Veterans' Mental Health and Other Care Improvements Act of 2008
PL 110-387 (S.2162), enacted 10/10/2008

122 STAT. 4110 
PUBLIC LAW 110–387—OCT. 10, 2008 
Public Law 110–387 
110th Congress 
An Act 
To improve the treatment and services provided by the Department of Veterans 
Affairs to veterans with post-traumatic stress disorder and substance use disorders, 
and for other purposes. 
Be it enacted by the Senate and House of Representatives of 
the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the ‘‘Veterans’ 
Mental Health and Other Care Improvements Act of 2008’’. 
(b) TABLE OF CONTENTS.—The table of contents for this Act 
is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. References to title 38, United States Code. 
TITLE I—SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE 
Sec. 101. Tribute to Justin Bailey. 
Sec. 102. Findings on substance use disorders and mental health. 
Sec. 103. Expansion of substance use disorder treatment services provided by De-
partment of Veterans Affairs. 
Sec. 104. Care for veterans with mental health and substance use disorders. 
Sec. 105. Pilot program for Internet-based substance use disorder treatment for 
veterans of Operation Iraqi Freedom and Operation Enduring Freedom. 
Sec. 106. Report on residential mental health care facilities of the Veterans Health 
Administration. 
Sec. 107. Pilot program on peer outreach and support for veterans and use of com-
munity mental health centers and Indian Health Service facilities. 
TITLE II—MENTAL HEALTH RESEARCH 
Sec. 201. Research program on comorbid post-traumatic stress disorder and sub-
stance use disorders. 
Sec. 202. Extension of authorization for Special Committee on Post-Traumatic 
Stress Disorder. 
TITLE III—ASSISTANCE FOR FAMILIES OF VETERANS 
Sec. 301. Clarification of authority of Secretary of Veterans Affairs to provide men-
tal health services to families of veterans. 
Sec. 302. Pilot program on provision of readjustment and transition assistance to 
veterans and their families in cooperation with Vet Centers. 
TITLE IV—HEALTH CARE MATTERS 
Sec. 401. Veterans beneficiary travel program. 
Sec. 402. Mandatory reimbursement of veterans receiving emergency treatment in 
non-Department of Veterans Affairs facilities until transfer to Depart-
ment facilities. 
Sec. 403. Pilot program of enhanced contract care authority for health care needs 
of veterans in highly rural areas. 
Sec. 404. Epilepsy centers of excellence. 
Sec. 405. Establishment of qualifications for peer specialist appointees. 
Sec. 406. Establishment of consolidated patient accounting centers. 
Sec. 407. Repeal of limitation on authority to conduct widespread HIV testing pro-
gram. 
38 USC 101 note. 
Veterans’ Mental 
Health and 
Other Care 
Improvements 
Act of 2008. 
Oct. 10, 2008 
[S. 2162] 
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122 STAT. 4111 
PUBLIC LAW 110–387—OCT. 10, 2008 
Sec. 408. Provision of comprehensive health care by Secretary of Veterans Affairs 
to children of Vietnam veterans born with Spina Bifida. 
Sec. 409. Exemption from copayment requirement for veterans receiving hospice 
care. 
TITLE V—PAIN CARE 
Sec. 501. Comprehensive policy on pain management. 
TITLE VI—HOMELESS VETERANS MATTERS 
Sec. 601. Increased authorization of appropriations for comprehensive service pro-
grams. 
Sec. 602. Expansion and extension of authority for program of referral and coun-
seling services for at-risk veterans transitioning from certain institu-
tions. 
Sec. 603. Permanent authority for domiciliary services for homeless veterans and 
enhancement of capacity of domiciliary care programs for female vet-
erans. 
Sec. 604. Financial assistance for supportive services for very low-income veteran 
families in permanent housing. 
TITLE VII—AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND 
MAJOR MEDICAL FACILITY LEASES 
Sec. 701. Authorization for fiscal year 2009 major medical facility projects. 
Sec. 702. Modification of authorization amounts for certain major medical facility 
construction projects previously authorized. 
Sec. 703. Authorization of fiscal year 2009 major medical facility leases. 
Sec. 704. Authorization of appropriations. 
Sec. 705. Increase in threshold for major medical facility leases requiring Congres-
sional approval. 
Sec. 706. Conveyance of certain non-Federal land by City of Aurora, Colorado, to 
Secretary of Veterans Affairs for construction of veterans medical facil-
ity. 
Sec. 707. Report on facilities administration. 
Sec. 708. Annual report on outpatient clinics. 
Sec. 709. Name of Department of Veterans Affairs spinal cord injury center, 
Tampa, Florida. 
TITLE VIII—EXTENSION OF CERTAIN AUTHORITIES 
Sec. 801. Repeal of sunset on inclusion of noninstitutional extended care services 
in definition of medical services. 
Sec. 802. Extension of recovery audit authority. 
Sec. 803. Permanent authority for provision of hospital care, medical services, and 
nursing home care to veterans who participated in certain chemical and 
biological testing conducted by the Department of Defense. 
Sec. 804. Extension of expiring collections authorities. 
Sec. 805. Extension of nursing home care. 
Sec. 806. Permanent authority to establish research corporations. 
Sec. 807. Extension of requirement to submit annual report on the Committee on 
Care of Severely Chronically Mentally Ill Veterans. 
Sec. 808. Permanent requirement for biannual report on Women’s Advisory Com-
mittee. 
Sec. 809. Extension of pilot program on improvement of caregiver assistance serv-
ices. 
TITLE IX—OTHER MATTERS 
Sec. 901. Technical amendments. 
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE. 
Except as otherwise expressly provided, whenever in this Act 
an amendment or repeal is expressed in terms of an amendment 
to, or repeal of, a section or other provision, the reference shall 
be considered to be made to a section or other provision of title 
38, United States Code. 
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122 STAT. 4112 
PUBLIC LAW 110–387—OCT. 10, 2008 
TITLE I—SUBSTANCE USE DISORDERS 
AND MENTAL HEALTH CARE 
SEC. 101. TRIBUTE TO JUSTIN BAILEY. 
This title is enacted in tribute to Justin Bailey, who, after 
returning to the United States from service as a member of the 
Armed Forces in Operation Iraqi Freedom, died in a domiciliary 
facility of the Department of Veterans Affairs while receiving care 
for post-traumatic stress disorder and a substance use disorder. 
SEC. 102. FINDINGS ON SUBSTANCE USE DISORDERS AND MENTAL 
HEALTH. 
Congress makes the following findings: 
(1) More than 1,500,000 members of the Armed Forces 
have been deployed in Operation Iraqi Freedom and Operation 
Enduring Freedom. The 2005 Department of Defense Survey 
of Health Related Behaviors Among Active Duty Personnel 
reports that 23 percent of members of the Armed Forces on 
active duty acknowledge a significant problem with alcohol 
use disorder, with similar rates of acknowledged problems with 
alcohol use disorder among members of the National Guard. 
(2) The effects of substance use disorder are wide ranging, 
including significantly increased risk of suicide, exacerbation 
of mental and physical health disorders, breakdown of family 
support, and increased risk of unemployment and homelessness. 
(3) While veterans suffering from mental health conditions, 
chronic physical illness, and polytrauma may be at increased 
risk for development of a substance use disorder, treatment 
for these veterans is complicated by the need to address ade-
quately the physical and mental symptoms associated with 
these conditions through appropriate medical intervention. 
(4) While the Veterans Health Administration has dramati-
cally increased health services for veterans from 1996 through 
2006, the number of veterans receiving specialized substance 
use disorder treatment services decreased 18 percent during 
that time. No comparable decrease in the national rate of 
substance use disorder has been observed during that time. 
(5) While some facilities of the Veterans Health Administra-
tion provide exemplary substance use disorder treatment serv-
ices, the availability of such treatment services throughout 
the health care system of the Veterans Health Administration 
is inconsistent. 
(6) According to a 2006 report by the Government Account-
ability Office, the Department of Veterans Affairs significantly 
reduced its substance use disorder treatment and rehabilitation 
services between 1996 and 2006, and the Fiscal Year 2007 
National Mental Health Program Monitoring System report 
shows that little progress has been made in restoring these 
services to their pre-1996 levels. 
SEC. 103. EXPANSION OF SUBSTANCE USE DISORDER TREATMENT 
SERVICES PROVIDED BY DEPARTMENT OF VETERANS 
AFFAIRS. 
(a) IN GENERAL.—The Secretary of Veterans Affairs shall 
ensure the provision of such services and treatment to each veteran 
enrolled in the health care system of the Department of Veterans 
38 USC 1720A 
note. 
38 USC 1720A 
note. 
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122 STAT. 4113 
PUBLIC LAW 110–387—OCT. 10, 2008 
Affairs who is in need of services and treatments for a substance 
use disorder as follows: 
(1) Screening for substance use disorder in all settings, 
including primary care settings. 
(2) Short term motivational counseling services. 
(3) Marital and family counseling. 
(4) Intensive outpatient or residential care services. 
(5) Relapse prevention services. 
(6) Ongoing aftercare and outpatient counseling services. 
(7) Opiate substitution therapy services. 
(8) Pharmacological treatments aimed at reducing craving 
for drugs and alcohol. 
(9) Detoxification and stabilization services. 
(10) Coordination with groups providing peer to peer coun-
seling. 
(11) Such other services as the Secretary considers appro-
priate. 
(b) PROVISION OF SERVICES.— 
(1) ALLOCATION OF RESOURCES FOR PROVISION OF SERV-
ICES.—The Secretary shall ensure that amounts made available 
for care, treatment, and services provided under this section 
are allocated in such a manner that a full continuum of care, 
treatment, and services described in subsection (a) is available 
to veterans seeking such care, treatment, or services, without 
regard to the location of the residence of any such veterans. 
(2) MANNER OF PROVISION.—The services and treatment 
described in subsection (a) may be provided to a veteran 
described in such subsection— 
(A) at Department of Veterans Affairs medical centers 
or clinics; 
(B) by referral to other facilities of the Department 
that are accessible to such veteran; or 
(C) by contract or fee-for-service payments with 
community-based organizations for the provision of such 
services and treatments. 
(c) ALTERNATIVES IN CASE OF SERVICES DENIED DUE TO CLIN-
ICAL NECESSITY.—If the Secretary denies the provision to a veteran 
of services or treatment for a substance use disorder due to clinical 
necessity, the Secretary shall provide the veteran such other serv-
ices or treatment as are medically appropriate. 
SEC. 104. CARE FOR VETERANS WITH MENTAL HEALTH AND SUB-
STANCE USE DISORDERS. 
(a) IN GENERAL.—If the Secretary of Veterans Affairs provides 
a veteran inpatient or outpatient care for a substance use disorder 
and a comorbid mental health disorder, the Secretary shall ensure 
that treatment for such disorders is provided concurrently— 
(1) through a service provided by a clinician or health 
professional who has training and expertise in treatment of 
substance use disorders and mental health disorders; 
(2) by separate substance use disorder and mental health 
disorder treatment services when there is appropriate coordina-
tion, collaboration, and care management between such treat-
ment services; or 
(3) by a team of clinicians with appropriate expertise. 
38 USC 1720A 
note. 
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122 STAT. 4114 
PUBLIC LAW 110–387—OCT. 10, 2008 
(b) TEAM
OF
CLINICIANS
WITH
APPROPRIATE
EXPERTISE 
DEFINED.—In this section, the term ‘‘team of clinicians with appro-
priate expertise’’ means a team consisting of the following: 
(1) Clinicians and health professionals with expertise in 
treatment of substance use disorders and mental health dis-
orders who act in coordination and collaboration with each 
other. 
(2) Such other professionals as the Secretary considers 
appropriate for the provision of treatment to veterans for sub-
stance use and mental health disorders. 
SEC. 105. PILOT PROGRAM FOR INTERNET-BASED SUBSTANCE USE 
DISORDER TREATMENT FOR VETERANS OF OPERATION 
IRAQI FREEDOM AND OPERATION ENDURING FREEDOM. 
(a) FINDINGS.—Congress makes the following findings: 
(1) Stigma associated with seeking treatment for mental 
health disorders has been demonstrated to prevent some vet-
erans from seeking such treatment at a medical facility oper-
ated by the Department of Defense or the Department of Vet-
erans Affairs. 
(2) There is a significant incidence among veterans of post- 
deployment mental health problems, especially among members 
of a reserve component who return as veterans to civilian 
life. 
(3) Computer-based self-guided training has been dem-
onstrated to be an effective strategy for supplementing the 
care of psychological conditions. 
(4) Younger veterans, especially those who served in Oper-
ation Enduring Freedom or Operation Iraqi Freedom, are com-
fortable with and proficient at computer-based technology. 
(5) Veterans living in rural areas may find access to treat-
ment for substance use disorder limited. 
(6) Self-assessment and treatment options for substance 
use disorders through an Internet website may reduce stigma 
and provides additional access for individuals seeking care and 
treatment for such disorders. 
(b) IN GENERAL.—Not later than October 1, 2009, the Secretary 
of Veterans Affairs shall carry out a pilot program to assess the 
feasibility and advisability of providing veterans who seek treat-
ment for substance use disorders access to a computer-based self- 
assessment, education, and specified treatment program through 
a secure Internet website operated by the Secretary. Participation 
in the pilot program shall be available on a voluntary basis for 
those veterans who have served in Operation Enduring Freedom 
or Operation Iraqi Freedom. 
(c) ELEMENTS OF PILOT PROGRAM.— 
(1) IN GENERAL.—In carrying out the pilot program under 
this section, the Secretary shall ensure that— 
(A) access to the Internet website and the programs 
available on the website by a veteran (or family member) 
does not involuntarily generate an identifiable medical 
record of that access by that veteran in any medical data-
base maintained by the Department of Veterans Affairs; 
(B) the Internet website is accessible from remote loca-
tions, especially rural areas; and 
(C) the Internet website includes a self-assessment 
tool for substance use disorders, self-guided treatment and 
Deadline. 
38 USC 1720A 
note. 
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122 STAT. 4115 
PUBLIC LAW 110–387—OCT. 10, 2008 
educational materials for such disorders, and appropriate 
information and materials for family members of veterans. 
(2) CONSIDERATION OF SIMILAR PROJECTS.—In designing the 
pilot program under this section, the Secretary shall consider 
similar pilot projects of the Department of Defense for the 
early diagnosis and treatment of post-traumatic stress disorder 
and other mental health conditions established under section 
741 of the John Warner National Defense Authorization Act 
of Fiscal Year 2007 (Public Law 109–364; 120 Stat. 2304). 
(3) LOCATION
OF
PILOT
PROGRAM.—The Secretary shall 
carry out the pilot program through those medical centers 
of the Department of Veterans Affairs that have established 
Centers for Excellence for Substance Abuse Treatment and 
Education or that have established a Substance Abuse Program 
Evaluation and Research Center. 
(4) CONTRACT AUTHORITY.—The Secretary may enter into 
contracts with qualified entities or organizations to carry out 
the pilot program required under this section. 
(d) DURATION OF PILOT PROGRAM.—The pilot program required 
by subsection (a) shall be carried out during the two-year period 
beginning on the date of the commencement of the pilot program. 
(e) REPORT.—Not later than six months after the completion 
of the pilot program, the Secretary shall submit to Congress a 
report on the pilot program, and shall include in that report— 
an assessment of the feasibility and advisability of continuing or 
expanding the pilot program, of any cost savings or other benefits 
associated with the pilot program, and any other recommendations. 
(f) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 
to be appropriated to the Secretary of Veterans Affairs $1,500,000 
for each of fiscal years 2010 and 2011 to carry out the pilot program 
under this section. 
SEC. 106. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILI-
TIES OF THE VETERANS HEALTH ADMINISTRATION. 
(a) REVIEW.— 
(1) IN GENERAL.—Not later than six months after the date 
of the enactment of this Act, the Secretary of Veterans Affairs 
shall, acting through the Inspector General of the Department 
of Veterans Affairs, complete a review of all residential mental 
health care facilities, including domiciliary facilities, of the 
Veterans Health Administration. 
(2) ASSESSMENT.—As part of the review required by para-
graph (1), the Secretary, acting through the Inspector General, 
shall assess the following: 
(A) The availability of care in residential mental health 
care facilities in each Veterans Integrated Service Network 
(VISN). 
(B) The supervision and support provided in the resi-
dential mental health care facilities of the Veterans Health 
Administration. 
(C) The ratio of staff members at each residential 
mental health care facility to patients at such facility. 
(D) The appropriateness of rules and procedures for 
the prescription and administration of medications to 
patients in such residential mental health care facilities. 
(E) The protocols at each residential mental health 
care facility for handling missed appointments. 
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122 STAT. 4116 
PUBLIC LAW 110–387—OCT. 10, 2008 
(3) RECOMMENDATIONS.—As part of the review required 
by paragraph (1), the Secretary, acting through the Inspector 
General, shall develop such recommendations as the Secretary 
considers appropriate for improvements to residential mental 
health care facilities of the Veterans Health Administration 
and the care provided in such facilities. 
(b) FOLLOW-UP REVIEW.—Not later than two years after the 
date of the completion of the review required by subsection (a), 
the Secretary of Veterans Affairs shall, acting through the Inspector 
General of the Department of Veterans Affairs, complete a follow- 
up review of the facilities reviewed under subsection (a) to evaluate 
any improvements made or problems remaining since the review 
under subsection (a) was completed. 
(c) REPORT.—Not later than 90 days after the completion of 
the review required by subsection (a), the Secretary of Veterans 
Affairs shall submit to the Committee on Veterans’ Affairs of the 
Senate and the Committee on Veterans’ Affairs of the House of 
Representatives a report on the findings of the Secretary with 
respect to such review. 
SEC. 107. PILOT PROGRAM ON PEER OUTREACH AND SUPPORT FOR 
VETERANS AND USE OF COMMUNITY MENTAL HEALTH 
CENTERS AND INDIAN HEALTH SERVICE FACILITIES. 
(a) PILOT PROGRAM REQUIRED.—Commencing not later than 
180 days after the date of the enactment of this Act, the Secretary 
of Veterans Affairs shall carry out a pilot program to assess the 
feasability and advisability of providing to veterans of Operation 
Iraqi Freedom and Operation Enduring Freedom, and, in particular, 
veterans who served in such operations as a member of the National 
Guard or Reserve, the following: 
(1) Peer outreach services. 
(2) Peer support services provided by licensed providers 
of peer support services or veterans who have personal experi-
ence with mental illness. 
(3) Readjustment counseling services described in section 
1712A of title 38, United States Code. 
(4) Other mental health services. 
(b) PROVISION
OF CERTAIN SERVICES.—In providing services 
described in paragraphs (3) and (4) of subsection (a) under the 
pilot program to veterans who reside in rural areas and do not 
have adequate access through the Department of Veterans Affairs 
to the services described in such paragraphs, the Secretary shall, 
acting through the Office of Mental Health Services and the Office 
of Rural Health, provide such services as follows: 
(1) Through community mental health centers under con-
tracts or other agreements if entered into by the Secretary 
of Veterans Affairs and the Secretary of Health and Human 
Services for the provision of such services for purposes of the 
pilot program. 
(2) Through the Indian Health Service, or an Indian tribe 
or tribal organization that has entered into an agreement with 
the Indian Health Service pursuant to the Indian Self-Deter-
mination and Education Assistance Act (25 U.S.C. 450 et seq.), 
if a memorandum of understanding is entered into by the 
Secretary of Veterans Affairs and the Secretary of Health and 
Human Services for purposes of the pilot program. 
Deadline. 
38 USC 1712A 
note. 
Deadline. 
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122 STAT. 4117 
PUBLIC LAW 110–387—OCT. 10, 2008 
(3) Through other appropriate entities under contracts or 
other agreements entered into by the Secretary of Veterans 
Affairs for the provision of such services for purposes of the 
pilot program. 
(c) DURATION.—The pilot program shall be carried out during 
the three-year period beginning on the date of the commencement 
of the pilot program. 
(d) PROGRAM LOCATIONS.— 
(1) IN GENERAL.—The pilot program shall be carried out 
within areas selected by the Secretary for the purpose of the 
pilot program in at least three Veterans Integrated Service 
Networks (VISNs). 
(2) RURAL GEOGRAPHIC LOCATIONS.—The locations selected 
shall be in rural geographic locations that, as determined by 
the Secretary, lack access to comprehensive mental health serv-
ices through the Department of Veterans Affairs. 
(3) QUALIFIED PROVIDERS.—In selecting locations for the 
pilot program, the Secretary shall select locations in which 
an adequate number of licensed mental health care providers 
with credentials equivalent to those of Department mental 
health care providers are available in Indian Health Service 
facilities, community mental health centers, and other entities 
for participation in the pilot program. 
(e) PARTICIPATION
IN
PROGRAM.—Each community mental 
health center, facility of the Indian Health Service, or other entity 
participating in the pilot program under subsection (b) shall— 
(1) provide the services described in paragraphs (3) and 
(4) of subsection (a) to eligible veterans, including, to the extent 
practicable, telehealth services that link the center or facility 
with Department of Veterans Affairs clinicians; 
(2) use the clinical practice guidelines of the Veterans 
Health Administration or the Department of Defense in the 
provision of such services; and 
(3) meet such other requirements as the Secretary shall 
require. 
(f) COMPLIANCE WITH DEPARTMENT PROTOCOLS.—Each commu-
nity mental health center, facility of the Indian Health Service, 
or other entity participating in the pilot program under subsection 
(b) shall comply with— 
(1) applicable protocols of the Department before incurring 
any liability on behalf of the Department for the provision 
of services as part of the pilot program; and 
(2) access and quality standards of the Department relevant 
to the provision of services as part of the pilot program. 
(g) PROVISION
OF CLINICAL INFORMATION.—Each community 
mental health center, facility of the Indian Health Service, or other 
entity participating in the pilot program under subsection (b) shall, 
in a timely fashion, provide the Secretary with such clinical informa-
tion on each veteran for whom such health center or facility provides 
mental health services under the pilot program as the Secretary 
shall require. 
(h) TRAINING.— 
(1) TRAINING OF VETERANS.—As part of the pilot program, 
the Secretary shall carry out a program of training for veterans 
described in subsection (a) to provide the services described 
in paragraphs (1) and (2) of such subsection. 
(2) TRAINING OF CLINICIANS.— 
Requirements. 
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122 STAT. 4118 
PUBLIC LAW 110–387—OCT. 10, 2008 
(A) IN
GENERAL.—The Secretary shall conduct a 
training program for clinicians of community mental health 
centers, Indian Health Service facilities, or other entities 
participating in the pilot program under subsection (b) 
to ensure that such clinicians can provide the services 
described in paragraphs (3) and (4) of subsection (a) in 
a manner that accounts for factors that are unique to 
the experiences of veterans who served on active duty 
in Operation Iraqi Freedom or Operation Enduring 
Freedom (including their combat and military training 
experiences). 
(B) PARTICIPATION
IN
TRAINING.—Personnel of each 
community mental health center, facility of the Indian 
Health Service, or other entity participating in the pilot 
program under subsection (b) shall participate in the 
training program conducted pursuant to subparagraph (A). 
(i) ANNUAL REPORTS.—Each community mental health center, 
facility of the Indian Health Service, or other entity participating 
in the pilot program under subsection (b) shall submit to the Sec-
retary on an annual basis a report containing, with respect to 
the provision of services under subsection (b) and for the last 
full calendar year ending before the submission of such report— 
(1) the number of— 
(A) veterans served; and 
(B) courses of treatment provided; and 
(2) demographic information for such services, diagnoses, 
and courses of treatment. 
(j) PROGRAM EVALUATION.— 
(1) IN GENERAL.—The Secretary shall, through Department 
of Veterans Affairs Mental Health Services investigators and 
in collaboration with relevant program offices of the Depart-
ment, design and implement a strategy for evaluating the pilot 
program. 
(2) ELEMENTS.—The strategy implemented under para-
graph (1) shall assess the impact that contracting with commu-
nity mental health centers, the Indian Health Service, and 
other entities participating in the pilot program under sub-
section (b) has on the following: 
(A) Access to mental health care by veterans in need 
of such care. 
(B) The use of telehealth services by veterans for 
mental health care needs. 
(C) The quality of mental health care and substance 
use disorder treatment services provided to veterans in 
need of such care and services. 
(D) The coordination of mental health care and other 
medical services provided to veterans. 
(k) DEFINITIONS.—In this section: 
(1) The term ‘‘community mental health center’’ has the 
meaning given such term in section 410.2 of title 42, Code 
of Federal Regulations (as in effect on the day before the 
date of the enactment of this Act). 
(2) The term ‘‘eligible veteran’’ means a veteran in need 
of mental health services who— 
(A) is enrolled in the Department of Veterans Affairs 
health care system; and 
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122 STAT. 4119 
PUBLIC LAW 110–387—OCT. 10, 2008 
(B) has received a referral from a health professional 
of the Veterans Health Administration to a community 
mental health center, a facility of the Indian Health 
Service, or other entity for purposes of the pilot program. 
(3) The term ‘‘Indian Health Service’’ means the organiza-
tion established by section 601(a) of the Indian Health Care 
Improvement Act (25 U.S.C. 1661(a)). 
(l) AUTHORIZATION OF APPROPRIATIONS.—There is authorized 
to be appropriated such sums as may be necessary to carry out 
the provisions of this section. 
TITLE II—MENTAL HEALTH RESEARCH 
SEC. 201. RESEARCH PROGRAM ON COMORBID POST-TRAUMATIC 
STRESS DISORDER AND SUBSTANCE USE DISORDERS. 
(a) PROGRAM REQUIRED.—The Secretary of Veterans Affairs 
shall, through the Office of Research and Development, carry out 
a program of research into comorbid post-traumatic stress disorder 
(PTSD) and substance use disorder. 
(b) 
DISCHARGE
THROUGH
NATIONAL
CENTER
FOR 
POSTTRAUMATIC STRESS DISORDER.—The research program required 
by subsection (a) shall be carried out by the National Center for 
Posttraumatic Stress Disorder. In carrying out the program, the 
Center shall— 
(1) develop protocols and goals with respect to research 
under the program; and 
(2) coordinate research, data collection, and data dissemina-
tion under the program. 
(c) RESEARCH.—The program of research required by subsection 
(a) shall address the following: 
(1) Comorbid post-traumatic stress disorder and substance 
use disorder. 
(2) The systematic integration of treatment for post-trau-
matic stress disorder with treatment for substance use disorder. 
(3) The development of protocols to evaluate care of vet-
erans with comorbid post-traumatic stress disorder and sub-
stance use disorder. 
(d) FUNDING.— 
(1) AUTHORIZATION OF APPROPRIATIONS.—There is author-
ized to be appropriated for the Department of Veterans Affairs 
for each of fiscal years 2009 through 2012, $2,000,000 to carry 
out this section. 
(2) AVAILABILITY.—Amounts authorized to be appropriated 
by paragraph (1) shall be made available to the National Center 
on Posttraumatic Stress Disorder for the purpose specified in 
that paragraph. 
(3) SUPPLEMENT NOT SUPPLANT.—Any amount made avail-
able to the National Center on Posttraumatic Stress Disorder 
for a fiscal year under paragraph (2) is in addition to any 
other amounts made available to the National Center on 
Posttraumatic Stress Disorder for such year under any other 
provision of law. 
38 USC 1712A 
note. 
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122 STAT. 4120 
PUBLIC LAW 110–387—OCT. 10, 2008 
SEC. 202. EXTENSION OF AUTHORIZATION FOR SPECIAL COMMITTEE 
ON POST-TRAUMATIC STRESS DISORDER. 
Section 110(e)(2) of the Veterans’ Health Care Act of 1984 
(38 U.S.C. 1712A note; Public Law 98–528) is amended by striking 
‘‘through 2008’’ and inserting ‘‘through 2012’’. 
TITLE III—ASSISTANCE FOR FAMILIES 
OF VETERANS 
SEC. 301. CLARIFICATION OF AUTHORITY OF SECRETARY OF VET-
ERANS AFFAIRS TO PROVIDE MENTAL HEALTH SERVICES 
TO FAMILIES OF VETERANS. 
(a) IN GENERAL.—Chapter 17 is amended— 
(1) in section 1701(5)(B)— 
(A) by inserting ‘‘marriage and family counseling,’’ after 
‘‘professional counseling,’’; and 
(B) by striking ‘‘as may be essential to’’ and inserting 
‘‘as the Secretary considers appropriate for’’; and 
(2) in section 1782— 
(A) in subsection (a), by inserting ‘‘marriage and family 
counseling,’’ after ‘‘professional counseling,’’; and 
(B) in subsection (b)— 
(i) by inserting ‘‘marriage and family counseling,’’ 
after ‘‘professional counseling,’’; and 
(ii) by striking ‘‘if—’’ and all that follows and 
inserting a period. 
(b) LOCATION.—Paragraph (5) of section 1701 of title 38, United 
States Code, shall not be construed to prevent the Secretary of 
Veterans Affairs from providing services described in subparagraph 
(B) of such paragraph to individuals described in such subparagraph 
in centers under section 1712A of such title (commonly referred 
to as ‘‘Vet Centers’’), Department of Veterans Affairs medical cen-
ters, community-based outpatient clinics, or in such other facilities 
of the Department of Veterans Affairs as the Secretary considers 
necessary. 
SEC. 302. PILOT PROGRAM ON PROVISION OF READJUSTMENT AND 
TRANSITION ASSISTANCE TO VETERANS AND THEIR FAMI-
LIES IN COOPERATION WITH VET CENTERS. 
(a) PILOT PROGRAM.—The Secretary of Veterans Affairs shall 
carry out, through a non-Department of Veterans Affairs entity, 
a pilot program to assess the feasability and advisability of pro-
viding readjustment and transition assistance described in sub-
section (b) to veterans and their families in cooperation with centers 
under section 1712A of title 38, United States Code (commonly 
referred to as ‘‘Vet Centers’’). 
(b) READJUSTMENT
AND TRANSITION ASSISTANCE.—Readjust-
ment and transition assistance described in this subsection is assist-
ance as follows: 
(1) Readjustment and transition assistance that is preemp-
tive, proactive, and principle-centered. 
(2) Assistance and training for veterans and their families 
in coping with the challenges associated with making the transi-
tion from military to civilian life. 
(c) NON-DEPARTMENT OF VETERANS AFFAIRS ENTITY.— 
38 USC 1712A 
note. 
38 USC 1701 
note. 
38 USC 1701. 
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122 STAT. 4121 
PUBLIC LAW 110–387—OCT. 10, 2008 
(1) IN GENERAL.—The Secretary shall carry out the pilot 
program through any for-profit or non-profit organization 
selected by the Secretary for purposes of the pilot program 
that has demonstrated expertise and experience in the provision 
of assistance and training described in subsection (b). 
(2) CONTRACT OR AGREEMENT.—The Secretary shall carry 
out the pilot program through a non-Department entity 
described in paragraph (1) pursuant to a contract or other 
agreement entered into by the Secretary and the entity for 
purposes of the pilot program. 
(d) COMMENCEMENT OF PILOT PROGRAM.—The pilot program 
shall commence not later than 180 days after the date of the 
enactment of this Act. 
(e) DURATION OF PILOT PROGRAM.—The pilot program shall 
be carried out during the three-year period beginning on the date 
of the commencement of the pilot program, and may be carried 
out for additional one-year periods thereafter. 
(f) LOCATION OF PILOT PROGRAM.— 
(1) IN GENERAL.—The Secretary shall provide assistance 
under the pilot program in cooperation with 10 centers 
described in subsection (a) designated by the Secretary for 
purposes of the pilot program. 
(2) DESIGNATIONS.—In designating centers described in 
subsection (a) for purposes of the pilot program, the Secretary 
shall designate centers so as to provide a balanced geographical 
representation of such centers throughout the United States, 
including the District of Columbia, the Commonwealth of 
Puerto Rico, tribal lands, and other territories and possessions 
of the United States. 
(g) PARTICIPATION OF CENTERS.—A center described in sub-
section (a) that is designated under subsection (f) for participation 
in the pilot program shall participate in the pilot program by 
promoting awareness of the assistance and training available to 
veterans and their families through— 
(1) the facilities and other resources of such center; 
(2) the non-Department of Veterans Affairs entity selected 
pursuant to subsection (c); and 
(3) other appropriate mechanisms. 
(h) ADDITIONAL SUPPORT.—In carrying out the pilot program, 
the Secretary may enter into contracts or other agreements, in 
addition to the contract or agreement described in subsection (c), 
with such other non-Department of Veterans Affairs entities 
meeting the requirements of subsection (c) as the Secretary con-
siders appropriate for purposes of the pilot program. 
(i) REPORT ON PILOT PROGRAM.— 
(1) REPORT REQUIRED.—Not later than three years after 
the date of the enactment of this Act, the Secretary shall 
submit to the congressional veterans affairs committees a report 
on the pilot program. 
(2) ELEMENTS.—Each report under paragraph (1) shall 
include the following: 
(A) A description of the activities under the pilot pro-
gram as of the date of such report, including the number 
of veterans and families provided assistance under the 
pilot program and the scope and nature of the assistance 
so provided. 
Deadline. 
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122 STAT. 4122 
PUBLIC LAW 110–387—OCT. 10, 2008 
(B) A current assessment of the effectiveness of the 
pilot program. 
(C) Any recommendations that the Secretary considers 
appropriate for the extension or expansion of the pilot 
program. 
(3) 
CONGRESSIONAL
VETERANS
AFFAIRS
COMMITTEES 
DEFINED.—In this subsection, the term ‘‘congressional veterans 
affairs committees’’ means— 
(A) the Committees on Veterans’ Affairs and Appropria-
tions of the Senate; and 
(B) the Committees on Veterans’ Affairs and Appropria-
tions of the House of Representatives. 
(j) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—There is authorized to be appropriated 
for the Department of Veterans Affairs for each of fiscal years 
2009 through 2011 $1,000,000 to carry out this section. 
(2) AVAILABILITY.—Amounts authorized to be appropriated 
by paragraph (1) shall remain available until expended. 
TITLE IV—HEALTH CARE MATTERS 
SEC. 401. VETERANS BENEFICIARY TRAVEL PROGRAM. 
(a) REPEAL OF REQUIREMENT TO ADJUST AMOUNTS DEDUCTED 
FROM PAYMENTS OR ALLOWANCES FOR BENEFICIARY TRAVEL.— 
(1) IN GENERAL.—Section 111(c) is amended— 
(A) by striking paragraph (5); and 
(B) in paragraph (2), by striking ‘‘, except as provided 
in paragraph (5) of this subsection,’’. 
(2) REINSTATEMENT OF AMOUNT OF DEDUCTION SPECIFIED 
BY STATUTE.—Notwithstanding any adjustment made by the 
Secretary of Veterans Affairs under paragraph (5) of section 
111(c) of title 38, United States Code, as such paragraph was 
in effect before the date of the enactment of this Act, the 
amount deducted under paragraph (1) of such section 111(c) 
on or after such date shall be the amount specified in such 
paragraph. 
(b) DETERMINATION OF MILEAGE REIMBURSEMENT RATE.—Sec-
tion 111(g) is amended— 
(1) by amending paragraph (1) to read as follows: 
‘‘(1) Subject to paragraph (3), in determining the amount of 
allowances or reimbursement to be paid under this section, the 
Secretary shall use the mileage reimbursement rate for the use 
of privately owned vehicles by Government employees on official 
business (when a Government vehicle is available), as prescribed 
by the Administrator of General Services under section 5707(b) 
of title 5.’’; 
(2) by striking paragraphs (3) and (4); and 
(3) by inserting after paragraph (2) the following new para-
graph (3): 
‘‘(3) Subject to the availability of appropriations, the Secretary 
may modify the amount of allowances or reimbursement to be 
paid under this section using a mileage reimbursement rate in 
excess of that prescribed under paragraph (1).’’. 
(c) REPORT.—Not later than 14 months after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit 
38 USC 111 
note. 
38 USC 111. 
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122 STAT. 4123 
PUBLIC LAW 110–387—OCT. 10, 2008 
to the Committee on Veterans’ Affairs of the Senate and the Com-
mittee on Veterans’ Affairs of the House of Representatives a report 
containing an estimate of the additional costs incurred by the 
Department of Veterans Affairs because of this section, including— 
(1) any costs resulting from increased utilization of 
healthcare services by veterans eligible for travel allowances 
or reimbursements under section 111 of title 38, United States 
Code; and 
(2) the additional costs that would be incurred by the 
Department should the Secretary exercise the authority 
described in subsection (g)(3) of such section. 
(d) EFFECTIVE DATE.—The amendments made by this section 
shall apply with respect to travel expenses incurred after the expira-
tion of the 90-day period that begins on the date of the enactment 
of this Act. 
SEC. 402. MANDATORY REIMBURSEMENT OF VETERANS RECEIVING 
EMERGENCY TREATMENT IN NON-DEPARTMENT OF VET-
ERANS AFFAIRS FACILITIES UNTIL TRANSFER TO DEPART-
MENT FACILITIES. 
(a) CERTAIN VETERANS WITHOUT SERVICE-CONNECTED DIS-
ABILITY.—Section 1725 is amended— 
(1) in subsection (a)(1), by striking ‘‘may reimburse’’ and 
inserting ‘‘shall reimburse’’; and 
(2) in subsection (f)(1), by striking subparagraph (C) and 
inserting the following new subparagraph (C): 
‘‘(C) until— 
‘‘(i) such time as the veteran can be transferred 
safely to a Department facility or other Federal facility 
and such facility is capable of accepting such transfer; 
or 
‘‘(ii) such time as a Department facility or other 
Federal facility accepts such transfer if— 
‘‘(I) at the time the veteran could have been 
transferred safely to a Department facility or other 
Federal facility, no Department facility or other 
Federal facility agreed to accept such transfer; and 
‘‘(II) the non-Department facility in which such 
medical care or services was furnished made and 
documented reasonable attempts to transfer the 
veteran to a Department facility or other Federal 
facility.’’. 
(b) 
CERTAIN
VETERANS
WITH
SERVICE-CONNECTED
DIS-
ABILITY.—Section 1728 is amended— 
(1) by striking subsection (a) and inserting the following 
new subsection (a): 
‘‘(a) The Secretary shall, under such regulations as the Sec-
retary prescribes, reimburse veterans eligible for hospital care or 
medical services under this chapter for the customary and usual 
charges of emergency treatment (including travel and incidental 
expenses under the terms and conditions set forth in section 111 
of this title) for which such veterans have made payment, from 
sources other than the Department, where such emergency treat-
ment was rendered to such veterans in need thereof for any of 
the following: 
‘‘(1) An adjudicated service-connected disability. 
Regulations. 
38 USC 1725. 
38 USC 111 
note. 
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122 STAT. 4124 
PUBLIC LAW 110–387—OCT. 10, 2008 
‘‘(2) A non-service-connected disability associated with and 
held to be aggravating a service-connected disability. 
‘‘(3) Any disability of a veteran if the veteran has a total 
disability permanent in nature from a service-connected dis-
ability. 
‘‘(4) Any illness, injury, or dental condition of a veteran 
who— 
‘‘(A) is a participant in a vocational rehabilitation pro-
gram (as defined in section 3101(9) of this title); and 
‘‘(B) is medically determined to have been in need 
of care or treatment to make possible the veteran’s entrance 
into a course of training, or prevent interruption of a course 
of training, or hasten the return to a course of training 
which was interrupted because of such illness, injury, or 
dental condition.’’; 
(2) in subsection (b), by striking ‘‘care or services’’ both 
places it appears and inserting ‘‘emergency treatment’’; and 
(3) by adding at the end the following new subsection: 
‘‘(c) In this section, the term ‘emergency treatment’ has the 
meaning given such term in section 1725(f)(1) of this title.’’. 
SEC. 
403. 
PILOT 
PROGRAM 
OF 
ENHANCED 
CONTRACT 
CARE 
AUTHORITY FOR HEALTH CARE NEEDS OF VETERANS IN 
HIGHLY RURAL AREAS. 
(a) PILOT PROGRAM REQUIRED.— 
(1) IN GENERAL.—The Secretary of Veterans Affairs shall 
conduct a pilot program under which the Secretary provides 
covered health services to covered veterans through qualifying 
non-Department of Veterans Affairs health care providers. 
(2) COMMENCEMENT.—The Secretary shall commence the 
conduct of the pilot program on the date that is 120 days 
after the date of the enactment of this Act. 
(3) TERMINATION.—A veteran may receive health services 
under the pilot program only during the three-year period 
beginning on the date of the commencement of the pilot pro-
gram under paragraph (2). 
(4) PROGRAM LOCATIONS.—The pilot program shall be car-
ried out within areas selected by the Secretary for the purposes 
of the pilot program in at least five Veterans Integrated Service 
Networks (VISNs). Of the Veterans Integrated Service Net-
works so selected— 
(A) not less than four such networks shall include 
at least three highly rural counties, as determined by the 
Secretary upon consideration of the most recent decennial 
census; 
(B) not less than one such network, not including a 
network selected under subparagraph (A), shall include 
only one highly rural county, as determined by the Sec-
retary upon consideration of the most recent decennial 
census; 
(C) all such networks shall include area within the 
borders of at least four States; and 
(D) no such networks shall be participants in the 
Healthcare Effectiveness through Resource Optimization 
pilot program of the Department of Veterans Affairs. 
(b) COVERED VETERANS.— 
Deadline. 
38 USC 1703 
note. 
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122 STAT. 4125 
PUBLIC LAW 110–387—OCT. 10, 2008 
(1) IN GENERAL.—For purposes of the pilot program under 
this section, a covered veteran is any highly rural veteran 
who is— 
(A) enrolled in the system of patient enrollment estab-
lished under section 1705(a) of title 38, United States Code, 
as of the date of the commencement of the pilot program 
under subsection (a)(2); or 
(B) eligible for health care under section 1710(e)(3)(C) 
of title 38, United States Code. 
(2) HIGHLY RURAL VETERANS.—For purposes of this sub-
section, a highly rural veteran is any veteran who— 
(A) resides in a location that is— 
(i) more than 60 miles driving distance from the 
nearest Department health care facility providing pri-
mary care services, if the veteran is seeking such serv-
ices; 
(ii) more than 120 miles driving distance from 
the nearest Department health care facility providing 
acute hospital care, if the veteran is seeking such 
care; or 
(iii) more than 240 miles driving distance from 
the nearest Department health care facility providing 
tertiary care, if the veteran is seeking such care; or 
(B) in the case of a veteran who resides in a location 
less than the distance specified in clause (i), (ii), or (iii) 
of subparagraph (A), as applicable, experiences such hard-
ship or other difficulties in travel to the nearest appropriate 
Department health care facility that such travel is not 
in the best interest of the veteran, as determined by the 
Secretary pursuant to regulations prescribed for purposes 
of this subsection. 
(c) COVERED HEALTH SERVICES.—For purposes of the pilot pro-
gram under this section, a covered health service with respect 
to a covered veteran is any hospital care, medical service, rehabilita-
tive service, or preventative health service that is authorized to 
be provided by the Secretary to the veteran under chapter 17 
of title 38, United States Code, or any other provision of law. 
(d) QUALIFYING NON-DEPARTMENT HEALTH CARE PROVIDERS.— 
For purposes of the pilot program under this section, an entity 
or individual is a qualifying non-Department health care provider 
of a covered health service if the Secretary determines that the 
entity or individual is qualified to furnish such service to veterans 
under the pilot program. 
(e) ELECTION.—A covered veteran seeking to be provided cov-
ered health services under the pilot program under this section 
shall submit to the Secretary an application therefor in such form, 
and containing such information as the Secretary shall specify 
for purposes of the pilot program. 
(f) PROVISION OF SERVICES THROUGH CONTRACT.—The Secretary 
shall provide covered health services to veterans under the pilot 
program under this section through contracts with qualifying non- 
Department health care providers for the provision of such services. 
(g) EXCHANGE OF MEDICAL INFORMATION.—In conducting the 
pilot program under this section, the Secretary shall develop and 
utilize a functional capability to provide for the exchange of appro-
priate medical information between the Department and non- 
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122 STAT. 4126 
PUBLIC LAW 110–387—OCT. 10, 2008 
Department health care providers providing health services under 
the pilot program. 
(h) REPORTS.—Not later than the 30 days after the end of 
each year in which the pilot program under this section is con-
ducted, the Secretary shall submit to the Committee of Veterans’ 
Affairs of the Senate and the Committee on Veterans’ Affairs of 
the House of Representatives a report which includes— 
(1) the assessment of the Secretary of the pilot program 
during the preceding year, including its cost, volume, quality, 
patient satisfaction, benefit to veterans, and such other findings 
and conclusions with respect to pilot program as the Secretary 
considers appropriate; and 
(2) such recommendations as the Secretary considers appro-
priate regarding— 
(A) the continuation of the pilot program; 
(B) extension of the pilot program to other or all Vet-
erans Integrated Service Networks of the Department; 
(C) making the pilot program permanent. 
SEC. 404. EPILEPSY CENTERS OF EXCELLENCE. 
(a) IN GENERAL.—Subchapter II of chapter 73 is amended by 
adding at the end the following new section: 
‘‘§ 7330A. Epilepsy centers of excellence 
‘‘(a) ESTABLISHMENT OF CENTERS.—(1) Not later than 120 days 
after the date of the enactment of the Veterans’ Mental Health 
and Other Care Improvements Act of 2008, the Secretary shall 
designate at least four but not more than six Department health 
care facilities as locations for epilepsy centers of excellence for 
the Department. 
‘‘(2) Of the facilities designated under paragraph (1), not less 
than two shall be centers designated under section 7327 of this 
title. 
‘‘(3) Of the facilities designated under paragraph (1), not less 
than two shall be facilities that are not centers designated under 
section 7327 of this title. 
‘‘(4) Subject to the availability of appropriations for such pur-
pose, the Secretary shall establish and operate an epilepsy center 
of excellence at each location designated under paragraph (1). 
‘‘(b) DESIGNATION OF FACILITIES.—(1) In designating locations 
for epilepsy centers of excellence under subsection (a), the Secretary 
shall solicit proposals from Department health care facilities seeking 
designation as a location for an epilepsy center of excellence. 
‘‘(2) The Secretary may not designate a facility as a location 
for an epilepsy center of excellence under subsection (a) unless 
the peer review panel established under subsection (c) has deter-
mined under that subsection that the proposal submitted by such 
facility seeking designation as a location for an epilepsy center 
of excellence is among those proposals that meet the highest 
competitive standards of scientific and clinical merit. 
‘‘(3) In choosing from among the facilities meeting the require-
ments of paragraph (2), the Secretary shall also consider appro-
priate geographic distribution when designating the epilepsy centers 
of excellence under subsection (a). 
‘‘(c) PEER REVIEW PANEL.—(1) The Under Secretary for Health 
shall establish a peer review panel to assess the scientific and 
clinical merit of proposals that are submitted to the Secretary 
Deadline. 
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122 STAT. 4127 
PUBLIC LAW 110–387—OCT. 10, 2008 
for the designation of epilepsy centers of excellence under this 
section. 
‘‘(2)(A) The membership of the peer review panel shall consist 
of experts on epilepsy, including post-traumatic epilepsy. 
‘‘(B) Members of the peer review panel shall serve for a period 
of no longer than two years, except as specified in subparagraph 
(C). 
‘‘(C) Of the members first appointed to the panel, one half 
shall be appointed for a period of three years and one half shall 
be appointed for a period of two years, as designated by the Under 
Secretary at the time of appointment. 
‘‘(3) The peer review panel shall review each proposal submitted 
to the panel by the Under Secretary for Health and shall submit 
its views on the relative scientific and clinical merit of each such 
proposal to the Under Secretary. 
‘‘(4) The peer review panel shall, in conjunction with the 
national coordinator designated under subsection (e), conduct reg-
ular evaluations of each epilepsy center of excellence established 
and operated under subsection (a) to ensure compliance with the 
requirements of this section. 
‘‘(5) The peer review panel shall not be subject to the Federal 
Advisory Committee Act. 
‘‘(d) EPILEPSY CENTER OF EXCELLENCE DEFINED.—In this sec-
tion, the term ‘epilepsy center of excellence’ means a health care 
facility that has (or in the foreseeable future can develop) the 
necessary capacity to function as a center of excellence in research, 
education, and clinical care activities in the diagnosis and treatment 
of epilepsy and has (or may reasonably be anticipated to develop) 
each of the following: 
‘‘(1) An affiliation with an accredited medical school that 
provides education and training in neurology, including an 
arrangement with such school under which medical residents 
receive education and training in the diagnosis and treatment 
of epilepsy (including neurosurgery). 
‘‘(2) The ability to attract the participation of scientists 
who are capable of ingenuity and creativity in health care 
research efforts. 
‘‘(3) An advisory committee composed of veterans and 
appropriate health care and research representatives of the 
facility and of the affiliated school or schools to advise the 
directors of such facility and such center on policy matters 
pertaining to the activities of the center during the period 
of the operation of such center. 
‘‘(4) The capability to conduct effectively evaluations of 
the activities of such center. 
‘‘(5) The capability to assist in the expansion of the Depart-
ment’s use of information systems and databases to improve 
the quality and delivery of care for veterans enrolled within 
the Department’s health care system. 
‘‘(6) The capability to assist in the expansion of the Depart-
ment telehealth program to develop, transmit, monitor, and 
review neurological diagnostic tests. 
‘‘(7) The ability to perform epilepsy research, education, 
and clinical care activities in collaboration with Department 
medical facilities that have centers for research, education, 
and clinical care activities on complex multi-trauma associated 
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122 STAT. 4128 
PUBLIC LAW 110–387—OCT. 10, 2008 
with combat injuries established under section 7327 of this 
title. 
‘‘(e) NATIONAL COORDINATOR FOR EPILEPSY PROGRAMS.—(1) To 
assist the Secretary and the Under Secretary for Health in carrying 
out this section, the Secretary shall designate an individual in 
the Veterans Health Administration to act as a national coordinator 
for epilepsy programs of the Veterans Health Administration. 
‘‘(2) The duties of the national coordinator for epilepsy programs 
shall include the following: 
‘‘(A) To supervise the operation of the centers established 
pursuant to this section. 
‘‘(B) To coordinate and support the national consortium 
of providers with interest in treating epilepsy at Department 
health care facilities lacking such centers in order to ensure 
better access to state-of-the-art diagnosis, research, clinical 
care, and education for traumatic brain injury and epilepsy 
throughout the health care system of the Department. 
‘‘(C) To conduct, in conjunction with the peer review panel 
established under subsection (c), regular evaluations of the 
epilepsy centers of excellence to ensure compliance
with the 
requirements of this section. 
‘‘(D) To coordinate (as part of an integrated national 
system) education, clinical care, and research activities within 
all facilities with an epilepsy center of excellence. 
‘‘(E) To develop jointly a national consortium of providers 
with interest in treating epilepsy at Department health care 
facilities lacking an epilepsy center of excellence in order to 
ensure better access to state-of-the-art diagnosis, research, clin-
ical care, and education for traumatic brain injury and epilepsy 
throughout the health care system of the Department. Such 
consortium should include a designated epilepsy referral clinic 
in each Veterans Integrated Service Network. 
‘‘(3) In carrying out duties under this subsection, the national 
coordinator for epilepsy programs shall report to the official of 
the Veterans Health Administration responsible for neurology. 
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—(1) There are author-
ized to be appropriated $6,000,000 for each of fiscal years 2009 
through 2013 for the support of the clinical care, research, and 
education activities of the epilepsy centers of excellence established 
and operated pursuant to subsection (a)(2). 
‘‘(2) There are authorized to be appropriated for each fiscal 
year after fiscal year 2013 such sums as may be necessary for 
the support of the clinical care, research, and education activities 
of the epilepsy centers of excellence established and operated pursu-
ant to subsection (a)(2). 
‘‘(3) The Secretary shall ensure that funds for such centers 
are designated for the first three years of operation as a special 
purpose program for which funds are not allocated through the 
Veterans Equitable Resource Allocation system. 
‘‘(4) In addition to amounts authorized to be appropriated under 
paragraphs (1) and (2) for a fiscal year, the Under Secretary for 
Health shall allocate to such centers from other funds appropriated 
generally for the Department medical services account and medical 
and prosthetics research account, as appropriate, such amounts 
as the Under Secretary for Health determines appropriate. 
‘‘(5) In addition to amounts authorized to be appropriated under 
paragraphs (1) and (2) for a fiscal year, there are authorized to 
Designation. 
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122 STAT. 4129 
PUBLIC LAW 110–387—OCT. 10, 2008 
be appropriated such sums as may be necessary to fund the national 
coordinator established by subsection (e).’’. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 73 is amended by inserting after the item relating 
to section 7330 the following new item: 
‘‘7330A. Epilepsy centers of excellence.’’. 
SEC. 405. ESTABLISHMENT OF QUALIFICATIONS FOR PEER SPECIALIST 
APPOINTEES. 
(a) IN GENERAL.—Section 7402(b) is amended— 
(1) by redesignating the paragraph (11) relating to other 
health care positions as paragraph (14); and 
(2) by inserting after paragraph (12) the following new 
paragraph (13): 
‘‘(13) PEER SPECIALIST.—To be eligible to be appointed to a 
peer specialist position, a person must— 
‘‘(A) be a veteran who has recovered or is recovering from 
a mental health condition; and 
‘‘(B) be certified by— 
‘‘(i) a not-for-profit entity engaged in peer specialist 
training as having met such criteria as the Secretary shall 
establish for a peer specialist position; or 
‘‘(ii) a State as having satisfied relevant State require-
ments for a peer specialist position.’’. 
(b) PEER SPECIALIST TRAINING.—Section 7402 is amended by 
adding at the end the following new subsection: 
‘‘(g) The Secretary may enter into contracts with not-for-profit 
entities to provide— 
‘‘(1) peer specialist training to veterans; and 
‘‘(2) 
certification 
for 
veterans 
under 
subsection 
(b)(13)(B)(i).’’. 
SEC. 406. ESTABLISHMENT OF CONSOLIDATED PATIENT ACCOUNTING 
CENTERS. 
(a) ESTABLISHMENT OF CENTERS.—Chapter 17 is amended by 
inserting after section 1729A the following new section: 
‘‘§ 1729B. Consolidated patient accounting centers 
‘‘(a) IN GENERAL.—Not later than five years after the date 
of the enactment of this section, the Secretary of Veterans Affairs 
shall establish not more than seven consolidated patient accounting 
centers for conducting industry-modeled regionalized billing and 
collection activities of the Department. 
‘‘(b) FUNCTIONS.—The centers shall carry out the following func-
tions: 
‘‘(1) Reengineer and integrate all business processes of 
the revenue cycle of the Department. 
‘‘(2) Standardize and coordinate all activities of the Depart-
ment related to the revenue cycle for all health care services 
furnished to veterans for non-service-connected medical condi-
tions. 
‘‘(3) Apply commercial industry standards for measures 
of access, timeliness, and performance metrics with respect 
to revenue enhancement of the Department. 
‘‘(4) Apply other requirements with respect to such revenue 
cycle improvement as the Secretary may specify.’’. 
Deadline. 
38 USC 7402. 
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122 STAT. 4130 
PUBLIC LAW 110–387—OCT. 10, 2008 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such chapter is amended by inserting after the item relating 
to section 1729A the following: 
‘‘1729B. Consolidated patient accounting centers.’’. 
SEC. 407. REPEAL OF LIMITATION ON AUTHORITY TO CONDUCT WIDE-
SPREAD HIV TESTING PROGRAM. 
Section 124 of the Veterans’ Benefits and Services Act of 1988 
(title I of Public Law 100–322, as amended; 38 U.S.C. 7333 note) 
is repealed. 
SEC. 408. PROVISION OF COMPREHENSIVE HEALTH CARE BY SEC-
RETARY 
OF 
VETERANS 
AFFAIRS 
TO 
CHILDREN 
OF 
VIETNAM VETERANS BORN WITH SPINA BIFIDA. 
(a) PROVISION
OF
COMPREHENSIVE
HEALTH
CARE.—Section 
1803(a) is amended by striking ‘‘such health care as the Secretary 
determines is needed by the child for the spina bifida or any 
disability that is associated with such condition’’ and inserting 
‘‘health care under this section’’. 
(b) EFFECTIVE DATE.—The amendment made by subsection (a) 
shall apply with respect to care furnished after the date of the 
enactment of this Act. 
SEC. 409. EXEMPTION FROM COPAYMENT REQUIREMENT FOR VET-
ERANS RECEIVING HOSPICE CARE. 
Section 1710 is amended— 
(1) in subsection (f)(1), by inserting ‘‘(except if such care 
constitutes hospice care)’’ after ‘‘nursing home care’’; and 
(2) in subsection (g)(1), by inserting ‘‘(except if such care 
constitutes hospice care)’’ after ‘‘medical services’’. 
TITLE V—PAIN CARE 
SEC. 501. COMPREHENSIVE POLICY ON PAIN MANAGEMENT. 
(a) COMPREHENSIVE POLICY REQUIRED.—Not later than October 
1, 2009, the Secretary of Veterans Affairs shall develop and imple-
ment a comprehensive policy on the management of pain experi-
enced by veterans enrolled for health care services provided by 
the Department of Veterans Affairs. 
(b) SCOPE OF POLICY.—The policy required by subsection (a) 
shall cover each of the following: 
(1) The Department-wide management of acute and chronic 
pain experienced by veterans. 
(2) The standard of care for pain management to be used 
throughout the Department. 
(3) The consistent application of pain assessments to be 
used throughout the Department. 
(4) The assurance of prompt and appropriate pain care 
treatment and management by the Department, system-wide, 
when medically necessary. 
(5) Department programs of research related to acute and 
chronic pain suffered by veterans, including pain attributable 
to central and peripheral nervous system damage characteristic 
of injuries incurred in modern warfare. 
(6) Department programs of pain care education and 
training for health care personnel of the Department. 
Deadline. 
38 USC 7311 
note. 
38 USC 1803 
note. 
38 USC 1803. 
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122 STAT. 4131 
PUBLIC LAW 110–387—OCT. 10, 2008 
(7) Department programs of patient education for veterans 
suffering from acute or chronic pain and their families. 
(c) UPDATES.—The Secretary shall revise the policy required 
by subsection (a) on a periodic basis in accordance with experience 
and evolving best practice guidelines. 
(d) CONSULTATION.—The Secretary shall develop the policy 
required by subsection (a), and revise such policy under subsection 
(c), in consultation with veterans service organizations and 
organizations with expertise in the assessment, diagnosis, treat-
ment, and management of pain. 
(e) ANNUAL REPORT.— 
(1) IN GENERAL.—Not later than 180 days after the date 
of the completion and initial implementation of the policy 
required by subsection (a) and on October 1 of every fiscal 
year thereafter through fiscal year 2018, the Secretary shall 
submit to the Committee on Veterans’ Affairs of the Senate 
and the Committee on Veterans’ Affairs of the House of Rep-
resentatives a report on the implementation of the policy 
required by subsection (a). 
(2) CONTENTS.—The report required by paragraph (1) shall 
include the following: 
(A) A description of the policy developed and imple-
mented under subsection (a) and any revisions to such 
policy under subsection (c). 
(B) A description of the performance measures used 
to determine the effectiveness of such policy in improving 
pain care for veterans system-wide. 
(C) An assessment of the adequacy of Department pain 
management services based on a survey of patients man-
aged in Department clinics. 
(D) An assessment of the research projects of the 
Department relevant to the treatment of the types of acute 
and chronic pain suffered by veterans. 
(E) An assessment of the training provided to Depart-
ment health care personnel with respect to the diagnosis, 
treatment, and management of acute and chronic pain. 
(F) An assessment of the patient pain care education 
programs of the Department. 
(f) VETERANS SERVICE ORGANIZATION DEFINED.—In this section, 
the term ‘‘veterans service organization’’ means any organization 
recognized by the Secretary for the representation of veterans under 
section 5902 of title 38, United States Code. 
TITLE VI—HOMELESS VETERANS 
MATTERS 
SEC. 601. INCREASED AUTHORIZATION OF APPROPRIATIONS FOR COM-
PREHENSIVE SERVICE PROGRAMS. 
Section 2013 is amended by striking ‘‘$130,000,000’’ and 
inserting ‘‘$150,000,000’’. 
38 USC 2013. 
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122 STAT. 4132 
PUBLIC LAW 110–387—OCT. 10, 2008 
SEC. 602. EXPANSION AND EXTENSION OF AUTHORITY FOR PROGRAM 
OF REFERRAL AND COUNSELING SERVICES FOR AT-RISK 
VETERANS 
TRANSITIONING 
FROM 
CERTAIN 
INSTITU-
TIONS. 
(a) PROGRAM AUTHORITY.—Subsection (a) of section 2023 is 
amended by striking ‘‘a demonstration program for the purpose 
of determining the costs and benefits of providing’’ and inserting 
‘‘a program of’’. 
(b) SCOPE
OF PROGRAM.—Subsection (b) of such section is 
amended— 
(1) by striking ‘‘DEMONSTRATION’’ in the subsection heading; 
(2) by striking ‘‘demonstration’’; and 
(3) by striking ‘‘in at least six locations’’ and inserting 
‘‘in at least 12 locations’’. 
(c) EXTENSION OF AUTHORITY.—Subsection (d) of such section 
is amended by striking ‘‘shall cease’’ and all that follows and 
inserting ‘‘shall cease on September 30, 2012.’’. 
(d) CONFORMING AMENDMENTS.— 
(1) Subsection (c)(1) of such section is amended by striking 
‘‘demonstration’’. 
(2) The heading of such section is amended to read as 
follows: 
‘‘§ 2023. Referral and counseling services: veterans at risk 
of homelessness who are transitioning from certain 
institutions’’. 
(3) Section 2022(f)(2)(C) of such title is amended by striking 
‘‘demonstration’’. 
(e) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of chapter 20 is amended by striking the item relating to 
section 2023 and inserting the following: 
‘‘2023. Referral and counseling services: veterans at risk of homelessness who are 
transitioning from certain institutions.’’. 
SEC. 603. PERMANENT AUTHORITY FOR DOMICILIARY SERVICES FOR 
HOMELESS VETERANS AND ENHANCEMENT OF CAPACITY 
OF DOMICILIARY CARE PROGRAMS FOR FEMALE VET-
ERANS. 
Subsection (b) of section 2043 is amended to read as follows: 
‘‘(b) ENHANCEMENT OF CAPACITY OF DOMICILIARY CARE PRO-
GRAMS FOR FEMALE VETERANS.—The Secretary shall take appro-
priate actions to ensure that the domiciliary care programs of 
the Department are adequate, with respect to capacity and with 
respect to safety, to meet the needs of veterans who are women.’’. 
SEC. 604. FINANCIAL ASSISTANCE FOR SUPPORTIVE SERVICES FOR 
VERY LOW-INCOME VETERAN FAMILIES IN PERMANENT 
HOUSING. 
(a) PURPOSE.—The purpose of this section is to facilitate the 
provision of supportive services for very low-income veteran families 
in permanent housing. 
(b) FINANCIAL ASSISTANCE.— 
(1) IN GENERAL.—Subchapter V of chapter 20 is amended 
by adding at the end the following new section: 
38 USC 2044 
note. 
Termination 
date. 
38 USC 2023. 
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122 STAT. 4133 
PUBLIC LAW 110–387—OCT. 10, 2008 
‘‘§ 2044. Financial assistance for supportive services for very 
low-income veteran families in permanent housing 
‘‘(a) DISTRIBUTION
OF FINANCIAL ASSISTANCE.—(1) The Sec-
retary shall provide financial assistance to eligible entities approved 
under this section to provide and coordinate the provision of sup-
portive services described in subsection (b) for very low-income 
veteran families occupying permanent housing. 
‘‘(2) Financial assistance under this section shall consist of 
grants for each such family for which an approved eligible entity 
is providing or coordinating the provision of supportive services. 
‘‘(3)(A) The Secretary shall provide such grants to each eligible 
entity that is providing or coordinating the provision of supportive 
services. 
‘‘(B) The Secretary is authorized to establish intervals of pay-
ment for the administration of such grants and establish a max-
imum amount to be awarded, in accordance with the services being 
provided and their duration. 
‘‘(4) In providing financial assistance under paragraph (1), the 
Secretary shall give preference to entities providing or coordinating 
the provision of supportive services for very low-income veteran 
families who are transitioning from homelessness to permanent 
housing. 
‘‘(5) The Secretary shall ensure that, to the extent practicable, 
financial assistance under this subsection is equitably distributed 
across geographic regions, including rural communities and tribal 
lands. 
‘‘(6) Each entity receiving financial assistance under this section 
to provide supportive services to a very low-income veteran family 
shall notify that family that such services are being paid for, in 
whole or in part, by the Department. 
‘‘(7) The Secretary may require entities receiving financial 
assistance under this section to submit a report to the Secretary 
that describes the projects carried out with such financial assist-
ance. 
‘‘(b) SUPPORTIVE SERVICES.—The supportive services referred 
to in subsection (a) are the following: 
‘‘(1) Services provided by an eligible entity or a subcon-
tractor of an eligible entity that address the needs of very 
low-income veteran families occupying permanent housing, 
including— 
‘‘(A) outreach services; 
‘‘(B) case management services; 
‘‘(C) assistance in obtaining any benefits from the 
Department which the veteran may be eligible to receive, 
including, but not limited to, vocational and rehabilitation 
counseling, employment and training service, educational 
assistance, and health care services; and 
‘‘(D) assistance in obtaining and coordinating the provi-
sion of other public benefits provided in federal, State, 
or local agencies, or any organization defined in subsection 
(f), including— 
‘‘(i) health care services (including obtaining health 
insurance); 
‘‘(ii) daily living services; 
‘‘(iii) personal financial planning; 
‘‘(iv) transportation services; 
‘‘(v) income support services; 
Notification. 
Grants. 
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122 STAT. 4134 
PUBLIC LAW 110–387—OCT. 10, 2008 
‘‘(vi) fiduciary and representative payee services; 
‘‘(vii) legal services to assist the veteran family 
with issues that interfere with the family’s ability to 
obtain or retain housing or supportive services; 
‘‘(viii) child care; 
‘‘(ix) housing counseling; and 
‘‘(x) other services necessary for maintaining inde-
pendent living. 
‘‘(2) Services described in paragraph (1) that are delivered 
to very low-income veteran families who are homeless and 
who are scheduled to become residents of permanent housing 
within 90 days pending the location or development of housing 
suitable for permanent housing. 
‘‘(3) Services described in paragraph (1) for very low-income 
veteran families who have voluntarily chosen to seek other 
housing after a period of tenancy in permanent housing, that 
are provided, for a period of 90 days after such families exit 
permanent housing or until such families commence receipt 
of other housing services adequate to meet their current needs, 
but only to the extent that services under this paragraph are 
designed to support such families in their choice to transition 
into housing that is responsive to their individual needs and 
preferences. 
‘‘(c) APPLICATION FOR FINANCIAL ASSISTANCE.—(1) An eligible 
entity seeking financial assistance under subsection (a) shall submit 
to the Secretary an application therefor in such form, in such 
manner, and containing such commitments and information as the 
Secretary determines to be necessary to carry out this section. 
‘‘(2) Each application submitted by an eligible entity under 
paragraph (1) shall contain— 
‘‘(A) a description of the supportive services proposed to 
be provided by the eligible entity and the identified needs 
for those services; 
‘‘(B) a description of the types of very low-income veteran 
families proposed to be provided such services; 
‘‘(C) an estimate of the number of very low-income veteran 
families proposed to be provided such services; 
‘‘(D) evidence of the experience of the eligible entity in 
providing supportive services to very low-income veteran fami-
lies; and 
‘‘(E) a description of the managerial capacity of the eligible 
entity— 
‘‘(i) to coordinate the provision of supportive services 
with the provision of permanent housing by the eligible 
entity or by other organizations; 
‘‘(ii) to assess continuously the needs of very low-income 
veteran families for supportive services; 
‘‘(iii) to coordinate the provision of supportive services 
with the services of the Department; 
‘‘(iv) to tailor supportive services to the needs of very 
low-income veteran families; and 
‘‘(v) to seek continuously new sources of assistance 
to ensure the long-term provision of supportive services 
to very low-income veteran families. 
‘‘(3) The Secretary shall establish criteria for the selection of 
eligible entities to be provided financial assistance under this sec-
tion. 
Criteria. 
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122 STAT. 4135 
PUBLIC LAW 110–387—OCT. 10, 2008 
‘‘(d) TECHNICAL ASSISTANCE.—(1) The Secretary shall provide 
training and technical assistance to participating eligible entities 
regarding the planning, development, and provision of supportive 
services to very low-income veteran families occupying permanent 
housing, through the Technical Assistance grants program in section 
2064 of this title. 
‘‘(2) The Secretary may provide the training described in para-
graph (1) directly or through grants or contracts with appropriate 
public or nonprofit private entities. 
‘‘(e) FUNDING.—(1) From amounts appropriated to the Depart-
ment for Medical Services, there shall be available to carry out 
subsection (a), (b), and (c) amounts as follows: 
‘‘(A) $15,000,000 for fiscal year 2009. 
‘‘(B) $20,000,000 for fiscal year 2010. 
‘‘(C) $25,000,000 for fiscal year 2011. 
‘‘(2) Not more than $750,000 may be available under paragraph 
(1) in any fiscal year to provide technical assistance under sub-
section (d). 
‘‘(3) There is authorized to be appropriated $1,000,000 for each 
of the fiscal year 2009 through 2011 to carry out the provisions 
of subsection (d). 
‘‘(f) DEFINITIONS.—In this section: 
‘‘(1) The term ‘consumer cooperative’ has the meaning given 
such term in section 202 of the Housing Act of 1959 (12 U.S.C. 
1701q). 
‘‘(2) The term ‘eligible entity’ means— 
‘‘(A) a private nonprofit organization; or 
‘‘(B) a consumer cooperative. 
‘‘(3) The term ‘homeless’ has the meaning given that term 
in section 103 of the McKinney-Vento Homeless Assistance 
Act (42 U.S.C. 11302). 
‘‘(4) The term ‘permanent housing’ means community-based 
housing without a designated length of stay. 
‘‘(5) The term ‘private nonprofit organization’ means any 
of the following: 
‘‘(A) Any incorporated private institution or founda-
tion— 
‘‘(i) no part of the net earnings of which inures 
to the benefit of any member, founder, contributor, 
or individual; 
‘‘(ii) which has a governing board that is respon-
sible for the operation of the supportive services pro-
vided under this section; and 
‘‘(iii) which is approved by the Secretary as to 
financial responsibility. 
‘‘(B) A for-profit limited partnership, the sole general 
partner of which is an organization meeting the require-
ments of clauses (i), (ii), and (iii) of subparagraph (A). 
‘‘(C) A corporation wholly owned and controlled by 
an organization meeting the requirements of clauses (i), 
(ii), and (iii) of subparagraph (A). 
‘‘(D) A tribally designated housing entity (as defined 
in section 4 of the Native American Housing Assistance 
and Self-Determination Act of 1996 (25 U.S.C. 4103)). 
‘‘(6)(A) Subject to subparagraphs (B) and (C), the term 
‘very low-income veteran family’ means a veteran family whose 
income does not exceed 50 percent of the median income for 
Appropriation 
authorization. 
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122 STAT. 4136 
PUBLIC LAW 110–387—OCT. 10, 2008 
an area specified by the Secretary for purposes of this section, 
as determined by the Secretary in accordance with this para-
graph. 
‘‘(B) The Secretary shall make appropriate adjustments 
to the income requirement under subparagraph (A) based on 
family size. 
‘‘(C) The Secretary may establish an income ceiling higher 
or lower than 50 percent of the median income for an area 
if the Secretary determines that such variations are necessary 
because the area has unusually high or low construction costs, 
fair market rents (as determined under section 8 of the United 
States Housing Act of 1937 (42 U.S.C. 1437f)), or family 
incomes. 
‘‘(7) The term ‘veteran family’ includes a veteran who is 
a single person and a family in which the head of household 
or the spouse of the head of household is a veteran.’’. 
(2) CLERICAL AMENDMENT.—The table of sections at the 
beginning of chapter 20 is amended by inserting after the 
item relating to section 2043 the following new item: 
‘‘2044. Financial assistance for supportive services for very low-income veteran fami-
lies in permanent housing.’’. 
(c) STUDY OF EFFECTIVENESS OF PERMANENT HOUSING PRO-
GRAM.— 
(1) IN GENERAL.—For fiscal years 2009 and 2010, the Sec-
retary shall conduct a study of the effectiveness of the perma-
nent housing program under section 2044 of title 38, United 
States Code, as added by subsection (b), in meeting the needs 
of very low-income veteran families, as that term is defined 
in that section. 
(2) COMPARISON.—In the study required by paragraph (1), 
the Secretary shall compare the results of the program referred 
to in that subsection with other programs of the Department 
of Veterans Affairs dedicated to the delivery of housing and 
services to veterans. 
(3) CRITERIA.—In making the comparison required in para-
graph (2), the Secretary shall examine the following: 
(A) The satisfaction of veterans targeted by the pro-
grams described in paragraph (2). 
(B) The health status of such veterans. 
(C) The housing provided such veterans under such 
programs. 
(D) The degree to which such veterans are encouraged 
to productive activity by such programs. 
(4) REPORT.—Not later than March 31, 2011, the Secretary 
shall submit to the Committee on Veterans’ Affairs of the 
Senate and the Committee on Veterans’ Affairs of the House 
of Representatives a report on the results of the study required 
by paragraph (1). 
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122 STAT. 4137 
PUBLIC LAW 110–387—OCT. 10, 2008 
TITLE VII—AUTHORIZATION OF MED-
ICAL 
FACILITY 
PROJECTS 
AND 
MAJOR MEDICAL FACILITY LEASES 
SEC. 701. AUTHORIZATION FOR FISCAL YEAR 2009 MAJOR MEDICAL 
FACILITY PROJECTS. 
The Secretary of Veterans Affairs may carry out the following 
major medical facility projects in fiscal year 2009 in the amount 
specified for each project: 
(1) Seismic corrections, Building 2, at the Department of 
Veterans Affairs Palo Alto Health Care System, Palo Alto Divi-
sion Palo Alto, California, in an amount not to exceed 
$54,000,000. 
(2) Construction of a polytrauma healthcare and rehabilita-
tion center at the Department of Veterans Affairs Medical 
Center, San Antonio, Texas, in an amount not to exceed 
$66,000,000. 
(3) Seismic corrections, Building 1, at the Department of 
Veterans Affairs Medical Center, San Juan, Puerto Rico, in 
an amount not to exceed $225,900,000. 
SEC. 702. MODIFICATION OF AUTHORIZATION AMOUNTS FOR CERTAIN 
MAJOR MEDICAL FACILITY CONSTRUCTION PROJECTS 
PREVIOUSLY AUTHORIZED. 
(a) MODIFICATION
OF MAJOR MEDICAL FACILITY AUTHORIZA-
TIONS.—Section 801(a) of the Veterans Benefits, Health Care, and 
Information Technology Act of 2006 (Public Law 109–461) is 
amended— 
(1) in paragraph (1)— 
(A) 
by 
striking 
‘‘$300,000,000’’ 
and 
inserting 
‘‘$625,000,000’’; and 
(B) by striking the second sentence; and 
(2) in paragraph (3), by striking ‘‘$98,000,000’’ and inserting 
‘‘$568,400,000’’. 
(b) MODIFICATION OF AUTHORIZATION FOR CERTAIN MAJOR MED-
ICAL FACILITY CONSTRUCTION PROJECTS PREVIOUSLY AUTHORIZED 
IN CONNECTION WITH CAPITAL ASSET REALIGNMENT INITIATIVE.— 
(1) CORRECTION OF PATIENT PRIVACY DEFICIENCIES AT THE 
DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, GAINES-
VILLE, FLORIDA.—Paragraph (5) of section 802 of the Veterans 
Benefits, Health Care, and Information Technology Act of 2006 
(Public Law 109–461) is amended by striking ‘‘$85,200,000’’ 
and inserting ‘‘$136,700,000’’. 
(2) CONSTRUCTION
OF
A
NEW
MEDICAL
CENTER
FACILITY 
AT THE DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, 
LAS VEGAS, NEVADA.—Paragraph (7) of such section is amended 
by striking ‘‘$406,000,000’’ and inserting ‘‘$600,400,000’’. 
(3) CONSTRUCTION
OF
A
NEW
OUTPATIENT
CLINIC, LEE 
COUNTY, FLORIDA.—Paragraph (8) of such section is amended— 
(A) by striking ‘‘ambulatory’’ and all that follows 
through ‘‘purchase,’’ and inserting ‘‘outpatient clinic in’’; 
and 
(B) 
by 
striking 
‘‘$65,100,000’’ 
and 
inserting 
‘‘$131,800,000’’. 
120 Stat. 3443. 
120 Stat. 3442. 
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122 STAT. 4138 
PUBLIC LAW 110–387—OCT. 10, 2008 
(4) CONSTRUCTION OF A NEW MEDICAL CENTER FACILITY, 
ORLANDO, FLORIDA.—Paragraph (11) of such section is amended 
by striking ‘‘$377,700,000’’ and inserting ‘‘$656,800,000’’. 
(5) CONSOLIDATION OF CAMPUSES AT THE UNIVERSITY DRIVE 
AND H. JOHN HEINZ III DIVISIONS, PITTSBURGH, PENNSYLVANIA.— 
Paragraph (12) of such section is amended by striking 
‘‘$189,205,000’’ and inserting ‘‘$295,600,000’’. 
SEC. 703. AUTHORIZATION OF FISCAL YEAR 2009 MAJOR MEDICAL 
FACILITY LEASES. 
The Secretary of Veterans Affairs may carry out the following 
major medical facility leases in fiscal year 2009 at the locations 
specified, and in an amount for each lease not to exceed the amount 
shown for such location: 
(1) For an outpatient clinic, Brandon, Florida, $4,326,000. 
(2) For an outpatient clinic, Colorado Springs, Colorado, 
$10,300,000. 
(3) For an outpatient clinic, Eugene, Oregon, $5,826,000. 
(4) For the expansion of an outpatient clinic, Green Bay, 
Wisconsin, $5,891,000. 
(5) For an outpatient clinic, Greenville, South Carolina, 
$3,731,000. 
(6) For an outpatient clinic, Mansfield, Ohio, $2,212,000. 
(7) For an outpatient clinic, Mayaguez, Puerto Rico, 
$6,276,000. 
(8) For an outpatient clinic, Mesa, Arizona, $5,106,000. 
(9) For interim research space, Palo Alto, California, 
$8,636,000. 
(10) For the expansion of an outpatient clinic, Savannah, 
Georgia, $3,168,000. 
(11) For an outpatient clinic, Sun City, Arizona, $2,295,000. 
(12) For a primary care annex, Tampa, Florida, $8,652,000. 
(13) For an outpatient clinic, Peoria, Illinois, $3,600,000. 
SEC. 704. AUTHORIZATION OF APPROPRIATIONS. 
(a) AUTHORIZATION OF APPROPRIATIONS FOR FISCAL YEAR 2009 
MAJOR MEDICAL FACILITY PROJECTS.—There is authorized to be 
appropriated for the Secretary of Veterans Affairs for fiscal year 
2009 for the Construction, Major Projects, account— 
(1) $345,900,000 for the projects authorized in section 701; 
and 
(2) $1,493,495,000 for the increased amounts authorized 
for projects whose authorizations are modified by section 702. 
(b) AUTHORIZATION FOR APPROPRIATIONS FOR FISCAL YEAR 2009 
MAJOR MEDICAL FACILITY LEASES.—There is authorized to be appro-
priated for the Secretary of Veterans Affairs for fiscal year 2009 
for the Medical Facilities account, $70,019,000, for the leases 
authorized in section 703. 
SEC. 705. INCREASE IN THRESHOLD FOR MAJOR MEDICAL FACILITY 
LEASES REQUIRING CONGRESSIONAL APPROVAL. 
Section 8104(a)(3)(B) is amended by striking ‘‘$600,000’’ and 
inserting ‘‘$1,000,000’’. 
38 USC 8104. 
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122 STAT. 4139 
PUBLIC LAW 110–387—OCT. 10, 2008 
SEC. 706. CONVEYANCE OF CERTAIN NON-FEDERAL LAND BY CITY OF 
AURORA, 
COLORADO, 
TO 
SECRETARY 
OF 
VETERANS 
AFFAIRS FOR CONSTRUCTION OF VETERANS MEDICAL 
FACILITY. 
Section 410 of title IV of division I of the Consolidated Appro-
priations Act, 2008 (Public Law 110–161; 121 Stat. 2276) is 
amended to read as follows: 
‘‘SEC. 410. CONVEYANCE OF CERTAIN NON-FEDERAL LAND. 
‘‘(a) DEFINITIONS.—In this section: 
‘‘(1) CITY.—The term ‘City’ means the City of Aurora, Colo-
rado. 
‘‘(2) DEED.—The term ‘deed’ means the quitclaim deed— 
‘‘(A) conveyed to the City by the Secretary (acting 
through the Director of the National Park Service); and 
‘‘(B) dated May 24, 1999. 
‘‘(3) NON-FEDERAL
LAND.—The term ‘non-Federal land’ 
means— 
‘‘(A) parcel I of the former United States Army Garrison 
Fitzsimons, Adams County, Colorado, as more specifically 
described in the deed; and 
‘‘(B) the parcel of land described in the deed. 
‘‘(4) SECRETARY.—The term ‘Secretary’ means the Secretary 
of the Interior. 
‘‘(b) DUTY
OF SECRETARY.—To allow the City to convey by 
donation to the United States the non-Federal land to be used 
by the Secretary of Veterans Affairs for the construction of a vet-
erans medical facility, not later than 60 days after the date of 
enactment of this section, the Secretary shall execute each 
instrument that is necessary to release all rights, conditions, and 
restrictions retained by the United States in and to the non-Federal 
land conveyed in the deed.’’. 
SEC. 707. REPORT ON FACILITIES ADMINISTRATION. 
Not later than 60 days after the date of the enactment of 
this Act, the Secretary of Veterans Affairs shall submit to the 
Committee on Veterans’ Affairs of the Senate and the Committee 
on Veterans’ Affairs of the House of Representatives a report on 
the progress of the Secretary in complying with section 312A of 
title 38, United States Code. 
SEC. 708. ANNUAL REPORT ON OUTPATIENT CLINICS. 
(a) ANNUAL REPORT REQUIRED.—Subchapter I of chapter 81 
is amended by adding at the end the following new section: 
‘‘§ 8119. Annual report on outpatient clinics 
‘‘(a) ANNUAL REPORT REQUIRED.—The Secretary shall submit 
to the committees an annual report on community-based outpatient 
clinics and other outpatient clinics of the Department. The report 
shall be submitted each year not later than the date on which 
the budget for the next fiscal year is submitted to the Congress 
under section 1105 of title 31. 
‘‘(b) CONTENTS OF REPORT.—Each report required under sub-
section (a) shall include the following: 
‘‘(1) A list of each community-based outpatient clinic and 
other outpatient clinic of the Department, and for each such 
clinic, the type of clinic, location, size, number of health profes-
sionals employed by the clinic, workload, whether the clinic 
Deadline. 
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122 STAT. 4140 
PUBLIC LAW 110–387—OCT. 10, 2008 
is leased or constructed and operated by the Secretary, and 
the annual cost of operating the clinic. 
‘‘(2) A list of community-based outpatient clinics and other 
outpatient clinics that the Secretary opened during the fiscal 
year preceding the fiscal year during which the report is sub-
mitted and a list of clinics the Secretary proposes opening 
during the fiscal year during which the report is submitted 
and the subsequent fiscal year, together with the cost of acti-
vating each such clinic and the information required to be 
provided under paragraph (1) for each such clinic and proposed 
clinic. 
‘‘(3) A list of proposed community-based outpatient clinics 
and other outpatient clinics that are, as of the date of the 
submission of the report, under review by the National Review 
Panel and a list of possible locations for future clinics identified 
in the Department’s strategic planning process, including any 
identified locations in rural and underserved areas. 
‘‘(4) A prioritized list of sites of care identified by the 
Secretary that the Secretary could establish without carrying 
out construction or entering into a lease, including— 
‘‘(A) any such sites that could be expanded by hiring 
additional staff or allocating staff to Federal facilities or 
facilities operating in collaboration with the Federal 
Government; and 
‘‘(B) any sites established, or able to be established, 
under sections 8111 and 8153 of this title.’’. 
(b) DEADLINE FOR FIRST ANNUAL REPORT.—The Secretary of 
Veterans Affairs shall submit the first report required under section 
8119(a) of title 38, United States Code, as added by subsection 
(a), by not later than 90 days after the date of the enactment 
of this Act. 
(c) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such chapter is amended by adding at the end of the 
items relating to subchapter I the following new item: 
‘‘8119. Annual report on outpatient clinics.’’. 
SEC. 709. NAME OF DEPARTMENT OF VETERANS AFFAIRS SPINAL CORD 
INJURY CENTER, TAMPA, FLORIDA. 
The spinal cord injury center located at the James A. Haley 
Department of Veterans Affairs Medical Center in Tampa, Florida, 
shall after the date of the enactment of this Act be known and 
designated as the ‘‘Michael Bilirakis Department of Veterans Affairs 
Spinal Cord Injury Center’’. Any reference to such center in any 
law, regulation, map, document, record, or other paper of the United 
States shall be considered to be a reference to the ‘‘Michael Bilirakis 
Department of Veterans Affairs Spinal Cord Injury Center’’. 
TITLE VIII—EXTENSION OF CERTAIN 
AUTHORITIES 
SEC. 801. REPEAL OF SUNSET ON INCLUSION OF NONINSTITUTIONAL 
EXTENDED CARE SERVICES IN DEFINITION OF MEDICAL 
SERVICES. 
Section 1701 is amended— 
(1) by striking paragraph (10); and 
38 USC 1701. 
38 USC 8119 
note. 
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122 STAT. 4141 
PUBLIC LAW 110–387—OCT. 10, 2008 
(2) in paragraph (6)— 
(A) by redesignating subparagraphs (E) and (F) as 
subparagraphs (F) and (G), respectively; and 
(B) by inserting after subparagraph (D) the following 
new subparagraph (E): 
‘‘(E) Noninstitutional extended care services, including 
alternatives to institutional extended care that the Sec-
retary may furnish directly, by contract, or through provi-
sion of case management by another provider or payer.’’. 
SEC. 802. EXTENSION OF RECOVERY AUDIT AUTHORITY. 
Section 1703(d)(4) is amended by striking ‘‘September 30, 2008’’ 
and inserting ‘‘September 30, 2013’’. 
SEC. 803. PERMANENT AUTHORITY FOR PROVISION OF HOSPITAL 
CARE, MEDICAL SERVICES, AND NURSING HOME CARE TO 
VETERANS WHO PARTICIPATED IN CERTAIN CHEMICAL 
AND BIOLOGICAL TESTING CONDUCTED BY THE DEPART-
MENT OF DEFENSE. 
(a) PERMANENT AUTHORITY.—Subsection (e)(3) of section 1710 
is amended— 
(1) in subparagraph (B), by inserting ‘‘and’’ after the semi-
colon; 
(2) in subparagraph (C), by striking ‘‘; and’’ and inserting 
a period; and 
(3) by striking subparagraph (D). 
(b) CONFORMING AMENDMENT.—Subsection (e)(1)(E) of such sec-
tion is amended by striking ‘‘paragraphs (2) and (3)’’ and inserting 
‘‘paragraph (2)’’. 
SEC. 804. EXTENSION OF EXPIRING COLLECTIONS AUTHORITIES. 
(a) HEALTH
CARE
COPAYMENTS.—Section 1710(f)(2)(B) is 
amended by striking ‘‘September 30, 2008’’ and inserting ‘‘Sep-
tember 30, 2010’’. 
(b) MEDICAL CARE COST RECOVERY.—Section 1729(a)(2)(E) is 
amended by striking ‘‘October 1, 2008’’ and inserting ‘‘October 1, 
2010’’. 
SEC. 805. EXTENSION OF NURSING HOME CARE. 
Section 1710A(d) is amended by striking ‘‘December 31, 2008’’ 
and inserting ‘‘December 31, 2013’’. 
SEC. 806. PERMANENT AUTHORITY TO ESTABLISH RESEARCH COR-
PORATIONS. 
(a) REPEAL.—Chapter 73 is amended by striking section 7368. 
(b) CLERICAL AMENDMENT.—The table of sections at the begin-
ning of such chapter is amended by striking the item relating 
to section 7368. 
SEC. 807. EXTENSION OF REQUIREMENT TO SUBMIT ANNUAL REPORT 
ON THE COMMITTEE ON CARE OF SEVERELY CHRON-
ICALLY MENTALLY ILL VETERANS. 
Section 7321(d)(2) is amended by striking ‘‘through 2008’’ and 
inserting ‘‘through 2012’’. 
SEC. 808. PERMANENT REQUIREMENT FOR BIANNUAL REPORT ON 
WOMEN’S ADVISORY COMMITTEE. 
Section 542(c)(1) is amended by striking ‘‘through 2008’’. 
38 USC 1703. 
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122 STAT. 4142 
PUBLIC LAW 110–387—OCT. 10, 2008 
SEC. 809. EXTENSION OF PILOT PROGRAM ON IMPROVEMENT OF CARE-
GIVER ASSISTANCE SERVICES. 
Section 214 of the Veterans Benefits, Health Care, and Informa-
tion Technology Act of 2006 (Public Law 109–461; 38 U.S.C. 1710B 
note) is amended— 
(1) in subsection (b), by striking ‘‘two-year period’’ and 
inserting ‘‘three-year period’’; and 
(2) in subsection (d), by striking ‘‘fiscal years 2007 and 
2008’’ and inserting ‘‘fiscal years 2007 through 2009’’. 
TITLE IX—OTHER MATTERS 
SEC. 901. TECHNICAL AMENDMENTS. 
(a) TITLE 38.—Title 38, United States Code, is amended— 
(1) in section 1712A— 
(A) by striking subsection (g); 
(B) by redesignating subsections (d) through (i) as sub-
sections (c) through (f), respectively; and 
(C) in subsection (f), as so redesignated, by striking 
‘‘(including a Resource Center designated under subsection 
(h)(3)(A) of this section)’’; 
(2) in section 2065(b)(3)(C), by striking ‘‘)’’; 
(3) in the table of sections at the beginning of chapter 
36, by striking the item relating to section 3684A and inserting 
the following new item: 
‘‘3684A. Procedures relating to computer matching program.’’; 
(4) in section 4110(c)(1), by striking ‘‘15’’ and inserting 
‘‘16’’; 
(5) in the table of sections at the beginning of chapter 
51, by striking the item relating to section 5121 and inserting 
the following new item: 
‘‘5121. Payment of certain accrued benefits upon death of a beneficiary.’’; 
(6) in section 7458(b)(2), by striking ‘‘pro rated’’ and 
inserting ‘‘pro-rated’’; 
(7) in section 8117(a)(1), by striking ‘‘such such’’ and 
inserting ‘‘such’’; and 
(8) in each of sections 1708(d), 7314(f), 7320(j)(2), 7325(i)(2), 
and 7328(i)(2), by striking ‘‘medical care account’’ and inserting 
‘‘medical services account’’. 
(b) VETERANS BENEFITS, HEALTH CARE, AND INFORMATION 
TECHNOLOGY ACT OF 2006.—Section 807(e) of the Veterans Benefits, 
Health Care, and Information Technology Act of 2006 (Public Law 
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122 STAT. 4143 
PUBLIC LAW 110–387—OCT. 10, 2008 
LEGISLATIVE HISTORY—S. 2162: 
SENATE REPORTS: No. 110–281 (Comm. on Veterans’ Affairs). 
CONGRESSIONAL RECORD, Vol. 154 (2008): 
June 3, considered and passed Senate. 
Sept. 24, considered and passed House, amended. 
Sept. 27, Senate concurred in House amendment. 
109–461) is amended by striking ‘‘Medical Care’’ each place it 
appears and inserting ‘‘Medical Facilities’’. 
Approved October 10, 2008. 
120 Stat. 3445. 
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