Veterans Health Care Authorization Act of 2009 - Title I: Department Personnel Matters - (Sec. 101) Authorizes the Secretary of Veterans Affairs to appoint personnel for health care positions within the Veterans Health Administration (VHA) of the Department of Veterans Affairs (VA) not specifically listed in authorized classes for appointment, as long as the Secretary provides prior notification to the congressional veterans committees and the Office of Management and Budget (OMB). Requires the Secretary, before submitting notification, to solicit comments from any labor organization representing employees in any such class and include such comments in such notification. Authorizes the appointment of nurse assistants within the VHA.
Makes the probationary period after appointment as a registered nurse two years. Provides that an appointment on a part-time basis of a VHA health care professional who has previously served on a full-time basis shall be without a probationary period. Limits to two years the probationary period for the appointment of a registered nurse on a temporary, part-time basis, after which time the appointment shall be considered permanent. Provides an exception with respect to appointments made on a term-limited basis of three years or less.
Authorizes the Secretary to waive, on a case-by-case basis, the application of salary offsets for VHA retirees reemployed in the VHA. Bases the rate of basic pay for appointees to the Office of the Under Secretary for Health on pay levels in the Senior Executive Service for equivalent positions. Allows for the payment of special incentive pay of up to $40,000 annually for a VHA pharmacist executive.
Removes, adjusts, or waives certain pay restrictions, including on the non-foreign cost-of-living adjustment, market pay, and basic and locality pay, for VHA: (1) physicians and dentists; (2) physicians or dentists occupying administrative or executive leadership positions; (3) nurses; and (4) certified registered nurse anesthetists. Requires additional training, education, and support for appropriate VHA employees in the conduct and use of locality pay scale surveys. Requires VHA facility wage-related information, currently provided by way of reports from facility directors to the Secretary, to be made available, upon request, to individuals in VHA positions covered by such report.
Increases from $25,000 to $100,000 the special pay for nurse executives. Makes part-time nurses eligible for additional premium nurse pay. Adds nurse service in excess of eight consecutive hours to the services eligible for additional overtime pay. Adds licensed practical nurses, licensed vocational nurses, and certain other nurse positions to those positions exempted from limitations on increases in basic pay rates.
(Sec. 102) Prohibits: (1) the Secretary from requiring nursing staff to work more than 40 hours in a week or eight hours in a day (12 hours in the case of three-day workweeks), except under non-recurring emergency circumstances; and (2) discrimination or adverse personnel actions against nurse staff who refuse to work such additional hours. Revises the calculation of leave for nurses working two 12-hour shifts on a weekend. Redefines the VHA alternative work schedule for nurses as six 12-hours shifts within an 80-hour pay period (as opposed to three 12-hour shifts within a work week).
(Sec. 103) Reinstates through 2014 the VA's health professionals educational assistance scholarship program. Revises the VA's education debt reduction program to: (1) add recruitment as a program purpose; and (2) allow all (under current law, only recently appointed) employees to participate. Authorizes the Secretary to utilize certain authorities under the Public Health Service Act to repay educational loans of qualified health professionals from disadvantaged backgrounds in order to secure VHA clinical research by such professionals.
(Sec. 104) Directs the Secretary to prescribe standards for appointment and practice as a physician within the VHA. Requires: (1) applicants to provide certain information, including each lawsuit, civil action, or other claim against the individual for medical malpractice or negligence, and the results thereof; (2) each appointee to disclose any judgments against the individual for medical malpractice or negligence and any payments made; (3) physicians already employed within the VHA to disclose such information; and (4) the Veterans Integrated Services Network (Network) director in the region in which the physician seeks employment to investigate the information disclosed by such physician. Prohibits a new appointment without the approval of the appropriate Network regional director. Requires each VHA medical facility to enroll practicing physicians in the Proactive Disclosure Service of the National Practitioner Data Bank. Encourages the hiring of physicians who are board-certified or eligible for such certification in their field.
Title II: Health Care Matters - (Sec. 201) Repeals the requirement for annual reports concerning: (1) pay adjustments for registered nurses; and (2) VA long-range health planning.
(Sec. 202) Changes the due date of an annual report to Congress concerning research on the health effects of military service during the Persian Gulf War, and terminates such report after July 1, 2015.
(Sec. 203) Provides that VA payments made to providers who furnish medical care to a veteran's beneficiary under the Civilian Health and Medical Program of the Veterans Administration (CHAMPVA) shall constitute payment in full (thereby extinguishing the beneficiary's liability to that provider).
(Sec. 204) Authorizes disclosure of VA medical information to a representative of a patient who lacks decision-making capacity.
(Sec. 205) Requires VA patients to disclose health-plan information and their Social Security number. Authorizes the Secretary to deny or terminate medical care and services (with an exception for medical emergencies) to individuals who do not provide such information.
(Sec. 206) Requires: (1) the VHA's Under Secretary of Health to designate a National Quality Management Officer for the VHA quality assurance program; (2) each Network regional director to appoint a quality management officer; and (3) the director of each VHA medical facility to appoint a quality management officer. Outlines duties for each officer. Authorizes appropriations. Directs: (1) the Under Secretary to establish mechanisms through which VHA employees may submit confidential reports on matters relating to quality of care in VHA facilities to the designated quality management officers; and (2) the Secretary to review, and report to Congress on, current policies and protocols for maintaining health care quality and patient safety at VA medical facilities.
(Sec. 207) Requires a report from the Secretary to the veterans committees on the implementation of provisions of this Act (sections 104 and 206) concerning: (1) standards for the appointment and practice of physicians in VA medical facilities; and (2) the enhancement of VHA medical quality assurance through the appointment of quality management officers.
(Sec. 208) Directs the Secretary to: (1) conduct a two-year pilot program to assess the feasibility and advisability of using community-based organizations and local and state governmental entities to ensure that veterans receive the care and benefits for which they are eligible, including while transitioning from military service to civilian life; and (2) report to Congress on the pilot program.
(Sec. 209) Authorizes the Secretary to contract with appropriate entities to provide specialized residential care and rehabilitation services to a veteran of Operations Enduring Freedom or Iraqi Freedom who suffers from a traumatic brain injury (TBI), has an accumulation of deficits in activities of daily living and instrumental activities of daily living and, because of these deficits, would otherwise require nursing home admission even though such care would generally exceed the veteran's nursing needs.
(Sec. 210) Directs the Secretary to contract with the Institute of Medicine of the National Academies to conduct an expanded study on the health impact of Project Shipboard Hazard and Defense (SHAD). Requires the study to include, as practicable, all veterans who participated in Project SHAD.
(Sec. 211) Authorizes the Secretary to utilize non-VA facilities for the care and treatment of veterans suffering from TBI when the Secretary: (1) is unable to provide such treatment or services at the frequency or for the duration necessary; or (2) determines that it is optimal to the veteran's recovery and rehabilitation. Requires the non-VA facility selected to maintain care standards established by an independent, peer-reviewed organization that accredits specialized rehabilitation programs for adults with TBI.
(Sec. 212) Provides for treatment of a health facility of a tribal organization as a state home for purposes of grant payments to such homes for veterans' domiciliary care, nursing home care, and hospital care. Exempts a health facility of a tribal organization from the prohibition against the Secretary treating a new facility as a state home after September 30, 2009. Authorizes the Secretary to make grants to assist tribal organizations in constructing or acquiring facilities in order to furnish domiciliary or nursing home care to veterans and in expanding, remodeling, or altering existing buildings in order to furnish domiciliary care, nursing home care, adult day health care, or hospital care to veterans in homes.
(Sec. 213) Directs the Secretary to conduct a three-year pilot program to assess the feasibility and advisability of providing a dental insurance plan for any veteran enrolled in the VA annual patient enrollment system, as well as survivors and dependents eligible for VA medical care. Provides for: (1) voluntary plan enrollment and disenrollment; and (2) the payment of plan premiums.
Title III: Women Veterans Health Care Matters - (Sec. 301) Requires the Secretary to report to the veterans committees on barriers to the receipt of comprehensive health care through the VA encountered by women veterans, especially those of Operations Iraqi Freedom or Enduring Freedom.
(Sec. 302) Directs the Secretary to: (1) develop a plan to improve the provision of health care services to women veterans and to plan appropriately for the future health care needs of women serving on active duty in Operations Iraqi Freedom and Enduring Freedom; and (2) submit such plan to the veterans committees.
(Sec. 303) Requires: (1) the Secretary to contract with a non-VA entity for an independent study on health consequences of women veterans of active-duty service in Operations Iraqi Freedom and Enduring Freedom; (2) the entity chosen to report study results to the Secretary and Congress; and (3) the Secretary to report to Congress on the study results.
(Sec. 304) Directs the Secretary to: (1) implement a program for education, training, certification, and continuing medical education for mental health professionals specializing in the provision of counseling and care to veterans suffering from sexual trauma; and (2) report annually to Congress on the counseling and care provided.
(Sec. 305) Requires the Secretary to: (1) conduct a two-year pilot program to evaluate the feasibility and advisability of providing reintegration and readjustment services in group retreat settings to women veterans recently separated from military service after a prolonged deployment; and (2) report to Congress on the pilot program. Authorizes appropriations.
(Sec. 306) Directs the Secretary to report to Congress on employment of full-time women veteran program managers at VA medical centers to ensure that health care needs of women veterans are met.
(Sec. 307) Requires the inclusion, respectively, of women veterans recently separated from service and minority women veterans recently separated from service on: (1) the Advisory Committee on Women Veterans; and (2) the Advisory Committee on Minority Veterans.
(Sec. 308) Directs the Secretary to: (1) carry out a two-year pilot program to assess the feasibility and advisability of providing subsidies to veterans receiving regular and intensive mental health services and other intensive health care services in order to obtain child care while receiving such services; and (2) report to Congress on the pilot program. Authorizes appropriations.
(Sec. 309) Authorizes the Secretary to furnish care to a newborn child of a woman veteran receiving VA maternity care for up to seven days after the birth of the child.
Title IV: Mental Health Care Matters - (Sec. 401) Makes any member who serves in Operations Iraqi Freedom or Enduring Freedom eligible for readjustment counseling and related mental health services through Vet Centers (centers for readjustment counseling and related mental health services for veterans), regardless of whether the member is on active duty at the time of receipt of such counseling and services.
(Sec. 402) Directs the Secretary, upon receipt of a request for counseling from an individual who has been discharged or released from active service, to: (1) provide referrals to assist the individual in obtaining mental health care and services outside the VA; and (2) if pertinent, advise such individual of the right to apply for review of the discharge or release.
(Sec. 403) Requires the Secretary to: (1) conduct a study to determine the number of veterans who died by suicide between January 1, 1999, and the date of enactment of this Act; and (2) report study results to the veterans committees. Authorizes appropriations.
(Sec. 404) Directs the Secretary to transfer specified VHA funds to the Secretary of Health and Human Services for the Graduate Psychology Education program established under the Public Health Service Act. Requires such funds to be used to award grants to support the training of psychologists in the treatment of veterans with post-traumatic stress disorder (PTSD), TBI, and other combat-related disorders. Provides a preference for VA health care facilities in the awarding of such grants.
Title V: Homeless Veterans Matters - (Sec. 501) Authorizes the Secretary to carry out a five-year pilot program to make grants to public and nonprofit organizations to coordinate the provision of supportive services to very low income, formerly homeless veterans residing in permanent housing on property that was part of a military installation that was closed and that has a redevelopment plan that includes use of the property for homeless veterans. Authorizes appropriations.
(Sec. 502) Authorizes the Secretary to carry out a five-year pilot program to make grants to public and nonprofit organizations to coordinate the provision of supportive services to very low income, formerly homeless veterans residing in permanent housing. Authorizes appropriations.
(Sec. 503) Authorizes the Secretary to carry out a five-year pilot program to make grants to public and nonprofit organizations to provide outreach to inform low-income and elderly veterans and their spouses who reside in rural areas of the veterans' pension benefits for which they may be eligible. Authorizes appropriations.
(Sec. 504) Directs the Secretary to submit to Congress progress reports on each of the pilot programs authorized under this title.
Title VI: Nonprofit Research and Education Corporations - (Sec. 601) Amends federal provisions concerning the establishment at Department of Veterans Affairs (VA) medical facilities of nonprofit research and education corporations (NRECs) to allow an NREC to facilitate the conduct of research or education, or both, at more than one VA medical center. States that such an NREC shall be known as a multi-medical center research corporation (MCRC).
Allows an NREC to act as a MCRC if: (1) the NREC board of directors approve a resolution permitting that NREC to act as a MCRC; and (2) the Secretary of Veterans Affairs approves the resolution.
Requires each NREC and MCRC (corporation) to be established in accordance with the nonprofit corporation laws of the state in which the VA medical center which it supports is located. States that neither such corporation shall be considered to be owned by, or an agent or instrumentality of, the United States.
(Sec. 602) Restates the purposes of the corporations, including with respect to their role in: (1) providing a flexible funding mechanism; and (2) residencies or similar programs.
(Sec. 603) Modifies the composition of corporation boards of directors. Revises requirements concerning non-VA members of boards of directors of NRECs and MCRCs to: (1) state a minimum number who are not officers or employees of the federal government; and (2) expand the required areas of experience or expertise.
Removes financial relationship restrictions from conflict of interest standards applicable to directors.
(Sec. 604) Increases authorized corporate powers of the corporations to include entering into contracts and setting fees for education and training facilitated through a corporation.
(Sec. 606) Revises annual report procedures to require submission of an Internal Revenue Service return form applicable to organizations exempt from income tax.
Revises conflict of interest policies applicable to directors, officers, and employees of a corporation.
Revises requirements for a report to Congress to increase the threshold for providing information identifying payees of the corporation.
Title VII: Other Matters - (Sec. 701) Expands the authority of VA police officers to include: (1) carrying VA-issued weapons while off VA property in an official capacity or while on official travel; (2) conducting investigations, on and off VA property, of offenses that may have been committed on VA property; (3) carrying out any VA-authorized duties when engaged in duties authorized by other federal statutes; and (4) serving arrest warrants issued by competent judicial authority.
(Sec. 702) Makes the uniform allowance for VA police officers the lesser of: (1) the amount currently permitted by the Office of Personnel Management (OPM); or (2) estimated or actual costs as determined by periodic VA surveys. Requires the allowance to be paid: (1) at the beginning of the officer's employment, for those appointed on or after October 1, 2008; or (2) in the case of any other officer, upon the officer's request.
[Congressional Bills 111th Congress]
[From the U.S. Government Printing Office]
[S. 252 Introduced in Senate (IS)]
111th CONGRESS
1st Session
S. 252
To amend title 38, United States Code, to enhance the capacity of the
Department of Veterans Affairs to recruit and retain nurses and other
critical health-care professionals, to improve the provision of health
care to veterans, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
January 15, 2009
Mr. Akaka (for himself, Mr. Durbin, and Mrs. Murray) introduced the
following bill; which was read twice and referred to the Committee on
Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to enhance the capacity of the
Department of Veterans Affairs to recruit and retain nurses and other
critical health-care professionals, to improve the provision of health
care to veterans, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Veterans Health
Care Authorization Act of 2009''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.
TITLE I--DEPARTMENT PERSONNEL MATTERS
Sec. 101. Enhancement of authorities for retention of medical
professionals.
Sec. 102. Limitations on overtime duty, weekend duty, and alternative
work schedules for nurses.
Sec. 103. Improvements to certain educational assistance programs.
Sec. 104. Standards for appointment and practice of physicians in
Department of Veterans Affairs medical
facilities.
TITLE II--HEALTH CARE MATTERS
Sec. 201. Repeal of certain annual reporting requirements.
Sec. 202. Modifications to annual Gulf War research report.
Sec. 203. Payment for care furnished to CHAMPVA beneficiaries.
Sec. 204. Payor provisions for care furnished to certain children of
Vietnam veterans.
Sec. 205. Disclosures from certain medical records.
Sec. 206. Disclosure to Secretary of health-plan contract information
and social security number of certain
veterans receiving care.
Sec. 207. Enhancement of quality management.
Sec. 208. Reports on improvements to Department health care quality
management.
Sec. 209. Pilot program on training and certification for family
caregiver personal care attendants for
veterans and members of the Armed Forces
with traumatic brain injury.
Sec. 210. Pilot program on provision of respite care to members of the
Armed Forces and veterans with traumatic
brain injury by students in graduate
programs of education related to mental
health or rehabilitation.
Sec. 211. Pilot program on use of community-based organizations and
local and State government entities to
ensure that veterans receive care and
benefits for which they are eligible.
Sec. 212. Specialized residential care and rehabilitation for certain
veterans.
Sec. 213. Authority to disclose medical records to third party for
collection of charges for provision of
certain care.
Sec. 214. Expanded study on the health impact of Project Shipboard
Hazard and Defense.
Sec. 215. Use of non-Department facilities for rehabilitation of
individuals with traumatic brain injury.
Sec. 216. Inclusion of federally recognized tribal organizations in
certain programs for State veterans homes.
Sec. 217. Pilot program on provision of dental insurance plans to
veterans and survivors and dependents of
veterans.
TITLE III--WOMEN VETERANS HEALTH CARE
Sec. 301. Report on barriers to receipt of health care for women
veterans.
Sec. 302. Plan to improve provision of health care services to women
veterans.
Sec. 303. Independent study on health consequences of women veterans of
military service in Operation Iraqi Freedom
and Operation Enduring Freedom.
Sec. 304. Training and certification for mental health care providers
on care for veterans suffering from sexual
trauma.
Sec. 305. Pilot program on counseling in retreat settings for women
veterans newly separated from service in
the Armed Forces.
Sec. 306. Report on full-time women veterans program managers at
medical centers.
Sec. 307. Service on certain advisory committees of women recently
separated from service in the Armed Forces.
Sec. 308. Pilot program on subsidies for child care for certain
veterans receiving health care.
Sec. 309. Care for newborn children of women veterans receiving
maternity care.
TITLE IV--MENTAL HEALTH CARE
Sec. 401. Eligibility of members of the Armed Forces who serve in
Operation Iraqi Freedom or Operation
Enduring Freedom for counseling and
services through Readjustment Counseling
Service.
Sec. 402. Restoration of authority of Readjustment Counseling Service
to provide referral and other assistance
upon request to former members of the Armed
Forces not authorized counseling.
Sec. 403. Study on suicides among veterans.
Sec. 404. Transfer of funds to Secretary of Health and Human Services
for Graduate Psychology Education program.
TITLE V--HOMELESS VETERANS
Sec. 501. Pilot program on financial support for entities that
coordinate the provision of supportive
services to formerly homeless veterans
residing on certain military property.
Sec. 502. Pilot program on financial support of entities that
coordinate the provision of supportive
services to formerly homeless veterans
residing in permanent housing.
Sec. 503. Pilot program on financial support of entities that provide
outreach to inform certain veterans about
pension benefits.
Sec. 504. Pilot program on financial support of entities that provide
transportation assistance, child care
assistance, and clothing assistance to
veterans entitled to a rehabilitation
program.
Sec. 505. Assessment of pilot programs.
TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS
Sec. 601. General authorities on establishment of corporations.
Sec. 602. Clarification of purposes of corporations.
Sec. 603. Modification of requirements for boards of directors of
corporations.
Sec. 604. Clarification of powers of corporations.
Sec. 605. Redesignation of section 7364A of title 38, United States
Code.
Sec. 606. Improved accountability and oversight of corporations.
TITLE VII--MISCELLANEOUS PROVISIONS
Sec. 701. Expansion of authority for Department of Veterans Affairs
police officers.
Sec. 702. Uniform allowance for Department of Veterans Affairs police
officers.
SEC. 2. REFERENCES TO TITLE 38, UNITED STATES CODE.
Except as otherwise expressly provided, whenever in this Act an
amendment or repeal is expressed in terms of an amendment or repeal to
a section or other provision, the reference shall be considered to be
made to a section or other provision of title 38, United States Code.
TITLE I--DEPARTMENT PERSONNEL MATTERS
SEC. 101. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL
PROFESSIONALS.
(a) Secretarial Authority To Extend Title 38 Status to Additional
Positions.--
(1) In general.--Paragraph (3) of section 7401 is amended
by striking ``and blind rehabilitation outpatient
specialists.'' and inserting the following: ``blind
rehabilitation outpatient specialists, and such other classes
of health care occupations as the Secretary considers necessary
for the recruitment and retention needs of the Department
subject to the following requirements:
``(A) Not later than 45 days before the Secretary
appoints any personnel for a class of health care
occupations that is not specifically listed in this
paragraph, the Secretary shall submit to the Committee
on Veterans' Affairs of the Senate, the Committee on
Veterans' Affairs of the House of Representatives, and
the Office of Management and Budget notice of such
appointment.
``(B) Before submitting notice under subparagraph
(A), the Secretary shall solicit comments from any
labor organization representing employees in such class
and include such comments in such notice.''.
(2) Appointment of nurse assistants.--Such paragraph is
further amended by inserting ``nurse assistants,'' after
``licensed practical or vocational nurses,''.
(b) Probationary Periods for Registered Nurses.--Section 7403(b) is
amended--
(1) in paragraph (1), by striking ``Appointments'' and
inserting ``Except as otherwise provided in this subsection,
appointments'';
(2) by redesignating paragraph (2) as paragraph (4); and
(3) by inserting after paragraph (1) the following new
paragraphs:
``(2) An appointment of a registered nurse under this chapter,
whether on a full-time basis or a part-time basis, shall be for a
probationary period ending upon the completion by the person so
appointed of a number of hours of work pursuant to such appointment
that the Secretary considers appropriate for such appointment but not
more than 4,180 hours.
``(3) An appointment described in subsection (a) on a part-time
basis of a person who has previously served on a full-time basis for
the probationary period for the position concerned shall be without a
probationary period.''.
(c) Prohibition on Temporary Part-Time Registered Nurse
Appointments in Excess of 4,180 Hours.--Section 7405 is amended by
adding at the end the following new subsection:
``(g)(1) Employment of a registered nurse on a temporary part-time
basis under subsection (a)(1) shall be for a probationary period ending
upon the completion by the person so employed of a number of hours of
work pursuant to such employment that the Secretary considers
appropriate for such employment but not more than 4,180 hours.
``(2) Upon completion by a registered nurse of the probationary
period described in paragraph (1)--
``(A) the employment of such nurse shall--
``(i) no longer be considered temporary; and
``(ii) be considered an appointment described in
section 7403(a) of this title; and
``(B) the nurse shall be considered to have served the
probationary period required by section 7403(b).''.
(d) Waiver of Offset From Pay for Certain Reemployed Annuitants.--
(1) In general.--Section 7405, as amended by subsection
(c), is further amended by adding at the end the following new
subsection:
``(h)(1) The Secretary may waive the application of sections 8344
and 8468 of title 5 (relating to annuities and pay on reemployment) or
any other similar provision of law under a Government retirement system
on a case-by-case basis for an annuitant reemployed on a temporary
basis under the authority of subsection (a) in a position described
under paragraph (1) of that subsection.
``(2) An annuitant to whom a waiver under paragraph (1) is in
effect shall not be considered an employee for purposes of any
Government retirement system.
``(3) An annuitant to whom a waiver under paragraph (1) is in
effect shall be subject to the provisions of chapter 71 of title 5
(including all labor authority and labor representative collective
bargaining agreements) applicable to the position to which appointed.
``(4) In this subsection:
``(A) The term `annuitant' means an annuitant under a
Government retirement system.
``(B) The term `employee' has the meaning under section
2105 of title 5.
``(C) The term `Government retirement system' means a
retirement system established by law for employees of the
Government of the United States.''.
(2) Effective date.--The amendment made by paragraph (1)
shall take effect on the date that is six months after the date
of the enactment of this Act, and shall apply to pay periods
beginning on or after such effective date.
(e) Rate of Basic Pay for Appointees to the Office of the Under
Secretary for Health Set to Rate of Basic Pay for Senior Executive
Service Positions.--
(1) In general.--Section 7404(a) is amended--
(A) by striking ``The annual'' and inserting ``(1)
The annual'';
(B) by striking ``The pay'' and inserting the
following:
``(2) The pay'';
(C) by striking ``under the preceding sentence''
and inserting ``under paragraph (1)''; and
(D) by adding at the end the following new
paragraph:
``(3) The rate of basic pay for a position to which an Executive
order applies under paragraph (1) and is not described by paragraph (2)
shall be set in accordance with section 5382 of title 5 as if such
position were a Senior Executive Service position (as such term is
defined in section 3132(a) of title 5).''.
(2) Effective date.--The amendments made by paragraph (1)
shall take effect on the first day of the first pay period
beginning after the day that is 180 days after the date of the
enactment of this Act.
(f) Comparability Pay Program for Appointees to the Office of the
Under Secretary for Health.--Section 7410 is amended--
(1) by striking ``The Secretary may'' and inserting ``(a)
In General.--The Secretary may''; and
(2) by adding at the end the following new subsection:
``(b) Comparability Pay for Appointees to the Office of the Under
Secretary for Health.--(1) The Secretary may authorize the Under
Secretary for Health to provide comparability pay of not more than
$100,000 per year to individuals of the Veterans Health Administration
appointed under section 7306 of this title who are not physicians or
dentists and to individuals who are appointed to Senior Executive
Service positions (as such term is defined in section 3132(a) of title
5) to achieve annual pay levels for such individuals that are
comparable with annual pay levels of individuals with similar positions
in the private sector.
``(2) Comparability pay under paragraph (1) for an individual is in
addition to all other pay, awards, and performance bonuses paid to such
individual under this title.
``(3) Except as provided in paragraph (4), comparability pay under
paragraph (1) for an individual shall be considered basic pay for all
purposes, including retirement benefits under chapters 83 and 84 of
title 5, and other benefits.
``(4) Comparability pay under paragraph (1) for an individual shall
not be considered basic pay for purposes of adverse actions under
subchapter V of this chapter.
``(5) Comparability pay under paragraph (1) may not be awarded to
an individual in an amount that would result in an aggregate amount of
pay (including bonuses and awards) received by such individual in a
year under this title that is greater than the annual pay of the
President.''.
(g) Special Incentive Pay for Department Pharmacist Executives.--
Section 7410, as amended by subsection (f) of this section, is further
amended by adding at the end the following new subsection:
``(c) Special Incentive Pay for Department Pharmacist Executives.--
(1) In order to recruit and retain highly qualified Department
pharmacist executives, the Secretary may authorize the Under Secretary
for Health to pay special incentive pay of not more than $40,000 per
year to an individual of the Veterans Health Administration who is a
pharmacist executive.
``(2) In determining whether and how much special pay to provide to
such individual, the Under Secretary shall consider the following:
``(A) The grade and step of the position of the individual.
``(B) The scope and complexity of the position of the
individual.
``(C) The personal qualifications of the individual.
``(D) The characteristics of the labor market concerned.
``(E) Such other factors as the Secretary considers
appropriate.
``(3) Special incentive pay under paragraph (1) for an individual
is in addition to all other pay (including basic pay) and allowances to
which the individual is entitled.
``(4) Except as provided in paragraph (5), special incentive pay
under paragraph (1) for an individual shall be considered basic pay for
all purposes, including retirement benefits under chapters 83 and 84 of
title 5, and other benefits.
``(5) Special incentive pay under paragraph (1) for an individual
shall not be considered basic pay for purposes of adverse actions under
subchapter V of this chapter.
``(6) Special incentive pay under paragraph (1) may not be awarded
to an individual in an amount that would result in an aggregate amount
of pay (including bonuses and awards) received by such individual in a
year under this title that is greater than the annual pay of the
President.''.
(h) Pay for Physicians and Dentists.--
(1) Non-foreign cost of living adjustment allowance.--
Section 7431(b) is amended by adding at the end the following
new paragraph:
``(5) The non-foreign cost of living adjustment allowance
authorized under section 5941 of title 5 for physicians and
dentists whose pay is set under this section shall be
determined as a percentage of base pay only.''.
(2) Market pay determinations for physicians and dentists
in administrative or executive leadership positions.--Section
7431(c)(4)(B)(i) is amended by adding at the end the following:
``The Secretary may exempt physicians and dentists occupying
administrative or executive leadership positions from the
requirements of the previous sentence.''.
(3) Exception to prohibition on reduction of market pay.--
Section 7431(c)(7) is amended by striking ``concerned.'' and
inserting ``concerned, unless there is a change in board
certification or reduction of privileges.''.
(i) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) is
amended by striking ``level V'' and inserting ``level IV''.
(j) Exemption for Certified Registered Nurse Anesthetists From
Limitation on Authorized Competitive Pay.--Section 7451(c)(2) is
further amended by adding at the end the following new sentence: ``The
maximum rate of basic pay for a grade for the position of certified
registered nurse anesthetist pursuant to an adjustment under subsection
(d) may exceed the maximum rate otherwise provided in the preceding
sentence.''.
(k) Locality Pay Scale Computations.--
(1) Education, training, and support for facility directors
in wage surveys.--Section 7451(d)(3) is amended by adding at
the end the following new subparagraph:
``(F) The Under Secretary for Health shall provide appropriate
education, training, and support to directors of Department health care
facilities in the conduct and use of surveys, including the use of
third-party surveys, under this paragraph.''.
(2) Information on methodology used in wage surveys.--
Section 7451(e)(4) is amended--
(A) by redesignating subparagraph (D) as
subparagraph (E); and
(B) by inserting after subparagraph (C) the
following new subparagraph (D):
``(D) In any case in which the director conducts such a
wage survey during the period covered by the report and makes
adjustment in rates of basic pay applicable to one or more
covered positions at the facility, information on the
methodology used in making such adjustment or adjustments.''.
(3) Disclosure of information to persons in covered
positions.--Section 7451(e), as amended by paragraph (2) of
this subsection, is further amended by adding at the end the
following new paragraph:
``(6)(A) Upon the request of an individual described in
subparagraph (B) for a report provided under paragraph (4) with respect
to a Department health-care facility, the Under Secretary for Health or
the director of such facility shall provide to the individual the most
current report for such facility provided under such paragraph.
``(B) An individual described in this subparagraph is--
``(i) an individual in a covered position at a Department
health-care facility; or
``(ii) a representative of the labor organization
representing that individual who is designated by that
individual to make the request.''.
(l) Increased Limitation on Special Pay for Nurse Executives.--
Section 7452(g)(2) is amended by striking ``$25,000'' and inserting
``$100,000''.
(m) Eligibility of Part-Time Nurses for Additional Nurse Pay.--
(1) In general.--Section 7453 is amended--
(A) in subsection (a), by striking ``a nurse'' and
inserting ``a full-time nurse or part-time nurse'';
(B) in subsection (b)--
(i) in the first sentence--
(I) by striking ``on a tour of
duty'';
(II) by striking ``service on such
tour'' and inserting ``such service'';
and
(III) by striking ``of such tour''
and inserting ``of such service''; and
(ii) in the second sentence, by striking
``of such tour'' and inserting ``of such
service'';
(C) in subsection (c)--
(i) by striking ``on a tour of duty''; and
(ii) by striking ``service on such tour''
and inserting ``such service''; and
(D) in subsection (e)--
(i) in paragraph (1), by striking ``eight
hours in a day'' and inserting ``eight
consecutive hours''; and
(ii) in paragraph (5)(A), by striking
``tour of duty'' and inserting ``period of
service''.
(2) Exclusion of application of additional nurse pay
provisions to certain additional employees.--Paragraph (3) of
section 7454(b) is amended to read as follows:
``(3) Employees appointed under section 7408 of this title
performing service on a tour of duty, any part of which is within the
period commencing at midnight Friday and ending at midnight Sunday,
shall receive additional pay in addition to the rate of basic pay
provided such employees for each hour of service on such tour at a rate
equal to 25 percent of such employee's hourly rate of basic pay.''.
(n) Exemption of Additional Nurse Positions From Limitation on
Increase in Rates of Basic Pay.--Section 7455(c)(1) is amended by
inserting after ``nurse anesthetists,'' the following: ``licensed
practical nurses, licensed vocational nurses, and nursing positions
otherwise covered by title 5,''.
SEC. 102. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND ALTERNATIVE
WORK SCHEDULES FOR NURSES.
(a) Overtime Duty.--
(1) In general.--Subchapter IV of chapter 74 is amended by
adding at the end the following new section:
``Sec. 7459. Nursing staff: special rules for overtime duty
``(a) Limitation.--Except as provided in subsection (c), the
Secretary may not require nursing staff to work more than 40 hours (or
24 hours if such staff is covered under section 7456 of this title) in
an administrative work week or more than eight consecutive hours (or 12
hours if such staff is covered under section 7456 or 7456A of this
title).
``(b) Voluntary Overtime.--(1) Nursing staff may on a voluntary
basis elect to work hours otherwise prohibited by subsection (a).
``(2) The refusal of nursing staff to work hours prohibited by
subsection (a) shall not be grounds to discriminate (within the meaning
of section 704(a) of the Civil Rights Act of 1964 (42 U.S.C. 2000e-
3(a))) against the staff, dismissal or discharge of the staff, or any
other adverse personnel action against the staff.
``(c) Overtime Under Emergency Circumstances.--(1) Subject to
paragraph (2), the Secretary may require nursing staff to work hours
otherwise prohibited by subsection (a) if--
``(A) the work is a consequence of an emergency that could
not have been reasonably anticipated;
``(B) the emergency is non-recurring and is not caused by
or aggravated by the inattention of the Secretary or lack of
reasonable contingency planning by the Secretary;
``(C) the Secretary has exhausted all good faith,
reasonable attempts to obtain voluntary workers;
``(D) the nurse staff have critical skills and expertise
that are required for the work; and
``(E) the work involves work for which the standard of care
for a patient assignment requires continuity of care through
completion of a case, treatment, or procedure.
``(2) Nursing staff may not be required to work hours under this
subsection after the requirement for a direct role by the staff in
responding to medical needs resulting from the emergency ends.
``(d) Nursing Staff Defined.--In this section, the term `nursing
staff' includes the following;
``(1) A registered nurse.
``(2) A licensed practical or vocational nurse.
``(3) A nurse assistant appointed under this chapter or
title 5.
``(4) Any other nurse position designated by the Secretary
for purposes of this section.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 74 is amended by inserting after the item
relating to section 7458 the following new item:
``7459. Nursing staff: special rules for overtime duty.''.
(b) Weekend Duty.--Section 7456 is amended--
(1) by striking subsection (c); and
(2) by redesignating subsection (d) as subsection (c).
(c) Alternate Work Schedules.--
(1) In general.--Section 7456A(b)(1)(A) is amended by
striking ``three regularly scheduled'' and all that follows
through the period at the end and inserting ``six regularly
scheduled 12-hour periods of service within a pay period shall
be considered for all purposes to have worked a full 80-hour
pay period.''.
(2) Conforming amendments.--Section 7456A(b) is amended--
(A) in the subsection heading, by striking ``36/
40'' and inserting ``72/80'';
(B) in paragraph (2)--
(i) in subparagraph (A), by striking ``40-
hour basic work week'' and inserting ``80-hour
pay period'';
(ii) in subparagraph (B), by striking
``regularly scheduled 36-hour tour of duty
within the work week'' and inserting
``scheduled 72-hour period of service within
the bi-weekly pay period'';
(iii) in subparagraph (C)--
(I) in clause (i), by striking
``regularly scheduled 36-hour tour of
duty within an administrative work
week'' and inserting ``scheduled 72-
hour period of service within an
administrative pay period'';
(II) in clause (ii), by striking
``regularly scheduled 12-hour tour of
duty'' and inserting ``scheduled 12-
hour period of service''; and
(III) in clause (iii), by striking
``regularly scheduled 36-hour tour of
duty work week'' and inserting
``scheduled 72-hour period of service
pay period''; and
(iv) in subparagraph (D), by striking
``regularly scheduled 12-hour tour of duty''
and inserting ``scheduled 12-hour period of
service''; and
(C) in paragraph (3), by striking ``regularly
scheduled 12-hour tour of duty'' and inserting
``scheduled 12-hour period of service''.
SEC. 103. IMPROVEMENTS TO CERTAIN EDUCATIONAL ASSISTANCE PROGRAMS.
(a) Reinstatement of Health Professionals Educational Assistance
Scholarship Program.--
(1) In general.--Section 7618 is amended by striking
``December 31, 1998'' and inserting ``December 31, 2014''.
(2) Expansion of eligibility requirements.--Section
7612(b)(2) is amended by striking ``(under section'' and all
that follows through ``or vocational nurse.'' and inserting the
following: ``as an appointee under paragraph (1) or (3) of
section 7401 of this title.''.
(b) Improvements to Education Debt Reduction Program.--
(1) Inclusion of employee retention as purpose of
program.--Section 7681(a)(2) is amended by inserting ``and
retention'' after ``recruitment'' the first time it appears.
(2) Eligibility.--Section 7682 is amended--
(A) in subsection (a)(1), by striking ``a recently
appointed'' and inserting ``an''; and
(B) by striking subsection (c).
(3) Maximum amounts of assistance.--Section 7683(d)(1) is
amended--
(A) by striking ``$44,000'' and inserting
``$60,000''; and
(B) by striking ``$10,000'' and inserting
``$12,000''.
(c) Loan Repayment Program for Clinical Researchers From
Disadvantaged Backgrounds.--
(1) In general.--The Secretary of Veterans Affairs may, in
consultation with the Secretary of Health and Human Services,
utilize the authorities available in section 487E of the Public
Health Service Act (42 U.S.C. 288-5) for the repayment of the
principal and interest of educational loans of appropriately
qualified health professionals who are from disadvantaged
backgrounds in order to secure clinical research by such
professionals for the Veterans Health Administration.
(2) Limitations.--The exercise by the Secretary of Veterans
Affairs of the authorities referred to in paragraph (1) shall
be subject to the conditions and limitations specified in
paragraphs (2) and (3) of section 487E(a) of the Public Health
Service Act (42 U.S.C. 288-5(a)(2) and (3)).
(3) Funding.--Amounts for the repayment of principal and
interest of educational loans under this subsection shall be
derived from amounts available to the Secretary of Veterans
Affairs for the Veterans Health Administration for Medical
Services.
SEC. 104. STANDARDS FOR APPOINTMENT AND PRACTICE OF PHYSICIANS IN
DEPARTMENT OF VETERANS AFFAIRS MEDICAL FACILITIES.
(a) Standards.--
(1) In general.--Subchapter I of chapter 74 is amended by
inserting after section 7402 the following new section:
``Sec. 7402A. Appointment and practice of physicians: standards
``(a) In General.--The Secretary shall, acting through the Under
Secretary for Health, prescribe standards to be met by individuals in
order to qualify for appointment in the Veterans Health Administration
in the position of physician and to practice as a physician in medical
facilities of the Administration. The standards shall incorporate the
requirements of this section.
``(b) Disclosure of Certain Information Before Appointment.--Each
individual seeking appointment in the Veterans Health Administration in
the position of physician shall do the following:
``(1) Provide the Secretary a full and complete explanation
of the following:
``(A) Each lawsuit, civil action, or other claim
(whether open or closed) brought against the individual
for medical malpractice or negligence (other than a
lawsuit, action, or claim closed without any judgment
against or payment by or on behalf of the individual).
``(B) Each payment made by or on behalf of the
individual to settle any lawsuit, action, or claim
covered by subparagraph (A).
``(C) Each investigation or disciplinary action
taken against the individual relating to the
individual's performance as a physician.
``(2) Submit a written request and authorization to the
State licensing board of each State in which the individual
holds or has held a license to practice medicine to disclose to
the Secretary any information in the records of such State on
the following:
``(A) Each lawsuit, civil action, or other claim
brought against the individual for medical malpractice
or negligence covered by paragraph (1)(A) that occurred
in such State.
``(B) Each payment made by or on behalf of the
individual to settle any lawsuit, action, or claim
covered by subparagraph (A).
``(C) Each medical malpractice judgment against the
individual by the courts or administrative agencies or
bodies of such State.
``(D) Each disciplinary action taken or under
consideration against the individual by an
administrative agency or body of such State.
``(E) Any change in the status of the license to
practice medicine issued the individual by such State,
including any voluntary or nondisciplinary surrendering
of such license by the individual.
``(F) Any open investigation of the individual by
an administrative agency or body of such State, or any
outstanding allegation against the individual before
such an administrative agency or body.
``(G) Any written notification by the State to the
individual of potential termination of a license for
cause or otherwise.
``(c) Disclosure of Certain Information Following Appointment.--(1)
Each individual appointed in the Veterans Health Administration in the
position of physician after the date of the enactment of this section
shall, as a condition of service under the appointment, disclose to the
Secretary, not later than 30 days after the occurrence of such event,
the following:
``(A) A judgment against the individual for medical
malpractice or negligence.
``(B) A payment made by or on behalf of the individual to
settle any lawsuit, action, or claim disclosed under paragraph
(1) or (2) of subsection (b).
``(C) Any disposition of or material change in a matter
disclosed under paragraph (1) or (2) of subsection (b).
``(2) Each individual appointed in the Veterans Health
Administration in the position of physician as of the date of the
enactment of this section shall do the following:
``(A) Not later than the end of the 60-day period beginning
on the date of the enactment of this section and as a condition
of service under the appointment after the end of that period,
submit the request and authorization described in subsection
(b)(2).
``(B) Agree, as a condition of service under the
appointment, to disclose to the Secretary, not later than 30
days after the occurrence of such event, the following:
``(i) A judgment against the individual for medical
malpractice or negligence.
``(ii) A payment made by or on behalf of the
individual to settle any lawsuit, action, or claim
disclosed pursuant to subparagraph (A) or under this
subparagraph.
``(iii) Any disposition of or material change in a
matter disclosed pursuant to subparagraph (A) or under
this subparagraph.
``(3) Each individual appointed in the Veterans Health
Administration in the position of physician shall, as part of the
biennial review of the performance of the physician under the
appointment, submit the request and authorization described in
subsection (b)(2). The requirement of this paragraph is in addition to
the requirements of paragraph (1) or (2), as applicable.
``(d) Investigation of Disclosed Matters.--(1) The Director of the
Veterans Integrated Services Network (VISN) in which an individual is
seeking appointment in the Veterans Health Administration in the
position of physician shall perform an investigation (in such manner as
the standards required by this section shall specify) of each matter
disclosed under subsection (b) with respect to the individual.
``(2) The Director of the Veterans Integrated Services Network in
which an individual is appointed in the Veterans Health Administration
in the position of physician shall perform an investigation (in a
manner so specified) of each matter disclosed under subsection (c) with
respect to the individual.
``(3) The results of each investigation performed under this
subsection shall be fully documented.
``(e) Approval of Appointments by Directors of VISNs.--(1) An
individual may not be appointed in the Veterans Health Administration
in the position of physician without the approval of the Director of
the Veterans Integrated Services Network in which the individual will
first serve under the appointment.
``(2) In approving the appointment under this subsection of an
individual for whom any matters have been disclosed under subsection
(b), a Director shall--
``(A) certify in writing the completion of the performance
of the investigation under subsection (d)(1) of each such
matter, including the results of such investigation; and
``(B) provide a written justification why any matters
raised in the course of such investigation do not disqualify
the individual from appointment.
``(f) Enrollment of Physicians With Practice Privileges in
Proactive Disclosure Service.--Each medical facility of the Department
at which physicians are extended the privileges of practice shall
enroll each physician extended such privileges in the Proactive
Disclosure Service of the National Practitioner Data Bank.
``(g) Encouraging Hiring of Physicians With Board Certification.--
(1) The Secretary shall, for each performance contract with a Director
of a Veterans Integrated Services Network (VISN), include in such
contract a provision that encourages such director to hire physicians
who are board eligible or board certified in the specialty in which the
physicians will practice.
``(2) The Secretary may determine the nature and manner of the
provision described in paragraph (1).''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 74 is amended by inserting after the item
relating to section 7402 the following new item:
``7402A. Appointment and practice of physicians: standards.''.
(b) Effective Date and Applicability.--
(1) Effective date.--Except as provided in paragraphs (2)
and (3), the amendments made by subsection (a) shall take
effect on the date of the enactment of this Act.
(2) Applicability of certain requirements to physicians
practicing on effective date.--In the case of an individual
appointed to the Veterans Health Administration in the position
of physician as of the date of the enactment of this Act, the
requirements of section 7402A(f) of title 38, United States
Code, as added by subsection (a) of this section, shall take
effect on the date that is 60 days after the date of the
enactment of this Act.
(3) Applicability of requirements related to hiring of
physicians with board certification.--The requirement of
section 7402A(g) of such title, as added by subsection (a),
shall begin with the first cycle of performance contracts for
directors of Veterans Integrated Services Networks beginning
after the date of the enactment of this Act.
TITLE II--HEALTH CARE MATTERS
SEC. 201. REPEAL OF CERTAIN ANNUAL REPORTING REQUIREMENTS.
(a) Nurse Pay Report.--Section 7451 is amended--
(1) by striking subsection (f); and
(2) by redesignating subsection (g) as subsection (f).
(b) Long-Term Planning Report.--
(1) In general.--Section 8107 is repealed.
(2) Conforming amendment.--The table of sections at the
beginning of chapter 81 is amended by striking the item
relating to section 8107.
SEC. 202. MODIFICATIONS TO ANNUAL GULF WAR RESEARCH REPORT.
Section 707(c)(1) of the Persian Gulf War Veterans' Health Status
Act (title VII of Public Law 102-585; 38 U.S.C. 527 note) is amended by
striking ``Not later than March 1 of each year'' and inserting ``Not
later than July 1, 2008, and July 1 of each of the five following
years''.
SEC. 203. PAYMENT FOR CARE FURNISHED TO CHAMPVA BENEFICIARIES.
Section 1781 is amended at the end by adding the following new
subsection:
``(e) Payment by the Secretary under this section on behalf of a
covered beneficiary for medical care shall constitute payment in full
and extinguish any liability on the part of the beneficiary for that
care.''.
SEC. 204. PAYOR PROVISIONS FOR CARE FURNISHED TO CERTAIN CHILDREN OF
VIETNAM VETERANS.
(a) Children of Vietnam Veterans Born With Spina Bifida.--Section
1803 is amended--
(1) by redesignating subsection (c) as subsection (d); and
(2) by inserting after subsection (b) the following new
subsection (c):
``(c) Where payment by the Secretary under this section is less
than the amount of the charges billed, the health care provider or
agent of the health care provider may seek payment for the difference
between the amount billed and the amount paid by the Secretary from a
responsible third party to the extent that the provider or agent
thereof would be eligible to receive payment for such care or services
from such third party, but--
``(1) the health care provider or agent for the health care
provider may not impose any additional charge on the
beneficiary who received the medical care, or the family of
such beneficiary, for any service or item for which the
Secretary has made payment under this section;
``(2) the total amount of payment a provider or agent of
the provider may receive for care and services furnished under
this section may not exceed the amount billed to the Secretary;
and
``(3) the Secretary, upon request, shall disclose to such
third party information received for the purposes of carrying
out this section.''.
(b) Children of Women Vietnam Veterans Born With Birth Defects.--
Section 1813 is amended--
(1) by redesignating subsection (c) as subsection (d); and
(2) by inserting after subsection (b) the following new
subsection (c):
``(c) Seeking Payment From Third Parties.--Where payment by the
Secretary under this section is less than the amount of the charges
billed, the health care provider or agent of the health care provider
may seek payment for the difference between the amount billed and the
amount paid by the Secretary from a responsible third party to the
extent that the health care provider or agent thereof would be eligible
to receive payment for such care or services from such third party,
but--
``(1) the health care provider or agent for the health care
provider may not impose any additional charge on the
beneficiary who received medical care, or the family of such
beneficiary, for any service or item for which the Secretary
has made payment under this section;
``(2) the total amount of payment a provider or agent of
the provider may receive for care and services furnished under
this section may not exceed the amount billed to the Secretary;
and
``(3) the Secretary, upon request, shall disclose to such
third party information received for the purposes of carrying
out this section.''.
SEC. 205. DISCLOSURES FROM CERTAIN MEDICAL RECORDS.
Section 7332(b)(2) is amended by adding at the end the following
new subparagraph:
``(F)(i) To a representative of a patient who lacks
decision-making capacity, when a practitioner deems the content
of the given record necessary for that representative to make
an informed decision regarding the patient's treatment.
``(ii) In this subparagraph, the term `representative'
means an individual, organization, or other body authorized
under section 7331 of this title and its implementing
regulations to give informed consent on behalf of a patient who
lacks decision-making capacity.''.
SEC. 206. DISCLOSURE TO SECRETARY OF HEALTH-PLAN CONTRACT INFORMATION
AND SOCIAL SECURITY NUMBER OF CERTAIN VETERANS RECEIVING
CARE.
(a) In General.--Subchapter I of chapter 17 is amended by adding at
the end the following new section:
``Sec. 1709. Disclosure to Secretary of health-plan contract
information and social security number of certain
veterans receiving care
``(a) Required Disclosure of Health-Plan Contracts.--(1) Any
individual who applies for or is in receipt of care described in
paragraph (2) shall, at the time of such application, or otherwise when
requested by the Secretary, submit to the Secretary such current
information as the Secretary may require to identify any health-plan
contract (as defined in section 1729(i) of this title) under which such
individual is covered, to include, as applicable--
``(A) the name, address, and telephone number of such
health-plan contract;
``(B) the name of the individual's spouse, if the
individual's coverage is under the spouse's health-plan
contract;
``(C) the plan number; and
``(D) the plan's group code.
``(2) The care described in this paragraph is--
``(A) hospital, nursing home, or domiciliary care;
``(B) medical, rehabilitative, or preventive health
services; or
``(C) other medical care under laws administered by the
Secretary.
``(b) Required Disclosure of Social Security Number.--(1) Any
individual who applies for or is in receipt of care described in
paragraph (2) shall, at the time of such application, or otherwise when
requested by the Secretary, submit to the Secretary--
``(A) the individual's social security number; and
``(B) the social security number of any dependent or
Department beneficiary on whose behalf, or based upon whom,
such individual applies for or is in receipt of such care.
``(2) The care described in this paragraph is--
``(A) hospital, nursing home, or domiciliary care;
``(B) medical, rehabilitative, or preventive health
services; or
``(C) other medical care under laws administered by the
Secretary.
``(3) This subsection does not require an individual to furnish the
Secretary with a social security number for any individual to whom a
social security number has not been assigned.
``(c) Failure To Disclose Social Security Number.--(1) The
Secretary shall deny an individual's application for, or may terminate
an individual's enrollment in, the system of patient enrollment
established by the Secretary under section 1705 of this title, if such
individual does not provide the social security number required or
requested to be submitted pursuant to subsection (b).
``(2) Following a denial or termination under paragraph (1) with
respect to an individual, the Secretary may, upon receipt of the
information required or requested under subsection (b), approve such
individual's application or reinstate such individual's enrollment (if
otherwise in order), for such medical care and services provided on and
after the date of such receipt of information.
``(d) Construction.--Nothing in this section shall be construed as
authority to deny medical care and treatment to an individual in a
medical emergency.''.
(b) Clerical Amendment.--The table of sections at the beginning of
such chapter 17 is amended by inserting after the item relating to
section 1708 the following new item:
``1709. Disclosure to Secretary of health-plan contract information and
social security number of certain veterans
receiving care.''.
SEC. 207. ENHANCEMENT OF QUALITY MANAGEMENT.
(a) Enhancement of Quality Management Through Quality Management
Officers.--
(1) In general.--Subchapter II of chapter 73 is amended by
inserting after section 7311 the following new section:
``Sec. 7311A. Quality management officers
``(a) National Quality Management Officer.--(1) The Under Secretary
for Health shall designate an official of the Veterans Health
Administration to act as the principal quality management officer for
the quality-assurance program required by section 7311 of this title.
The official so designated may be known as the `National Quality
Management Officer of the Veterans Health Administration' (in this
section referred to as the `National Quality Management Officer').
``(2) The National Quality Management Officer shall report directly
to the Under Secretary for Health in the discharge of responsibilities
and duties of the Officer under this section.
``(3) The National Quality Management Officer shall be the official
within the Veterans Health Administration who is principally
responsible for the quality-assurance program referred to in paragraph
(1). In carrying out that responsibility, the Officer shall be
responsible for the following:
``(A) Establishing and enforcing the requirements of the
program referred to in paragraph (1).
``(B) Developing an aggregate quality metric from existing
data sources, such as the Inpatient Evaluation Center of the
Department, the National Surgical Quality Improvement Program
of the American College of Surgeons, and the External Peer
Review Program of the Veterans Health Administration, that
could be used to assess reliably the quality of care provided
at individual Department medical centers and associated
community based outpatient clinics.
``(C) Ensuring that existing measures of quality, including
measures from the Inpatient Evaluation Center, the National
Surgical Quality Improvement Program, System-Wide Ongoing
Assessment and Review reports of the Department, and Combined
Assessment Program reviews of the Office of Inspector General
of the Department, are monitored routinely and analyzed in a
manner that ensures the timely detection of quality of care
issues.
``(D) Encouraging research and development in the area of
quality metrics for the purposes of improving how the
Department measures quality in individual facilities.
``(E) Carrying out such other responsibilities and duties
relating to quality management in the Veterans Health
Administration as the Under Secretary for Health shall specify.
``(4) The requirements under paragraph (3) shall include
requirements regarding the following:
``(A) A confidential system for the submittal of reports by
Veterans Health Administration personnel regarding quality
management at Department facilities.
``(B) Mechanisms for the peer review of the actions of
individuals appointed in the Veterans Health Administration in
the position of physician.
``(b) Quality Management Officers for VISNs.--(1) The Regional
Director of each Veterans Integrated Services Network (VISN) shall
appoint an official of the Network to act as the quality management
officer of the Network.
``(2) The quality management officer for a Veterans Integrated
Services Network shall report to the Regional Director of the Veterans
Integrated Services Network, and to the National Quality Management
Officer, regarding the discharge of the responsibilities and duties of
the officer under this section.
``(3) The quality management officer for a Veterans Integrated
Services Network shall--
``(A) direct the quality management office in the Network;
and
``(B) coordinate, monitor, and oversee the quality
management programs and activities of the Administration
medical facilities in the Network in order to ensure the
thorough and uniform discharge of quality management
requirements under such programs and activities throughout such
facilities.
``(c) Quality Management Officers for Medical Facilities.--(1) The
director of each Veterans Health Administration medical facility shall
appoint a quality management officer for that facility.
``(2) The quality management officer for a facility shall report
directly to the director of the facility, and to the quality management
officer of the Veterans Integrated Services Network in which the
facility is located, regarding the discharge of the responsibilities
and duties of the quality management officer under this section.
``(3) The quality management officer for a facility shall be
responsible for designing, disseminating, and implementing quality
management programs and activities for the facility that meet the
requirements established by the National Quality Management Officer
under subsection (a).
``(d) Authorization of Appropriations.--(1) Except as provided in
paragraph (2), there are authorized to be appropriated such sums as may
be necessary to carry out this section.
``(2) There are authorized to be appropriated to carry out the
provisions of subparagraphs (B), (C), and (D) of subsection (a)(3),
$25,000,000 for the two-year period of fiscal years beginning after the
date of the enactment of this section.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 73 is amended by inserting after the item
relating to section 7311 the following new item:
``7311A. Quality management officers.''.
(b) Reports on Quality Concerns Under Quality-Assurance Program.--
Section 7311(b) is amended by adding at the end the following new
paragraph:
``(4) As part of the quality-assurance program, the Under Secretary
for Health shall establish mechanisms through which employees of
Veterans Health Administration facilities may submit reports, on a
confidential basis, on matters relating to quality of care in Veterans
Health Administration facilities to the quality management officers of
such facilities under section 7311A(b) of this title. The mechanisms
shall provide for the prompt and thorough review of any reports so
submitted by the receiving officials.''.
(c) Review of Current Health Care Quality Safeguards.--
(1) In general.--The Secretary of Veterans Affairs shall
conduct a comprehensive review of all current policies and
protocols of the Department of Veterans Affairs for maintaining
health care quality and patient safety at Department medical
facilities. The review shall include a review and assessment of
the National Surgical Quality Improvement Program (NSQIP),
including an assessment of--
(A) the efficacy of the quality indicators under
the program;
(B) the efficacy of the data collection methods
under the program;
(C) the efficacy of the frequency with which
regular data analyses are performed under the program;
and
(D) the extent to which the resources allocated to
the program are adequate to fulfill the stated function
of the program.
(2) Report.--Not later than 60 days after the date of the
enactment of this Act, the Secretary shall submit to Congress a
report on the review conducted under paragraph (1), including
the findings of the Secretary as a result of the review and
such recommendations as the Secretary considers appropriate in
light of the review.
SEC. 208. REPORTS ON IMPROVEMENTS TO DEPARTMENT HEALTH CARE QUALITY
MANAGEMENT.
(a) Report.--Not later than December 15, 2009, and each year
thereafter through 2012, the Secretary of Veterans Affairs shall submit
to the congressional veterans affairs committees a report on the
implementation of sections 104 and 207 of this Act and the amendments
made by such sections during the preceding fiscal year. Each report
shall include, for the fiscal year covered by such report, the
following:
(1) A comprehensive description of the implementation of
sections 104 and 207 of this Act and the amendments made by
such sections.
(2) Such recommendations as the Secretary considers
appropriate for legislative or administrative action to improve
the authorities and requirements in such sections and the
amendments made by such sections or to otherwise improve the
quality of health care and the quality of the physicians in the
Veterans Health Administration.
(b) Congressional Veterans Affairs Committees Defined.--In this
section, the term ``congressional veterans affairs committees'' means--
(1) the Committees on Veterans' Affairs and Appropriations
of the Senate; and
(2) the Committees on Veterans' Affairs and Appropriations
of the House of Representatives.
SEC. 209. PILOT PROGRAM ON TRAINING AND CERTIFICATION FOR FAMILY
CAREGIVER PERSONAL CARE ATTENDANTS FOR VETERANS AND
MEMBERS OF THE ARMED FORCES WITH TRAUMATIC BRAIN INJURY.
(a) Pilot Program Authorized.--The Secretary of Veterans Affairs
shall, in collaboration with the Secretary of Defense, carry out a
pilot program to assess the feasibility and advisability of providing
training and certification for family caregivers of veterans and
members of the Armed Forces with traumatic brain injury as personal
care attendants of such veterans and members.
(b) Duration of Program.--The pilot program required by subsection
(a) shall be carried out during the three-year period beginning on the
date of the commencement of the pilot program.
(c) Locations.--
(1) In general.--The pilot program under this section shall
be carried out--
(A) in three medical facilities of the Department
of Veterans Affairs; and
(B) if determined appropriate by the Secretary of
Veterans Affairs and the Secretary of Defense, one
medical facility of the Department of Defense.
(2) Emphasis on polytrauma centers.--In selecting the
locations of the pilot program at facilities of the Department
of Veterans Affairs, the Secretary of Veterans Affairs shall
give special emphasis to the polytrauma centers of the
Department of Veterans Affairs designated as Tier I polytrauma
centers.
(d) Training Curricula.--
(1) In general.--The Secretary of Veterans Affairs shall
develop curricula for the training of personal care attendants
under the pilot program under this section. Such curricula
shall incorporate--
(A) applicable standards and protocols utilized by
certification programs of national brain injury care
specialist organizations; and
(B) best practices recognized by caregiving
organizations.
(2) Use of existing curricula.--In developing the curricula
required by paragraph (1), the Secretary of Veterans Affairs
shall, to the extent practicable, utilize and expand upon
training curricula developed pursuant to section 744(b) of the
John Warner National Defense Authorization Act for Fiscal Year
2007 (Public Law 109-364; 120 Stat. 2308).
(e) Participation in Programs.--
(1) In general.--The Secretary of Veterans Affairs shall
determine the eligibility of a family member of a veteran or
member of the Armed Forces for participation in the pilot
program under this section.
(2) Basis for determination.--A determination made under
paragraph (1) shall be based on the needs of the veteran or
member of the Armed Forces concerned, as determined by the
physician of such veteran or member.
(f) Eligibility for Compensation.--A family caregiver of a veteran
or member of the Armed Forces who receives certification as a personal
care attendant under the pilot program under this section shall be
eligible for compensation from the Department of Veterans Affairs for
care provided to such veteran or member.
(g) Costs of Training.--
(1) Training of families of veterans.--Any costs of
training provided under the pilot program under this section
for family members of veterans shall be borne by the Secretary
of Veterans Affairs.
(2) Training of families of members of the armed forces.--
The Secretary of Defense shall reimburse the Secretary of
Veterans Affairs for any costs of training provided under the
pilot program for family members of members of the Armed
Forces.
(h) Assessment of Family Caregiver Needs.--
(1) In general.--The Secretary of Veterans Affairs may
provide to a family caregiver who receives training under the
pilot program under this section--
(A) an assessment of their needs with respect to
their role as a family caregiver; and
(B) a referral to services and support that--
(i) are relevant to any needs identified in
such assessment; and
(ii) are provided in the community where
the family caregiver resides, including such
services and support provided by community-
based organizations, publicly funded programs,
and the Department of Veterans Affairs.
(2) Use of existing tools.--In developing and administering
an assessment under paragraph (1), the Secretary shall, to the
extent practicable, use and expand upon caregiver assessment
tools already developed and in use by the Department.
(i) Report.--Not later than 2 years after the date of the enactment
of this Act, the Secretary of Veterans Affairs shall submit to Congress
a report on the pilot program carried out under this section, including
the recommendations of the Secretary with respect to expansion or
modification of the pilot program.
(j) Construction.--Nothing in this section shall be construed--
(1) to establish a mandate or right for a family caregiver
to be trained and certified under this section; and
(2) to prohibit the Secretary from considering or adopting
the preference of a veteran or member of the Armed Forces for
services provided by a personal care attendant who is not a
family caregiver.
(k) Family Caregiver Defined.--In this section, with respect to
member of the Armed Forces or a veteran with traumatic brain injury,
the term ``family caregiver'' means a family member of such member or
veteran, or such other individual of similar affinity to such member or
veteran as the Secretary proscribes, who is providing care to such
member or veteran for such traumatic brain injury.
SEC. 210. PILOT PROGRAM ON PROVISION OF RESPITE CARE TO MEMBERS OF THE
ARMED FORCES AND VETERANS WITH TRAUMATIC BRAIN INJURY BY
STUDENTS IN GRADUATE PROGRAMS OF EDUCATION RELATED TO
MENTAL HEALTH OR REHABILITATION.
(a) Pilot Program Authorized.--The Secretary of Veterans Affairs
shall, in collaboration with the Secretary of Defense, carry out a
pilot program to assess the feasibility and advisability of providing
respite care to members of the Armed Forces and veterans described in
subsection (c) through students enrolled in graduate programs of
education described in subsection (d)(1) to provide--
(1) relief to the family caregivers of such members and
veterans from the responsibilities associated with providing
care to such members and veterans; and
(2) socialization and cognitive skill development to such
members and veterans.
(b) Duration of Program.--The pilot program required by subsection
(a) shall be carried out during the three-year period beginning on the
date of the commencement of the pilot program.
(c) Covered Members and Veterans.--The members of the Armed Forces
and veterans described in this subsection are the individuals as
follows:
(1) Members of the Armed Forces who have been diagnosed
with traumatic brain injury, including limitations of
ambulatory mobility, cognition, and verbal abilities.
(2) Veterans who have been so diagnosed.
(d) Program Locations.--
(1) In general.--The pilot program shall be carried out at
not more than 10 locations selected by the Secretary of
Veterans Affairs for purposes of the pilot program. Each
location so selected shall be a medical facility of the
Department of Veterans Affairs that is in close proximity to,
or that has a relationship, affiliation, or established
partnership with, an institution of higher education that has a
graduate program in an appropriate mental health or
rehabilitation related field, such as social work, nursing,
psychology, occupational therapy, physical therapy, or
interdisciplinary training programs.
(2) Considerations.--In selecting medical facilities of the
Department for the pilot program, the Secretary shall give
special consideration to the following:
(A) The polytrauma centers of the Department
designated as Tier I polytrauma centers.
(B) Facilities of the Department in regions with a
high concentration of veterans with traumatic brain
injury.
(e) Scope of Assistance.--
(1) Use of graduate students.--In carrying out the pilot
program, the Secretary shall--
(A) recruit students enrolled in a graduate program
of education selected by the Secretary under subsection
(d)(1) to provide respite care to the members of the
Armed Forces and veterans described in subsection (c);
(B) train such students to provide respite care to
such members and veterans; and
(C) match such students with such members and
veterans in the student's local area for the provision
of individualized respite care to such members and
veterans.
(2) Determinations in conjunction with heads of graduate
programs of education.--The Secretary shall determine, in
collaboration with the head of the graduate program of
education chosen to participate in the pilot program under
subsection (d)(1), the following:
(A) The amount of training that a student shall
complete before providing respite care under the pilot
program.
(B) The number of hours of respite care to be
provided by the students who participate in the pilot
program.
(C) The requirements for successful participation
by a student in the pilot program.
(f) Training Standards and Best Practices.--In providing training
under subsection (e)(1)(B), the Secretary shall use--
(1) applicable standards and protocols used by
certification programs of national brain injury care specialist
organizations in the provision of respite care training; and
(2) best practices recognized by caregiving organizations.
(g) Definitions.--In this section:
(1) Family caregiver.--With respect to member of the Armed
Forces or a veteran with traumatic brain injury, the term
``family caregiver'' means a relative, partner, or friend of
such member or veteran who is providing care to such member or
veteran for such traumatic brain injury.
(2) Respite care.--The term ``respite care'' means the
temporary provision of care to an individual to provide relief
to the regular caregiver of the individual from the ongoing
responsibility of providing care to such individual.
SEC. 211. PILOT PROGRAM ON USE OF COMMUNITY-BASED ORGANIZATIONS AND
LOCAL AND STATE GOVERNMENT ENTITIES TO ENSURE THAT
VETERANS RECEIVE CARE AND BENEFITS FOR WHICH THEY ARE
ELIGIBLE.
(a) Pilot Program Required.--The Secretary of Veterans Affairs
shall carry out a pilot program to assess the feasibility and
advisability of using community-based organizations and local and State
government entities--
(1) to increase the coordination of community, local,
State, and Federal providers of health care and benefits for
veterans to assist veterans who are transitioning from military
service to civilian life in such transition;
(2) to increase the availability of high quality medical
and mental health services to veterans transitioning from
military service to civilian life;
(3) to provide assistance to families of veterans who are
transitioning from military service to civilian life to help
such families adjust to such transition; and
(4) to provide outreach to veterans and their families to
inform them about the availability of benefits and connect them
with appropriate care and benefit programs.
(b) Duration of Program.--The pilot program shall be carried out
during the two-year period beginning on the date of the enactment of
this Act.
(c) Program Locations.--
(1) In general.--The pilot program shall be carried out at
five locations selected by the Secretary for purposes of the
pilot program.
(2) Considerations.--In selecting locations for the pilot
program, the Secretary shall consider the advisability of
selecting locations in--
(A) rural areas;
(B) areas with populations that have a high
proportion of minority group representation;
(C) areas with populations that have a high
proportion of individuals who have limited access to
health care; and
(D) areas that are not in close proximity to an
active duty military installation.
(d) Grants.--The Secretary shall carry out the pilot program
through the award of grants to community-based organizations and local
and State government entities.
(e) Selection of Grant Recipients.--
(1) In general.--A community-based organization or local or
State government entity seeking a grant under the pilot program
shall submit to the Secretary of Veterans Affairs an
application therefor in such form and in such manner as the
Secretary considers appropriate.
(2) Elements.--Each application submitted under paragraph
(1) shall include the following:
(A) A description of how the proposal was developed
in consultation with the Department of Veterans
Affairs.
(B) A plan to coordinate activities under the pilot
program, to the greatest extent possible, with the
local, State, and Federal providers of services for
veterans to reduce duplication of services and to
increase the effect of such services.
(f) Use of Grant Funds.--The Secretary shall prescribe appropriate
uses of grant funds received under the pilot program.
(g) Report on Program.--
(1) In general.--Not later than 180 days after the
completion of the pilot program, the Secretary shall submit to
Congress a report on the pilot program.
(2) Elements.--The report required by paragraph (1) shall
include the following:
(A) The findings and conclusions of the Secretary
with respect to the pilot program.
(B) An assessment of the benefits to veterans of
the pilot program.
(C) The recommendations of the Secretary as to the
advisability of continuing the pilot program.
SEC. 212. SPECIALIZED RESIDENTIAL CARE AND REHABILITATION FOR CERTAIN
VETERANS.
Section 1720 is amended by adding at the end the following new
subsection:
``(g) The Secretary may contract with appropriate entities to
provide specialized residential care and rehabilitation services to a
veteran of Operation Enduring Freedom or Operation Iraqi Freedom who
the Secretary determines suffers from a traumatic brain injury, has an
accumulation of deficits in activities of daily living and instrumental
activities of daily living, and because of these deficits, would
otherwise require admission to a nursing home even though such care
would generally exceed the veteran's nursing needs.''.
SEC. 213. AUTHORITY TO DISCLOSE MEDICAL RECORDS TO THIRD PARTY FOR
COLLECTION OF CHARGES FOR PROVISION OF CERTAIN CARE.
(a) Limited Exception to Confidentiality of Medical Records.--
Section 5701 is amended by adding at the end the following new
subsection:
``(l) Under regulations that the Secretary shall prescribe, the
Secretary may disclose the name or address, or both, of any individual
who is a present or former member of the Armed Forces, or who is a
dependent of a present or former member of the Armed Forces, to a third
party, as defined in section 1729(i)(3)(D) of this title, in order to
enable the Secretary to collect reasonable charges under section
1729(a)(2)(E) of this title for care or services provided for a non-
service-connected disability.''.
(b) Disclosures From Certain Medical Records.--Section 7332(b)(2),
as amended by section 205 of this Act, is further amended by adding at
the end the following new subparagraph:
``(G) To a third party, as defined in section 1729(i)(3)(D)
of this title, to collect reasonable charges under section
1729(a)(2)(E) of this title for care or services provided for a
non-service-connected disability.''.
SEC. 214. EXPANDED STUDY ON THE HEALTH IMPACT OF PROJECT SHIPBOARD
HAZARD AND DEFENSE.
(a) In General.--Not later than 90 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall enter
into a contract with the Institute of Medicine of the National
Academies to conduct an expanded study on the health impact of Project
Shipboard Hazard and Defense (Project SHAD).
(b) Covered Veterans.--The study required by subsection (a) shall
include, to the extent practicable, all veterans who participated in
Project Shipboard Hazard and Defense.
(c) Utilization of Existing Studies.--The study required by
subsection (a) may use results from the study covered in the report
entitled ``Long-Term Health Effects of Participation in Project SHAD''
of the Institute of Medicine of the National Academies.
SEC. 215. USE OF NON-DEPARTMENT FACILITIES FOR REHABILITATION OF
INDIVIDUALS WITH TRAUMATIC BRAIN INJURY.
Section 1710E is amended--
(1) by redesignating subsection (b) as subsection (c);
(2) by inserting after subsection (a) the following new
subsection (b):
``(b) Covered Individuals.--The care and services provided under
subsection (a) shall be made available to an individual--
``(1) who is described in section 1710C(a) of this title;
and
``(2)(A) to whom the Secretary is unable to provide such
treatment or services at the frequency or for the duration
prescribed in such plan; or
``(B) for whom the Secretary determines that it is optimal
with respect to the recovery and rehabilitation for such
individual.''; and
(3) by adding at the end the following new subsection:
``(d) Standards.--The Secretary may not provide treatment or
services as described in subsection (a) at a non-Department facility
under such subsection unless such facility maintains standards for the
provision of such treatment or services established by an independent,
peer-reviewed organization that accredits specialized rehabilitation
programs for adults with traumatic brain injury.''.
SEC. 216. INCLUSION OF FEDERALLY RECOGNIZED TRIBAL ORGANIZATIONS IN
CERTAIN PROGRAMS FOR STATE VETERANS HOMES.
(a) Treatment of Tribal Organization Health Facilities as State
Homes.--Section 8138 is amended--
(1) by redesignating subsection (e) as subsection (f); and
(2) by inserting after subsection (d) the following new
subsection (e):
``(e)(1) A health facility (or certain beds in a health facility)
of a tribal organization is treatable as a State home under subsection
(a) in accordance with the provisions of that subsection.
``(2) Except as provided in paragraph (3), the provisions of this
section shall apply to a health facility (or certain beds in such
facility) treated as a State home under subsection (a) by reason of
this subsection to the same extent as health facilities (or beds)
treated as a State home under subsection (a).
``(3) Subsection (f) shall not apply to the treatment of health
facilities (or certain beds in such facilities) of tribal organizations
as a State home under subsection (a).''.
(b) State Home Facilities for Domiciliary, Nursing, and Other
Care.--
(1) In general.--Chapter 81 is further amended--
(A) in section 8131, by adding at the end the
following new paragraph:
``(5) The term `tribal organization' has the meaning given
such term in section 3765 of this title.'';
(B) in section 8132, by inserting ``and tribal
organizations'' after ``the several States''; and
(C) by inserting after section 8133 the following
new section:
``Sec. 8133A. Tribal organizations
``(a) Authority To Award Grants.--The Secretary may award a grant
to a tribal organization under this subchapter in order to carry out
the purposes of this subchapter.
``(b) Manner and Condition of Grant Awards.--(1) Grants to tribal
organizations under this section shall be awarded in the same manner,
and under the same conditions, as grants awarded to the several States
under the provisions of this subchapter, subject to such exceptions as
the Secretary shall prescribe for purposes of this subchapter to take
into account the unique circumstances of tribal organizations.
``(2) For purposes of according priority under subsection (c)(2) of
section 8135 of this title to an application submitted under subsection
(a) of such section, an application submitted under such subsection (a)
by a tribal organization of a State that has previously applied for
award of a grant under this subchapter for construction or acquisition
of a State nursing home shall be considered under subparagraph (C) of
such subsection (c)(2) an application from a tribal organization that
has not previously applied for such a grant.''.
(2) Clerical amendment.--The table of sections at the
beginning of chapter 81 is amended by inserting after the item
relating to section 8133 the following new item:
``8133A. Tribal organizations.''.
SEC. 217. PILOT PROGRAM ON PROVISION OF DENTAL INSURANCE PLANS TO
VETERANS AND SURVIVORS AND DEPENDENTS OF VETERANS.
(a) Pilot Program Required.--The Secretary of Veterans Affairs
shall carry out a pilot program to assess the feasibility and
advisability of providing a dental insurance plan to veterans and
survivors and dependents of veterans described in subsection (b).
(b) Covered Veterans and Survivors and Dependents.--The veterans
and survivors and dependents of veterans described in this subsection
are as follows:
(1) Any veteran who is enrolled in the system of annual
patient enrollment under section 1705 of this title.
(2) Any survivor or dependent of a veteran who is eligible
for medical care under section 1781 of this title.
(c) Duration of Program.--The pilot program shall be carried out
during the three-year period beginning on the date of the enactment of
this Act.
(d) Pilot Program Locations.--The pilot program shall be carried
out in not less than two and not more than four Veterans Integrated
Services Networks (VISNs) selected by the Secretary of Veterans Affairs
for purposes of the pilot program.
(e) Administration.--The Secretary of Veterans Affairs shall
contract with a dental insurer to administer the dental plan provided
under the pilot program.
(f) Benefits.--The dental insurance plan under the pilot program
shall provide such benefits for dental care and treatment as the
Secretary considers appropriate for the dental insurance plan,
including diagnostic services, preventative services, endodontics and
other restorative services, surgical services, and emergency services.
(g) Enrollment.--
(1) Voluntary.--Enrollment in the dental insurance plan
under this section shall be voluntary.
(2) Minimum period.--Enrollment in the dental insurance
plan shall be for such minimum period as the Secretary shall
prescribe for purposes of this section.
(h) Premiums.--
(1) In general.--Premiums for coverage under the dental
insurance plan under the pilot program shall be in such amount
or amounts as the Secretary of Veterans Affairs shall prescribe
to cover all costs associated with the pilot program.
(2) Annual adjustment.--The Secretary shall adjust the
premiums payable under the pilot program for coverage under the
dental insurance plan on an annual basis. Each individual
covered by the dental insurance plan at the time of such an
adjustment shall be notified of the amount and effective date
of such adjustment.
(3) Responsibility for payment.--Each individual covered by
the dental insurance plan shall pay the entire premium for
coverage under the dental insurance plan, in addition to the
full cost of any copayments.
(i) Voluntary Disenrollment.--
(1) In general.--With respect to enrollment in the dental
insurance plan under the pilot program, the Secretary shall--
(A) permit the voluntary disenrollment of an
individual in the dental insurance plan if the
disenrollment occurs during the 30-day period beginning
on the date of the enrollment of the individual in the
dental insurance plan; and
(B) permit the voluntary disenrollment of an
individual in the dental insurance plan for such
circumstances as the Secretary shall prescribe for
purposes of this subsection, but only to the extent
such disenrollment does not jeopardize the fiscal
integrity of the dental insurance plan.
(2) Allowable circumstances.--The circumstances prescribed
under paragraph (1)(B) shall include the following:
(A) If an individual enrolled in the dental
insurance plan relocates to a location outside the
jurisdiction of the dental insurance plan that prevents
utilization of the benefits under the dental insurance
plan.
(B) If an individual enrolled in the dental
insurance plan is prevented by a serious medical
condition from being able to obtain benefits under the
dental insurance plan.
(C) Such other circumstances as the Secretary shall
prescribe for purposes of this subsection.
(3) Establishment of procedures.--The Secretary shall
establish procedures for determinations on the permissibility
of voluntary disenrollments under paragraph (1)(B). Such
procedures shall ensure timely determinations on the
permissibility of such disenrollments.
(j) Relationship to Dental Care Provided by Secretary.--Nothing in
this section shall affect the responsibility of the Secretary to
provide dental care under section 1712 of title 38, United States Code,
and the participation of an individual in the dental insurance plan
under the pilot program shall not affect the individual's entitlement
to outpatient dental services and treatment, and related dental
appliances, under that section.
(k) Regulations.--The dental insurance plan under the pilot program
shall be administered under such regulations as the Secretary shall
prescribe.
TITLE III--WOMEN VETERANS HEALTH CARE
SEC. 301. REPORT ON BARRIERS TO RECEIPT OF HEALTH CARE FOR WOMEN
VETERANS.
(a) Report.--Not later than June 1, 2010, the Secretary of Veterans
Affairs shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives a report on the barriers to the receipt of
comprehensive health care through the Department of Veterans Affairs
that are encountered by women veterans, especially veterans of
Operation Iraqi Freedom and Operation Enduring Freedom.
(b) Elements.--The report required by subsection (a) shall include
the following:
(1) An identification and assessment of the following:
(A) Any stigma perceived or associated with seeking
mental health care services through the Department of
Veterans Affairs.
(B) The effect on access to care through the
Department of driving distance or availability of other
forms of transportation to the nearest appropriate
facility of the Department.
(C) The availability of child care.
(D) The receipt of health care through women's
health clinics, integrated primary care clinics, or
both.
(E) The extent of comprehension of eligibility
requirements for health care through the Department,
and the scope of health care services available through
the Department.
(F) The quality and nature of the reception of
women veterans by Department health care providers and
other staff.
(G) The perception of personal safety and comfort
of women veterans in inpatient, outpatient, and
behavioral health facilities of the Department.
(H) The sensitivity of Department health care
providers and other staff to issues that particularly
affect women.
(I) The effectiveness of outreach on health care
services of the Department that are available to women
veterans.
(J) Such other matters as the Secretary identifies
for purposes of the assessment.
(2) Such recommendations for administrative and legislative
action as the Secretary considers appropriate in light of the
report.
(c) Facility of the Department Defined.--In this section, the term
``facility of the Department'' has the meaning given that term in
section 1701 of title 38, United States Code.
SEC. 302. PLAN TO IMPROVE PROVISION OF HEALTH CARE SERVICES TO WOMEN
VETERANS.
(a) Plan To Improve Services.--
(1) In general.--The Secretary of Veterans Affairs shall
develop a plan--
(A) to improve the provision of health care
services to women veterans; and
(B) to plan appropriately for the future health
care needs, including mental health care needs, of
women serving on active duty in the Armed Forces in the
combat theaters of Operation Iraqi Freedom and
Operation Enduring Freedom.
(2) Required actions.--In developing the plan required by
this subsection, the Secretary of Veterans Affairs shall--
(A) identify the types of health care services to
be available to women veterans at each Department of
Veterans Affairs medical center; and
(B) identify the personnel and other resources
required to provide such services to women veterans
under the plan at each such medical center.
(b) Submittal of Plan to Congress.--Not later than 18 months after
the date of the enactment of this Act, the Secretary of Veterans
Affairs shall submit to the Committee on Veterans' Affairs of the
Senate and the Committee on Veterans' Affairs of the House of
Representatives the plan required by this section, along with such
recommendations for administrative and legislative action as the
Secretary considers appropriate in light of the plan.
SEC. 303. INDEPENDENT STUDY ON HEALTH CONSEQUENCES OF WOMEN VETERANS OF
MILITARY SERVICE IN OPERATION IRAQI FREEDOM AND OPERATION
ENDURING FREEDOM.
(a) Study Required.--The Secretary of Veterans Affairs shall enter
into an agreement with a non-Department of Veterans Affairs entity for
the purpose of conducting a study on health consequences for women
veterans of service on active duty in the Armed Forces in deployment in
Operation Iraqi Freedom and Operation Enduring Freedom.
(b) Specific Matters Studied.--The study under subsection (a) shall
include the following:
(1) A determination of any association of environmental and
occupational exposures and combat in Operation Iraqi Freedom or
Operation Enduring Freedom with the general health, mental
health, or reproductive health of women who served on active
duty in the Armed Forces in Operation Iraqi Freedom or
Operation Enduring Freedom.
(2) A review and analysis of published literature on
environmental and occupational exposures of women while serving
in the Armed Forces, including combat trauma, military sexual
trauma, and exposure to potential teratogens associated with
reproductive problems and birth defects.
(c) Report.--
(1) In general.--Not later than 18 months after entering
into the agreement for the study under subsection (a), the
entity described in subsection (a) shall submit to the
Secretary of Veterans Affairs and to Congress a report on the
study containing such findings and determinations as the entity
considers appropriate.
(2) Responsive report.--Not later than 90 days after the
receipt of the report under paragraph (1), the Secretary shall
submit to Congress a report setting forth the response of the
Secretary to the findings and determinations of the entity
described in subsection (a) in the report under paragraph (1).
SEC. 304. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE PROVIDERS
ON CARE FOR VETERANS SUFFERING FROM SEXUAL TRAUMA.
(a) Program Required.--Section 1720D is amended--
(1) by redesignating subsection (d) as subsection (f); and
(2) by inserting after subsection (c) the following new
subsections:
``(d)(1) The Secretary shall implement a program for education,
training, certification, and continuing medical education for mental
health professionals to specialize in the provision of counseling and
care to veterans eligible for services under subsection (a). In
carrying out the program, the Secretary shall ensure that all such
mental health professionals have been trained in a consistent manner
and that such training includes principles of evidence-based treatment
and care for sexual trauma.
``(2) The Secretary shall determine the minimum qualifications
necessary for mental health professionals certified by the program
under paragraph (1) to provide evidence-based treatment and therapy to
veterans eligible for services under subsection (a) in facilities of
the Department.
``(e) The Secretary shall submit to Congress each year a report on
the counseling, care, and services provided to veterans under this
section. Each report shall include data for the preceding year with
respect to the following:
``(1) The number of mental health professionals and primary
care providers who have been certified under the program under
subsection (d), and the amount and nature of continuing medical
education provided under such program to professionals and
providers who have been so certified.
``(2) The number of women veterans who received counseling,
care, and services under subsection (a) from professionals and
providers who have been trained or certified under the program
under subsection (d).
``(3) The number of training, certification, and continuing
medical education programs operating under subsection (d).
``(4) The number of trained full-time equivalent employees
required in each facility of the Department to meet the needs
of veterans requiring treatment and care for sexual trauma.
``(5) Such other information as the Secretary considers
appropriate.''.
(b) Standards for Personnel Providing Treatment for Sexual
Trauma.--The Secretary of Veterans Affairs shall establish education,
training, certification, and staffing standards for Department of
Veterans Affairs health-care facilities for full-time equivalent
employees who are trained to provide treatment and care to veterans for
sexual trauma.
SEC. 305. PILOT PROGRAM ON COUNSELING IN RETREAT SETTINGS FOR WOMEN
VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED
FORCES.
(a) Pilot Program Required.--
(1) In general.--Commencing not later than 180 days after
the date of the enactment of this Act, the Secretary of
Veterans Affairs shall carry out, through the Readjustment
Counseling Service of the Veterans Health Administration, a
pilot program to evaluate the feasibility and advisability of
providing reintegration and readjustment services described in
subsection (b) in group retreat settings to women veterans who
are recently separated from service in the Armed Forces after a
prolonged deployment.
(2) Participation at election of veteran.--The
participation of a veteran in the pilot program under this
section shall be at the election of the veteran.
(b) Covered Services.--The services provided to a woman veteran
under the pilot program shall include the following:
(1) Information on reintegration into the veteran's family,
employment, and community.
(2) Financial counseling.
(3) Occupational counseling.
(4) Information and counseling on stress reduction.
(5) Information and counseling on conflict resolution.
(6) Such other information and counseling as the Secretary
considers appropriate to assist a woman veteran under the pilot
program in reintegration into the veteran's family and
community.
(c) Locations.--The Secretary shall carry out the pilot program at
not fewer than five locations selected by the Secretary for purposes of
the pilot program.
(d) Duration.--The pilot program shall be carried out during the
two-year period beginning on the date of the commencement of the pilot
program.
(e) Report.--Not later than 180 days after the completion of the
pilot program, the Secretary shall submit to Congress a report on the
pilot program. The report shall contain the findings and conclusions of
the Secretary as a result of the pilot program, and shall include such
recommendations for the continuation or expansion of the pilot program
as the Secretary considers appropriate.
(f) Authorization of Appropriations.--There are authorized to be
appropriated to the Secretary of Veterans Affairs for each of fiscal
years 2010 and 2011, $2,000,000 to carry out the pilot program.
SEC. 306. REPORT ON FULL-TIME WOMEN VETERANS PROGRAM MANAGERS AT
MEDICAL CENTERS.
The Secretary shall, acting through the Under Secretary for Health,
submit to Congress a report on employment of full-time women veterans
program managers at Department of Veterans Affairs medical centers to
ensure that health care needs of women veterans are met. Such report
should include an assessment of whether there is at least one full-time
employee at each Department medical center who is a full-time women
veterans program manager.
SEC. 307. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN RECENTLY
SEPARATED FROM SERVICE IN THE ARMED FORCES.
(a) Advisory Committee on Women Veterans.--Section 542(a)(2)(A) is
amended--
(1) in clause (ii), by striking ``and'' at the end;
(2) in clause (iii), by striking the period at the end and
inserting ``; and''; and
(3) by inserting after clause (iii) the following new
clause:
``(iv) women veterans who are recently separated from
service in the Armed Forces.''.
(b) Advisory Committee on Minority Veterans.--Section 544(a)(2)(A)
is amended--
(1) in clause (iii), by striking ``and'' at the end;
(2) in clause (iv), by striking the period at the end and
inserting ``; and''; and
(3) by inserting after clause (iv) the following new
clause:
``(v) women veterans who are minority group members and are
recently separated from service in the Armed Forces.''.
(c) Effective Date.--The amendments made by this section shall
apply to appointments made on or after the date of the enactment of
this Act.
SEC. 308. PILOT PROGRAM ON SUBSIDIES FOR CHILD CARE FOR CERTAIN
VETERANS RECEIVING HEALTH CARE.
(a) Pilot Program Required.--The Secretary of Veterans Affairs
shall carry out a pilot program to assess the feasibility and
advisability of providing, subject to subsection (b), subsidies to
qualified veterans described in subsection (c) to obtain child care so
that such veterans can receive health care services described in such
subsection.
(b) Limitation on Period of Payments.--A subsidy may only be
provided to a qualified veteran under the pilot program for receipt of
child care during the period that the qualified veteran--
(1) receives the types of health care services referred to
in subsection (c) at a facility of the Department; and
(2) requires to travel to and return from such facility for
the receipt of such health care services.
(c) Qualified Veterans.--In this section, the term ``qualified
veteran'' means a veteran who is the primary caretaker of a child or
children and who is receiving from the Department one or more of the
following health care services:
(1) Regular mental health care services.
(2) Intensive mental health care services.
(3) Such other intensive health care services that the
Secretary determines that payment to the veteran for the
provision of child care would improve access to those health
care services by the veteran.
(d) Locations.--The Secretary shall carry out the pilot program in
no fewer than three Veterans Integrated Service Networks (VISNs)
selected by the Secretary for purposes of the pilot program.
(e) Duration.--The pilot program shall be carried out during the
two-year period beginning on the date of the commencement of the pilot
program.
(f) Existing Model.--To the extent practicable, the Secretary shall
model the pilot program after the Department of Veterans Affairs Child
Care Subsidy Program that was established pursuant to section 630 of
the Treasury and General Government Appropriations Act, 2002 (Public
Law 107-67; 115 Stat. 552), using the same income eligibility standards
and payment structure.
(g) Report.--Not later than six months after the completion of the
pilot program, the Secretary shall submit to Congress a report on the
pilot program. The report shall include the findings and conclusions of
the Secretary as a result of the pilot program, and shall include such
recommendations for the continuation or expansion of the pilot program
as the Secretary considers appropriate.
(h) Authorization of Appropriations.--There are authorized to be
appropriated to the Secretary of Veterans Affairs for each of fiscal
years 2010 and 2011, $1,500,000 to carry out the pilot program.
SEC. 309. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING
MATERNITY CARE.
(a) In General.--Subchapter VIII of chapter 17 is amended by adding
at the end the following new section:
``SEC. 1786. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING
MATERNITY CARE.
``(a) In General.--The Secretary may furnish health care services
described in subsection (b) to a newborn child of a woman veteran who
is receiving maternity care furnished by the Department for not more
than 7 days after the birth of the child if the veteran delivered the
child in--
``(1) a facility of the Department; or
``(2) another facility pursuant to a Department contract
for services relating to such delivery.
``(b) Covered Health Care Services.--Health care services described
in this subsection are all post-delivery care services, including
routine care services, that a newborn requires.''.
(b) Clerical Amendment.--The table of sections at the beginning of
chapter 17 is amended by inserting after the item relating to section
1785 the following new item:
``1786. Care for newborn children of women veterans receiving maternity
care.''.
TITLE IV--MENTAL HEALTH CARE
SEC. 401. ELIGIBILITY OF MEMBERS OF THE ARMED FORCES WHO SERVE IN
OPERATION IRAQI FREEDOM OR OPERATION ENDURING FREEDOM FOR
COUNSELING AND SERVICES THROUGH READJUSTMENT COUNSELING
SERVICE.
(a) In General.--Any member of the Armed Forces, including a member
of the National Guard or Reserve, who serves on active duty in the
Armed Forces in Operation Iraqi Freedom or Operation Enduring Freedom
is eligible for readjustment counseling and related mental health
services under section 1712A of title 38, United States Code, through
the Readjustment Counseling Service of the Veterans Health
Administration.
(b) No Requirement for Current Active Duty Service.--A member of
the Armed Forces who meets the requirements for eligibility for
counseling and services under subsection (a) is entitled to counseling
and services under that subsection regardless of whether or not the
member is currently on active duty in the Armed Forces at the time of
receipt of counseling and services under that subsection.
(c) Regulations.--The eligibility of members of the Armed Forces
for counseling and services under subsection (a) shall be subject to
such regulations as the Secretary of Defense and the Secretary of
Veterans Affairs shall jointly prescribe for purposes of this section.
(d) Subject to Availability of Appropriations.--The provision of
counseling and services under subsection (a) shall be subject to the
availability of appropriations for such purpose.
SEC. 402. RESTORATION OF AUTHORITY OF READJUSTMENT COUNSELING SERVICE
TO PROVIDE REFERRAL AND OTHER ASSISTANCE UPON REQUEST TO
FORMER MEMBERS OF THE ARMED FORCES NOT AUTHORIZED
COUNSELING.
Section 1712A is amended--
(1) by redesignating subsections (c) through (f) as
subsections (d) through (g), respectively; and
(2) by inserting after subsection (b) the following new
subsection (c):
``(c) Upon receipt of a request for counseling under this section
from any individual who has been discharged or released from active
military, naval, or air service but who is not otherwise eligible for
such counseling, the Secretary shall--
``(1) provide referral services to assist such individual,
to the maximum extent practicable, in obtaining mental health
care and services from sources outside the Department; and
``(2) if pertinent, advise such individual of such
individual's rights to apply to the appropriate military,
naval, or air service, and to the Department, for review of
such individual's discharge or release from such service.''.
SEC. 403. STUDY ON SUICIDES AMONG VETERANS.
(a) Study Required.--The Secretary of Veterans Affairs shall
conduct a study to determine the number of veterans who died by suicide
between January 1, 1997, and the date of the enactment of this Act.
(b) Coordination.--In carrying out the study under subsection (b)
the Secretary of Veterans Affairs shall coordinate with--
(1) the Secretary of Defense;
(2) Veterans Service Organizations;
(3) the Centers for Disease Control and Prevention; and
(4) State public health offices and veterans agencies.
(c) Report to Congress.--The Secretary of Veterans Affairs shall
submit to the Committee on Veterans' Affairs of the Senate and the
Committee on Veterans' Affairs of the House of Representatives a report
on the study required under subsection (b) and the findings of the
Secretary.
(d) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 404. TRANSFER OF FUNDS TO SECRETARY OF HEALTH AND HUMAN SERVICES
FOR GRADUATE PSYCHOLOGY EDUCATION PROGRAM.
(a) Transfer of Funds.--Not later than September 30, 2010, the
Secretary of Veterans Affairs shall transfer $5,000,000 from accounts
of the Veterans Health Administration to the Secretary of Health and
Human Services for the Graduate Psychology Education program
established under section 755(b)(1)(J) of the Public Health Service Act
(42 U.S.C. 294e(b)(1)(J)).
(b) Use of Funds Transferred.--Funds transferred under subsection
(a) shall be used to award grants to support the training of
psychologists in the treatment of veterans with post traumatic stress
disorder, traumatic brain injury, and other combat-related disorders.
(c) Preference for Department of Veterans Affairs Health Care
Facilities.--In the awarding of grants under subsection (b), the
Graduate Psychology Education program shall give preference to health
care facilities of the Department of Veterans Affairs and graduate
programs of education that are affiliated with such facilities.
TITLE V--HOMELESS VETERANS
SEC. 501. PILOT PROGRAM ON FINANCIAL SUPPORT FOR ENTITIES THAT
COORDINATE THE PROVISION OF SUPPORTIVE SERVICES TO
FORMERLY HOMELESS VETERANS RESIDING ON CERTAIN MILITARY
PROPERTY.
(a) Establishment.--
(1) In general.--Subject to the availability of
appropriations for such purpose, the Secretary of Veterans
Affairs may carry out a pilot program to make grants to public
and nonprofit organizations (including faith-based and
community organizations) to coordinate the provision of
supportive services available in the local community to very
low income, formerly homeless veterans residing in permanent
housing that is located on qualifying property described in
subsection (b).
(2) Number of grants.--The Secretary may make grants at up
to 10 qualifying properties under the pilot program.
(b) Qualifying Property.--Qualifying property under the pilot
program is property that--
(1) was part of a military installation that was closed in
accordance with--
(A) decisions made as part of the 2005 round of
defense base closure and realignment under the Defense
Base Closure and Realignment Act of 1990 (part A of
title XXIX of Public Law 101-510; 10 U.S.C. 2687 note);
and
(B) subchapter III of chapter 5 of title 40, United
States Code; and
(2) the Secretary of Defense determines, after considering
any redevelopment plans of any local redevelopment authority
relating to such property, may be used to assist the homeless
in accordance with such redevelopment plan.
(c) Criteria for Grants.--The Secretary shall prescribe criteria
and requirements for grants under this section and shall publish such
criteria and requirements in the Federal Register.
(d) Duration of Program.--The authority of the Secretary to provide
grants under a pilot program under this section shall cease on the date
that is five years after the date of the commencement of the pilot
program.
(e) Very Low Income Defined.--In this section, the term ``very low
income'' has the meaning given that term in the Resident
Characteristics Report issued annually by the Department of Housing and
Urban Development.
(f) Authorization of Appropriations.--There is authorized to be
appropriated from amounts made available under the heading ``General
Operating Expenses'', not more than $3,000,000 in each of fiscal years
2010 through 2014 to carry out the purposes of this section.
SEC. 502. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT
COORDINATE THE PROVISION OF SUPPORTIVE SERVICES TO
FORMERLY HOMELESS VETERANS RESIDING IN PERMANENT HOUSING.
(a) Establishment of Pilot Program.--
(1) In general.--Subject to the availability of
appropriations for such purpose, the Secretary of Veterans
Affairs may carry out a pilot program to make grants to public
and nonprofit organizations (including faith-based and
community organizations) to coordinate the provision of
supportive services available in the local community to very
low income, formerly homeless veterans residing in permanent
housing.
(2) Number of grants.--The Secretary may make grants at up
to 10 qualifying properties under the pilot program.
(b) Qualifying Property.--Qualifying property under the pilot
program is any property in the United States on which permanent housing
is provided or afforded to formerly homeless veterans, as determined by
the Secretary.
(c) Criteria for Grants.--The Secretary shall prescribe criteria
and requirements for grants under this section and shall publish such
criteria and requirements in the Federal Register.
(d) Duration of Pilot Program.--The authority of the Secretary to
provide grants under a pilot program under this section shall cease on
the date that is five years after the date of the commencement of the
pilot program.
(e) Very Low Income Defined.--In this section, the term ``very low
income'' has the meaning given that term in the Resident
Characteristics Report issued annually by the Department of Housing and
Urban Development.
(f) Authorization of Appropriations.--There is authorized to be
appropriated from amounts made available under the heading ``General
Operating Expenses'', not more than $3,000,000 in each of fiscal years
2010 through 2014 to carry out the purposes of this section.
SEC. 503. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT PROVIDE
OUTREACH TO INFORM CERTAIN VETERANS ABOUT PENSION
BENEFITS.
(a) Authority To Make Grants.--In addition to the outreach
authority provided to the Secretary of Veterans Affairs by section 6303
of title 38, United States Code, the Secretary may carry out a pilot
program to make grants to public and nonprofit organizations (including
faith-based and community organizations) for services to provide
outreach to inform low-income and elderly veterans and their spouses
who reside in rural areas of benefits for which they may be eligible
under chapter 15 of such title.
(b) Criteria for Grants.--The Secretary shall prescribe criteria
and requirements for grants under this section and shall publish such
criteria and requirements in the Federal Register.
(c) Duration of Pilot Program.--The authority of the Secretary to
provide grants under a pilot program under this section shall cease on
the date that is five years after the date of the commencement of the
pilot program.
(d) Authorization of Appropriations.--There is authorized to be
appropriated from amounts made available under the heading ``General
Operating Expenses'', not more than $1,275,000 in each of fiscal years
2010 through 2014 to carry out the purposes of this section.
SEC. 504. PILOT PROGRAM ON FINANCIAL SUPPORT OF ENTITIES THAT PROVIDE
TRANSPORTATION ASSISTANCE, CHILD CARE ASSISTANCE, AND
CLOTHING ASSISTANCE TO VETERANS ENTITLED TO A
REHABILITATION PROGRAM.
(a) Pilot Program Authorized.--
(1) In general.--Subject to the availability of
appropriations authorized under subsection (g), the Secretary
of Veterans Affairs may carry out a pilot program to assess the
feasibility and advisability of providing financial assistance
to eligible entities to establish new programs or activities,
or expand or modify existing programs or activities, to provide
to each eligible transitioning individual who is entitled and
eligible for a rehabilitation program under chapter 31 of title
38, United States Code, the following assistance:
(A) Transportation assistance to facilitate such
eligible transitioning individual's participation in
such rehabilitation program or related activity. Such
assistance may include--
(i) providing transportation;
(ii) paying for or reimbursing
transportation costs; and
(iii) paying for or reimbursing other
transportation-related expenses (including
orientation on the use of transportation).
(B) Child care assistance to facilitate such
eligible transitioning individual's participation in
such rehabilitation program or related activity. Such
assistance may include--
(i) child care services; or
(ii) reimbursement of expenses related to
child care.
(C) Clothing assistance, which may include personal
services in selecting, and payment of a monetary
allowance to cover the cost of purchasing, clothing and
accessories suitable for a job interview or related
activity consistent with such eligible transitioning
individual's participation in such rehabilitation
program or related activity.
(2) Eligible transitioning individual.--For purposes of
this section, an eligible transitioning individual is a
person--
(A) described in section 3102 of title 38, United
States Code; or
(B) who was separated or released from active duty
in the Armed Forces on or after October 1, 2006,
because of a service-connected disability.
(b) Duration of Program.--The authority of the Secretary to provide
grants under a pilot program established under subsection (a)(1) shall
cease on the date that is three years after the date of the
commencement of the pilot program.
(c) Grants.--
(1) In general.--The Secretary of Veterans Affairs shall
carry out the pilot program through the award of grants to
eligible entities to establish new programs or activities, or
to expand or modify existing programs or activities, as
described in subsection (a)(1).
(2) Grant criteria.--
(A) In general.--The Secretary shall establish
criteria and requirements for grants under the pilot
program, including criteria for eligible entities to
receive such grants. The criteria established under
this subparagraph shall include the following:
(i) Specification as to the kinds of
projects or activities for which grants are
available.
(ii) Specification as to the number of
projects or activities for which grants are
available.
(iii) Provisions to ensure that grants
awarded under the pilot program do not result
in duplication of ongoing services.
(B) Publication of criteria in federal register.--
The Secretary shall publish the criteria and
requirements established under subparagraph (A) in the
Federal Register.
(3) Funding limitation.--A grant under the pilot program
may not be used to support the operational costs of an eligible
entity.
(d) Eligible Entities.--For purposes of this section, an eligible
entity is a public or nonprofit organization (including a faith-based
or community organization) that--
(1) has the capacity to administer effectively a grant
under the pilot program, as determined by the Secretary of
Veterans Affairs;
(2) demonstrates that adequate financial support will be
available to establish new programs or activities, or to expand
or modify existing programs or activities, as described in
subsection (a)(1) consistent with the plans, specifications,
and schedule submitted by the applicant to the Secretary under
subsection (e)(2);
(3) agrees to meet the applicable criteria and requirements
established under subsection (c)(2) and described in subsection
(e)(2)(C); and
(4) has the capacity, as determined by the Secretary, to
meet the criteria and requirements described in paragraph (3).
(e) Selection of Grant Recipients.--
(1) Application.--An eligible entity seeking a grant under
the pilot program shall submit to the Secretary of Veterans
Affairs an application therefor in such form and in such manner
as the Secretary considers appropriate.
(2) Elements.--Each application submitted under paragraph
(1) shall include the following:
(A) The amount of the grant sought for the project
or activity.
(B) Plans, specifications, and the schedule for
implementation of the project or activity in accordance
with criteria and requirements prescribed by the
Secretary under subsection (c)(2).
(C) An agreement--
(i) to provide the services for which the
grant is sought at locations accessible to
eligible transitioning individuals;
(ii) to ensure the confidentiality of
records maintained on eligible transitioning
individuals receiving services through the
pilot program; and
(iii) to establish such procedures for
fiscal control and fund accounting as may be
necessary to ensure proper disbursement and
accounting with respect to the grant and to
such payments as may be made under this
section.
(3) Applicant agreement.--The Secretary may not select an
eligible entity for a grant under the pilot program unless the
eligible entity agrees to the provisions listed in paragraph
(2)(C).
(f) Recovery of Unused Grant Amounts.--
(1) In general.--The United States shall be entitled to
recover from a grant recipient under this section the total of
all unused grant amounts made under this section to such
recipient in connection with such program if such grant
recipient--
(A) does not establish a program or activity in
accordance with this section; or
(B) ceases to furnish services under such a program
for which the grant was made.
(2) Obligation.--Any amount recovered by the United States
under paragraph (1) may be obligated by the Secretary of
Veterans Affairs without fiscal year limitation to carry out
provisions of this section.
(3) Limitation on recovery.--An amount may not be recovered
under paragraph (1)(A) as an unused grant amount before the end
of the three-year period beginning on the date on which the
grant is made.
(g) Authorization of Appropriations.--There is authorized to be
appropriated from amounts made available under the heading ``General
Operating Expenses'', not more than $5,000,000 in each of fiscal years
2010 through 2012 to carry out this section.
SEC. 505. ASSESSMENT OF PILOT PROGRAMS.
(a) Progress Reports.--Not less than one year before the expiration
of the authority to carry out a pilot program authorized by sections
501 through 504, the Secretary of Veterans Affairs shall submit to
Congress a progress report on such pilot program.
(b) Contents.--Each progress report submitted for a pilot program
under subsection (a) shall include the following:
(1) The lessons learned by the Secretary of Veterans
Affairs with respect to such pilot program that can be applied
to other programs with similar purposes.
(2) The recommendations of the Secretary on whether to
continue such pilot program.
(3) The number of veterans and dependents served by such
pilot program.
(4) An assessment of the quality of service provided to
veterans and dependents under such pilot program.
(5) The amount of funds provided to grant recipients under
such pilot program.
(6) The names of organizations that have received grants
under such pilot program.
TITLE VI--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS
SEC. 601. GENERAL AUTHORITIES ON ESTABLISHMENT OF CORPORATIONS.
(a) Authorization of Multi-Medical Center Research Corporations.--
(1) In general.--Section 7361 is amended--
(A) by redesignating subsection (b) as subsection
(e); and
(B) by inserting after subsection (a) the following
new subsection (b):
``(b)(1) Subject to paragraph (2), a corporation established under
this subchapter may facilitate the conduct of research, education, or
both at more than one medical center. Such a corporation shall be known
as a `multi-medical center research corporation'.
``(2) The board of directors of a multi-medical center research
corporation under this subsection shall include the official at each
Department medical center concerned who is, or who carries out the
responsibilities of, the medical center director of such center as
specified in section 7363(a)(1)(A)(i) of this title.
``(3) In facilitating the conduct of research, education, or both
at more than one Department medical center under this subchapter, a
multi-medical center research corporation may administer receipts and
expenditures relating to such research, education, or both, as
applicable, performed at the Department medical centers concerned.''.
(2) Expansion of existing corporations to multi-medical
center research corporations.--Such section is further amended
by adding at the end the following new subsection:
``(f) A corporation established under this subchapter may act as a
multi-medical center research corporation under this subchapter in
accordance with subsection (b) if--
``(1) the board of directors of the corporation approves a
resolution permitting facilitation by the corporation of the
conduct of research, education, or both at the other Department
medical center or medical centers concerned; and
``(2) the Secretary approves the resolution of the
corporation under paragraph (1).''.
(b) Restatement and Modification of Authorities on Applicability of
State Law.--
(1) In general.--Section 7361, as amended by subsection (a)
of this section, is further amended by inserting after
subsection (b) the following new subsection (c):
``(c) Any corporation established under this subchapter shall be
established in accordance with the nonprofit corporation laws of the
State in which the applicable Department medical center is located and
shall, to the extent not inconsistent with any Federal law, be subject
to the laws of such State. In the case of any multi-medical center
research corporation that facilitates the conduct of research,
education, or both at Department medical centers located in different
States, the corporation shall be established in accordance with the
nonprofit corporation laws of the State in which one of such Department
medical centers is located.''.
(2) Conforming amendment.--Section 7365 is repealed.
(c) Clarification of Status of Corporations.--Section 7361, as
amended by this section, is further amended--
(1) in subsection (a), by striking the second sentence; and
(2) by inserting after subsection (c) the following new
subsection (d):
``(d)(1) Except as otherwise provided in this subchapter or under
regulations prescribed by the Secretary, any corporation established
under this subchapter, and its officers, directors, and employees,
shall be required to comply only with those Federal laws, regulations,
and executive orders and directives that apply generally to private
nonprofit corporations.
``(2) A corporation under this subchapter is not--
``(A) owned or controlled by the United States; or
``(B) an agency or instrumentality of the United States.''.
(d) Reinstatement of Requirement for 501(c)(3) Status of
Corporations.--Subsection (e) of section 7361, as redesignated by
subsection (a)(1) of this section, is further amended by inserting
``section 501(c)(3) of'' after ``exempt from taxation under''.
SEC. 602. CLARIFICATION OF PURPOSES OF CORPORATIONS.
(a) Clarification of Purposes.--Subsection (a) of section 7362 is
amended--
(1) in the first sentence--
(A) by striking ``Any corporation'' and all that
follows through ``facilitate'' and inserting ``A
corporation established under this subchapter shall be
established to provide a flexible funding mechanism for
the conduct of approved research and education at one
or more Department medical centers and to facilitate
functions related to the conduct of''; and
(B) by inserting before the period at the end the
following: ``or centers''; and
(2) in the second sentence, by inserting ``or centers''
after ``at the medical center''.
(b) Modification of Defined Term Relating to Education and
Training.--Subsection (b) of such section is amended in the matter
preceding paragraph (1) by striking ``the term `education and
training''' and inserting ``the term `education' includes education and
training and''.
(c) Repeal of Role of Corporations With Respect to Fellowships.--
Paragraph (1) of subsection (b) of such section is amended by striking
the flush matter following subparagraph (C).
(d) Availability of Education for Families of Veteran Patients.--
Paragraph (2) of subsection (b) of such section is amended by striking
``to patients and to the families'' and inserting ``and includes
education and training for patients and families''.
SEC. 603. MODIFICATION OF REQUIREMENTS FOR BOARDS OF DIRECTORS OF
CORPORATIONS.
(a) Requirements for Department Board Members.--Paragraph (1) of
section 7363(a) is amended to read as follows:
``(1) with respect to the Department medical center--
``(A)(i) the director (or directors of each
Department medical center, in the case of a multi-
medical center research corporation);
``(ii) the chief of staff; and
``(iii) as appropriate for the activities of such
corporation, the associate chief of staff for research
and the associate chief of staff for education; or
``(B) in the case of a Department medical center at
which one or more of the positions referred to in
subparagraph (A) do not exist, the official or
officials who are responsible for carrying out the
responsibilities of such position or positions at the
Department medical center; and''.
(b) Requirements for Non-Department Board Members.--Paragraph (2)
of such section is amended--
(1) by inserting ``not less than two'' before ``members'';
and
(2) by striking ``and who'' and all that follows through
the period at the end and inserting ``and who have backgrounds,
or business, legal, financial, medical, or scientific
expertise, of benefit to the operations of the corporation.''.
(c) Conflicts of Interest.--Subsection (c) of section 7363 is
amended by striking ``, employed by, or have any other financial
relationship with'' and inserting ``or employed by''.
SEC. 604. CLARIFICATION OF POWERS OF CORPORATIONS.
(a) In General.--Section 7364 is amended to read as follows:
``Sec. 7364. General powers
``(a) In General.--(1) A corporation established under this
subchapter may, solely to carry out the purposes of this subchapter--
``(A) accept, administer, retain, and spend funds derived
from gifts, contributions, grants, fees, reimbursements, and
bequests from individuals and public and private entities;
``(B) enter into contracts and agreements with individuals
and public and private entities;
``(C) subject to paragraph (2), set fees for education and
training facilitated under section 7362 of this title, and
receive, retain, administer, and spend funds in furtherance of
such education and training;
``(D) reimburse amounts to the applicable appropriation
account of the Department for the Office of General Counsel for
any expenses of that Office in providing legal services
attributable to research and education agreements under this
subchapter; and
``(E) employ such employees as the corporation considers
necessary for such purposes and fix the compensation of such
employees.
``(2) Fees charged under paragraph (1)(C) for education and
training described in that paragraph to individuals who are officers or
employees of the Department may not be paid for by any funds
appropriated to the Department.
``(3) Amounts reimbursed to the Office of General Counsel under
paragraph (1)(D) shall be available for use by the Office of the
General Counsel only for staff and training, and related travel, for
the provision of legal services described in that paragraph and shall
remain available for such use without fiscal year limitation.
``(b) Transfer and Administration of Funds.--(1) Except as provided
in paragraph (2), any funds received by the Secretary for the conduct
of research or education at a Department medical center or centers,
other than funds appropriated to the Department, may be transferred to
and administered by a corporation established under this subchapter for
such purposes.
``(2) A Department medical center may reimburse the corporation for
all or a portion of the pay, benefits, or both of an employee of the
corporation who is assigned to the Department medical center if the
assignment is carried out pursuant to subchapter VI of chapter 33 of
title 5.
``(3) A Department medical center may retain and use funds provided
to it by a corporation established under this subchapter. Such funds
shall be credited to the applicable appropriation account of the
Department and shall be available, without fiscal year limitation, for
the purposes of that account.
``(c) Research Projects.--Except for reasonable and usual
preliminary costs for project planning before its approval, a
corporation established under this subchapter may not spend funds for a
research project unless the project is approved in accordance with
procedures prescribed by the Under Secretary for Health for research
carried out with Department funds. Such procedures shall include a
scientific review process.
``(d) Education Activities.--Except for reasonable and usual
preliminary costs for activity planning before its approval, a
corporation established under this subchapter may not spend funds for
an education activity unless the activity is approved in accordance
with procedures prescribed by the Under Secretary for Health.
``(e) Policies and Procedures.--The Under Secretary for Health may
prescribe policies and procedures to guide the spending of funds by
corporations established under this subchapter that are consistent with
the purpose of such corporations as flexible funding mechanisms and
with Federal and State laws and regulations, and executive orders,
circulars, and directives that apply generally to the receipt and
expenditure of funds by nonprofit organizations exempt from taxation
under section 501(c)(3) of the Internal Revenue Code of 1986.''.
(b) Conforming Amendment.--Section 7362(a), as amended by section
602(a)(1) of this Act, is further amended by striking the last
sentence.
SEC. 605. REDESIGNATION OF SECTION 7364A OF TITLE 38, UNITED STATES
CODE.
(a) Redesignation.--Section 7364A is redesignated as section 7365.
(b) Clerical Amendments.--The table of sections at the beginning of
chapter 73 is amended--
(1) by striking the item relating to section 7364A; and
(2) by striking the item relating to section 7365 and
inserting the following new item:
``7365. Coverage of employees under certain Federal tort claims
laws.''.
SEC. 606. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF CORPORATIONS.
(a) Additional Information in Annual Reports.--Subsection (b) of
section 7366 is amended to read as follows:
``(b)(1) Each corporation shall submit to the Secretary each year a
report providing a detailed statement of the operations, activities,
and accomplishments of the corporation during that year.
``(2)(A) A corporation with revenues in excess of $300,000 for any
year shall obtain an audit of the corporation for that year.
``(B) A corporation with annual revenues between $10,000 and
$300,000 shall obtain an audit of the corporation at least once every
three years.
``(C) Any audit under this paragraph shall be performed by an
independent auditor.
``(3) The corporation shall include in each report to the Secretary
under paragraph (1) the following:
``(A) The most recent audit of the corporation under
paragraph (2).
``(B) The most recent Internal Revenue Service Form 990
`Return of Organization Exempt from Income Tax' or equivalent
and the applicable schedules under such form.''.
(b) Confirmation of Application of Conflict of Interest Regulations
to Appropriate Corporation Positions.--Subsection (c) of such section
is amended--
(1) by striking ``laws and'' each place it appears;
(2) in paragraph (1)--
(A) by inserting ``each officer and'' after ``under
this subchapter,''; and
(B) by striking ``, and each employee of the
Department'' and all that follows through ``during any
year''; and
(3) in paragraph (2)--
(A) by inserting ``, officer,'' after ``verifying
that each director''; and
(B) by striking ``in the same manner'' and all that
follows before the period at the end.
(c) Establishment of Appropriate Payee Reporting Threshold.--
Subsection (d)(3)(C) of such section is amended by striking ``$35,000''
and inserting ``$50,000''.
TITLE VII--MISCELLANEOUS PROVISIONS
SEC. 701. EXPANSION OF AUTHORITY FOR DEPARTMENT OF VETERANS AFFAIRS
POLICE OFFICERS.
Section 902 is amended--
(1) in subsection (a)--
(A) by amending paragraph (1) to read as follows:
``(1) Employees of the Department who are Department police
officers shall, with respect to acts occurring on Department
property--
``(A) enforce Federal laws;
``(B) enforce the rules prescribed under section
901 of this title;
``(C) enforce traffic and motor vehicle laws of a
State or local government (by issuance of a citation
for violation of such laws) within the jurisdiction of
which such Department property is located as authorized
by an express grant of authority under applicable State
or local law;
``(D) carry the appropriate Department-issued
weapons, including firearms, while off Department
property in an official capacity or while in an
official travel status;
``(E) conduct investigations, on and off Department
property, of offenses that may have been committed on
property under the original jurisdiction of Department,
consistent with agreements or other consultation with
affected local, State, or Federal law enforcement
agencies; and
``(F) carry out, as needed and appropriate, the
duties described in subparagraphs (A) through (E) of
this paragraph when engaged in duties authorized by
other Federal statutes.'';
(B) by striking paragraph (2) and redesignating
paragraph (3) as paragraph (2); and
(C) in paragraph (2), as redesignated by
subparagraph (B) of this paragraph, by inserting ``,
and on any arrest warrant issued by competent judicial
authority'' before the period; and
(2) by amending subsection (c) to read as follows:
``(c) The powers granted to Department police officers designated
under this section shall be exercised in accordance with guidelines
approved by the Secretary and the Attorney General.''.
SEC. 702. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS AFFAIRS POLICE
OFFICERS.
Section 903 is amended--
(1) by amending subsection (b) to read as follows:
``(b)(1) The amount of the allowance that the Secretary may pay
under this section is the lesser of--
``(A) the amount currently allowed as prescribed by the
Office of Personnel Management; or
``(B) estimated costs or actual costs as determined by
periodic surveys conducted by the Department.
``(2) During any fiscal year no officer shall receive more for the
purchase of a uniform described in subsection (a) than the amount
established under this subsection.''; and
(2) by striking subsection (c) and inserting the following
new subsection (c):
``(c) The allowance established under subsection (b) shall be paid
at the beginning of a Department police officer's employment for those
appointed on or after October 1, 2008. In the case of any other
Department police officer, an allowance in the amount established under
subsection (b) shall be paid upon the request of the officer.''.
<all>
Introduced in Senate
Sponsor introductory remarks on measure. (CR S599)
Read twice and referred to the Committee on Veterans' Affairs. (text of measure as introduced: CR S599-612)
Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 111-76.
Committee on Veterans' Affairs. Ordered to be reported without amendment favorably.
Committee on Veterans' Affairs. Reported by Senator Akaka with an amendment in the nature of a substitute. With written report No. 111-60.
Committee on Veterans' Affairs. Reported by Senator Akaka with an amendment in the nature of a substitute. With written report No. 111-60.
Placed on Senate Legislative Calendar under General Orders. Calendar No. 128.
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