Text: S.2162 — 110th Congress (2007-2008)All Information (Except Text)

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Public Law No: 110-387 (10/10/2008)

 
[110th Congress Public Law 387]
[From the U.S. Government Printing Office]


[DOCID: f:publ387.110]

[[Page 4109]]

     VETERANS' MENTAL HEALTH AND OTHER CARE IMPROVEMENTS ACT OF 2008

[[Page 122 STAT. 4110]]

Public Law 110-387
110th Congress

                                 An Act


 
  To improve the treatment and services provided by the Department of 
  Veterans Affairs to veterans with post-traumatic stress disorder and 
   substance use disorders, and for other purposes. <<NOTE: Oct. 10, 
                          2008 -  [S. 2162]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Veterans' Mental 
Health and Other Care Improvements Act of 2008.>> 
SECTION 1. <<NOTE: 38 USC 101 note.>> SHORT TITLE; TABLE OF 
                              CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Veterans' Mental 
Health and Other Care Improvements Act of 2008''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. References to title 38, United States Code.

         TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

Sec. 101. Tribute to Justin Bailey.
Sec. 102. Findings on substance use disorders and mental health.
Sec. 103. Expansion of substance use disorder treatment services 
           provided by Department of Veterans Affairs.
Sec. 104. Care for veterans with mental health and substance use 
           disorders.
Sec. 105. Pilot program for Internet-based substance use disorder 
           treatment for veterans of Operation Iraqi Freedom and 
           Operation Enduring Freedom.
Sec. 106. Report on residential mental health care facilities of the 
           Veterans Health Administration.
Sec. 107. Pilot program on peer outreach and support for veterans and 
           use of community mental health centers and Indian Health 
           Service facilities.

                    TITLE II--MENTAL HEALTH RESEARCH

Sec. 201. Research program on comorbid post-traumatic stress disorder 
           and substance use disorders.
Sec. 202. Extension of authorization for Special Committee on Post-
           Traumatic Stress Disorder.

             TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

Sec. 301. Clarification of authority of Secretary of Veterans Affairs to 
           provide mental health services to families of veterans.
Sec. 302. Pilot program on provision of readjustment and transition 
           assistance to veterans and their families in cooperation with 
           Vet Centers.

                      TITLE IV--HEALTH CARE MATTERS

Sec. 401. Veterans beneficiary travel program.
Sec. 402. Mandatory reimbursement of veterans receiving emergency 
           treatment in non-Department of Veterans Affairs facilities 
           until transfer to Department facilities.
Sec. 403. Pilot program of enhanced contract care authority for health 
           care needs of veterans in highly rural areas.
Sec. 404. Epilepsy centers of excellence.
Sec. 405. Establishment of qualifications for peer specialist 
           appointees.
Sec. 406. Establishment of consolidated patient accounting centers.
Sec. 407. Repeal of limitation on authority to conduct widespread HIV 
           testing program.

[[Page 122 STAT. 4111]]

Sec. 408. Provision of comprehensive health care by Secretary of 
           Veterans Affairs to children of Vietnam veterans born with 
           Spina Bifida.
Sec. 409. Exemption from copayment requirement for veterans receiving 
           hospice care.

                           TITLE V--PAIN CARE

Sec. 501. Comprehensive policy on pain management.

                   TITLE VI--HOMELESS VETERANS MATTERS

Sec. 601. Increased authorization of appropriations for comprehensive 
           service programs.
Sec. 602. Expansion and extension of authority for program of referral 
           and counseling services for at-risk veterans transitioning 
           from certain institutions.
Sec. 603. Permanent authority for domiciliary services for homeless 
           veterans and enhancement of capacity of domiciliary care 
           programs for female veterans.
Sec. 604. Financial assistance for supportive services for very low-
           income veteran families in permanent housing.

TITLE VII--AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND MAJOR MEDICAL 
                             FACILITY LEASES

Sec. 701. Authorization for fiscal year 2009 major medical facility 
           projects.
Sec. 702. Modification of authorization amounts for certain major 
           medical facility construction projects previously authorized.
Sec. 703. Authorization of fiscal year 2009 major medical facility 
           leases.
Sec. 704. Authorization of appropriations.
Sec. 705. Increase in threshold for major medical facility leases 
           requiring Congressional approval.
Sec. 706. Conveyance of certain non-Federal land by City of Aurora, 
           Colorado, to Secretary of Veterans Affairs for construction 
           of veterans medical facility.
Sec. 707. Report on facilities administration.
Sec. 708. Annual report on outpatient clinics.
Sec. 709. Name of Department of Veterans Affairs spinal cord injury 
           center, Tampa, Florida.

              TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

Sec. 801. Repeal of sunset on inclusion of noninstitutional extended 
           care services in definition of medical services.
Sec. 802. Extension of recovery audit authority.
Sec. 803. Permanent authority for provision of hospital care, medical 
           services, and nursing home care to veterans who participated 
           in certain chemical and biological testing conducted by the 
           Department of Defense.
Sec. 804. Extension of expiring collections authorities.
Sec. 805. Extension of nursing home care.
Sec. 806. Permanent authority to establish research corporations.
Sec. 807. Extension of requirement to submit annual report on the 
           Committee on Care of Severely Chronically Mentally Ill 
           Veterans.
Sec. 808. Permanent requirement for biannual report on Women's Advisory 
           Committee.
Sec. 809. Extension of pilot program on improvement of caregiver 
           assistance services.

                         TITLE IX--OTHER MATTERS

Sec. 901. Technical amendments.

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

    Except as otherwise expressly provided, whenever in this Act an 
amendment or repeal is expressed in terms of an amendment to, or repeal 
of, a section or other provision, the reference shall be considered to 
be made to a section or other provision of title 38, United States Code.

[[Page 122 STAT. 4112]]

         TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

SEC. 101. TRIBUTE TO JUSTIN BAILEY.

    This title is enacted in tribute to Justin Bailey, who, after 
returning to the United States from service as a member of the Armed 
Forces in Operation Iraqi Freedom, died in a domiciliary facility of the 
Department of Veterans Affairs while receiving care for post-traumatic 
stress disorder and a substance use disorder.
SEC. 102. <<NOTE: 38 USC 1720A note.>> FINDINGS ON SUBSTANCE USE 
                        DISORDERS AND MENTAL HEALTH.

    Congress makes the following findings:
            (1) More than 1,500,000 members of the Armed Forces have 
        been deployed in Operation Iraqi Freedom and Operation Enduring 
        Freedom. The 2005 Department of Defense Survey of Health Related 
        Behaviors Among Active Duty Personnel reports that 23 percent of 
        members of the Armed Forces on active duty acknowledge a 
        significant problem with alcohol use disorder, with similar 
        rates of acknowledged problems with alcohol use disorder among 
        members of the National Guard.
            (2) The effects of substance use disorder are wide ranging, 
        including significantly increased risk of suicide, exacerbation 
        of mental and physical health disorders, breakdown of family 
        support, and increased risk of unemployment and homelessness.
            (3) While veterans suffering from mental health conditions, 
        chronic physical illness, and polytrauma may be at increased 
        risk for development of a substance use disorder, treatment for 
        these veterans is complicated by the need to address adequately 
        the physical and mental symptoms associated with these 
        conditions through appropriate medical intervention.
            (4) While the Veterans Health Administration has 
        dramatically increased health services for veterans from 1996 
        through 2006, the number of veterans receiving specialized 
        substance use disorder treatment services decreased 18 percent 
        during that time. No comparable decrease in the national rate of 
        substance use disorder has been observed during that time.
            (5) While some facilities of the Veterans Health 
        Administration provide exemplary substance use disorder 
        treatment services, the availability of such treatment services 
        throughout the health care system of the Veterans Health 
        Administration is inconsistent.
            (6) According to a 2006 report by the Government 
        Accountability Office, the Department of Veterans Affairs 
        significantly reduced its substance use disorder treatment and 
        rehabilitation services between 1996 and 2006, and the Fiscal 
        Year 2007 National Mental Health Program Monitoring System 
        report shows that little progress has been made in restoring 
        these services to their pre-1996 levels.
SEC. 103. <<NOTE: 38 USC 1720A note.>> EXPANSION OF SUBSTANCE USE 
                        DISORDER TREATMENT SERVICES PROVIDED BY 
                        DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall ensure the 
provision of such services and treatment to each veteran enrolled in the 
health care system of the Department of Veterans

[[Page 122 STAT. 4113]]

Affairs who is in need of services and treatments for a substance use 
disorder as follows:
            (1) Screening for substance use disorder in all settings, 
        including primary care settings.
            (2) Short term motivational counseling services.
            (3) Marital and family counseling.
            (4) Intensive outpatient or residential care services.
            (5) Relapse prevention services.
            (6) Ongoing aftercare and outpatient counseling services.
            (7) Opiate substitution therapy services.
            (8) Pharmacological treatments aimed at reducing craving for 
        drugs and alcohol.
            (9) Detoxification and stabilization services.
            (10) Coordination with groups providing peer to peer 
        counseling.
            (11) Such other services as the Secretary considers 
        appropriate.

    (b) Provision of Services.--
            (1) Allocation of resources for provision of services.--The 
        Secretary shall ensure that amounts made available for care, 
        treatment, and services provided under this section are 
        allocated in such a manner that a full continuum of care, 
        treatment, and services described in subsection (a) is available 
        to veterans seeking such care, treatment, or services, without 
        regard to the location of the residence of any such veterans.
            (2) Manner of provision.--The services and treatment 
        described in subsection (a) may be provided to a veteran 
        described in such subsection--
                    (A) at Department of Veterans Affairs medical 
                centers or clinics;
                    (B) by referral to other facilities of the 
                Department that are accessible to such veteran; or
                    (C) by contract or fee-for-service payments with 
                community-based organizations for the provision of such 
                services and treatments.

    (c) Alternatives in Case of Services Denied Due to Clinical 
Necessity.--If the Secretary denies the provision to a veteran of 
services or treatment for a substance use disorder due to clinical 
necessity, the Secretary shall provide the veteran such other services 
or treatment as are medically appropriate.
SEC. 104. <<NOTE: 38 USC 1720A note.>> CARE FOR VETERANS WITH 
                        MENTAL HEALTH AND SUBSTANCE USE DISORDERS.

    (a) In General.--If the Secretary of Veterans Affairs provides a 
veteran inpatient or outpatient care for a substance use disorder and a 
comorbid mental health disorder, the Secretary shall ensure that 
treatment for such disorders is provided concurrently--
            (1) through a service provided by a clinician or health 
        professional who has training and expertise in treatment of 
        substance use disorders and mental health disorders;
            (2) by separate substance use disorder and mental health 
        disorder treatment services when there is appropriate 
        coordination, collaboration, and care management between such 
        treatment services; or
            (3) by a team of clinicians with appropriate expertise.

[[Page 122 STAT. 4114]]

    (b) Team of Clinicians With Appropriate Expertise Defined.--In this 
section, the term ``team of clinicians with appropriate expertise'' 
means a team consisting of the following:
            (1) Clinicians and health professionals with expertise in 
        treatment of substance use disorders and mental health disorders 
        who act in coordination and collaboration with each other.
            (2) Such other professionals as the Secretary considers 
        appropriate for the provision of treatment to veterans for 
        substance use and mental health disorders.
SEC. 105. <<NOTE: 38 USC 1720A note.>> PILOT PROGRAM FOR INTERNET-
                        BASED SUBSTANCE USE DISORDER TREATMENT FOR 
                        VETERANS OF OPERATION IRAQI FREEDOM AND 
                        OPERATION ENDURING FREEDOM.

    (a) Findings.--Congress makes the following findings:
            (1) Stigma associated with seeking treatment for mental 
        health disorders has been demonstrated to prevent some veterans 
        from seeking such treatment at a medical facility operated by 
        the Department of Defense or the Department of Veterans Affairs.
            (2) There is a significant incidence among veterans of post-
        deployment mental health problems, especially among members of a 
        reserve component who return as veterans to civilian life.
            (3) Computer-based self-guided training has been 
        demonstrated to be an effective strategy for supplementing the 
        care of psychological conditions.
            (4) Younger veterans, especially those who served in 
        Operation Enduring Freedom or Operation Iraqi Freedom, are 
        comfortable with and proficient at computer-based technology.
            (5) Veterans living in rural areas may find access to 
        treatment for substance use disorder limited.
            (6) Self-assessment and treatment options for substance use 
        disorders through an Internet website may reduce stigma and 
        provides additional access for individuals seeking care and 
        treatment for such disorders.

    (b) In General.--Not <<NOTE: Deadline.>> later than October 1, 2009, 
the Secretary of Veterans Affairs shall carry out a pilot program to 
assess the feasibility and advisability of providing veterans who seek 
treatment for substance use disorders access to a computer-based self-
assessment, education, and specified treatment program through a secure 
Internet website operated by the Secretary. Participation in the pilot 
program shall be available on a voluntary basis for those veterans who 
have served in Operation Enduring Freedom or Operation Iraqi Freedom.

    (c) Elements of Pilot Program.--
            (1) In general.--In carrying out the pilot program under 
        this section, the Secretary shall ensure that--
                    (A) access to the Internet website and the programs 
                available on the website by a veteran (or family member) 
                does not involuntarily generate an identifiable medical 
                record of that access by that veteran in any medical 
                database maintained by the Department of Veterans 
                Affairs;
                    (B) the Internet website is accessible from remote 
                locations, especially rural areas; and
                    (C) the Internet website includes a self-assessment 
                tool for substance use disorders, self-guided treatment 
                and

[[Page 122 STAT. 4115]]

                educational materials for such disorders, and 
                appropriate information and materials for family members 
                of veterans.
            (2) Consideration of similar projects.--In designing the 
        pilot program under this section, the Secretary shall consider 
        similar pilot projects of the Department of Defense for the 
        early diagnosis and treatment of post-traumatic stress disorder 
        and other mental health conditions established under section 741 
        of the John Warner National Defense Authorization Act of Fiscal 
        Year 2007 (Public Law 109-364; 120 Stat. 2304).
            (3) Location of pilot program.--The Secretary shall carry 
        out the pilot program through those medical centers of the 
        Department of Veterans Affairs that have established Centers for 
        Excellence for Substance Abuse Treatment and Education or that 
        have established a Substance Abuse Program Evaluation and 
        Research Center.
            (4) Contract authority.--The Secretary may enter into 
        contracts with qualified entities or organizations to carry out 
        the pilot program required under this section.

    (d) Duration of Pilot Program.--The pilot program required by 
subsection (a) shall be carried out during the two-year period beginning 
on the date of the commencement of the pilot program.
    (e) Report.--Not later than six months after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program, and shall include in that report--an assessment of the 
feasibility and advisability of continuing or expanding the pilot 
program, of any cost savings or other benefits associated with the pilot 
program, and any other recommendations.
    (f) Authorization of Appropriations.--There are authorized to be 
appropriated to the Secretary of Veterans Affairs $1,500,000 for each of 
fiscal years 2010 and 2011 to carry out the pilot program under this 
section.
SEC. 106. REPORT ON RESIDENTIAL MENTAL HEALTH CARE FACILITIES OF 
                        THE VETERANS HEALTH ADMINISTRATION.

    (a) Review.--
            (1) In general.--Not later than six months after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall, acting through the Inspector General of the Department of 
        Veterans Affairs, complete a review of all residential mental 
        health care facilities, including domiciliary facilities, of the 
        Veterans Health Administration.
            (2) Assessment.--As part of the review required by paragraph 
        (1), the Secretary, acting through the Inspector General, shall 
        assess the following:
                    (A) The availability of care in residential mental 
                health care facilities in each Veterans Integrated 
                Service Network (VISN).
                    (B) The supervision and support provided in the 
                residential mental health care facilities of the 
                Veterans Health Administration.
                    (C) The ratio of staff members at each residential 
                mental health care facility to patients at such 
                facility.
                    (D) The appropriateness of rules and procedures for 
                the prescription and administration of medications to 
                patients in such residential mental health care 
                facilities.
                    (E) The protocols at each residential mental health 
                care facility for handling missed appointments.

[[Page 122 STAT. 4116]]

            (3) Recommendations.--As part of the review required by 
        paragraph (1), the Secretary, acting through the Inspector 
        General, shall develop such recommendations as the Secretary 
        considers appropriate for improvements to residential mental 
        health care facilities of the Veterans Health Administration and 
        the care provided in such facilities.

    (b) Follow-up <<NOTE: Deadline.>> Review.--Not later than two years 
after the date of the completion of the review required by subsection 
(a), the Secretary of Veterans Affairs shall, acting through the 
Inspector General of the Department of Veterans Affairs, complete a 
follow-up review of the facilities reviewed under subsection (a) to 
evaluate any improvements made or problems remaining since the review 
under subsection (a) was completed.

    (c) Report.--Not later than 90 days after the completion of the 
review required by subsection (a), the Secretary of Veterans Affairs 
shall submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
on the findings of the Secretary with respect to such review.
SEC. 107. <<NOTE: 38 USC 1712A note.>> PILOT PROGRAM ON PEER 
                        OUTREACH AND SUPPORT FOR VETERANS AND USE 
                        OF COMMUNITY MENTAL HEALTH CENTERS AND 
                        INDIAN HEALTH SERVICE FACILITIES.

    (a) Pilot Program Required.--Commencing <<NOTE: Deadline.>> not 
later than 180 days after the date of the enactment of this Act, the 
Secretary of Veterans Affairs shall carry out a pilot program to assess 
the feasability and advisability of providing to veterans of Operation 
Iraqi Freedom and Operation Enduring Freedom, and, in particular, 
veterans who served in such operations as a member of the National Guard 
or Reserve, the following:
            (1) Peer outreach services.
            (2) Peer support services provided by licensed providers of 
        peer support services or veterans who have personal experience 
        with mental illness.
            (3) Readjustment counseling services described in section 
        1712A of title 38, United States Code.
            (4) Other mental health services.

    (b) Provision of Certain Services.--In providing services described 
in paragraphs (3) and (4) of subsection (a) under the pilot program to 
veterans who reside in rural areas and do not have adequate access 
through the Department of Veterans Affairs to the services described in 
such paragraphs, the Secretary shall, acting through the Office of 
Mental Health Services and the Office of Rural Health, provide such 
services as follows:
            (1) Through community mental health centers under contracts 
        or other agreements if entered into by the Secretary of Veterans 
        Affairs and the Secretary of Health and Human Services for the 
        provision of such services for purposes of the pilot program.
            (2) Through the Indian Health Service, or an Indian tribe or 
        tribal organization that has entered into an agreement with the 
        Indian Health Service pursuant to the Indian Self-Determination 
        and Education Assistance Act (25 U.S.C. 450 et seq.), if a 
        memorandum of understanding is entered into by the Secretary of 
        Veterans Affairs and the Secretary of Health and Human Services 
        for purposes of the pilot program.

[[Page 122 STAT. 4117]]

            (3) Through other appropriate entities under contracts or 
        other agreements entered into by the Secretary of Veterans 
        Affairs for the provision of such services for purposes of the 
        pilot program.

    (c) Duration.--The pilot program shall be carried out during the 
three-year period beginning on the date of the commencement of the pilot 
program.
    (d) Program Locations.--
            (1) In general.--The pilot program shall be carried out 
        within areas selected by the Secretary for the purpose of the 
        pilot program in at least three Veterans Integrated Service 
        Networks (VISNs).
            (2) Rural geographic locations.--The locations selected 
        shall be in rural geographic locations that, as determined by 
        the Secretary, lack access to comprehensive mental health 
        services through the Department of Veterans Affairs.
            (3) Qualified providers.--In selecting locations for the 
        pilot program, the Secretary shall select locations in which an 
        adequate number of licensed mental health care providers with 
        credentials equivalent to those of Department mental health care 
        providers are available in Indian Health Service facilities, 
        community mental health centers, and other entities for 
        participation in the pilot program.

    (e) Participation in Program.--Each community mental health center, 
facility of the Indian Health Service, or other entity participating in 
the pilot program under subsection (b) shall--
            (1) provide the services described in paragraphs (3) and (4) 
        of subsection (a) to eligible veterans, including, to the extent 
        practicable, telehealth services that link the center or 
        facility with Department of Veterans Affairs clinicians;
            (2) use the clinical practice guidelines of the Veterans 
        Health Administration or the Department of Defense in the 
        provision of such services; and
            (3) <<NOTE: Requirements.>> meet such other requirements as 
        the Secretary shall require.

    (f) Compliance With Department Protocols.--Each community mental 
health center, facility of the Indian Health Service, or other entity 
participating in the pilot program under subsection (b) shall comply 
with--
            (1) applicable protocols of the Department before incurring 
        any liability on behalf of the Department for the provision of 
        services as part of the pilot program; and
            (2) access and quality standards of the Department relevant 
        to the provision of services as part of the pilot program.

    (g) Provision of Clinical Information.--Each community mental health 
center, facility of the Indian Health Service, or other entity 
participating in the pilot program under subsection (b) shall, in a 
timely fashion, provide the Secretary with such clinical information on 
each veteran for whom such health center or facility provides mental 
health services under the pilot program as the Secretary shall require.
    (h) Training.--
            (1) Training of veterans.--As part of the pilot program, the 
        Secretary shall carry out a program of training for veterans 
        described in subsection (a) to provide the services described in 
        paragraphs (1) and (2) of such subsection.
            (2) Training of clinicians.--

[[Page 122 STAT. 4118]]

                    (A) In general.--The Secretary shall conduct a 
                training program for clinicians of community mental 
                health centers, Indian Health Service facilities, or 
                other entities participating in the pilot program under 
                subsection (b) to ensure that such clinicians can 
                provide the services described in paragraphs (3) and (4) 
                of subsection (a) in a manner that accounts for factors 
                that are unique to the experiences of veterans who 
                served on active duty in Operation Iraqi Freedom or 
                Operation Enduring Freedom (including their combat and 
                military training experiences).
                    (B) Participation in training.--Personnel of each 
                community mental health center, facility of the Indian 
                Health Service, or other entity participating in the 
                pilot program under subsection (b) shall participate in 
                the training program conducted pursuant to subparagraph 
                (A).

    (i) Annual Reports.--Each community mental health center, facility 
of the Indian Health Service, or other entity participating in the pilot 
program under subsection (b) shall submit to the Secretary on an annual 
basis a report containing, with respect to the provision of services 
under subsection (b) and for the last full calendar year ending before 
the submission of such report--
            (1) the number of--
                    (A) veterans served; and
                    (B) courses of treatment provided; and
            (2) demographic information for such services, diagnoses, 
        and courses of treatment.

    (j) Program Evaluation.--
            (1) In general.--The Secretary shall, through Department of 
        Veterans Affairs Mental Health Services investigators and in 
        collaboration with relevant program offices of the Department, 
        design and implement a strategy for evaluating the pilot 
        program.
            (2) Elements.--The strategy implemented under paragraph (1) 
        shall assess the impact that contracting with community mental 
        health centers, the Indian Health Service, and other entities 
        participating in the pilot program under subsection (b) has on 
        the following:
                    (A) Access to mental health care by veterans in need 
                of such care.
                    (B) The use of telehealth services by veterans for 
                mental health care needs.
                    (C) The quality of mental health care and substance 
                use disorder treatment services provided to veterans in 
                need of such care and services.
                    (D) The coordination of mental health care and other 
                medical services provided to veterans.

    (k) Definitions.--In this section:
            (1) The term ``community mental health center'' has the 
        meaning given such term in section 410.2 of title 42, Code of 
        Federal Regulations (as in effect on the day before the date of 
        the enactment of this Act).
            (2) The term ``eligible veteran'' means a veteran in need of 
        mental health services who--
                    (A) is enrolled in the Department of Veterans 
                Affairs health care system; and

[[Page 122 STAT. 4119]]

                    (B) has received a referral from a health 
                professional of the Veterans Health Administration to a 
                community mental health center, a facility of the Indian 
                Health Service, or other entity for purposes of the 
                pilot program.
            (3) The term ``Indian Health Service'' means the 
        organization established by section 601(a) of the Indian Health 
        Care Improvement Act (25 U.S.C. 1661(a)).

    (l) Authorization of Appropriations.--There is authorized to be 
appropriated such sums as may be necessary to carry out the provisions 
of this section.

                    TITLE II--MENTAL HEALTH RESEARCH

SEC. 201. <<NOTE: 38 USC 1712A note.>> RESEARCH PROGRAM ON 
                        COMORBID POST-TRAUMATIC STRESS DISORDER 
                        AND SUBSTANCE USE DISORDERS.

    (a) Program Required.--The Secretary of Veterans Affairs shall, 
through the Office of Research and Development, carry out a program of 
research into comorbid post-traumatic stress disorder (PTSD) and 
substance use disorder.
    (b) Discharge Through National Center for Posttraumatic Stress 
Disorder.--The research program required by subsection (a) shall be 
carried out by the National Center for Posttraumatic Stress Disorder. In 
carrying out the program, the Center shall--
            (1) develop protocols and goals with respect to research 
        under the program; and
            (2) coordinate research, data collection, and data 
        dissemination under the program.

    (c) Research.--The program of research required by subsection (a) 
shall address the following:
            (1) Comorbid post-traumatic stress disorder and substance 
        use disorder.
            (2) The systematic integration of treatment for post-
        traumatic stress disorder with treatment for substance use 
        disorder.
            (3) The development of protocols to evaluate care of 
        veterans with comorbid post-traumatic stress disorder and 
        substance use disorder.

    (d) Funding.--
            (1) Authorization of appropriations.--There is authorized to 
        be appropriated for the Department of Veterans Affairs for each 
        of fiscal years 2009 through 2012, $2,000,000 to carry out this 
        section.
            (2) Availability.--Amounts authorized to be appropriated by 
        paragraph (1) shall be made available to the National Center on 
        Posttraumatic Stress Disorder for the purpose specified in that 
        paragraph.
            (3) Supplement not supplant.--Any amount made available to 
        the National Center on Posttraumatic Stress Disorder for a 
        fiscal year under paragraph (2) is in addition to any other 
        amounts made available to the National Center on Posttraumatic 
        Stress Disorder for such year under any other provision of law.

[[Page 122 STAT. 4120]]

SEC. 202. EXTENSION OF AUTHORIZATION FOR SPECIAL COMMITTEE ON 
                        POST-TRAUMATIC STRESS DISORDER.

    Section 110(e)(2) of the Veterans' Health Care Act of 1984 (38 
U.S.C. 1712A note; Public Law 98-528) is amended by striking ``through 
2008'' and inserting ``through 2012''.

             TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

SEC. 301. CLARIFICATION OF AUTHORITY OF SECRETARY OF VETERANS 
                        AFFAIRS TO PROVIDE MENTAL HEALTH SERVICES 
                        TO FAMILIES OF VETERANS.

    (a) In General.--Chapter 17 is amended--
            (1) in <<NOTE: 38 USC 1701.>> section 1701(5)(B)--
                    (A) by inserting ``marriage and family counseling,'' 
                after ``professional counseling,''; and
                    (B) by striking ``as may be essential to'' and 
                inserting ``as the Secretary considers appropriate 
                for''; and
            (2) in section 1782--
                    (A) in subsection (a), by inserting ``marriage and 
                family counseling,'' after ``professional counseling,''; 
                and
                    (B) in subsection (b)--
                          (i) by inserting ``marriage and family 
                      counseling,'' after ``professional counseling,''; 
                      and
                          (ii) by striking ``if--'' and all that follows 
                      and inserting a period.

    (b) Location.--Paragraph (5) <<NOTE: 38 USC 1701 note.>> of section 
1701 of title 38, United States Code, shall not be construed to prevent 
the Secretary of Veterans Affairs from providing services described in 
subparagraph (B) of such paragraph to individuals described in such 
subparagraph in centers under section 1712A of such title (commonly 
referred to as ``Vet Centers''), Department of Veterans Affairs medical 
centers, community-based outpatient clinics, or in such other facilities 
of the Department of Veterans Affairs as the Secretary considers 
necessary.
SEC. 302. <<NOTE: 38 USC 1712A note.>> PILOT PROGRAM ON PROVISION 
                        OF READJUSTMENT AND TRANSITION ASSISTANCE 
                        TO VETERANS AND THEIR FAMILIES IN 
                        COOPERATION WITH VET CENTERS.

    (a) Pilot Program.--The Secretary of Veterans Affairs shall carry 
out, through a non-Department of Veterans Affairs entity, a pilot 
program to assess the feasability and advisability of providing 
readjustment and transition assistance described in subsection (b) to 
veterans and their families in cooperation with centers under section 
1712A of title 38, United States Code (commonly referred to as ``Vet 
Centers'').
    (b) Readjustment and Transition Assistance.--Readjustment and 
transition assistance described in this subsection is assistance as 
follows:
            (1) Readjustment and transition assistance that is 
        preemptive, proactive, and principle-centered.
            (2) Assistance and training for veterans and their families 
        in coping with the challenges associated with making the 
        transition from military to civilian life.

    (c) Non-Department of Veterans Affairs Entity.--

[[Page 122 STAT. 4121]]

            (1) In general.--The Secretary shall carry out the pilot 
        program through any for-profit or non-profit organization 
        selected by the Secretary for purposes of the pilot program that 
        has demonstrated expertise and experience in the provision of 
        assistance and training described in subsection (b).
            (2) Contract or agreement.--The Secretary shall carry out 
        the pilot program through a non-Department entity described in 
        paragraph (1) pursuant to a contract or other agreement entered 
        into by the Secretary and the entity for purposes of the pilot 
        program.

    (d) Commencement of Pilot Program.--The <<NOTE: Deadline.>> pilot 
program shall commence not later than 180 days after the date of the 
enactment of this Act.

    (e) Duration of Pilot Program.--The pilot program shall be carried 
out during the three-year period beginning on the date of the 
commencement of the pilot program, and may be carried out for additional 
one-year periods thereafter.
    (f) Location of Pilot Program.--
            (1) In general.--The Secretary shall provide assistance 
        under the pilot program in cooperation with 10 centers described 
        in subsection (a) designated by the Secretary for purposes of 
        the pilot program.
            (2) Designations.--In designating centers described in 
        subsection (a) for purposes of the pilot program, the Secretary 
        shall designate centers so as to provide a balanced geographical 
        representation of such centers throughout the United States, 
        including the District of Columbia, the Commonwealth of Puerto 
        Rico, tribal lands, and other territories and possessions of the 
        United States.

    (g) Participation of Centers.--A center described in subsection (a) 
that is designated under subsection (f) for participation in the pilot 
program shall participate in the pilot program by promoting awareness of 
the assistance and training available to veterans and their families 
through--
            (1) the facilities and other resources of such center;
            (2) the non-Department of Veterans Affairs entity selected 
        pursuant to subsection (c); and
            (3) other appropriate mechanisms.

    (h) Additional Support.--In carrying out the pilot program, the 
Secretary may enter into contracts or other agreements, in addition to 
the contract or agreement described in subsection (c), with such other 
non-Department of Veterans Affairs entities meeting the requirements of 
subsection (c) as the Secretary considers appropriate for purposes of 
the pilot program.
    (i) Report on Pilot Program.--
            (1) Report required.--Not later than three years after the 
        date of the enactment of this Act, the Secretary shall submit to 
        the congressional veterans affairs committees a report on the 
        pilot program.
            (2) Elements.--Each report under paragraph (1) shall include 
        the following:
                    (A) A description of the activities under the pilot 
                program as of the date of such report, including the 
                number of veterans and families provided assistance 
                under the pilot program and the scope and nature of the 
                assistance so provided.

[[Page 122 STAT. 4122]]

                    (B) A current assessment of the effectiveness of the 
                pilot program.
                    (C) Any recommendations that the Secretary considers 
                appropriate for the extension or expansion of the pilot 
                program.
            (3) Congressional veterans affairs committees defined.--In 
        this subsection, the term ``congressional veterans affairs 
        committees'' means--
                    (A) the Committees on Veterans' Affairs and 
                Appropriations of the Senate; and
                    (B) the Committees on Veterans' Affairs and 
                Appropriations of the House of Representatives.

    (j) Authorization of Appropriations.--
            (1) In general.--There is authorized to be appropriated for 
        the Department of Veterans Affairs for each of fiscal years 2009 
        through 2011 $1,000,000 to carry out this section.
            (2) Availability.--Amounts authorized to be appropriated by 
        paragraph (1) shall remain available until expended.

                      TITLE IV--HEALTH CARE MATTERS

SEC. 401. VETERANS BENEFICIARY TRAVEL PROGRAM.

    (a) Repeal of Requirement To Adjust Amounts Deducted From Payments 
or Allowances for Beneficiary Travel.--
            (1) In <<NOTE: 38 USC 111.>> general.--Section 111(c) is 
        amended--
                    (A) by striking paragraph (5); and
                    (B) in paragraph (2), by striking ``, except as 
                provided in paragraph (5) of this subsection,''.
            (2) Reinstatement <<NOTE: 38 USC 111 note.>> of amount of 
        deduction specified by statute.--Notwithstanding any adjustment 
        made by the Secretary of Veterans Affairs under paragraph (5) of 
        section 111(c) of title 38, United States Code, as such 
        paragraph was in effect before the date of the enactment of this 
        Act, the amount deducted under paragraph (1) of such section 
        111(c) on or after such date shall be the amount specified in 
        such paragraph.

    (b) Determination of Mileage Reimbursement Rate.--Section 111(g) is 
amended--
            (1) by amending paragraph (1) to read as follows:

    ``(1) Subject to paragraph (3), in determining the amount of 
allowances or reimbursement to be paid under this section, the Secretary 
shall use the mileage reimbursement rate for the use of privately owned 
vehicles by Government employees on official business (when a Government 
vehicle is available), as prescribed by the Administrator of General 
Services under section 5707(b) of title 5.'';
            (2) by striking paragraphs (3) and (4); and
            (3) by inserting after paragraph (2) the following new 
        paragraph (3):

    ``(3) Subject to the availability of appropriations, the Secretary 
may modify the amount of allowances or reimbursement to be paid under 
this section using a mileage reimbursement rate in excess of that 
prescribed under paragraph (1).''.
    (c) Report.--Not later than 14 months after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall submit

[[Page 122 STAT. 4123]]

to the Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a report containing an 
estimate of the additional costs incurred by the Department of Veterans 
Affairs because of this section, including--
            (1) any costs resulting from increased utilization of 
        healthcare services by veterans eligible for travel allowances 
        or reimbursements under section 111 of title 38, United States 
        Code; and
            (2) the additional costs that would be incurred by the 
        Department should the Secretary exercise the authority described 
        in subsection (g)(3) of such section.

    (d) Effective <<NOTE: 38 USC 111 note.>> Date.--The amendments made 
by this section shall apply with respect to travel expenses incurred 
after the expiration of the 90-day period that begins on the date of the 
enactment of this Act.
SEC. 402. MANDATORY REIMBURSEMENT OF VETERANS RECEIVING EMERGENCY 
                        TREATMENT IN NON-DEPARTMENT OF VETERANS 
                        AFFAIRS FACILITIES UNTIL TRANSFER TO 
                        DEPARTMENT FACILITIES.

    (a) Certain Veterans Without Service-Connected Disability.--
Section <<NOTE: 38 USC 1725.>> 1725 is amended--
            (1) in subsection (a)(1), by striking ``may reimburse'' and 
        inserting ``shall reimburse''; and
            (2) in subsection (f)(1), by striking subparagraph (C) and 
        inserting the following new subparagraph (C):
                    ``(C) until--
                          ``(i) such time as the veteran can be 
                      transferred safely to a Department facility or 
                      other Federal facility and such facility is 
                      capable of accepting such transfer; or
                          ``(ii) such time as a Department facility or 
                      other Federal facility accepts such transfer if--
                                    ``(I) at the time the veteran could 
                                have been transferred safely to a 
                                Department facility or other Federal 
                                facility, no Department facility or 
                                other Federal facility agreed to accept 
                                such transfer; and
                                    ``(II) the non-Department facility 
                                in which such medical care or services 
                                was furnished made and documented 
                                reasonable attempts to transfer the 
                                veteran to a Department facility or 
                                other Federal facility.''.

    (b) Certain Veterans With Service-Connected Disability.--Section 
1728 is amended--
            (1) by striking subsection (a) and inserting the following 
        new subsection (a):

    ``(a) The <<NOTE: Regulations.>> Secretary shall, under such 
regulations as the Secretary prescribes, reimburse veterans eligible for 
hospital care or medical services under this chapter for the customary 
and usual charges of emergency treatment (including travel and 
incidental expenses under the terms and conditions set forth in section 
111 of this title) for which such veterans have made payment, from 
sources other than the Department, where such emergency treatment was 
rendered to such veterans in need thereof for any of the following:
            ``(1) An adjudicated service-connected disability.

[[Page 122 STAT. 4124]]

            ``(2) A non-service-connected disability associated with and 
        held to be aggravating a service-connected disability.
            ``(3) Any disability of a veteran if the veteran has a total 
        disability permanent in nature from a service-connected 
        disability.
            ``(4) Any illness, injury, or dental condition of a veteran 
        who--
                    ``(A) is a participant in a vocational 
                rehabilitation program (as defined in section 3101(9) of 
                this title); and
                    ``(B) is medically determined to have been in need 
                of care or treatment to make possible the veteran's 
                entrance into a course of training, or prevent 
                interruption of a course of training, or hasten the 
                return to a course of training which was interrupted 
                because of such illness, injury, or dental condition.'';
            (2) in subsection (b), by striking ``care or services'' both 
        places it appears and inserting ``emergency treatment''; and
            (3) by adding at the end the following new subsection:

    ``(c) In this section, the term `emergency treatment' has the 
meaning given such term in section 1725(f)(1) of this title.''.
SEC. 403. <<NOTE: 38 USC 1703 note.>> PILOT PROGRAM OF ENHANCED 
                        CONTRACT CARE AUTHORITY FOR HEALTH CARE 
                        NEEDS OF VETERANS IN HIGHLY RURAL AREAS.

    (a) Pilot Program Required.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        conduct a pilot program under which the Secretary provides 
        covered health services to covered veterans through qualifying 
        non-Department of Veterans Affairs health care providers.
            (2) Commencement.--The <<NOTE: Deadline.>> Secretary shall 
        commence the conduct of the pilot program on the date that is 
        120 days after the date of the enactment of this Act.
            (3) Termination.--A veteran may receive health services 
        under the pilot program only during the three-year period 
        beginning on the date of the commencement of the pilot program 
        under paragraph (2).
            (4) Program locations.--The pilot program shall be carried 
        out within areas selected by the Secretary for the purposes of 
        the pilot program in at least five Veterans Integrated Service 
        Networks (VISNs). Of the Veterans Integrated Service Networks so 
        selected--
                    (A) not less than four such networks shall include 
                at least three highly rural counties, as determined by 
                the Secretary upon consideration of the most recent 
                decennial census;
                    (B) not less than one such network, not including a 
                network selected under subparagraph (A), shall include 
                only one highly rural county, as determined by the 
                Secretary upon consideration of the most recent 
                decennial census;
                    (C) all such networks shall include area within the 
                borders of at least four States; and
                    (D) no such networks shall be participants in the 
                Healthcare Effectiveness through Resource Optimization 
                pilot program of the Department of Veterans Affairs.

    (b) Covered Veterans.--

[[Page 122 STAT. 4125]]

            (1) In general.--For purposes of the pilot program under 
        this section, a covered veteran is any highly rural veteran who 
        is--
                    (A) enrolled in the system of patient enrollment 
                established under section 1705(a) of title 38, United 
                States Code, as of the date of the commencement of the 
                pilot program under subsection (a)(2); or
                    (B) eligible for health care under section 
                1710(e)(3)(C) of title 38, United States Code.
            (2) Highly rural veterans.--For purposes of this subsection, 
        a highly rural veteran is any veteran who--
                    (A) resides in a location that is--
                          (i) more than 60 miles driving distance from 
                      the nearest Department health care facility 
                      providing primary care services, if the veteran is 
                      seeking such services;
                          (ii) more than 120 miles driving distance from 
                      the nearest Department health care facility 
                      providing acute hospital care, if the veteran is 
                      seeking such care; or
                          (iii) more than 240 miles driving distance 
                      from the nearest Department health care facility 
                      providing tertiary care, if the veteran is seeking 
                      such care; or
                    (B) in the case of a veteran who resides in a 
                location less than the distance specified in clause (i), 
                (ii), or (iii) of subparagraph (A), as applicable, 
                experiences such hardship or other difficulties in 
                travel to the nearest appropriate Department health care 
                facility that such travel is not in the best interest of 
                the veteran, as determined by the Secretary pursuant to 
                regulations prescribed for purposes of this subsection.

    (c) Covered Health Services.--For purposes of the pilot program 
under this section, a covered health service with respect to a covered 
veteran is any hospital care, medical service, rehabilitative service, 
or preventative health service that is authorized to be provided by the 
Secretary to the veteran under chapter 17 of title 38, United States 
Code, or any other provision of law.
    (d) Qualifying Non-Department Health Care Providers.--For purposes 
of the pilot program under this section, an entity or individual is a 
qualifying non-Department health care provider of a covered health 
service if the Secretary determines that the entity or individual is 
qualified to furnish such service to veterans under the pilot program.
    (e) Election.--A covered veteran seeking to be provided covered 
health services under the pilot program under this section shall submit 
to the Secretary an application therefor in such form, and containing 
such information as the Secretary shall specify for purposes of the 
pilot program.
    (f) Provision of Services Through Contract.--The Secretary shall 
provide covered health services to veterans under the pilot program 
under this section through contracts with qualifying non-Department 
health care providers for the provision of such services.
    (g) Exchange of Medical Information.--In conducting the pilot 
program under this section, the Secretary shall develop and utilize a 
functional capability to provide for the exchange of appropriate medical 
information between the Department and non-

[[Page 122 STAT. 4126]]

Department health care providers providing health services under the 
pilot program.
    (h) Reports.--Not later than the 30 days after the end of each year 
in which the pilot program under this section is conducted, the 
Secretary shall submit to the Committee of Veterans' Affairs of the 
Senate and the Committee on Veterans' Affairs of the House of 
Representatives a report which includes--
            (1) the assessment of the Secretary of the pilot program 
        during the preceding year, including its cost, volume, quality, 
        patient satisfaction, benefit to veterans, and such other 
        findings and conclusions with respect to pilot program as the 
        Secretary considers appropriate; and
            (2) such recommendations as the Secretary considers 
        appropriate regarding--
                    (A) the continuation of the pilot program;
                    (B) extension of the pilot program to other or all 
                Veterans Integrated Service Networks of the Department;
                    (C) making the pilot program permanent.
SEC. 404. EPILEPSY CENTERS OF EXCELLENCE.

    (a) In General.--Subchapter II of chapter 73 is amended by adding at 
the end the following new section:
``Sec. 7330A. Epilepsy centers of excellence

    ``(a) Establishment of Centers.--(1) <<NOTE: Deadline.>> Not later 
than 120 days after the date of the enactment of the Veterans' Mental 
Health and Other Care Improvements Act of 2008, the Secretary shall 
designate at least four but not more than six Department health care 
facilities as locations for epilepsy centers of excellence for the 
Department.

    ``(2) Of the facilities designated under paragraph (1), not less 
than two shall be centers designated under section 7327 of this title.
    ``(3) Of the facilities designated under paragraph (1), not less 
than two shall be facilities that are not centers designated under 
section 7327 of this title.
    ``(4) Subject to the availability of appropriations for such 
purpose, the Secretary shall establish and operate an epilepsy center of 
excellence at each location designated under paragraph (1).
    ``(b) Designation of Facilities.--(1) In designating locations for 
epilepsy centers of excellence under subsection (a), the Secretary shall 
solicit proposals from Department health care facilities seeking 
designation as a location for an epilepsy center of excellence.
    ``(2) The Secretary may not designate a facility as a location for 
an epilepsy center of excellence under subsection (a) unless the peer 
review panel established under subsection (c) has determined under that 
subsection that the proposal submitted by such facility seeking 
designation as a location for an epilepsy center of excellence is among 
those proposals that meet the highest competitive standards of 
scientific and clinical merit.
    ``(3) In choosing from among the facilities meeting the requirements 
of paragraph (2), the Secretary shall also consider appropriate 
geographic distribution when designating the epilepsy centers of 
excellence under subsection (a).
    ``(c) Peer Review Panel.--(1) The Under Secretary for Health shall 
establish a peer review panel to assess the scientific and clinical 
merit of proposals that are submitted to the Secretary

[[Page 122 STAT. 4127]]

for the designation of epilepsy centers of excellence under this 
section.
    ``(2)(A) The membership of the peer review panel shall consist of 
experts on epilepsy, including post-traumatic epilepsy.
    ``(B) Members of the peer review panel shall serve for a period of 
no longer than two years, except as specified in subparagraph (C).
    ``(C) Of the members first appointed to the panel, one half shall be 
appointed for a period of three years and one half shall be appointed 
for a period of two years, as designated by the Under Secretary at the 
time of appointment.
    ``(3) The peer review panel shall review each proposal submitted to 
the panel by the Under Secretary for Health and shall submit its views 
on the relative scientific and clinical merit of each such proposal to 
the Under Secretary.
    ``(4) The peer review panel shall, in conjunction with the national 
coordinator designated under subsection (e), conduct regular evaluations 
of each epilepsy center of excellence established and operated under 
subsection (a) to ensure compliance with the requirements of this 
section.
    ``(5) The peer review panel shall not be subject to the Federal 
Advisory Committee Act.
    ``(d) Epilepsy Center of Excellence Defined.--In this section, the 
term `epilepsy center of excellence' means a health care facility that 
has (or in the foreseeable future can develop) the necessary capacity to 
function as a center of excellence in research, education, and clinical 
care activities in the diagnosis and treatment of epilepsy and has (or 
may reasonably be anticipated to develop) each of the following:
            ``(1) An affiliation with an accredited medical school that 
        provides education and training in neurology, including an 
        arrangement with such school under which medical residents 
        receive education and training in the diagnosis and treatment of 
        epilepsy (including neurosurgery).
            ``(2) The ability to attract the participation of scientists 
        who are capable of ingenuity and creativity in health care 
        research efforts.
            ``(3) An advisory committee composed of veterans and 
        appropriate health care and research representatives of the 
        facility and of the affiliated school or schools to advise the 
        directors of such facility and such center on policy matters 
        pertaining to the activities of the center during the period of 
        the operation of such center.
            ``(4) The capability to conduct effectively evaluations of 
        the activities of such center.
            ``(5) The capability to assist in the expansion of the 
        Department's use of information systems and databases to improve 
        the quality and delivery of care for veterans enrolled within 
        the Department's health care system.
            ``(6) The capability to assist in the expansion of the 
        Department telehealth program to develop, transmit, monitor, and 
        review neurological diagnostic tests.
            ``(7) The ability to perform epilepsy research, education, 
        and clinical care activities in collaboration with Department 
        medical facilities that have centers for research, education, 
        and clinical care activities on complex multi-trauma associated

[[Page 122 STAT. 4128]]

        with combat injuries established under section 7327 of this 
        title.

    ``(e) National Coordinator for 
Epilepsy <<NOTE: Designation.>> Programs.--(1) To assist the Secretary 
and the Under Secretary for Health in carrying out this section, the 
Secretary shall designate an individual in the Veterans Health 
Administration to act as a national coordinator for epilepsy programs of 
the Veterans Health Administration.

    ``(2) The duties of the national coordinator for epilepsy programs 
shall include the following:
            ``(A) To supervise the operation of the centers established 
        pursuant to this section.
            ``(B) To coordinate and support the national consortium of 
        providers with interest in treating epilepsy at Department 
        health care facilities lacking such centers in order to ensure 
        better access to state-of-the-art diagnosis, research, clinical 
        care, and education for traumatic brain injury and epilepsy 
        throughout the health care system of the Department.
            ``(C) To conduct, in conjunction with the peer review panel 
        established under subsection (c), regular evaluations of the 
        epilepsy centers of excellence to ensure compliance  with the 
        requirements of this section.
            ``(D) To coordinate (as part of an integrated national 
        system) education, clinical care, and research activities within 
        all facilities with an epilepsy center of excellence.
            ``(E) To develop jointly a national consortium of providers 
        with interest in treating epilepsy at Department health care 
        facilities lacking an epilepsy center of excellence in order to 
        ensure better access to state-of-the-art diagnosis, research, 
        clinical care, and education for traumatic brain injury and 
        epilepsy throughout the health care system of the Department. 
        Such consortium should include a designated epilepsy referral 
        clinic in each Veterans Integrated Service Network.

    ``(3) In carrying out duties under this subsection, the national 
coordinator for epilepsy programs shall report to the official of the 
Veterans Health Administration responsible for neurology.
    ``(f) Authorization of Appropriations.--(1) There are authorized to 
be appropriated $6,000,000 for each of fiscal years 2009 through 2013 
for the support of the clinical care, research, and education activities 
of the epilepsy centers of excellence established and operated pursuant 
to subsection (a)(2).
    ``(2) There are authorized to be appropriated for each fiscal year 
after fiscal year 2013 such sums as may be necessary for the support of 
the clinical care, research, and education activities of the epilepsy 
centers of excellence established and operated pursuant to subsection 
(a)(2).
    ``(3) The Secretary shall ensure that funds for such centers are 
designated for the first three years of operation as a special purpose 
program for which funds are not allocated through the Veterans Equitable 
Resource Allocation system.
    ``(4) In addition to amounts authorized to be appropriated under 
paragraphs (1) and (2) for a fiscal year, the Under Secretary for Health 
shall allocate to such centers from other funds appropriated generally 
for the Department medical services account and medical and prosthetics 
research account, as appropriate, such amounts as the Under Secretary 
for Health determines appropriate.
    ``(5) In addition to amounts authorized to be appropriated under 
paragraphs (1) and (2) for a fiscal year, there are authorized to

[[Page 122 STAT. 4129]]

be appropriated such sums as may be necessary to fund the national 
coordinator established by subsection (e).''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 is amended by inserting after the item relating to section 
7330 the following new item:

``7330A. Epilepsy centers of excellence.''.

SEC. 405. ESTABLISHMENT OF QUALIFICATIONS FOR PEER SPECIALIST 
                        APPOINTEES.

    (a) In General.--Section <<NOTE: 38 USC 7402.>> 7402(b) is amended--
            (1) by redesignating the paragraph (11) relating to other 
        health care positions as paragraph (14); and
            (2) by inserting after paragraph (12) the following new 
        paragraph (13):

    ``(13) Peer Specialist.--To be eligible to be appointed to a peer 
specialist position, a person must--
            ``(A) be a veteran who has recovered or is recovering from a 
        mental health condition; and
            ``(B) be certified by--
                    ``(i) a not-for-profit entity engaged in peer 
                specialist training as having met such criteria as the 
                Secretary shall establish for a peer specialist 
                position; or
                    ``(ii) a State as having satisfied relevant State 
                requirements for a peer specialist position.''.

    (b) Peer Specialist Training.--Section 7402 is amended by adding at 
the end the following new subsection:
    ``(g) The Secretary may enter into contracts with not-for-profit 
entities to provide--
            ``(1) peer specialist training to veterans; and
            ``(2) certification for veterans under subsection 
        (b)(13)(B)(i).''.
SEC. 406. ESTABLISHMENT OF CONSOLIDATED PATIENT ACCOUNTING 
                        CENTERS.

    (a) Establishment of Centers.--Chapter 17 is amended by inserting 
after section 1729A the following new section:
``Sec. 1729B. Consolidated patient accounting centers

    ``(a) In General.--Not <<NOTE: Deadline.>> later than five years 
after the date of the enactment of this section, the Secretary of 
Veterans Affairs shall establish not more than seven consolidated 
patient accounting centers for conducting industry-modeled regionalized 
billing and collection activities of the Department.

    ``(b) Functions.--The centers shall carry out the following 
functions:
            ``(1) Reengineer and integrate all business processes of the 
        revenue cycle of the Department.
            ``(2) Standardize and coordinate all activities of the 
        Department related to the revenue cycle for all health care 
        services furnished to veterans for non-service-connected medical 
        conditions.
            ``(3) Apply commercial industry standards for measures of 
        access, timeliness, and performance metrics with respect to 
        revenue enhancement of the Department.
            ``(4) Apply other requirements with respect to such revenue 
        cycle improvement as the Secretary may specify.''.

[[Page 122 STAT. 4130]]

    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by inserting after the item relating to section 
1729A the following:

``1729B. Consolidated patient accounting centers.''.

SEC. 407. REPEAL OF LIMITATION ON AUTHORITY TO CONDUCT WIDESPREAD 
                        HIV TESTING PROGRAM.

    Section 124 of the Veterans' Benefits and Services Act of 1988 
(title I of Public Law 100-322, as amended; 38 U.S.C. 7333 note) is 
repealed.
SEC. 408. PROVISION OF COMPREHENSIVE HEALTH CARE BY SECRETARY OF 
                        VETERANS AFFAIRS TO CHILDREN OF VIETNAM 
                        VETERANS BORN WITH SPINA BIFIDA.

    (a) Provision of Comprehensive Health Care.--Section 1803(a) 
is <<NOTE: 38 USC 1803.>> amended by striking ``such health care as the 
Secretary determines is needed by the child for the spina bifida or any 
disability that is associated with such condition'' and inserting 
``health care under this section''.

    (b) Effective <<NOTE: 38 USC 1803 note.>> Date.--The amendment made 
by subsection (a) shall apply with respect to care furnished after the 
date of the enactment of this Act.
SEC. 409. EXEMPTION FROM COPAYMENT REQUIREMENT FOR VETERANS 
                        RECEIVING HOSPICE CARE.

    Section 1710 is amended--
            (1) in subsection (f)(1), by inserting ``(except if such 
        care constitutes hospice care)'' after ``nursing home care''; 
        and
            (2) in subsection (g)(1), by inserting ``(except if such 
        care constitutes hospice care)'' after ``medical services''.

                           TITLE V--PAIN CARE

SEC. 501. <<NOTE: 38 USC 7311 note.>> COMPREHENSIVE POLICY ON PAIN 
                        MANAGEMENT.

    (a) Comprehensive Policy Required.--Not <<NOTE: Deadline.>> later 
than October 1, 2009, the Secretary of Veterans Affairs shall develop 
and implement a comprehensive policy on the management of pain 
experienced by veterans enrolled for health care services provided by 
the Department of Veterans Affairs.

    (b) Scope of Policy.--The policy required by subsection (a) shall 
cover each of the following:
            (1) The Department-wide management of acute and chronic pain 
        experienced by veterans.
            (2) The standard of care for pain management to be used 
        throughout the Department.
            (3) The consistent application of pain assessments to be 
        used throughout the Department.
            (4) The assurance of prompt and appropriate pain care 
        treatment and management by the Department, system-wide, when 
        medically necessary.
            (5) Department programs of research related to acute and 
        chronic pain suffered by veterans, including pain attributable 
        to central and peripheral nervous system damage characteristic 
        of injuries incurred in modern warfare.
            (6) Department programs of pain care education and training 
        for health care personnel of the Department.

[[Page 122 STAT. 4131]]

            (7) Department programs of patient education for veterans 
        suffering from acute or chronic pain and their families.

    (c) Updates.--The Secretary shall revise the policy required by 
subsection (a) on a periodic basis in accordance with experience and 
evolving best practice guidelines.
    (d) Consultation.--The Secretary shall develop the policy required 
by subsection (a), and revise such policy under subsection (c), in 
consultation with veterans service organizations and organizations with 
expertise in the assessment, diagnosis, treatment, and management of 
pain.
    (e) Annual Report.--
            (1) In general.--Not later than 180 days after the date of 
        the completion and initial implementation of the policy required 
        by subsection (a) and on October 1 of every fiscal year 
        thereafter through fiscal year 2018, the Secretary shall submit 
        to the Committee on Veterans' Affairs of the Senate and the 
        Committee on Veterans' Affairs of the House of Representatives a 
        report on the implementation of the policy required by 
        subsection (a).
            (2) Contents.--The report required by paragraph (1) shall 
        include the following:
                    (A) A description of the policy developed and 
                implemented under subsection (a) and any revisions to 
                such policy under subsection (c).
                    (B) A description of the performance measures used 
                to determine the effectiveness of such policy in 
                improving pain care for veterans system-wide.
                    (C) An assessment of the adequacy of Department pain 
                management services based on a survey of patients 
                managed in Department clinics.
                    (D) An assessment of the research projects of the 
                Department relevant to the treatment of the types of 
                acute and chronic pain suffered by veterans.
                    (E) An assessment of the training provided to 
                Department health care personnel with respect to the 
                diagnosis, treatment, and management of acute and 
                chronic pain.
                    (F) An assessment of the patient pain care education 
                programs of the Department.

    (f) Veterans Service Organization Defined.--In this section, the 
term ``veterans service organization'' means any organization recognized 
by the Secretary for the representation of veterans under section 5902 
of title 38, United States Code.

                   TITLE VI--HOMELESS VETERANS MATTERS

SEC. 601. INCREASED AUTHORIZATION OF APPROPRIATIONS FOR 
                        COMPREHENSIVE SERVICE PROGRAMS.

    Section 2013 <<NOTE: 38 USC 2013.>> is amended by striking 
``$130,000,000'' and inserting ``$150,000,000''.

[[Page 122 STAT. 4132]]

SEC. 602. EXPANSION AND EXTENSION OF AUTHORITY FOR PROGRAM OF 
                        REFERRAL AND COUNSELING SERVICES FOR AT-
                        RISK VETERANS TRANSITIONING FROM CERTAIN 
                        INSTITUTIONS.

    (a) Program Authority.--Subsection (a) of <<NOTE: 38 USC 
2023.>> section 2023 is amended by striking ``a demonstration program 
for the purpose of determining the costs and benefits of providing'' and 
inserting ``a program of''.

    (b) Scope of Program.--Subsection (b) of such section is amended--
            (1) by striking ``Demonstration'' in the subsection heading;
            (2) by striking ``demonstration''; and
            (3) by striking ``in at least six locations'' and inserting 
        ``in at least 12 locations''.

    (c) Extension of Authority.--Subsection <<NOTE: Termination 
date.>> (d) of such section is amended by striking ``shall cease'' and 
all that follows and inserting ``shall cease on September 30, 2012.''.

    (d) Conforming Amendments.--
            (1) Subsection (c)(1) of such section is amended by striking 
        ``demonstration''.
            (2) The heading of such section is amended to read as 
        follows:
``Sec. 2023. Referral and counseling services: veterans at risk of 
                  homelessness who are transitioning from certain 
                  institutions''.
            (3) Section 2022(f)(2)(C) of such title is amended by 
        striking ``demonstration''.

    (e) Clerical Amendment.--The table of sections at the beginning of 
chapter 20 is amended by striking the item relating to section 2023 and 
inserting the following:

``2023. Referral and counseling services: veterans at risk of 
           homelessness who are transitioning from certain 
           institutions.''.

SEC. 603. PERMANENT AUTHORITY FOR DOMICILIARY SERVICES FOR 
                        HOMELESS VETERANS AND ENHANCEMENT OF 
                        CAPACITY OF DOMICILIARY CARE PROGRAMS FOR 
                        FEMALE VETERANS.

    Subsection (b) of section 2043 is amended to read as follows:
    ``(b) Enhancement of Capacity of Domiciliary Care Programs for 
Female Veterans.--The Secretary shall take appropriate actions to ensure 
that the domiciliary care programs of the Department are adequate, with 
respect to capacity and with respect to safety, to meet the needs of 
veterans who are women.''.
SEC. 604. FINANCIAL ASSISTANCE FOR SUPPORTIVE SERVICES FOR VERY 
                        LOW-INCOME VETERAN FAMILIES IN PERMANENT 
                        HOUSING.

    (a) Purpose.--The <<NOTE: 38 USC 2044 note.>> purpose of this 
section is to facilitate the provision of supportive services for very 
low-income veteran families in permanent housing.

    (b) Financial Assistance.--
            (1) In general.--Subchapter V of chapter 20 is amended by 
        adding at the end the following new section:

[[Page 122 STAT. 4133]]

``Sec. 2044. Financial assistance for supportive services for very 
                  low-income veteran families in permanent housing

    ``(a) Distribution of Financial Assistance.--(1) The Secretary shall 
provide financial assistance to eligible entities approved under this 
section to provide and coordinate the provision of supportive services 
described in subsection (b) for very low-income veteran families 
occupying permanent housing.
    ``(2) Financial assistance under this section shall consist of 
grants for each such family for which an approved eligible entity is 
providing or coordinating the provision of supportive services.
    ``(3)(A) The <<NOTE: Grants.>> Secretary shall provide such grants 
to each eligible entity that is providing or coordinating the provision 
of supportive services.

    ``(B) The Secretary is authorized to establish intervals of payment 
for the administration of such grants and establish a maximum amount to 
be awarded, in accordance with the services being provided and their 
duration.
    ``(4) In providing financial assistance under paragraph (1), the 
Secretary shall give preference to entities providing or coordinating 
the provision of supportive services for very low-income veteran 
families who are transitioning from homelessness to permanent housing.
    ``(5) The Secretary shall ensure that, to the extent practicable, 
financial assistance under this subsection is equitably distributed 
across geographic regions, including rural communities and tribal lands.
    ``(6) <<NOTE: Notification.>> Each entity receiving financial 
assistance under this section to provide supportive services to a very 
low-income veteran family shall notify that family that such services 
are being paid for, in whole or in part, by the Department.

    ``(7) The Secretary may require entities receiving financial 
assistance under this section to submit a report to the Secretary that 
describes the projects carried out with such financial assistance.
    ``(b) Supportive Services.--The supportive services referred to in 
subsection (a) are the following:
            ``(1) Services provided by an eligible entity or a 
        subcontractor of an eligible entity that address the needs of 
        very low-income veteran families occupying permanent housing, 
        including--
                    ``(A) outreach services;
                    ``(B) case management services;
                    ``(C) assistance in obtaining any benefits from the 
                Department which the veteran may be eligible to receive, 
                including, but not limited to, vocational and 
                rehabilitation counseling, employment and training 
                service, educational assistance, and health care 
                services; and
                    ``(D) assistance in obtaining and coordinating the 
                provision of other public benefits provided in federal, 
                State, or local agencies, or any organization defined in 
                subsection (f), including--
                          ``(i) health care services (including 
                      obtaining health insurance);
                          ``(ii) daily living services;
                          ``(iii) personal financial planning;
                          ``(iv) transportation services;
                          ``(v) income support services;

[[Page 122 STAT. 4134]]

                          ``(vi) fiduciary and representative payee 
                      services;
                          ``(vii) legal services to assist the veteran 
                      family with issues that interfere with the 
                      family's ability to obtain or retain housing or 
                      supportive services;
                          ``(viii) child care;
                          ``(ix) housing counseling; and
                          ``(x) other services necessary for maintaining 
                      independent living.
            ``(2) Services described in paragraph (1) that are delivered 
        to very low-income veteran families who are homeless and who are 
        scheduled to become residents of permanent housing within 90 
        days pending the location or development of housing suitable for 
        permanent housing.
            ``(3) Services described in paragraph (1) for very low-
        income veteran families who have voluntarily chosen to seek 
        other housing after a period of tenancy in permanent housing, 
        that are provided, for a period of 90 days after such families 
        exit permanent housing or until such families commence receipt 
        of other housing services adequate to meet their current needs, 
        but only to the extent that services under this paragraph are 
        designed to support such families in their choice to transition 
        into housing that is responsive to their individual needs and 
        preferences.

    ``(c) Application for Financial Assistance.--(1) An eligible entity 
seeking financial assistance under subsection (a) shall submit to the 
Secretary an application therefor in such form, in such manner, and 
containing such commitments and information as the Secretary determines 
to be necessary to carry out this section.
    ``(2) Each application submitted by an eligible entity under 
paragraph (1) shall contain--
            ``(A) a description of the supportive services proposed to 
        be provided by the eligible entity and the identified needs for 
        those services;
            ``(B) a description of the types of very low-income veteran 
        families proposed to be provided such services;
            ``(C) an estimate of the number of very low-income veteran 
        families proposed to be provided such services;
            ``(D) evidence of the experience of the eligible entity in 
        providing supportive services to very low-income veteran 
        families; and
            ``(E) a description of the managerial capacity of the 
        eligible entity--
                    ``(i) to coordinate the provision of supportive 
                services with the provision of permanent housing by the 
                eligible entity or by other organizations;
                    ``(ii) to assess continuously the needs of very low-
                income veteran families for supportive services;
                    ``(iii) to coordinate the provision of supportive 
                services with the services of the Department;
                    ``(iv) to tailor supportive services to the needs of 
                very low-income veteran families; and
                    ``(v) to seek continuously new sources of assistance 
                to ensure the long-term provision of supportive services 
                to very low-income veteran families.

    ``(3) The <<NOTE: Criteria.>> Secretary shall establish criteria for 
the selection of eligible entities to be provided financial assistance 
under this section.

[[Page 122 STAT. 4135]]

    ``(d) Technical Assistance.--(1) The Secretary shall provide 
training and technical assistance to participating eligible entities 
regarding the planning, development, and provision of supportive 
services to very low-income veteran families occupying permanent 
housing, through the Technical Assistance grants program in section 2064 
of this title.
    ``(2) The Secretary may provide the training described in paragraph 
(1) directly or through grants or contracts with appropriate public or 
nonprofit private entities.
    ``(e) Funding.--(1) From amounts appropriated to the Department for 
Medical Services, there shall be available to carry out subsection (a), 
(b), and (c) amounts as follows:
            ``(A) $15,000,000 for fiscal year 2009.
            ``(B) $20,000,000 for fiscal year 2010.
            ``(C) $25,000,000 for fiscal year 2011.

    ``(2) Not more than $750,000 may be available under paragraph (1) in 
any fiscal year to provide technical assistance under subsection (d).
    ``(3) <<NOTE: Appropriation authorization.>> There is authorized to 
be appropriated $1,000,000 for each of the fiscal year 2009 through 2011 
to carry out the provisions of subsection (d).

    ``(f) Definitions.--In this section:
            ``(1) The term `consumer cooperative' has the meaning given 
        such term in section 202 of the Housing Act of 1959 (12 U.S.C. 
        1701q).
            ``(2) The term `eligible entity' means--
                    ``(A) a private nonprofit organization; or
                    ``(B) a consumer cooperative.
            ``(3) The term `homeless' has the meaning given that term in 
        section 103 of the McKinney-Vento Homeless Assistance Act (42 
        U.S.C. 11302).
            ``(4) The term `permanent housing' means community-based 
        housing without a designated length of stay.
            ``(5) The term `private nonprofit organization' means any of 
        the following:
                    ``(A) Any incorporated private institution or 
                foundation--
                          ``(i) no part of the net earnings of which 
                      inures to the benefit of any member, founder, 
                      contributor, or individual;
                          ``(ii) which has a governing board that is 
                      responsible for the operation of the supportive 
                      services provided under this section; and
                          ``(iii) which is approved by the Secretary as 
                      to financial responsibility.
                    ``(B) A for-profit limited partnership, the sole 
                general partner of which is an organization meeting the 
                requirements of clauses (i), (ii), and (iii) of 
                subparagraph (A).
                    ``(C) A corporation wholly owned and controlled by 
                an organization meeting the requirements of clauses (i), 
                (ii), and (iii) of subparagraph (A).
                    ``(D) A tribally designated housing entity (as 
                defined in section 4 of the Native American Housing 
                Assistance and Self-Determination Act of 1996 (25 U.S.C. 
                4103)).
            ``(6)(A) Subject to subparagraphs (B) and (C), the term 
        `very low-income veteran family' means a veteran family whose 
        income does not exceed 50 percent of the median income for

[[Page 122 STAT. 4136]]

        an area specified by the Secretary for purposes of this section, 
        as determined by the Secretary in accordance with this 
        paragraph.
            ``(B) The Secretary shall make appropriate adjustments to 
        the income requirement under subparagraph (A) based on family 
        size.
            ``(C) The Secretary may establish an income ceiling higher 
        or lower than 50 percent of the median income for an area if the 
        Secretary determines that such variations are necessary because 
        the area has unusually high or low construction costs, fair 
        market rents (as determined under section 8 of the United States 
        Housing Act of 1937 (42 U.S.C. 1437f)), or family incomes.
            ``(7) The term `veteran family' includes a veteran who is a 
        single person and a family in which the head of household or the 
        spouse of the head of household is a veteran.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 20 is amended by inserting after the item 
        relating to section 2043 the following new item:

``2044. Financial assistance for supportive services for very low-income 
           veteran families in permanent housing.''.

    (c) Study of Effectiveness of Permanent Housing Program.--
            (1) In general.--For fiscal years 2009 and 2010, the 
        Secretary shall conduct a study of the effectiveness of the 
        permanent housing program under section 2044 of title 38, United 
        States Code, as added by subsection (b), in meeting the needs of 
        very low-income veteran families, as that term is defined in 
        that section.
            (2) Comparison.--In the study required by paragraph (1), the 
        Secretary shall compare the results of the program referred to 
        in that subsection with other programs of the Department of 
        Veterans Affairs dedicated to the delivery of housing and 
        services to veterans.
            (3) Criteria.--In making the comparison required in 
        paragraph (2), the Secretary shall examine the following:
                    (A) The satisfaction of veterans targeted by the 
                programs described in paragraph (2).
                    (B) The health status of such veterans.
                    (C) The housing provided such veterans under such 
                programs.
                    (D) The degree to which such veterans are encouraged 
                to productive activity by such programs.
            (4) Report.--Not later than March 31, 2011, the Secretary 
        shall submit to the Committee on Veterans' Affairs of the Senate 
        and the Committee on Veterans' Affairs of the House of 
        Representatives a report on the results of the study required by 
        paragraph (1).

[[Page 122 STAT. 4137]]

TITLE VII--AUTHORIZATION OF MEDICAL FACILITY PROJECTS AND MAJOR MEDICAL 
                             FACILITY LEASES

SEC. 701. AUTHORIZATION FOR FISCAL YEAR 2009 MAJOR MEDICAL 
                        FACILITY PROJECTS.

    The Secretary of Veterans Affairs may carry out the following major 
medical facility projects in fiscal year 2009 in the amount specified 
for each project:
            (1) Seismic corrections, Building 2, at the Department of 
        Veterans Affairs Palo Alto Health Care System, Palo Alto 
        Division Palo Alto, California, in an amount not to exceed 
        $54,000,000.
            (2) Construction of a polytrauma healthcare and 
        rehabilitation center at the Department of Veterans Affairs 
        Medical Center, San Antonio, Texas, in an amount not to exceed 
        $66,000,000.
            (3) Seismic corrections, Building 1, at the Department of 
        Veterans Affairs Medical Center, San Juan, Puerto Rico, in an 
        amount not to exceed $225,900,000.
SEC. 702. MODIFICATION OF AUTHORIZATION AMOUNTS FOR CERTAIN MAJOR 
                        MEDICAL FACILITY CONSTRUCTION PROJECTS 
                        PREVIOUSLY AUTHORIZED.

    (a) Modification of Major Medical Facility Authorizations.--Section 
801(a) of the Veterans Benefits, Health Care, and Information Technology 
Act of <<NOTE: 120 Stat. 3442.>> 2006 (Public Law 109-461) is amended--
            (1) in paragraph (1)--
                    (A) by striking ``$300,000,000'' and inserting 
                ``$625,000,000''; and
                    (B) by striking the second sentence; and
            (2) in paragraph (3), by striking ``$98,000,000'' and 
        inserting ``$568,400,000''.

    (b) Modification of Authorization for Certain Major Medical Facility 
Construction Projects Previously Authorized in Connection With Capital 
Asset Realignment Initiative.--
            (1) Correction of patient privacy deficiencies at the 
        department of veterans affairs medical center, gainesville, 
        florida.--Paragraph (5) of section 802 <<NOTE: 120 Stat. 
        3443.>> of the Veterans Benefits, Health Care, and Information 
        Technology Act of 2006 (Public Law 109-461) is amended by 
        striking ``$85,200,000'' and inserting ``$136,700,000''.
            (2) Construction of a new medical center facility at the 
        department of veterans affairs medical center, las vegas, 
        nevada.--Paragraph (7) of such section is amended by striking 
        ``$406,000,000'' and inserting ``$600,400,000''.
            (3) Construction of a new outpatient clinic, lee county, 
        florida.--Paragraph (8) of such section is amended--
                    (A) by striking ``ambulatory'' and all that follows 
                through ``purchase,'' and inserting ``outpatient clinic 
                in''; and
                    (B) by striking ``$65,100,000'' and inserting 
                ``$131,800,000''.

[[Page 122 STAT. 4138]]

            (4) Construction of a new medical center facility, orlando, 
        florida.--Paragraph (11) of such section is amended by striking 
        ``$377,700,000'' and inserting ``$656,800,000''.
            (5) Consolidation of campuses at the university drive and h. 
        john heinz iii divisions, pittsburgh, pennsylvania.--Paragraph 
        (12) of such section is amended by striking ``$189,205,000'' and 
        inserting ``$295,600,000''.
SEC. 703. AUTHORIZATION OF FISCAL YEAR 2009 MAJOR MEDICAL FACILITY 
                        LEASES.

    The Secretary of Veterans Affairs may carry out the following major 
medical facility leases in fiscal year 2009 at the locations specified, 
and in an amount for each lease not to exceed the amount shown for such 
location:
            (1) For an outpatient clinic, Brandon, Florida, $4,326,000.
            (2) For an outpatient clinic, Colorado Springs, Colorado, 
        $10,300,000.
            (3) For an outpatient clinic, Eugene, Oregon, $5,826,000.
            (4) For the expansion of an outpatient clinic, Green Bay, 
        Wisconsin, $5,891,000.
            (5) For an outpatient clinic, Greenville, South Carolina, 
        $3,731,000.
            (6) For an outpatient clinic, Mansfield, Ohio, $2,212,000.
            (7) For an outpatient clinic, Mayaguez, Puerto Rico, 
        $6,276,000.
            (8) For an outpatient clinic, Mesa, Arizona, $5,106,000.
            (9) For interim research space, Palo Alto, California, 
        $8,636,000.
            (10) For the expansion of an outpatient clinic, Savannah, 
        Georgia, $3,168,000.
            (11) For an outpatient clinic, Sun City, Arizona, 
        $2,295,000.
            (12) For a primary care annex, Tampa, Florida, $8,652,000.
            (13) For an outpatient clinic, Peoria, Illinois, $3,600,000.
SEC. 704. AUTHORIZATION OF APPROPRIATIONS.

    (a) Authorization of Appropriations for Fiscal Year 2009 Major 
Medical Facility Projects.--There is authorized to be appropriated for 
the Secretary of Veterans Affairs for fiscal year 2009 for the 
Construction, Major Projects, account--
            (1) $345,900,000 for the projects authorized in section 701; 
        and
            (2) $1,493,495,000 for the increased amounts authorized for 
        projects whose authorizations are modified by section 702.

    (b) Authorization For Appropriations For Fiscal Year 2009 Major 
Medical Facility Leases.--There is authorized to be appropriated for the 
Secretary of Veterans Affairs for fiscal year 2009 for the Medical 
Facilities account, $70,019,000, for the leases authorized in section 
703.
SEC. 705. INCREASE IN THRESHOLD FOR MAJOR MEDICAL FACILITY LEASES 
                        REQUIRING CONGRESSIONAL APPROVAL.

    Section 8104(a)(3)(B) <<NOTE: 38 USC 8104.>> is amended by striking 
``$600,000'' and inserting ``$1,000,000''.

[[Page 122 STAT. 4139]]

SEC. 706. CONVEYANCE OF CERTAIN NON-FEDERAL LAND BY CITY OF 
                        AURORA, COLORADO, TO SECRETARY OF VETERANS 
                        AFFAIRS FOR CONSTRUCTION OF VETERANS 
                        MEDICAL FACILITY.

    Section 410 of title IV of division I of the Consolidated 
Appropriations Act, 2008 (Public Law 110-161; 121 Stat. 2276) is amended 
to read as follows:
``SEC. 410. CONVEYANCE OF CERTAIN NON-FEDERAL LAND.

    ``(a) Definitions.--In this section:
            ``(1) City.--The term `City' means the City of Aurora, 
        Colorado.
            ``(2) Deed.--The term `deed' means the quitclaim deed--
                    ``(A) conveyed to the City by the Secretary (acting 
                through the Director of the National Park Service); and
                    ``(B) dated May 24, 1999.
            ``(3) Non-federal land.--The term `non-Federal land' means--
                    ``(A) parcel I of the former United States Army 
                Garrison Fitzsimons, Adams County, Colorado, as more 
                specifically described in the deed; and
                    ``(B) the parcel of land described in the deed.
            ``(4) Secretary.--The term `Secretary' means the Secretary 
        of the Interior.

    ``(b) Duty of Secretary.--To <<NOTE: Deadline.>> allow the City to 
convey by donation to the United States the non-Federal land to be used 
by the Secretary of Veterans Affairs for the construction of a veterans 
medical facility, not later than 60 days after the date of enactment of 
this section, the Secretary shall execute each instrument that is 
necessary to release all rights, conditions, and restrictions retained 
by the United States in and to the non-Federal land conveyed in the 
deed.''.
SEC. 707. REPORT ON FACILITIES ADMINISTRATION.

    Not later than 60 days after the date of the enactment of this Act, 
the Secretary of Veterans Affairs shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report on the progress of the 
Secretary in complying with section 312A of title 38, United States 
Code.
SEC. 708. ANNUAL REPORT ON OUTPATIENT CLINICS.

    (a) Annual Report Required.--Subchapter I of chapter 81 is amended 
by adding at the end the following new section:
``Sec. 8119. Annual report on outpatient clinics

    ``(a) Annual Report Required.--The Secretary shall submit to the 
committees an annual report on community-based outpatient clinics and 
other outpatient clinics of the Department. The report shall be 
submitted each year not later than the date on which the budget for the 
next fiscal year is submitted to the Congress under section 1105 of 
title 31.
    ``(b) Contents of Report.--Each report required under subsection (a) 
shall include the following:
            ``(1) A list of each community-based outpatient clinic and 
        other outpatient clinic of the Department, and for each such 
        clinic, the type of clinic, location, size, number of health 
        professionals employed by the clinic, workload, whether the 
        clinic

[[Page 122 STAT. 4140]]

        is leased or constructed and operated by the Secretary, and the 
        annual cost of operating the clinic.
            ``(2) A list of community-based outpatient clinics and other 
        outpatient clinics that the Secretary opened during the fiscal 
        year preceding the fiscal year during which the report is 
        submitted and a list of clinics the Secretary proposes opening 
        during the fiscal year during which the report is submitted and 
        the subsequent fiscal year, together with the cost of activating 
        each such clinic and the information required to be provided 
        under paragraph (1) for each such clinic and proposed clinic.
            ``(3) A list of proposed community-based outpatient clinics 
        and other outpatient clinics that are, as of the date of the 
        submission of the report, under review by the National Review 
        Panel and a list of possible locations for future clinics 
        identified in the Department's strategic planning process, 
        including any identified locations in rural and underserved 
        areas.
            ``(4) A prioritized list of sites of care identified by the 
        Secretary that the Secretary could establish without carrying 
        out construction or entering into a lease, including--
                    ``(A) any such sites that could be expanded by 
                hiring additional staff or allocating staff to Federal 
                facilities or facilities operating in collaboration with 
                the Federal Government; and
                    ``(B) any sites established, or able to be 
                established, under sections 8111 and 8153 of this 
                title.''.

    (b) Deadline <<NOTE: 38 USC 8119 note.>> for First Annual Report.--
The Secretary of Veterans Affairs shall submit the first report required 
under section 8119(a) of title 38, United States Code, as added by 
subsection (a), by not later than 90 days after the date of the 
enactment of this Act.

    (c) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by adding at the end of the items relating to 
subchapter I the following new item:

``8119. Annual report on outpatient clinics.''.

SEC. 709. NAME OF DEPARTMENT OF VETERANS AFFAIRS SPINAL CORD 
                        INJURY CENTER, TAMPA, FLORIDA.

    The spinal cord injury center located at the James A. Haley 
Department of Veterans Affairs Medical Center in Tampa, Florida, shall 
after the date of the enactment of this Act be known and designated as 
the ``Michael Bilirakis Department of Veterans Affairs Spinal Cord 
Injury Center''. Any reference to such center in any law, regulation, 
map, document, record, or other paper of the United States shall be 
considered to be a reference to the ``Michael Bilirakis Department of 
Veterans Affairs Spinal Cord Injury Center''.

              TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

SEC. 801. REPEAL OF SUNSET ON INCLUSION OF NONINSTITUTIONAL 
                        EXTENDED CARE SERVICES IN DEFINITION OF 
                        MEDICAL SERVICES.

    Section 1701 <<NOTE: 38 USC 1701.>> is amended--
            (1) by striking paragraph (10); and

[[Page 122 STAT. 4141]]

            (2) in paragraph (6)--
                    (A) by redesignating subparagraphs (E) and (F) as 
                subparagraphs (F) and (G), respectively; and
                    (B) by inserting after subparagraph (D) the 
                following new subparagraph (E):
                    ``(E) Noninstitutional extended care services, 
                including alternatives to institutional extended care 
                that the Secretary may furnish directly, by contract, or 
                through provision of case management by another provider 
                or payer.''.
SEC. 802. EXTENSION OF RECOVERY AUDIT AUTHORITY.

    Section 1703(d)(4) <<NOTE: 38 USC 1703.>> is amended by striking 
``September 30, 2008'' and inserting ``September 30, 2013''.
SEC. 803. PERMANENT AUTHORITY FOR PROVISION OF HOSPITAL CARE, 
                        MEDICAL SERVICES, AND NURSING HOME CARE TO 
                        VETERANS WHO PARTICIPATED IN CERTAIN 
                        CHEMICAL AND BIOLOGICAL TESTING CONDUCTED 
                        BY THE DEPARTMENT OF DEFENSE.

    (a) Permanent Authority.--Subsection (e)(3) of section 1710 is 
amended--
            (1) in subparagraph (B), by inserting ``and'' after the 
        semicolon;
            (2) in subparagraph (C), by striking ``; and'' and inserting 
        a period; and
            (3) by striking subparagraph (D).

    (b) Conforming Amendment.--Subsection (e)(1)(E) of such section is 
amended by striking ``paragraphs (2) and (3)'' and inserting ``paragraph 
(2)''.
SEC. 804. EXTENSION OF EXPIRING COLLECTIONS AUTHORITIES.

    (a) Health Care Copayments.--Section 1710(f)(2)(B) is amended by 
striking ``September 30, 2008'' and inserting ``September 30, 2010''.
    (b) Medical Care Cost Recovery.--Section 1729(a)(2)(E) is amended by 
striking ``October 1, 2008'' and inserting ``October 1, 2010''.
SEC. 805. EXTENSION OF NURSING HOME CARE.

    Section 1710A(d) is amended by striking ``December 31, 2008'' and 
inserting ``December 31, 2013''.
SEC. 806. PERMANENT AUTHORITY TO ESTABLISH RESEARCH CORPORATIONS.

    (a) Repeal.--Chapter 73 is amended by striking section 7368.
    (b) Clerical Amendment.--The table of sections at the beginning of 
such chapter is amended by striking the item relating to section 7368.
SEC. 807. EXTENSION OF REQUIREMENT TO SUBMIT ANNUAL REPORT ON THE 
                        COMMITTEE ON CARE OF SEVERELY CHRONICALLY 
                        MENTALLY ILL VETERANS.

    Section 7321(d)(2) is amended by striking ``through 2008'' and 
inserting ``through 2012''.
SEC. 808. PERMANENT REQUIREMENT FOR BIANNUAL REPORT ON WOMEN'S 
                        ADVISORY COMMITTEE.

    Section 542(c)(1) is amended by striking ``through 2008''.

[[Page 122 STAT. 4142]]

SEC. 809. EXTENSION OF PILOT PROGRAM ON IMPROVEMENT OF CAREGIVER 
                        ASSISTANCE SERVICES.

    Section 214 of the Veterans Benefits, Health Care, and Information 
Technology Act of 2006 (Public Law 109-461; 38 U.S.C. 1710B note) is 
amended--
            (1) in subsection (b), by striking ``two-year period'' and 
        inserting ``three-year period''; and
            (2) in subsection (d), by striking ``fiscal years 2007 and 
        2008'' and inserting ``fiscal years 2007 through 2009''.

                         TITLE IX--OTHER MATTERS

SEC. 901. TECHNICAL AMENDMENTS.

    (a) Title 38.--Title 38, United States Code, is amended--
            (1) in section 1712A--
                    (A) by striking subsection (g);
                    (B) by redesignating subsections (d) through (i) as 
                subsections (c) through (f), respectively; and
                    (C) in subsection (f), as so redesignated, by 
                striking ``(including a Resource Center designated under 
                subsection (h)(3)(A) of this section)'';
            (2) in section 2065(b)(3)(C), by striking ``)'';
            (3) in the table of sections at the beginning of chapter 36, 
        by striking the item relating to section 3684A and inserting the 
        following new item:

``3684A. Procedures relating to computer matching program.'';

            (4) in section 4110(c)(1), by striking ``15'' and inserting 
        ``16'';
            (5) in the table of sections at the beginning of chapter 51, 
        by striking the item relating to section 5121 and inserting the 
        following new item:

``5121. Payment of certain accrued benefits upon death of a 
           beneficiary.'';

            (6) in section 7458(b)(2), by striking ``pro rated'' and 
        inserting ``pro-rated'';
            (7) in section 8117(a)(1), by striking ``such such'' and 
        inserting ``such''; and
            (8) in each of sections 1708(d), 7314(f), 7320(j)(2), 
        7325(i)(2), and 7328(i)(2), by striking ``medical care account'' 
        and inserting ``medical services account''.

    (b) Veterans Benefits, Health Care, and Information Technology Act 
of 2006.--Section 807(e) of the Veterans Benefits, Health Care, and 
Information Technology Act of 2006 (Public Law

[[Page 122 STAT. 4143]]

109-461) is <<NOTE: 120 Stat. 3445.>> amended by striking ``Medical 
Care'' each place it appears and inserting ``Medical Facilities''.

    Approved October 10, 2008.

LEGISLATIVE HISTORY--S. 2162:
---------------------------------------------------------------------------

SENATE REPORTS: No. 110-281 (Comm. on Veterans' Affairs).
CONGRESSIONAL RECORD, Vol. 154 (2008):
            June 3, considered and passed Senate.
            Sept. 24, considered and passed House, amended.
            Sept. 27, Senate concurred in House amendment.

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