The Honoring America's Veterans and Caring for Camp Lejeune Families Act of 2012 ( H.R. 1627 , P.L. 112-154 , enacted on August 6, 2012) is an "omnibus" bill containing a number of provisions impacting various veterans programs. P.L. 112-154 reflects a compromise agreement by the House and Senate Committees on Veterans Affairs on provisions contained within several bills ( H.R. 1627 ; S. 277 ; S. 914 ; S. 951 ; H.R. 802 ; H.R. 1484 ; H.R. 2074 ; H.R. 2032 ; H.R. 2349 ; H.R. 2433 ; and H.R. 4299 ) reported during the 112 th Congress, and several free-standing provisions. This report provides information on the various provisions of P.L. 112-154 by program, benefit, or topic, rather than by each legislative provision. However, for each change in a program, benefit, etc., the section number of P.L. 112-154 is provided. The Department of Veterans Affairs (VA), through the Veterans Health Administration (VHA), operates the nation's largest integrated direct health care delivery system. Veterans' medical care is a discretionary program, and eligibility for VA medical care is based on an array of factors including (but not limited to) veteran status, presence of service-connected disabilities or exposures, income, status as a former prisoner of war (POW) or Purple Heart or Medal of Honor recipient. From time to time, Congress has passed legislation providing special treatment authority for certain groups of veterans. In 1981, Congress enacted the Veterans' Health Care, Training, and Small Business Loan Act of 1981 ( P.L. 97-72 ), which provided special authority to allow the VA to treat some veterans for disorders that may have been related to their exposure to Agent Orange and ionizing radiation, even though according to the Institutes of Medicine (IOM) there was no definitive scientific evidence showing that the disorders treated were related to the exposure. In 1993, Congress passed P.L. 103-210 to provide additional authority for the VA to provide health care for Persian Gulf War veterans, for medical conditions possibly related to exposure to toxic substances or environmental hazards during their active duty service in the Southwest Asia theater of operations during the Persian Gulf War. In the early 1980s, two water-supply systems at Camp Lejeune, North Carolina were found to be contaminated with the industrial solvents trichloroethylene (TCE) and perchloroethylene (PCE). P.L. 112-154 , among other things, addressed the chemical exposure at Camp Lejeune, North Carolina by providing eligibility for VA health care services for certain veterans. Section 102 of P.L. 112-154 provides eligibility to VA provided hospital care, medical services, and nursing home care to certain veterans and their eligible family members who were stationed at Camp Lejeune, North Carolina, from January 1, 1957 to December 31, 1987, during which time the well water was contaminated. These veterans are eligible to receive medical care for the following fifteen illnesses or conditions: esophageal cancer; lung cancer; breast cancer; bladder cancer; kidney cancer; leukemia; multiple myeloma; myleodysplasic syndromes; renal toxicity; hepatic steatosis; female infertility; miscarriage; scleroderma; neurobehavioral effects; and non-Hodgkin's lymphoma, although the law acknowledges that there is insufficient medical evidence to conclude that any particular illnesses are attributable to military service during that period. The VA will be the final payer to other third-party health insurance plans for eligible family members. The State Veterans' Home (SVH) program is a federal-state partnership to build, modify or acquire nursing home, domiciliary, and adult day health care facilities. In addition to providing grants to states for construction, the VA also provides a fixed per diem to states for each veteran who receives care in a state veterans' home. Although the VA sets basic eligibility criteria for access to nursing home care, state law governs the management and admission criteria for these SVHs. Also, state laws allow an individual SVH to exercise its prerogative on admitting veterans. Under the Veterans Millennium Health Care and Benefits Act ( P.L. 106-117 ), the VA was only required to pay the full cost of care for veterans who had a service-connected disability rated at 70% or more, or whose need for nursing home care was related directly to a service-connected condition, if the veterans were receiving care in a VA Community Living Center (formerly known as a VA Nursing Home) or in a VA contracted private nursing home. However, VA was not authorized to pay the full cost of care if these same veterans received care in a SVH. The Veterans Benefits, Health Care, and Information Technology Act of 2006 ( P.L. 109-461 ) equalized the cost of nursing home care for these veterans regardless of the setting, and included a provision, effective March 21, 2007, for the VA to use higher per diem rates when reimbursing SVHs for providing care to veterans who had a 70% service-connected disability or individual unemployability. P.L. 109-461 also stipulated that SVHs reimbursed at the higher per diem rates were not eligible to receive funding from other federal sources such as Medicare or Medicaid. However, after the VA implemented this new reimbursement methodology, some state veterans' nursing homes reported that they were receiving smaller reimbursements that were not covering the actual cost of care. Section 105 of P.L. 112-154 requires the VA to enter into contracts with SVHs to provide nursing home care to veterans who need nursing home care for a service-connected condition or have a service-connected disability rating of 70% or greater. The reimbursement methodology will be developed in consultation with SVHs. Also, this provision requires the VA, at the request of any SVH, to enter into a contract or agreement with that SVH that would replicate the reimbursement methodology that was in effect on the day before enactment of P.L. 112-154 . In June 2011, the Government Accountability Office (GAO) found about 300 sexual assault incidents were reported to the VA police from January 2007 through July 2010—"including alleged incidents that involved rape, inappropriate touching, forceful medical examinations, forced or inappropriate oral sex, and other types of sexual assault incidents." GAO also stated that many of the sexual assault incidents reported to the VA police were not reported to VA leadership officials and/or the VA Office of the Inspector General (OIG), as required by VA regulation due to the lack of a centralized VA management reporting system. Section 106 of P.L. 112-154 requires the VA to establish a comprehensive policy on the reporting and tracking of sexual assault and other safety incidents at VA medical facilities and requires a report on this policy 60 days after initial implementation and annually thereafter. Furthermore, this provision stipulates that in developing this comprehensive policy and related risk assessment tools, the VA should consider the effects on veterans' use of mental health and substance abuse treatments and the ability of the VA to refer veterans to such services. This provision also requires the VA to submit an interim report to Congress on the progress of developing this comprehensive policy within 30 days of the enactment of P.L. 112-154 . Traumatic brain injury (TBI) has become known as a "signature wound" of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF), because servicemembers in these operations have experienced TBI in greater numbers than those serving in past conflicts. Three factors contribute to the increase in TBI. First, the number of blast injuries caused by improvised explosive devices (IEDs), rocket-propelled grenades, and land mines has increased; it has been reported that the primary mechanism of injury in OIF is a blast injury. Second, injuries that would have been fatal in the past may not be fatal now, due to advances in protective equipment, combat medicine, and air evacuation. Third, health care professionals are more alert to the possibility of TBI and may therefore be more likely to diagnose TBI accurately. The total number of veterans who have experienced TBI is not known, in part because TBI is difficult to identify, and in part because some veterans may not have accessed VA health care services. Current law requires the VA to provide comprehensive care to veterans with TBI in accord with individualized rehabilitation plans. However, concerns were raised that the VA has interpreted the statute as limited only to those services that restore function, and that by limiting rehabilitative care, individuals with TBI may risk losing out on therapies that might prove vital in maintaining physical, cognitive, and other progress. Section 107 of P.L. 112-154 requires the VA to provide rehabilitative care to veterans with TBI with the goal of maximizing their independence and improving their behavioral and mental health functioning. Furthermore, this provision requires the inclusion of rehabilitative services within the VA's comprehensive programs of long-term care for veterans with TBI in both VA and non-VA facilities. According to the 2001 Telemedicine Report to Congress, telemedicine is referred to as the "use of electronic communication and information technologies for medical diagnostic, monitoring, and therapeutic purposes when distance and/or time separates the participants." Telehealth, a broader concept than telemedicine, is defined as the "use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration." According to an evidence synthesis prepared by the Agency for Healthcare Research and Quality (AHRQ), "telehealth indicates care beyond that provided in medical encounters (e.g., health education, health-related Web sites, etc.)."