tuition reimbursement, and 
        education debt reduction programs that need to be better 
        utilized by the Department of Veterans Affairs to relieve the 
        shortage in the number of licensed mental health professionals 
        employed by the Department who have received specialized 
        training in the treatment of combat stress.

SEC. 3. USE OF HEALTH PROFESSIONALS EDUCATIONAL ASSISTANCE PROGRAM TO 
              INCREASE NUMBER OF LICENSED MENTAL HEALTH PROFESSIONALS 
              EMPLOYED BY THE DEPARTMENT OF VETERANS AFFAIRS TRAINED TO 
              TREAT COMBAT STRESS.

    (a) In General.--Section 7603 of title 38, United States Code, is 
amended by adding at the end the following new subsection:
    ``(e)(1) The purpose of this subsection is to establish a means to 
increase the number of licensed mental health professionals employed by 
the Department of Veterans Affairs who have the specialized training 
necessary to treat combat stress by providing a selection priority 
under the following components of the Educational Assistance Program:
            ``(A) The scholarship program provided for in subchapter II 
        of this chapter.
            ``(B) The tuition reimbursement program provided for in 
        subchapter III of this chapter.
            ``(C) The Selected Reserve member stipend program provided 
        for under subchapter V of this chapter.
            ``(D) The employee incentive scholarship program provided 
        for in subchapter VI of this chapter.
            ``(E) The education debt reduction program provided for in 
        subchapter VII of this chapter.
    ``(2) In addition to the priority given under subsection (d) in 
selecting applicants for acceptance in the Educational Assistance 
Program under subchapter II, III, V, or VI of this chapter, the 
Secretary shall give priority to the application of an individual who--
            ``(A) is otherwise eligible to receive assistance under the 
        applicable subchapter; and
            ``(B) is accepted for enrollment, or is enrolled, as a 
        student at a qualifying educational institution in a course of 
        education or training that is approved by the Secretary and--
                    ``(i) leads to a degree as a licensed mental health 
                professional with specialized training in the treatment 
                of combat stress; or
                    ``(ii) in the case of an individual who is already 
                a licensed mental health professional, provides 
                specialized training in the field of combat stress.
    ``(3) In addition to the priority given under subsection (d) in 
selecting applicants for acceptance in the Educational Assistance 
Program under subchapter VII of this chapter, the Secretary shall give 
priority to the application of an individual who--
            ``(A) is otherwise eligible to receive assistance under 
        such subchapter;
            ``(B) has completed a degree qualifying the individual as a 
        licensed mental health professional;
            ``(C) is an employee of the Department who serves in a 
        position related to the treatment of combat stress; and
            ``(D) owes any amount of principal or interest under a loan 
        used by that individual to pay costs directly relating to 
        earning the degree as a licensed mental health professional.
    ``(4) The Secretary shall make available to personnel of the 
Department and to educational institutions offering courses in mental 
health such materials as the Secretary considers appropriate to provide 
information on the Educational Assistance Program priorities available 
under this subsection and shall encourage educational institutions to 
disseminate the materials to students.
    ``(5) The priority required by paragraphs (2) and (3) shall apply 
until such time as the Secretary certifies to Congress that the 
shortage no longer exists in the number of licensed mental health 
professionals employed by the Department of Veterans Affairs who have 
specialized training in the treatment of combat stress.
    ``(6) Not later than 60 days after the date of the enactment of the 
Veterans Combat Stress Healthcare Improvement Act, the Secretary shall 
issue guidelines for the identification of educational programs that 
are qualified to provide specialized training in the treatment of 
combat stress.
    ``(7) In this subsection:
            ``(A) The term `licensed mental health professional' 
        includes individuals certified as a social worker, 
        psychologist, psychiatrist, or in such other disciplines as the 
        Secretary determines to be appropriate for purposes of this 
        subsection.
            ``(B) The term `combat stress' refers to the expected and 
        predictable emotional, intellectual, physical, or behavioral 
        reactions of veterans who have been exposed to stressful events 
        in war or other military operations, and combat stress is often 
        associated with post-traumatic stress disorder, anxiety, 
        depression, alcohol or drug abuse, and readjustment 
        difficulties.
    ``(8) There is authorized to be appropriated to the Secretary 
$15,000,000 for each of fiscal years 2009 through 2011 to carry out 
this subsection.''.
    (b) Rule of Construction.--Nothing in the amendment made by 
subsection (a) is intended to limit or define the diagnosis or 
treatment of veterans' medical conditions.
    (c) Reauthorization of Expired Scholarship Program.--Section 7618 
of title 38, United States Code, is amended by striking ``1998'' and 
inserting ``2011''.

Veterans Combat Stress Healthcare Improvement Act - Revises the veterans' health professionals educational assistance program to provide a selection priority under various program components for those seeking to obtain the specialized training necessary to treat combat stress. Provides a similar priority for individuals who have completed the degree requirements necessary for qualification as a licensed mental health professional, are employees of the Department of Veterans Affairs (VA) in positions related to the treatment of combat stress, and owe any principal or interest on loans used to pay costs related to earning the degree.

Reauthorizes the program's scholarship program for FY2009-FY2011.