Text: S.1963 — 111th Congress (2009-2010)All Information (Except Text)

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Public Law No: 111-163 (05/05/2010)

 
[111th Congress Public Law 163]
[From the U.S. Government Printing Office]



[[Page 1129]]

       CAREGIVERS AND VETERANS OMNIBUS HEALTH SERVICES ACT OF 2010

[[Page 124 STAT. 1130]]

Public Law 111-163
111th Congress

                                 An Act


 
    To amend title 38, United States Code, to provide assistance to 
   caregivers of veterans, to improve the provision of health care to 
  veterans, and for other purposes. <<NOTE: May 5, 2010 -  [S. 1963]>> 

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled, <<NOTE: Caregivers and 
Veterans Omnibus Health Services Act of 2010.>> 
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) <<NOTE: 38 USC 101 note.>>  Short Title.--This Act may be cited 
as the ``Caregivers and Veterans Omnibus Health Services Act of 2010''.

    (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--CAREGIVER SUPPORT

Sec. 101. Assistance and support services for caregivers.
Sec. 102. Medical care for family caregivers.
Sec. 103. Counseling and mental health services for caregivers.
Sec. 104. Lodging and subsistence for attendants.

              TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

Sec. 201. Study of barriers for women veterans to health care from the 
           Department of Veterans Affairs.
Sec. 202. Training and certification for mental health care providers of 
           the Department of Veterans Affairs on care for veterans 
           suffering from sexual trauma and post-traumatic stress 
           disorder.
Sec. 203. Pilot program on counseling in retreat settings for women 
           veterans newly separated from service in the Armed Forces.
Sec. 204. Service on certain advisory committees of women recently 
           separated from service in the Armed Forces.
Sec. 205. Pilot program on assistance for child care for certain 
           veterans receiving health care.
Sec. 206. Care for newborn children of women veterans receiving 
           maternity care.

                  TITLE III--RURAL HEALTH IMPROVEMENTS

Sec. 301. Improvements to the Education Debt Reduction Program.
Sec. 302. Visual impairment and orientation and mobility professionals 
           education assistance program.
Sec. 303. Demonstration projects on alternatives for expanding care for 
           veterans in rural areas.
Sec. 304. Program on readjustment and mental health care services for 
           veterans who served in Operation Enduring Freedom and 
           Operation Iraqi Freedom.
Sec. 305. Travel reimbursement for veterans receiving treatment at 
           facilities of the Department of Veterans Affairs.
Sec. 306. Pilot program on incentives for physicians who assume 
           inpatient responsibilities at community hospitals in health 
           professional shortage areas.
Sec. 307. Grants for veterans service organizations for transportation 
           of highly rural veterans.
Sec. 308. Modification of eligibility for participation in pilot program 
           of enhanced contract care authority for health care needs of 
           certain veterans.

[[Page 124 STAT. 1131]]

                  TITLE IV--MENTAL HEALTH CARE MATTERS

Sec. 401. Eligibility of members of the Armed Forces who serve in 
           Operation Enduring Freedom or Operation Iraqi Freedom for 
           counseling and services through Readjustment Counseling 
           Service.
Sec. 402. Restoration of authority of Readjustment Counseling Service to 
           provide referral and other assistance upon request to former 
           members of the Armed Forces not authorized counseling.
Sec. 403. Study on suicides among veterans.

                   TITLE V--OTHER HEALTH CARE MATTERS

Sec. 501. Repeal of certain annual reporting requirements.
Sec. 502. Submittal date of annual report on Gulf War research.
Sec. 503. Payment for care furnished to CHAMPVA beneficiaries.
Sec. 504. Disclosure of patient treatment information from medical 
           records of patients lacking decisionmaking capacity.
Sec. 505. Enhancement of quality management.
Sec. 506. Pilot program on use of community-based organizations and 
           local and State government entities to ensure that veterans 
           receive care and benefits for which they are eligible.
Sec. 507. Specialized residential care and rehabilitation for certain 
           veterans.
Sec. 508. Expanded study on the health impact of Project Shipboard 
           Hazard and Defense.
Sec. 509. Use of non-Department facilities for rehabilitation of 
           individuals with traumatic brain injury.
Sec. 510. Pilot program on provision of dental insurance plans to 
           veterans and survivors and dependents of veterans.
Sec. 511. Prohibition on collection of copayments from veterans who are 
           catastrophically disabled.
Sec. 512. Higher priority status for certain veterans who are medal of 
           honor recipients.
Sec. 513. Hospital care, medical services, and nursing home care for 
           certain Vietnam-era veterans exposed to herbicide and 
           veterans of the Persian Gulf War.
Sec. 514. Establishment of Director of Physician Assistant Services in 
           Veterans Health Administration.
Sec. 515. Committee on Care of Veterans with Traumatic Brain Injury.
Sec. 516. Increase in amount available to disabled veterans for 
           improvements and structural alterations furnished as part of 
           home health services.
Sec. 517. Extension of statutorily defined copayments for certain 
           veterans for hospital care and nursing home care.
Sec. 518. Extension of authority to recover cost of certain care and 
           services from disabled veterans with health-plan contracts.

                 TITLE VI--DEPARTMENT PERSONNEL MATTERS

Sec. 601. Enhancement of authorities for retention of medical 
           professionals.
Sec. 602. Limitations on overtime duty, weekend duty, and alternative 
           work schedules for nurses.
Sec. 603. Reauthorization of health professionals educational assistance 
           scholarship program.
Sec. 604. Loan repayment program for clinical researchers from 
           disadvantaged backgrounds.

                  TITLE VII--HOMELESS VETERANS MATTERS

Sec. 701. Per diem grant payments to nonconforming entities.

        TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

Sec. 801. General authorities on establishment of corporations.
Sec. 802. Clarification of purposes of corporations.
Sec. 803. Modification of requirements for boards of directors of 
           corporations.
Sec. 804. Clarification of powers of corporations.
Sec. 805. Redesignation of section 7364A of title 38, United States 
           Code.
Sec. 806. Improved accountability and oversight of corporations.

                TITLE IX--CONSTRUCTION AND NAMING MATTERS

Sec. 901. Authorization of medical facility projects.
Sec. 902. Designation of Merril Lundman Department of Veterans Affairs 
           Outpatient Clinic, Havre, Montana.
Sec. 903. Designation of William C. Tallent Department of Veterans 
           Affairs Outpatient Clinic, Knoxville, Tennessee.
Sec. 904. Designation of Max J. Beilke Department of Veterans Affairs 
           Outpatient Clinic, Alexandria, Minnesota.

[[Page 124 STAT. 1132]]

                         TITLE X--OTHER MATTERS

Sec. 1001. Expansion of authority for Department of Veterans Affairs 
           police officers.
Sec. 1002. Uniform allowance for Department of Veterans Affairs police 
           officers.
Sec. 1003. Submission of reports to Congress by Secretary of Veterans 
           Affairs in electronic form.
Sec. 1004. Determination of budgetary effects for purposes of compliance 
           with Statutory Pay-As-You-Go Act of 2010.

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.

                       TITLE I--CAREGIVER SUPPORT

SEC. 101. ASSISTANCE AND SUPPORT SERVICES FOR CAREGIVERS.

    (a) Assistance and Support Services.--
            (1) In general.--Subchapter II of chapter 17 is amended by 
        adding at the end the following new section:
``Sec. 1720G. Assistance and support services for caregivers

    ``(a) Program of Comprehensive Assistance for Family Caregivers.--
(1)(A) The Secretary shall establish a program of comprehensive 
assistance for family caregivers of eligible veterans.
    ``(B) <<NOTE: Determination.>> The Secretary shall only provide 
support under the program required by subparagraph (A) to a family 
caregiver of an eligible veteran if the Secretary determines it is in 
the best interest of the eligible veteran to do so.

    ``(2) For purposes of this subsection, an eligible veteran is any 
individual who--
            ``(A) is a veteran or member of the Armed Forces undergoing 
        medical discharge from the Armed Forces;
            ``(B) has a serious injury (including traumatic brain 
        injury, psychological trauma, or other mental disorder) incurred 
        or aggravated in the line of duty in the active military, naval, 
        or air service on or after September 11, 2001; and
            ``(C) is in need of personal care services because of--
                    ``(i) an inability to perform one or more activities 
                of daily living;
                    ``(ii) a need for supervision or protection based on 
                symptoms or residuals of neurological or other 
                impairment or injury; or
                    ``(iii) such other matters as the Secretary 
                considers appropriate.

    ``(3)(A) As part of the program required by paragraph (1), the 
Secretary shall provide to family caregivers of eligible veterans the 
following assistance:
            ``(i) To each family caregiver who is approved as a provider 
        of personal care services for an eligible veteran under 
        paragraph (6)--
                    ``(I) such instruction, preparation, and training as 
                the Secretary considers appropriate for the family 
                caregiver to provide personal care services to the 
                eligible veteran;
                    ``(II) ongoing technical support consisting of 
                information and assistance to address, in a timely 
                manner, the

[[Page 124 STAT. 1133]]

                routine, emergency, and specialized caregiving needs of 
                the family caregiver in providing personal care services 
                to the eligible veteran;
                    ``(III) counseling; and
                    ``(IV) lodging and subsistence under section 111(e) 
                of this title.
            ``(ii) To each family caregiver who is designated as the 
        primary provider of personal care services for an eligible 
        veteran under paragraph (7)--
                    ``(I) the assistance described in clause (i);
                    ``(II) such mental health services as the Secretary 
                determines appropriate;
                    ``(III) respite care of not less than 30 days 
                annually, including 24-hour per day care of the veteran 
                commensurate with the care provided by the family 
                caregiver to permit extended respite;
                    ``(IV) medical care under section 1781 of this 
                title; and
                    ``(V) a monthly personal caregiver stipend.

    ``(B) Respite care provided under subparagraph (A)(ii)(III) shall be 
medically and age-appropriate and include in-home care.
    ``(C)(i) <<NOTE: Determinations.>> The amount of the monthly 
personal caregiver stipend provided under subparagraph (A)(ii)(V) shall 
be determined in accordance with a schedule established by the Secretary 
that specifies stipends based upon the amount and degree of personal 
care services provided.

    ``(ii) The Secretary shall ensure, to the extent practicable, that 
the schedule required by clause (i) specifies that the amount of the 
monthly personal caregiver stipend provided to a primary provider of 
personal care services for the provision of personal care services to an 
eligible veteran is not less than the monthly amount a commercial home 
health care entity would pay an individual in the geographic area of the 
eligible veteran to provide equivalent personal care services to the 
eligible veteran.
    ``(iii) If personal care services are not available from a 
commercial home health entity in the geographic area of an eligible 
veteran, the amount of the monthly personal caregiver stipend payable 
under the schedule required by clause (i) with respect to the eligible 
veteran shall be determined by taking into consideration the costs of 
commercial providers of personal care services in providing personal 
care services in geographic areas other than the geographic area of the 
eligible veteran with similar costs of living.
    ``(4) <<NOTE: Application.>> An eligible veteran and a family member 
of the eligible veteran seeking to participate in the program required 
by paragraph (1) shall jointly submit to the Secretary an application 
therefor in such form and in such manner as the Secretary considers 
appropriate.

    ``(5) For each application submitted jointly by an eligible veteran 
and family member, the Secretary shall evaluate--
            ``(A) the eligible veteran--
                    ``(i) to identify the personal care services 
                required by the eligible veteran; and
                    ``(ii) to determine whether such requirements could 
                be significantly or substantially satisfied through the 
                provision of personal care services from a family 
                member; and
            ``(B) the family member to determine the amount of 
        instruction, preparation, and training, if any, the family 
        member

[[Page 124 STAT. 1134]]

        requires to provide the personal care services required by the 
        eligible veteran--
                    ``(i) as a provider of personal care services for 
                the eligible veteran; and
                    ``(ii) as the primary provider of personal care 
                services for the eligible veteran.

    ``(6)(A) The Secretary shall provide each family member of an 
eligible veteran who makes a joint application under paragraph (4) the 
instruction, preparation, and training determined to be required by such 
family member under paragraph (5)(B).
    ``(B) Upon the successful completion by a family member of an 
eligible veteran of instruction, preparation, and training under 
subparagraph (A), the Secretary shall approve the family member as a 
provider of personal care services for the eligible veteran.
    ``(C) <<NOTE: Regulations.>> The Secretary shall, subject to 
regulations the Secretary shall prescribe, provide for necessary travel, 
lodging, and per diem expenses incurred by a family member of an 
eligible veteran in undergoing instruction, preparation, and training 
under subparagraph (A).

    ``(D) <<NOTE: Regulations.>> If the participation of a family member 
of an eligible veteran in instruction, preparation, and training under 
subparagraph (A) would interfere with the provision of personal care 
services to the eligible veteran, the Secretary shall, subject to 
regulations as the Secretary shall prescribe and in consultation with 
the veteran, provide respite care to the eligible veteran during the 
provision of such instruction, preparation, and training to the family 
member so that the family member can participate in such instruction, 
preparation, and training without interfering with the provision of such 
services to the eligible veteran.

    ``(7)(A) <<NOTE: Designation.>> For each eligible veteran with at 
least one family member who is described by subparagraph (B), the 
Secretary shall designate one family member of such eligible veteran as 
the primary provider of personal care services for such eligible 
veteran.

    ``(B) A primary provider of personal care services designated for an 
eligible veteran under subparagraph (A) shall be selected from among 
family members of the eligible veteran who--
            ``(i) are approved under paragraph (6) as a provider of 
        personal care services for the eligible veteran;
            ``(ii) <<NOTE: Determination.>> elect to provide the 
        personal care services to the eligible veteran that the 
        Secretary determines the eligible veteran requires under 
        paragraph (5)(A)(i);
            ``(iii) has the consent of the eligible veteran to be the 
        primary provider of personal care services for the eligible 
        veteran; and
            ``(iv) are considered by the Secretary as competent to be 
        the primary provider of personal care services for the eligible 
        veteran.

    ``(C) <<NOTE: Procedures.>> An eligible veteran receiving personal 
care services from a family member designated as the primary provider of 
personal care services for the eligible veteran under subparagraph (A) 
may, in accordance with procedures the Secretary shall establish for 
such purposes, revoke consent with respect to such family member under 
subparagraph (B)(iii).

    ``(D) If a family member designated as the primary provider of 
personal care services for an eligible veteran under subparagraph (A) 
subsequently fails to meet any requirement set forth in subparagraph 
(B), the Secretary--

[[Page 124 STAT. 1135]]

            ``(i) shall immediately revoke the family member's 
        designation under subparagraph (A); and
            ``(ii) may designate, in consultation with the eligible 
        veteran, a new primary provider of personal care services for 
        the eligible veteran under such subparagraph.

    ``(E) The Secretary shall take such actions as may be necessary to 
ensure that the revocation of a designation under subparagraph (A) with 
respect to an eligible veteran does not interfere with the provision of 
personal care services required by the eligible veteran.
    ``(8) If an eligible veteran lacks the capacity to make a decision 
under this subsection, the Secretary may, in accordance with regulations 
and policies of the Department regarding appointment of guardians or the 
use of powers of attorney, appoint a surrogate for the eligible veteran 
who may make decisions and take action under this subsection on behalf 
of the eligible veteran.
    ``(9)(A) The Secretary shall monitor the well-being of each eligible 
veteran receiving personal care services under the program required by 
paragraph (1).
    ``(B) The Secretary shall document each finding the Secretary 
considers pertinent to the appropriate delivery of personal care 
services to an eligible veteran under the program.
    ``(C) <<NOTE: Procedures.>> The Secretary shall establish procedures 
to ensure appropriate follow-up regarding findings described in 
subparagraph (B). Such procedures may include the following:
            ``(i) Visiting an eligible veteran in the eligible veteran's 
        home to review directly the quality of personal care services 
        provided to the eligible veteran.
            ``(ii) Taking such corrective action with respect to the 
        findings of any review of the quality of personal care services 
        provided an eligible veteran as the Secretary considers 
        appropriate, which may include--
                    ``(I) providing additional training to a family 
                caregiver; and
                    ``(II) suspending or revoking the approval of a 
                family caregiver under paragraph (6) or the designation 
                of a family caregiver under paragraph (7).

    ``(10) The Secretary shall carry out outreach to inform eligible 
veterans and family members of eligible veterans of the program required 
by paragraph (1) and the benefits of participating in the program.
    ``(b) Program of General Caregiver Support Services.--(1) The 
Secretary shall establish a program of support services for caregivers 
of covered veterans who are enrolled in the health care system 
established under section 1705(a) of this title (including caregivers 
who do not reside with such veterans).
    ``(2) For purposes of this subsection, a covered veteran is any 
individual who needs personal care services because of--
            ``(A) an inability to perform one or more activities of 
        daily living;
            ``(B) a need for supervision or protection based on symptoms 
        or residuals of neurological or other impairment or injury; or
            ``(C) such other matters as the Secretary shall specify.

    ``(3)(A) The support services furnished to caregivers of covered 
veterans under the program required by paragraph (1) shall include the 
following:

[[Page 124 STAT. 1136]]

            ``(i) Services regarding the administering of personal care 
        services, which, subject to subparagraph (B), shall include--
                    ``(I) educational sessions made available both in 
                person and on an Internet website;
                    ``(II) use of telehealth and other available 
                technologies; and
                    ``(III) teaching techniques, strategies, and skills 
                for caring for a disabled veteran;
            ``(ii) Counseling and other services under section 1782 of 
        this title.
            ``(iii) Respite care under section 1720B of this title that 
        is medically and age appropriate for the veteran (including 24-
        hour per day in-home care).
            ``(iv) Information concerning the supportive services 
        available to caregivers under this subsection and other public, 
        private, and nonprofit agencies that offer support to 
        caregivers.

    ``(B) <<NOTE: Certification. Time period.>> If the Secretary 
certifies to the Committees on Veterans' Affairs of the Senate and the 
House of Representatives that funding available for a fiscal year is 
insufficient to fund the provision of services specified in one or more 
subclauses of subparagraph (A)(i), the Secretary shall not be required 
under subparagraph (A) to provide the services so specified in the 
certification during the period beginning on the date that is 180 days 
after the date the certification is received by the Committees and 
ending on the last day of the fiscal year.

    ``(4) In providing information under paragraph (3)(A)(iv), the 
Secretary shall collaborate with the Assistant Secretary for Aging of 
the Department of Health and Human Services in order to provide 
caregivers access to aging and disability resource centers under the 
Administration on Aging of the Department of Health and Human Services.
    ``(5) In carrying out the program required by paragraph (1), the 
Secretary shall conduct outreach to inform covered veterans and 
caregivers of covered veterans about the program. The outreach shall 
include an emphasis on covered veterans and caregivers of covered 
veterans living in rural areas.
    ``(c) Construction.--(1) A decision by the Secretary under this 
section affecting the furnishing of assistance or support shall be 
considered a medical determination.
    ``(2) Nothing in this section shall be construed to create--
            ``(A) an employment relationship between the Secretary and 
        an individual in receipt of assistance or support under this 
        section; or
            ``(B) any entitlement to any assistance or support provided 
        under this section.

    ``(d) Definitions.--In this section:
            ``(1) The term `caregiver', with respect to an eligible 
        veteran under subsection (a) or a covered veteran under 
        subsection (b), means an individual who provides personal care 
        services to the veteran.
            ``(2) The term `family caregiver', with respect to an 
        eligible veteran under subsection (a), means a family member who 
        is a caregiver of the veteran.
            ``(3) The term `family member', with respect to an eligible 
        veteran under subsection (a), means an individual who--
                    ``(A) is a member of the family of the veteran, 
                including--

[[Page 124 STAT. 1137]]

                          ``(i) a parent;
                          ``(ii) a spouse;
                          ``(iii) a child;
                          ``(iv) a step-family member; and
                          ``(v) an extended family member; or
                    ``(B) lives with the veteran but is not a member of 
                the family of the veteran.
            ``(4) The term `personal care services', with respect to an 
        eligible veteran under subsection (a) or a covered veteran under 
        subsection (b), means services that provide the veteran the 
        following:
                    ``(A) Assistance with one or more independent 
                activities of daily living.
                    ``(B) Any other non-institutional extended care (as 
                such term is used in section 1701(6)(E) of this title).

    ``(e) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out the programs required by subsections (a) and 
(b)--
            ``(1) $60,000,000 for fiscal year 2010; and
            ``(2) $1,542,000,000 for the period of fiscal years 2011 
        through 2015.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 17 is amended by inserting after the item 
        related to section 1720F the following new item:

``1720G. Assistance and support services for caregivers.''.

            (3) <<NOTE: 38 USC 1720G note.>> Effective date.--
                    (A) In general.--The amendments made by this 
                subsection shall take effect on the date that is 270 
                days after the date of the enactment of this Act.
                    (B) Implementation.--The Secretary of Veterans 
                Affairs shall commence the programs required by 
                subsections (a) and (b) of section 1720G of title 38, 
                United States Code, as added by paragraph (1) of this 
                subsection, on the date on which the amendments made by 
                this subsection take effect.

    (b) Implementation Plan and Report.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall--
                    (A) develop a plan for the implementation of the 
                program of comprehensive assistance for family 
                caregivers required by section 1720G(a)(1) of title 38, 
                United States Code, as added by subsection (a)(1) of 
                this section; and
                    (B) submit to the Committee on Veterans' Affairs of 
                the Senate and the Committee on Veterans' Affairs of the 
                House of Representatives a report on such plan.
            (2) Consultation.--In developing the plan required by 
        paragraph (1)(A), the Secretary shall consult with the 
        following:
                    (A) Individuals described in section 1720G(a)(2) of 
                title 38, United States Code, as added by subsection 
                (a)(1) of this section.
                    (B) Family members of such individuals who provide 
                personal care services to such individuals.
                    (C) The Secretary of Defense with respect to matters 
                concerning personal care services for members of the 
                Armed Forces undergoing medical discharge from the Armed

[[Page 124 STAT. 1138]]

                Forces who are eligible to benefit from personal care 
                services furnished under the program of comprehensive 
                assistance required by section 1720G(a)(1) of such 
                title, as so added.
                    (D) Veterans service organizations, as recognized by 
                the Secretary for the representation of veterans under 
                section 5902 of such title.
                    (E) National organizations that specialize in the 
                provision of assistance to individuals with the types of 
                disabilities that family caregivers will encounter while 
                providing personal care services under the program of 
                comprehensive assistance required by section 1720G(a)(1) 
                of such title, as so added.
                    (F) National organizations that specialize in 
                provision of assistance to family members of veterans 
                who provide personal care services to such veterans.
                    (G) Such other organizations with an interest in the 
                provision of care to veterans and assistance to family 
                caregivers as the Secretary considers appropriate.
            (3) Report contents.--The report required by paragraph 
        (1)(B) shall contain the following:
                    (A) The plan required by paragraph (1)(A).
                    (B) A description of the individuals, caregivers, 
                and organizations consulted by the Secretary of Veterans 
                Affairs under paragraph (2).
                    (C) A description of such consultations.
                    (D) The recommendations of such individuals, 
                caregivers, and organizations, if any, that were not 
                adopted and incorporated into the plan required by 
                paragraph (1)(A), and the reasons the Secretary did not 
                adopt such recommendations.

    (c) <<NOTE: 38 USC 1720G note.>> Annual Evaluation Report.--
            (1) In general.--Not later than 2 years after the date 
        described in subsection (a)(3)(A) and annually thereafter, 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 comprehensive report on the implementation 
        of section 1720G of title 38, United States Code, as added by 
        subsection (a)(1).
            (2) Contents.--The report required by paragraph (1) shall 
        include the following:
                    (A) With respect to the program of comprehensive 
                assistance for family caregivers required by subsection 
                (a)(1) of such section 1720G and the program of general 
                caregiver support services required by subsection (b)(1) 
                of such section--
                          (i) the number of caregivers that received 
                      assistance under such programs;
                          (ii) the cost to the Department of providing 
                      assistance under such programs;
                          (iii) a description of the outcomes achieved 
                      by, and any measurable benefits of, carrying out 
                      such programs;
                          (iv) an assessment of the effectiveness and 
                      the efficiency of the implementation of such 
                      programs; and
                          (v) such recommendations, including 
                      recommendations for legislative or administrative 
                      action, as the

[[Page 124 STAT. 1139]]

                      Secretary considers appropriate in light of 
                      carrying out such programs.
                    (B) With respect to the program of comprehensive 
                assistance for family caregivers required by such 
                subsection (a)(1)--
                          (i) a description of the outreach activities 
                      carried out by the Secretary under such program; 
                      and
                          (ii) an assessment of the manner in which 
                      resources are expended by the Secretary under such 
                      program, particularly with respect to the 
                      provision of monthly personal caregiver stipends 
                      under paragraph (3)(A)(ii)(v) of such subsection 
                      (a).
                    (C) With respect to the provision of general 
                caregiver support services required by such subsection 
                (b)(1)--
                          (i) a summary of the support services made 
                      available under the program;
                          (ii) the number of caregivers who received 
                      support services under the program;
                          (iii) the cost to the Department of providing 
                      each support service provided under the program; 
                      and
                          (iv) such other information as the Secretary 
                      considers appropriate.

    (d) Report on Expansion of Family Caregiver Assistance.--
            (1) In general.--Not later than 2 years after the date 
        described in subsection (a)(3)(A), 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 feasibility and advisability of expanding the 
        provision of assistance under section 1720G(a) of title 38, 
        United States Code, as added by subsection (a)(1), to family 
        caregivers of veterans who have a serious injury incurred or 
        aggravated in the line of duty in the active military, naval, or 
        air service before September 11, 2001.
            (2) Recommendations.--The report required by paragraph (1) 
        shall include such recommendations as the Secretary considers 
        appropriate with respect to the expansion described in such 
        paragraph.
SEC. 102. MEDICAL CARE FOR FAMILY CAREGIVERS.

    Section 1781(a) is amended--
            (1) in paragraph (2), by striking ``and'' at the end;
            (2) in paragraph (3), by inserting ``and'' at the end; and
            (3) by inserting after paragraph (3), the following new 
        paragraph:
            ``(4) an individual designated as a primary provider of 
        personal care services under section 1720G(a)(7)(A) of this 
        title who is not entitled to care or services under a health-
        plan contract (as defined in section 1725(f) of this title);''.
SEC. 103. COUNSELING AND MENTAL HEALTH SERVICES FOR CAREGIVERS.

    (a) In General.--Section 1782(c) is amended--
            (1) in paragraph (1), by striking ``; or'' and inserting a 
        semicolon;
            (2) by redesignating paragraph (2) as paragraph (3); and
            (3) by inserting after paragraph (1) the following new 
        paragraph (2):

[[Page 124 STAT. 1140]]

            ``(2) a family caregiver of an eligible veteran or a 
        caregiver of a covered veteran (as those terms are defined in 
        section 1720G of this title); or''.

    (b) Conforming Amendment.--The section heading of section 1782 is 
amended by adding at the end, the following: ``and caregivers''.
    (c) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by striking the item relating to section 1782 and 
inserting the following new item:

``1782. Counseling, training, and mental health services for immediate 
           family members and caregivers.''.

SEC. 104. LODGING AND SUBSISTENCE FOR ATTENDANTS.

    Section 111(e) is amended--
            (1) by striking ``When'' and inserting the following: ``(1) 
        Except as provided in paragraph (2), when''; and
            (2) by adding at the end the following new paragraphs:

    ``(2)(A) Without regard to whether an eligible veteran entitled to 
mileage under this section for travel to a Department facility for the 
purpose of medical examination, treatment, or care requires an attendant 
in order to perform such travel, an attendant of such veteran described 
in subparagraph (B) may be allowed expenses of travel (including lodging 
and subsistence) upon the same basis as such veteran during--
            ``(i) the period of time in which such veteran is traveling 
        to and from a Department facility for the purpose of medical 
        examination, treatment, or care; and
            ``(ii) the duration of the medical examination, treatment, 
        or care episode for such veteran.

    ``(B) An attendant of a veteran described in this subparagraph is a 
provider of personal care services for such veteran who is approved 
under paragraph (6) of section 1720G(a) of this title or designated 
under paragraph (7) of such section 1720G(a).
    ``(C) The Secretary may prescribe regulations to carry out this 
paragraph. Such regulations may include provisions--
            ``(i) to limit the number of attendants that may receive 
        expenses of travel under this paragraph for a single medical 
        examination, treatment, or care episode of an eligible veteran; 
        and
            ``(ii) to require such attendants to use certain travel 
        services.

    ``(D) In this subsection, the term `eligible veteran' has the 
meaning given that term in section 1720G(a)(2) of this title.''.

              TITLE II--WOMEN VETERANS HEALTH CARE MATTERS

SEC. 201. STUDY OF BARRIERS FOR WOMEN VETERANS TO HEALTH CARE FROM 
                        THE DEPARTMENT OF VETERANS AFFAIRS.

    (a) Study Required.--The Secretary of Veterans Affairs shall conduct 
a comprehensive study of the barriers to the provision of comprehensive 
health care by the Department of Veterans Affairs encountered by women 
who are veterans. In conducting the study, the Secretary shall--

[[Page 124 STAT. 1141]]

            (1) survey women veterans who seek or receive hospital care 
        or medical services provided by the Department of Veterans 
        Affairs as well as women veterans who do not seek or receive 
        such care or services;
            (2) administer the survey to a representative sample of 
        women veterans from each Veterans Integrated Service Network; 
        and
            (3) ensure that the sample of women veterans surveyed is of 
        sufficient size for the study results to be statistically 
        significant and is a larger sample than that of the study 
        referred to in subsection (b).

    (b) Use of Previous Study.--In conducting the study required by 
subsection (a), the Secretary shall build on the work of the study of 
the Department of Veterans Affairs titled ``National Survey of Women 
Veterans in Fiscal Year 2007-2008''.
    (c) Elements of Study.--In conducting the study required by 
subsection (a), the Secretary shall conduct research on the effects of 
the following on the women veterans surveyed in the study:
            (1) The perceived stigma associated with seeking mental 
        health care services.
            (2) The effect of driving distance or availability of other 
        forms of transportation to the nearest medical facility on 
        access to care.
            (3) The availability of child care.
            (4) The acceptability of integrated primary care, women's 
        health clinics, or both.
            (5) The comprehension of eligibility requirements for, and 
        the scope of services available under, hospital care and medical 
        services.
            (6) The perception of personal safety and comfort in 
        inpatient, outpatient, and behavioral health facilities.
            (7) The gender sensitivity of health care providers and 
        staff to issues that particularly affect women.
            (8) The effectiveness of outreach for health care services 
        available to women veterans.
            (9) The location and operating hours of health care 
        facilities that provide services to women veterans.
            (10) Such other significant barriers as the Secretary 
        considers appropriate.

    (d) Discharge by Contract.--The Secretary shall enter into a 
contract with a qualified independent entity or organization to carry 
out the study and research required under this section.
    (e) Mandatory Review of Data by Certain Department Divisions.--
            (1) In general.--The Secretary shall ensure that the head of 
        each division of the Department of Veterans Affairs specified in 
        paragraph (2) reviews the results of the study conducted under 
        this section. <<NOTE: Submission.>> The head of each such 
        division shall submit findings with respect to the study to the 
        Under Secretary for Health and to other pertinent program 
        offices within the Department of Veterans Affairs with 
        responsibilities relating to health care services for women 
        veterans.
            (2) Specified divisions.--The divisions of the Department of 
        Veterans Affairs specified in this paragraph are the following:
                    (A) The Center for Women Veterans established under 
                section 318 of title 38, United States Code.

[[Page 124 STAT. 1142]]

                    (B) The Advisory Committee on Women Veterans 
                established under section 542 of such title.

    (f) Reports.--
            (1) Report on implementation.--Not later than 6 months after 
        the date on which the Department of Veterans Affairs publishes a 
        final report on the study titled ``National Survey of Women 
        Veterans in Fiscal Year 2007-2008'', the Secretary shall submit 
        to Congress a report on the status of the implementation of this 
        section.
            (2) Report on study.--Not later than 30 months after the 
        date on which the Department publishes such final report, the 
        Secretary shall submit to Congress a report on the study 
        required under this section. The report shall include 
        recommendations for such administrative and legislative action 
        as the Secretary considers appropriate. The report shall also 
        include the findings of the head of each division of the 
        Department specified under subsection (e)(2) and of the Under 
        Secretary for Health.

    (g) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs $4,000,000 to carry 
out this section.
SEC. 202. TRAINING AND CERTIFICATION FOR MENTAL HEALTH CARE 
                        PROVIDERS OF THE DEPARTMENT OF VETERANS 
                        AFFAIRS ON CARE FOR VETERANS SUFFERING 
                        FROM SEXUAL TRAUMA AND POST-TRAUMATIC 
                        STRESS DISORDER.

    Section 1720D is amended--
            (1) by redesignating subsection (d) as subsection (f); and
            (2) by inserting after subsection (c) the following new 
        subsections:

    ``(d)(1) The Secretary shall carry out a program to provide graduate 
medical education, training, certification, and continuing medical 
education for mental health professionals who provide counseling, care, 
and services under subsection (a).
    ``(2) In carrying out the program required by paragraph (1), the 
Secretary shall ensure that--
            ``(A) all mental health professionals described in such 
        paragraph have been trained in a consistent manner; and
            ``(B) training described in such paragraph includes 
        principles of evidence-based treatment and care for sexual 
        trauma and post-traumatic stress disorder.

    ``(e) <<NOTE: Deadline. Reports.>> Each year, the Secretary shall 
submit to Congress an annual report on the counseling, care, and 
services provided to veterans pursuant to this section. Each report 
shall include data for the year covered by the report with respect to 
each of the following:
            ``(1) The number of mental health professionals, graduate 
        medical education trainees, and primary care providers who have 
        been certified under the program required by subsection (d) and 
        the amount and nature of continuing medical education provided 
        under such program to such professionals, trainees, and 
        providers who are so certified.
            ``(2) The number of women veterans who received counseling 
        and care and services under subsection (a) from professionals 
        and providers who received training under subsection (d).

[[Page 124 STAT. 1143]]

            ``(3) The number of graduate medical education, training, 
        certification, and continuing medical education courses provided 
        by reason of subsection (d).
            ``(4) The number of trained full-time equivalent employees 
        required in each facility of the Department to meet the needs of 
        veterans requiring treatment and care for sexual trauma and 
        post-traumatic stress disorder.
            ``(5) Such recommendations for improvements in the treatment 
        of women veterans with sexual trauma and post-traumatic stress 
        disorder as the Secretary considers appropriate.
            ``(6) Such other information as the Secretary considers 
        appropriate.''.
SEC. 203. <<NOTE: 38 USC 1712A note.>> PILOT PROGRAM ON COUNSELING 
                        IN RETREAT SETTINGS FOR WOMEN VETERANS 
                        NEWLY SEPARATED FROM SERVICE IN THE ARMED 
                        FORCES.

    (a) Pilot Program Required.--
            (1) In general. <<NOTE: Deadline.>> --Commencing not later 
        than 180 days after the date of the enactment of this Act, the 
        Secretary of Veterans Affairs shall carry out, through the 
        Readjustment Counseling Service of the Veterans Health 
        Administration, a pilot program to evaluate the feasibility and 
        advisability of providing reintegration and readjustment 
        services described in subsection (b) in group retreat settings 
        to women veterans who are recently separated from service in the 
        Armed Forces after a prolonged deployment.
            (2) Participation at election of veteran.--The participation 
        of a veteran in the pilot program under this section shall be at 
        the election of the veteran.

    (b) Covered Services.--The services provided to a woman veteran 
under the pilot program shall include the following:
            (1) Information on reintegration into the veteran's family, 
        employment, and community.
            (2) Financial counseling.
            (3) Occupational counseling.
            (4) Information and counseling on stress reduction.
            (5) Information and counseling on conflict resolution.
            (6) Such other information and counseling as the Secretary 
        considers appropriate to assist a woman veteran under the pilot 
        program in reintegration into the veteran's family, employment, 
        and community.

    (c) Locations.--The Secretary shall carry out the pilot program at 
not fewer than three locations selected by the Secretary for purposes of 
the pilot program.
    (d) Duration.--The pilot program shall be carried out during the 2-
year period beginning on the date of the commencement of the pilot 
program.
    (e) Report.--Not later than 180 days after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program. The report shall contain the findings and conclusions of 
the Secretary as a result of the pilot program, and shall include such 
recommendations for the continuation or expansion of the pilot program 
as the Secretary considers appropriate.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs for each

[[Page 124 STAT. 1144]]

of fiscal years 2010 and 2011, $2,000,000 to carry out the pilot 
program.
SEC. 204. SERVICE ON CERTAIN ADVISORY COMMITTEES OF WOMEN RECENTLY 
                        SEPARATED FROM SERVICE IN THE ARMED 
                        FORCES.

    (a) Advisory Committee on Women Veterans.--Section 542(a)(2)(A) is 
amended--
            (1) in clause (ii), by striking ``and'' at the end;
            (2) in clause (iii), by striking the period at the end and 
        inserting ``; and''; and
            (3) by inserting after clause (iii) the following new 
        clause:
            ``(iv) women veterans who are recently separated from 
        service in the Armed Forces.''.

    (b) Advisory Committee on Minority Veterans.--Section 544(a)(2)(A) 
is amended--
            (1) in clause (iii), by striking ``and'' at the end;
            (2) in clause (iv), by striking the period at the end and 
        inserting ``; and''; and
            (3) by inserting after clause (iv) the following new clause:
            ``(v) women veterans who are minority group members and are 
        recently separated from service in the Armed Forces.''.

    (c) <<NOTE: 38 USC 542 note.>> Applicability.--The amendments made 
by this section shall apply to appointments made on or after the date of 
the enactment of this Act.
SEC. 205. <<NOTE: 38 USC 1710 note.>> PILOT PROGRAM ON ASSISTANCE 
                        FOR CHILD CARE FOR CERTAIN VETERANS 
                        RECEIVING HEALTH CARE.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall 
carry out a pilot program to assess the feasibility and advisability of 
providing, subject to subsection (b), assistance to qualified veterans 
described in subsection (c) to obtain child care so that such veterans 
can receive health care services described in subsection (c).
    (b) Limitation on Period of Payments.--Assistance may only be 
provided to a qualified veteran under the pilot program for receipt of 
child care during the period that the qualified veteran--
            (1) receives the types of health care services described in 
        subsection (c) at a facility of the Department; and
            (2) requires travel to and return from such facility for the 
        receipt of such health care services.

    (c) Qualified Veterans.--For purposes of this section, a qualified 
veteran is a veteran who is--
            (1) the primary caretaker of a child or children; and
            (2)(A) receiving from the Department--
                    (i) regular mental health care services;
                    (ii) intensive mental health care services; or
                    (iii) such other intensive health care services that 
                the Secretary determines that provision of assistance to 
                the veteran to obtain child care would improve access to 
                such health care services by the veteran; or
            (B) in need of regular or intensive mental health care 
        services from the Department, and but for lack of child care 
        services, would receive such health care services from the 
        Department.

    (d) Locations.--The Secretary shall carry out the pilot program in 
no fewer than three Veterans Integrated Service Networks selected by the 
Secretary for purposes of the pilot program.

[[Page 124 STAT. 1145]]

    (e) Duration.--The pilot program shall be carried out during the 2-
year period beginning on the date of the commencement of the pilot 
program.
    (f) Forms of Child Care Assistance.--
            (1) In general.--Child care assistance under this section 
        may include the following:
                    (A) Stipends for the payment of child care offered 
                by licensed child care centers (either directly or 
                through a voucher program) which shall be, to the extent 
                practicable, modeled after the Department of Veterans 
                Affairs Child Care Subsidy Program established pursuant 
                to section 630 of the Treasury and General Government 
                Appropriations Act, 2002 (Public Law 107-67; 115 Stat. 
                552).
                    (B) Direct provision of child care at an on-site 
                facility of the Department of Veterans Affairs.
                    (C) Payments to private child care agencies.
                    (D) Collaboration with facilities or programs of 
                other Federal departments or agencies.
                    (E) Such other forms of assistance as the Secretary 
                considers appropriate.
            (2) Amounts of stipends.--In the case that child care 
        assistance under this section is provided as a stipend under 
        paragraph (1)(A), such stipend shall cover the full cost of such 
        child care.

    (g) Report.--Not later than 6 months after the completion of the 
pilot program, the Secretary shall submit to Congress a report on the 
pilot program. The report shall include the findings and conclusions of 
the Secretary as a result of the pilot program, and shall include such 
recommendations for the continuation or expansion of the pilot program 
as the Secretary considers appropriate.
    (h) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs to carry out the pilot 
program $1,500,000 for each of fiscal years 2010 and 2011.
SEC. 206. CARE FOR NEWBORN CHILDREN OF WOMEN VETERANS RECEIVING 
                        MATERNITY CARE.

    (a) In General.--Subchapter VIII of chapter 17 is amended by adding 
at the end the following new section:
``Sec. 1786. Care for newborn children of women veterans receiving 
                  maternity care

    ``(a) In General.--The Secretary may furnish health care services 
described in subsection (b) to a newborn child of a woman veteran who is 
receiving maternity care furnished by the Department for not more than 
seven days after the birth of the child if the veteran delivered the 
child in--
            ``(1) a facility of the Department; or
            ``(2) another facility pursuant to a Department contract for 
        services relating to such delivery.

    ``(b) Covered Health Care Services.--Health care services described 
in this subsection are all post-delivery care services, including 
routine care services, that a newborn child requires.''.

[[Page 124 STAT. 1146]]

    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1785 the following new item:

``1786. Care for newborn children of women veterans receiving maternity 
           care.''.

                  TITLE III--RURAL HEALTH IMPROVEMENTS

SEC. 301. IMPROVEMENTS TO THE EDUCATION DEBT REDUCTION PROGRAM.

    (a) Inclusion of Employee Retention as Purpose of Program.--Section 
7681(a)(2) is amended by inserting ``and retention'' after 
``recruitment'' the first time it appears.
    (b) Expansion of Eligibility.--Section 7682 is amended--
            (1) in subsection (a)(1), by striking ``a recently 
        appointed'' and inserting ``an''; and
            (2) by striking subsection (c).

    (c) Increase in Maximum Annual Amount of Payments.--Paragraph (1) of 
subsection (d) of section 7683 is amended--
            (1) by striking ``$44,000'' and inserting ``$60,000''; and
            (2) by striking ``$10,000'' and inserting ``$12,000''.

    (d) Exception to Limitation on Amount for Certain Participants.--
Such subsection is further amended by adding at the end the following 
new paragraph:
    ``(3)(A) <<NOTE: Waiver authority.>> The Secretary may waive the 
limitations under paragraphs (1) and (2) in the case of a participant 
described in subparagraph (B). In the case of such a waiver, the total 
amount of education debt repayments payable to that participant is the 
total amount of the principal and the interest on the participant's 
loans referred to in subsection (a).

    ``(B) <<NOTE: Determination.>> A participant described in this 
subparagraph is a participant in the Program who the Secretary 
determines serves in a position for which there is a shortage of 
qualified employees by reason of either the location or the requirements 
of the position.''.
SEC. 302. VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY 
                        PROFESSIONALS EDUCATION ASSISTANCE 
                        PROGRAM.

    (a) Establishment of Program.--Part V is amended by inserting after 
chapter 74 the following new chapter:

      ``CHAPTER 75--VISUAL IMPAIRMENT AND ORIENTATION AND MOBILITY 
              PROFESSIONALS EDUCATIONAL ASSISTANCE PROGRAM

``Sec.
``7501. Establishment of scholarship program; purpose.
``7502. Application and acceptance.
``7503. Amount of assistance; duration.
``7504. Agreement.
``7505. Repayment for failure to satisfy requirements of agreement.

``Sec. 7501. Establishment of scholarship program; purpose

    ``(a) Establishment.--Subject to the availability of appropriations, 
the Secretary shall establish and carry out a scholarship program to 
provide financial assistance in accordance with this chapter to 
individuals who--

[[Page 124 STAT. 1147]]

            ``(1) are accepted for enrollment or currently enrolled in a 
        program of study leading to a degree or certificate in visual 
        impairment or orientation and mobility, or a dual degree or 
        certification in both such areas, at an accredited (as 
        determined by the Secretary) educational institution that is in 
        a State; and
            ``(2) <<NOTE: Contracts.>> enter into an agreement with the 
        Secretary as described in section 7504 of this title.

    ``(b) Purpose.--The purpose of the scholarship program is to 
increase the supply of qualified blind rehabilitation specialists for 
the Department and the Nation.
    ``(c) Outreach.--The Secretary shall publicize the scholarship 
program to educational institutions throughout the United States, with 
an emphasis on disseminating information to such institutions with high 
numbers of Hispanic students and to Historically Black Colleges and 
Universities.
``Sec. 7502. Application and acceptance

    ``(a) Application.--(1) To apply and participate in the scholarship 
program under this chapter, an individual shall submit to the Secretary 
an application for such participation together with an agreement 
described in section 7504 of this title under which the participant 
agrees to serve a period of obligated service in the Department as 
provided in the agreement in return for payment of educational 
assistance as provided in the agreement.
    ``(2) In distributing application forms and agreement forms to 
individuals desiring to participate in the scholarship program, the 
Secretary shall include with such forms the following:
            ``(A) A fair summary of the rights and liabilities of an 
        individual whose application is approved (and whose agreement is 
        accepted) by the Secretary.
            ``(B) A full description of the terms and conditions that 
        apply to participation in the scholarship program and service in 
        the Department.

    ``(b) <<NOTE: Notification.>> Approval.--(1) Upon the Secretary's 
approval of an individual's participation in the scholarship program, 
the Secretary shall, in writing, promptly notify the individual of that 
acceptance.

    ``(2) An individual becomes a participant in the scholarship program 
upon such approval by the Secretary.
``Sec. 7503. Amount of assistance; duration

    ``(a) Amount of Assistance. <<NOTE: Determination.>> --The amount of 
the financial assistance provided an individual under the scholarship 
program under this chapter shall be the amount determined by the 
Secretary as being necessary to pay the tuition and fees of the 
individual. In the case of an individual enrolled in a program of study 
leading to a dual degree or certification in both the areas of study 
described in section 7501(a)(1) of this title, the tuition and fees 
shall not exceed the amounts necessary for the minimum number of credit 
hours to achieve such dual degree or certification.

    ``(b) Relationship to Other Assistance.--Financial assistance may be 
provided to an individual under the scholarship program to supplement 
other educational assistance to the extent that the total amount of 
educational assistance received by the individual during an academic 
year does not exceed the total tuition and fees for such academic year.

[[Page 124 STAT. 1148]]

    ``(c) Maximum Amount of Assistance.--(1) The total amount of 
assistance provided under the scholarship program for an academic year 
to an individual who is a full-time student may not exceed $15,000.
    ``(2) In the case of an individual who is a part-time student, the 
total amount of assistance provided under the scholarship program shall 
bear the same ratio to the amount that would be paid under paragraph (1) 
if the participant were a full-time student in the program of study 
being pursued by the individual as the coursework carried by the 
individual to full-time coursework in that program of study.
    ``(3) The total amount of assistance provided to an individual under 
the scholarship program may not exceed $45,000.
    ``(d) Maximum Duration of Assistance.--Financial assistance may not 
be provided to an individual under the scholarship program for more than 
six academic years.
``Sec. 7504. Agreement

    ``An agreement between the Secretary and a participant in the 
scholarship program under this chapter shall be in writing, shall be 
signed by the participant, and shall include--
            ``(1) the Secretary's agreement to provide the participant 
        with financial assistance as authorized under this chapter;
            ``(2) the participant's agreement--
                    ``(A) to accept such financial assistance;
                    ``(B) to maintain enrollment and attendance in the 
                program of study described in section 7501(a)(1) of this 
                title;
                    ``(C) while enrolled in such program, to maintain an 
                acceptable level of academic standing (as determined by 
                the educational institution offering such program under 
                regulations prescribed by the Secretary); and
                    ``(D) after completion of the program, to serve as a 
                full-time employee in the Department for a period of 
                three years, to be served within the first six years 
                after the participant has completed such program and 
                received a degree or certificate described in section 
                7501(a)(1) of this title; and
            ``(3) any other terms and conditions that the Secretary 
        considers appropriate for carrying out this chapter.
``Sec. 7505. Repayment for failure to satisfy requirements of 
                  agreement

    ``(a) In General.--An individual who receives educational assistance 
under the scholarship program under this chapter shall repay to the 
Secretary an amount equal to the unearned portion of such assistance if 
the individual fails to satisfy the requirements of the agreement 
entered into under section 7504 of this title, except in circumstances 
authorized by the Secretary.
    ``(b) Amount of Repayment. <<NOTE: Regulations. Procedures.>> --The 
Secretary shall establish, by regulations, procedures for determining 
the amount of the repayment required under this section and the 
circumstances under which an exception to the required repayment may be 
granted.

    ``(c) Waiver or Suspension of Compliance. <<NOTE: Regulations.>> --
The Secretary shall prescribe regulations providing for the waiver or 
suspension of any obligation of an individual for service or payment 
under this chapter (or an agreement under this chapter) whenever--

[[Page 124 STAT. 1149]]

            ``(1) noncompliance by the individual is due to 
        circumstances beyond the control of the individual; or
            ``(2) <<NOTE: Determination.>> the Secretary determines that 
        the waiver or suspension of compliance is in the best interest 
        of the United States.

    ``(d) Obligation as Debt to United States.--An obligation to repay 
the Secretary under this section is, for all purposes, a debt owed the 
United States. A discharge in bankruptcy under title 11 does not 
discharge a person from such debt if the discharge order is entered less 
than five years after the date of the termination of the agreement or 
contract on which the debt is based.''.
    (b) Clerical Amendments.--The tables of chapters at the beginning of 
title 38, and of part V, are each amended by inserting after the item 
relating to chapter 74 the following new item:

``75. Visual Impairment and Orientation and Mobility Professionals 
Educational Assistance Program...................................7501''.

    (c) Implementation. <<NOTE: Deadline. 38 USC 7501 note.>> --The 
Secretary of Veterans Affairs shall implement chapter 75 of title 38, 
United States Code, as added by subsection (a), not later than 6 months 
after the date of the enactment of this Act.
SEC. 303. <<NOTE: 38 USC 1703 note.>> DEMONSTRATION PROJECTS ON 
                        ALTERNATIVES FOR EXPANDING CARE FOR 
                        VETERANS IN RURAL AREAS.

    (a) In General.--The Secretary of Veterans Affairs may, through the 
Director of the Office of Rural Health, carry out demonstration projects 
to examine the feasibility and advisability of alternatives for 
expanding care for veterans in rural areas, which may include the 
following:
            (1) Establishing a partnership between the Department of 
        Veterans Affairs and the Centers for Medicare and Medicaid 
        Services of the Department of Health and Human Services to 
        coordinate care for veterans in rural areas at critical access 
        hospitals (as designated or certified under section 1820 of the 
        Social Security Act (42 U.S.C. 1395i-4)).
            (2) Establishing a partnership between the Department of 
        Veterans Affairs and the Department of Health and Human Services 
        to coordinate care for veterans in rural areas at community 
        health centers.
            (3) Expanding coordination between the Department of 
        Veterans Affairs and the Indian Health Service to expand care 
        for Indian veterans.

    (b) Geographic Distribution.--The Secretary shall ensure that the 
demonstration projects carried out under subsection (a) are located at 
facilities that are geographically distributed throughout the United 
States.
    (c) Report.--Not later than 2 years after the date of the enactment 
of this Act, the Secretary shall submit a report on the results of the 
demonstration projects carried out under subsection (a) to--
            (1) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the Senate; and
            (2) the Committee on Veterans' Affairs and the Committee on 
        Appropriations of the House of Representatives.

    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $5,000,000 for fiscal year 2010 
and each fiscal year thereafter.

[[Page 124 STAT. 1150]]

SEC. 304. <<NOTE: 38 USC 1712A note.>> PROGRAM ON READJUSTMENT AND 
                        MENTAL HEALTH CARE SERVICES FOR VETERANS 
                        WHO SERVED IN OPERATION ENDURING FREEDOM 
                        AND OPERATION IRAQI FREEDOM.

    (a) Program Required. <<NOTE: Deadline.>> --Not later than 180 days 
after the date of the enactment of this Act, the Secretary of Veterans 
Affairs shall establish a program to provide--
            (1) to veterans of Operation Enduring Freedom and Operation 
        Iraqi Freedom, particularly veterans who served in such 
        operations while in the National Guard and the Reserves--
                    (A) peer outreach services;
                    (B) peer support services;
                    (C) readjustment counseling and services described 
                in section 1712A of title 38, United States Code; and
                    (D) mental health services; and
            (2) <<NOTE: Time period.>> to members of the immediate 
        family of veterans described in paragraph (1), during the 3-year 
        period beginning on the date of the return of such veterans from 
        deployment in Operation Enduring Freedom or Operation Iraqi 
        Freedom, education, support, counseling, and mental health 
        services to assist in--
                    (A) the readjustment of such veterans to civilian 
                life;
                    (B) in the case such veterans have an injury or 
                illness incurred during such deployment, the recovery of 
                such veterans from such injury or illness; and
                    (C) the readjustment of the family following the 
                return of such veterans.

    (b) Contracts With Community Mental Health Centers and Other 
Qualified Entities. <<NOTE: Determination.>> --In carrying out the 
program required by subsection (a), the Secretary may contract with 
community mental health centers and other qualified entities to provide 
the services required by such subsection only in areas the Secretary 
determines are not adequately served by other health care facilities or 
vet centers of the Department of Veterans Affairs. Such contracts shall 
require each contracting community health center or entity--
            (1) to the extent practicable, to use telehealth services 
        for the delivery of services required by subsection (a);
            (2) to the extent practicable, to employ veterans trained 
        under subsection (c) in the provision of services covered by 
        that subsection;
            (3) to participate in the training program conducted in 
        accordance with subsection (d);
            (4) to comply with applicable protocols of the Department 
        before incurring any liability on behalf of the Department for 
        the provision of services required by subsection (a);
            (5) for each veteran for whom a community mental health 
        center or other qualified entity provides mental health services 
        under such contract, to provide the Department with such 
        clinical summary information as the Secretary shall require;
            (6) <<NOTE: Deadline. Reports.>> to submit annual reports to 
        the Secretary containing, with respect to the program required 
        by subsection (a) and for the last full calendar year ending 
        before the submittal of such report--
                    (A) the number of the veterans served, veterans 
                diagnosed, and courses of treatment provided to veterans 
                as part of the program required by subsection (a); and
                    (B) demographic information for such services, 
                diagnoses, and courses of treatment; and

[[Page 124 STAT. 1151]]

            (7) to meet such other requirements as the Secretary shall 
        require.

    (c) Training of Veterans for Provision of Peer-outreach and Peer-
support Services. <<NOTE: Contracts.>> --In carrying out the program 
required by subsection (a), the Secretary shall contract with a national 
not-for-profit mental health organization to carry out a national 
program of training for veterans described in subsection (a) to provide 
the services described in subparagraphs (A) and (B) of paragraph (1) of 
such subsection.

    (d) Training of Clinicians for Provision of Services.--The Secretary 
shall conduct a training program for clinicians of community mental 
health centers or entities that have contracts with the Secretary under 
subsection (b) to ensure that such clinicians can provide the services 
required by subsection (a) in a manner that--
            (1) recognizes factors that are unique to the experience of 
        veterans who served on active duty in Operation Enduring Freedom 
        or Operation Iraqi Freedom (including their combat and military 
        training experiences); and
            (2) uses best practices and technologies.

    (e) Vet Center Defined.--In this section, the term ``vet center'' 
means a center for readjustment counseling and related mental health 
services for veterans under section 1712A of title 38, United States 
Code.
SEC. 305. TRAVEL REIMBURSEMENT FOR VETERANS RECEIVING TREATMENT AT 
                        FACILITIES OF THE DEPARTMENT OF VETERANS 
                        AFFAIRS.

    (a) Enhancement of Allowance Based Upon Mileage Traveled.--Section 
111 is amended--
            (1) in subsection (a), by striking ``traveled,'' and 
        inserting ``(at a rate of 41.5 cents per mile),''; and
            (2) by amending subsection (g) to read as follows:

    ``(g)(1) <<NOTE: Effective date.>> Beginning one year after the date 
of the enactment of the Caregivers and Veterans Omnibus Health Services 
Act of 2010, the Secretary may adjust the mileage rate described in 
subsection (a) to be equal to 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) <<NOTE: Deadline. Reports.>> If an adjustment in the mileage 
rate under paragraph (1) results in a lower mileage rate than the 
mileage rate otherwise specified in subsection (a), the Secretary shall, 
not later than 60 days before the date of the implementation of the 
mileage rate as so adjusted, submit to Congress a written report setting 
forth the adjustment in the mileage rate under this subsection, together 
with a justification for the decision to make the adjustment in the 
mileage rate under this subsection.''.

    (b) Coverage of Cost of Transportation by Air.--Subsection (a) of 
section 111, as amended by subsection (a)(1), is further amended by 
inserting after the first sentence the following new sentence: ``Actual 
necessary expense of travel includes the reasonable costs of airfare if 
travel by air is the only practical way to reach a Department 
facility.''.
    (c) Elimination of Limitation Based on Maximum Annual Rate of 
Pension.--Subsection (b)(1)(D)(i) of such section is

[[Page 124 STAT. 1152]]

amended by inserting ``who is not traveling by air and'' before ``whose 
annual''.
    (d) Determination of Practicality.--Subsection (b) of such section 
is amended by adding at the end the following new paragraph:
    ``(4) In determining for purposes of subsection (a) whether travel 
by air is the only practical way for a veteran to reach a Department 
facility, the Secretary shall consider the medical condition of the 
veteran and any other impediments to the use of ground transportation by 
the veteran.''.
    (e) <<NOTE: 38 USC 111 note.>> No Expansion of Eligibility for 
Beneficiary Travel.--The amendments made by subsections (b) and (d) of 
this section may not be construed as expanding or otherwise modifying 
eligibility for payments or allowances for beneficiary travel under 
section 111 of title 38, United States Code, as in effect on the day 
before the date of the enactment of this Act.

    (f) <<NOTE: 38 USC 111 note.>> Clarification of Relation to Public 
Transportation in Veterans Health Administration 
Handbook. <<NOTE: Deadline.>> --Not later than 30 days after the date of 
the enactment of this Act, the Secretary of Veterans Affairs shall 
revise the Veterans Health Administration Handbook to clarify that an 
allowance for travel based on mileage paid under section 111(a) of title 
38, United States Code, may exceed the cost of such travel by public 
transportation regardless of medical necessity.
SEC. 306. <<NOTE: 38 USC 7431 note.>> PILOT PROGRAM ON INCENTIVES 
                        FOR PHYSICIANS WHO ASSUME INPATIENT 
                        RESPONSIBILITIES AT COMMUNITY HOSPITALS IN 
                        HEALTH PROFESSIONAL SHORTAGE AREAS.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall 
carry out a pilot program to assess the feasability and advisability of 
each of the following:
            (1) The provision of financial incentives to eligible 
        physicians who obtain and maintain inpatient privileges at 
        community hospitals in health professional shortage areas in 
        order to facilitate the provision by such physicians of primary 
        care and mental health services to veterans at such hospitals.
            (2) The collection of payments from third-party providers 
        for care provided by eligible physicians to nonveterans while 
        discharging inpatient responsibilities at community hospitals in 
        the course of exercising the privileges described in paragraph 
        (1).

    (b) Eligible Physicians. <<NOTE: Definition.>> --For purposes of 
this section, an eligible physician is a primary care or mental health 
physician employed by the Department of Veterans Affairs on a full-time 
basis.

    (c) Duration of Program.--The pilot program shall be carried out 
during the 3-year period beginning on the date of the commencement of 
the pilot program.
    (d) Locations.--
            (1) In general.--The pilot program shall be carried out at 
        not less than five community hospitals in each of not less than 
        two Veterans Integrated Services Networks. The hospitals shall 
        be selected by the Secretary using the results of the survey 
        required under subsection (e).
            (2) Qualifying community hospitals.--A community hospital 
        may be selected by the Secretary as a location for the pilot 
        program if--

[[Page 124 STAT. 1153]]

                    (A) the hospital is located in a health professional 
                shortage area; and
                    (B) the number of eligible physicians willing to 
                assume inpatient responsibilities at the hospital (as 
                determined using the result of the survey) is sufficient 
                for purposes of the pilot program.

    (e) Survey of Physician Interest in Participation.--
            (1) In general. <<NOTE: Deadline.>> --Not later than 120 
        days after the date of the enactment of this Act, the Secretary 
        shall conduct a survey of eligible physicians to determine the 
        extent of the interest of such physicians in participating in 
        the pilot program.
            (2) Elements.--The survey shall disclose the type, amount, 
        and nature of the financial incentives to be provided under 
        subsection (h) to physicians participating in the pilot program.

    (f) Physician Participation.--
            (1) In general.--The Secretary shall select physicians for 
        participation in the pilot program from among eligible 
        physicians who--
                    (A) express interest in participating in the pilot 
                program in the survey conducted under subsection (e);
                    (B) are in good standing with the Department; and
                    (C) primarily have clinical responsibilities with 
                the Department.
            (2) Voluntary participation.--Participation in the pilot 
        program shall be voluntary. Nothing in this section shall be 
        construed to require a physician working for the Department to 
        assume inpatient responsibilities at a community hospital unless 
        otherwise required as a term or condition of employment with the 
        Department.

    (g) Assumption of Inpatient Physician Responsibilities.--
            (1) In general.--Each eligible physician selected for 
        participation in the pilot program shall assume and maintain 
        inpatient responsibilities, including inpatient responsibilities 
        with respect to nonveterans, at one or more community hospitals 
        selected by the Secretary for participation in the pilot program 
        under subsection (d).
            (2) Coverage under federal tort claims act.--If an eligible 
        physician participating in the pilot program carries out on-call 
        responsibilities at a community hospital where privileges to 
        practice at such hospital are conditioned upon the provision of 
        services to individuals who are not veterans while the physician 
        is on call for such hospital, the provision of such services by 
        the physician shall be considered an action within the scope of 
        the physician's office or employment for purposes of chapter 171 
        of title 28, United States Code (commonly referred to as the 
        ``Federal Tort Claims Act'').

    (h) Compensation.--
            (1) In general.--The Secretary shall provide each eligible 
        physician participating in the pilot program with such 
        compensation (including pay and other appropriate compensation) 
        as the Secretary considers appropriate to compensate such 
        physician for the discharge of any inpatient responsibilities by 
        such physician at a community hospital for which such physician 
        would not otherwise be compensated by the Department as a full-
        time employee of the Department.
            (2) Written agreement.--The amount of any compensation to be 
        provided a physician under the pilot program shall

[[Page 124 STAT. 1154]]

        be specified in a written agreement entered into by the 
        Secretary and the physician for purposes of the pilot program.
            (3) Treatment of compensation. <<NOTE: Consultation.>> --The 
        Secretary shall consult with the Director of the Office of 
        Personnel Management on the inclusion of a provision in the 
        written agreement required under paragraph (2) that describes 
        the treatment under Federal law of any compensation provided a 
        physician under the pilot program, including treatment for 
        purposes of retirement under the civil service laws.

    (i) <<NOTE: Implementation.>> Collections From Third Parties.--In 
carrying out the pilot program for the purpose described in subsection 
(a)(2), the Secretary shall implement a variety and range of 
requirements and mechanisms for the collection from third-party payors 
of amounts to reimburse the Department for health care services provided 
to nonveterans under the pilot program by eligible physicians 
discharging inpatient responsibilities under the pilot program.

    (j) Report.--Not later than 1 year after the date of the enactment 
of this Act and annually thereafter, the Secretary shall submit to 
Congress a report on the pilot program, including the following:
            (1) The findings of the Secretary with respect to the pilot 
        program.
            (2) The number of veterans and nonveterans provided 
        inpatient care by physicians participating in the pilot program.
            (3) The amounts payable and collected under subsection (i).

    (k) Definitions.--In this section:
            (1) Health professional shortage area.--The term ``health 
        professional shortage area'' has the meaning given the term in 
        section 332(a) of the Public Health Service Act (42 U.S.C. 
        254e(a)).
            (2) Inpatient responsibilities.--The term ``inpatient 
        responsibilities'' means on-call responsibilities customarily 
        required of a physician by a community hospital as a condition 
        of granting privileges to the physician to practice in the 
        hospital.
SEC. 307. <<NOTE: 38 USC 1710 note.>> GRANTS FOR VETERANS SERVICE 
                        ORGANIZATIONS FOR TRANSPORTATION OF HIGHLY 
                        RURAL VETERANS.

    (a) Grants Authorized.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        establish a grant program to provide innovative transportation 
        options to veterans in highly rural areas.
            (2) Eligible recipients.--The following may be awarded a 
        grant under this section:
                    (A) State veterans service agencies.
                    (B) Veterans service organizations.
            (3) Use of funds.--A State veterans service agency or 
        veterans service organization awarded a grant under this section 
        may use the grant amount to--
                    (A) assist veterans in highly rural areas to travel 
                to Department of Veterans Affairs medical centers; and
                    (B) otherwise assist in providing transportation in 
                connection with the provision of medical care to 
                veterans in highly rural areas.
            (4) Maximum amount.--The amount of a grant under this 
        section may not exceed $50,000.

[[Page 124 STAT. 1155]]

            (5) No matching requirement.--The recipient of a grant under 
        this section shall not be required to provide matching funds as 
        a condition for receiving such grant.

    (b) Regulations.--The Secretary shall prescribe regulations for--
            (1) evaluating grant applications under this section; and
            (2) otherwise administering the program established by this 
        section.

    (c) Definitions.--In this section:
            (1) Highly rural.--The term ``highly rural'', in the case of 
        an area, means that the area consists of a county or counties 
        having a population of less than seven persons per square mile.
            (2) Veterans service organization.--The term ``veterans 
        service organization'' means any organization recognized by the 
        Secretary of Veterans Affairs for the representation of veterans 
        under section 5902 of title 38, United States Code.

    (d) Authorization of Appropriations.--There is authorized to be 
appropriated $3,000,000 for each of fiscal years 2010 through 2014 to 
carry out this section.
SEC. 308. MODIFICATION OF ELIGIBILITY FOR PARTICIPATION IN PILOT 
                        PROGRAM OF ENHANCED CONTRACT CARE 
                        AUTHORITY FOR HEALTH CARE NEEDS OF CERTAIN 
                        VETERANS.

    Subsection (b) of section 403 of the Veterans' Mental Health and 
other Care Improvements Act of 2008 (Public Law 110-387; 122 Stat. 4125; 
38 U.S.C. 1703 note) is amended to read as follows:
    ``(b) Covered Veterans.--For purposes of the pilot program under 
this section, a covered veteran is any veteran who--
            ``(1) 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) of such title; and
            ``(2) resides in a location that is--
                    ``(A) more than 60 minutes driving distance from the 
                nearest Department health care facility providing 
                primary care services, if the veteran is seeking such 
                services;
                    ``(B) more than 120 minutes driving distance from 
                the nearest Department health care facility providing 
                acute hospital care, if the veteran is seeking such 
                care; or
                    ``(C) more than 240 minutes driving distance from 
                the nearest Department health care facility providing 
                tertiary care, if the veteran is seeking such care.''.

[[Page 124 STAT. 1156]]

                  TITLE IV--MENTAL HEALTH CARE MATTERS

SEC. 401. <<NOTE: 38 USC 1712A note.>> ELIGIBILITY OF MEMBERS OF 
                        THE ARMED FORCES WHO SERVE IN OPERATION 
                        ENDURING FREEDOM OR OPERATION IRAQI 
                        FREEDOM FOR COUNSELING AND SERVICES 
                        THROUGH READJUSTMENT COUNSELING SERVICE.

    (a) In General.--Any member of the Armed Forces, including a member 
of the National Guard or Reserve, who serves on active duty in the Armed 
Forces in Operation Enduring Freedom or Operation Iraqi Freedom is 
eligible for readjustment counseling and related mental health services 
under section 1712A of title 38, United States Code, through the 
Readjustment Counseling Service of the Veterans Health Administration.
    (b) No Requirement for Current Active Duty Service.--A member of the 
Armed Forces who meets the requirements for eligibility for counseling 
and services under subsection (a) is entitled to counseling and services 
under that subsection regardless of whether or not the member is 
currently on active duty in the Armed Forces at the time of receipt of 
counseling and services under that subsection.
    (c) Regulations.--The eligibility of members of the Armed Forces for 
counseling and services under subsection (a) shall be subject to such 
regulations as the Secretary of Defense and the Secretary of Veterans 
Affairs shall jointly prescribe for purposes of this section.
    (d) Subject to Availability of Appropriations.--The provision of 
counseling and services under subsection (a) shall be subject to the 
availability of appropriations for such purpose.
SEC. 402. RESTORATION OF AUTHORITY OF READJUSTMENT COUNSELING 
                        SERVICE TO PROVIDE REFERRAL AND OTHER 
                        ASSISTANCE UPON REQUEST TO FORMER MEMBERS 
                        OF THE ARMED FORCES NOT AUTHORIZED 
                        COUNSELING.

    Section 1712A is amended--
            (1) by redesignating subsections (c) through (f) as 
        subsections (d) through (g), respectively; and
            (2) by inserting after subsection (b) the following new 
        subsection (c):

    ``(c) Upon receipt of a request for counseling under this section 
from any individual who has been discharged or released from active 
military, naval, or air service but who is not otherwise eligible for 
such counseling, the Secretary shall--
            ``(1) provide referral services to assist such individual, 
        to the maximum extent practicable, in obtaining mental health 
        care and services from sources outside the Department; and
            ``(2) if pertinent, advise such individual of such 
        individual's rights to apply to the appropriate military, naval, 
        or air service, and to the Department, for review of such 
        individual's discharge or release from such service.''.
SEC. 403. STUDY ON SUICIDES AMONG VETERANS.

    (a) Study Required.--The Secretary of Veterans Affairs shall conduct 
a study to determine the number of veterans who died by suicide between 
January 1, 1999, and the date of the enactment of this Act.

[[Page 124 STAT. 1157]]

    (b) Coordination.--In carrying out the study under subsection (a) 
the Secretary of Veterans Affairs shall coordinate with--
            (1) the Secretary of Defense;
            (2) veterans service organizations;
            (3) the Centers for Disease Control and Prevention; and
            (4) State public health offices and veterans agencies.

    (c) Report to Congress.--The Secretary of Veterans Affairs shall 
submit to the Committee on Veterans' Affairs of the Senate and the 
Committee on Veterans' Affairs of the House of Representatives a report 
on the study required under subsection (a) and the findings of the 
Secretary.
    (d) 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 V--OTHER HEALTH CARE MATTERS

SEC. 501. REPEAL OF CERTAIN ANNUAL REPORTING REQUIREMENTS.

    (a) Nurse Pay Report.--Section 7451 is amended--
            (1) by striking subsection (f); and
            (2) by redesignating subsection (g) as subsection (f).

    (b) Long-term Planning Report.--
            (1) In general.--Section 8107 is repealed.
            (2) Conforming amendment.--The table of sections at the 
        beginning of chapter 81 is amended by striking the item relating 
        to section 8107.
SEC. 502. SUBMITTAL DATE OF ANNUAL REPORT ON GULF WAR RESEARCH.

    Section 707(c)(1) of the Persian Gulf War Veterans' Health Status 
Act (title VII of Public Law 102-585; 38 U.S.C. 527 note) is amended by 
striking ``Not later than March 1 of each year'' and inserting ``Not 
later than July 1, 2010, and July 1 of each of the five following 
years''.
SEC. 503. PAYMENT FOR CARE FURNISHED TO CHAMPVA BENEFICIARIES.

    Section 1781 is amended by adding at the end the following new 
subsection:
    ``(e) Payment by the Secretary under this section on behalf of a 
covered beneficiary for medical care shall constitute payment in full 
and extinguish any liability on the part of the beneficiary for that 
care.''.
SEC. 504. DISCLOSURE OF PATIENT TREATMENT INFORMATION FROM MEDICAL 
                        RECORDS OF PATIENTS LACKING DECISIONMAKING 
                        CAPACITY.

    Section 7332(b)(2) is amended by adding at the end the following new 
subparagraph:
            ``(F)(i) To a representative of a patient who lacks 
        decision-making capacity, when a practitioner deems the content 
        of the given record necessary for that representative to make an 
        informed decision regarding the patient's treatment.

[[Page 124 STAT. 1158]]

            ``(ii) In this subparagraph, the term `representative' means 
        an individual, organization, or other body authorized under 
        section 7331 of this title and its implementing regulations to 
        give informed consent on behalf of a patient who lacks decision-
        making capacity.''.
SEC. 505. ENHANCEMENT OF QUALITY MANAGEMENT.

    (a) Enhancement of Quality Management Through Quality Management 
Officers.--
            (1) In general.--Subchapter II of chapter 73 is amended by 
        inserting after section 7311 the following new section:
``Sec. 7311A. Quality management officers

    ``(a) <<NOTE: Designation.>> National Quality Management Officer.--
(1) The Under Secretary for Health shall designate an official of the 
Veterans Health Administration to act as the principal quality 
management officer for the quality-assurance program required by section 
7311 of this title. The official so designated may be known as the 
`National Quality Management Officer of the Veterans Health 
Administration' (in this section referred to as the `National Quality 
Management Officer').

    ``(2) The National Quality Management Officer shall report directly 
to the Under Secretary for Health in the discharge of responsibilities 
and duties of the Officer under this section.
    ``(3) The National Quality Management Officer shall be the official 
within the Veterans Health Administration who is principally responsible 
for the quality-assurance program referred to in paragraph (1). In 
carrying out that responsibility, the Officer shall be responsible for 
the following:
            ``(A) Establishing and enforcing the requirements of the 
        program referred to in paragraph (1).
            ``(B) Developing an aggregate quality metric from existing 
        data sources, such as the Inpatient Evaluation Center of the 
        Department, the National Surgical Quality Improvement Program, 
        and the External Peer Review Program of the Veterans Health 
        Administration, that could be used to assess reliably the 
        quality of care provided at individual Department medical 
        centers and associated community based outpatient clinics.
            ``(C) Ensuring that existing measures of quality, including 
        measures from the Inpatient Evaluation Center, the National 
        Surgical Quality Improvement Program, System-Wide Ongoing 
        Assessment and Review reports of the Department, and Combined 
        Assessment Program reviews of the Office of Inspector General of 
        the Department, are monitored routinely and analyzed in a manner 
        that ensures the timely detection of quality of care issues.
            ``(D) Encouraging research and development in the area of 
        quality metrics for the purposes of improving how the Department 
        measures quality in individual facilities.
            ``(E) Carrying out such other responsibilities and duties 
        relating to quality management in the Veterans Health 
        Administration as the Under Secretary for Health shall specify.

    ``(4) The requirements under paragraph (3) shall include 
requirements regarding the following:
            ``(A) A confidential system for the submittal of reports by 
        Veterans Health Administration personnel regarding quality 
        management at Department facilities.

[[Page 124 STAT. 1159]]

            ``(B) Mechanisms for the peer review of the actions of 
        individuals appointed in the Veterans Health Administration in 
        the position of physician.

    ``(b) <<NOTE: Appointment.>> Quality Management Officers for 
VISNs.--(1) The Regional Director of each Veterans Integrated Services 
Network shall appoint an official of the Network to act as the quality 
management officer of the Network.

    ``(2) The quality management officer for a Veterans Integrated 
Services Network shall report to the Regional Director of the Veterans 
Integrated Services Network, and to the National Quality Management 
Officer, regarding the discharge of the responsibilities and duties of 
the officer under this section.
    ``(3) The quality management officer for a Veterans Integrated 
Services Network shall--
            ``(A) direct the quality management office in the Network; 
        and
            ``(B) coordinate, monitor, and oversee the quality 
        management programs and activities of the Administration medical 
        facilities in the Network in order to ensure the thorough and 
        uniform discharge of quality management requirements under such 
        programs and activities throughout such facilities.

    ``(c) <<NOTE: Appointment.>> Quality Management Officers for Medical 
Facilities.--(1) The director of each Veterans Health Administration 
medical facility shall appoint a quality management officer for that 
facility.

    ``(2) The quality management officer for a facility shall report 
directly to the director of the facility, and to the quality management 
officer of the Veterans Integrated Services Network in which the 
facility is located, regarding the discharge of the responsibilities and 
duties of the quality management officer under this section.
    ``(3) The quality management officer for a facility shall be 
responsible for designing, disseminating, and implementing quality 
management programs and activities for the facility that meet the 
requirements established by the National Quality Management Officer 
under subsection (a).
    ``(d) Authorization of Appropriations.--(1) Except as provided in 
paragraph (2), there are authorized to be appropriated such sums as may 
be necessary to carry out this section.
    ``(2) There is authorized to be appropriated to carry out the 
provisions of subparagraphs (B), (C), and (D) of subsection (a)(3), 
$25,000,000 for the two-year period of fiscal years beginning after the 
date of the enactment of this section.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 73 is amended by inserting after the item 
        relating to section 7311 the following new item:

``7311A. Quality management officers.''.

    (b) Reports on Quality Concerns Under Quality-assurance Program.--
Section 7311(b) is amended by adding at the end the following new 
paragraph:
    ``(4) As part of the quality-assurance program, the Under Secretary 
for Health shall establish mechanisms through which employees of 
Veterans Health Administration facilities may submit reports, on a 
confidential basis, on matters relating to quality of care in Veterans 
Health Administration facilities to the quality management officers of 
such facilities under section 7311A(c) of

[[Page 124 STAT. 1160]]

this title. The mechanisms shall provide for the prompt and thorough 
review of any reports so submitted by the receiving officials.''.
    (c) Review of Current Health Care Quality Safeguards.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        conduct a comprehensive review of all current policies and 
        protocols of the Department of Veterans Affairs for maintaining 
        health care quality and patient safety at Department medical 
        facilities. The review shall include a review and assessment of 
        the National Surgical Quality Improvement Program, including an 
        assessment of--
                    (A) the efficacy of the quality indicators under the 
                program;
                    (B) the efficacy of the data collection methods 
                under the program;
                    (C) the efficacy of the frequency with which regular 
                data analyses are performed under the program; and
                    (D) the extent to which the resources allocated to 
                the program are adequate to fulfill the stated function 
                of the program.
            (2) Report.--Not later than 60 days after the date of the 
        enactment of this Act, the Secretary shall submit to Congress a 
        report on the review conducted under paragraph (1), including 
        the findings of the Secretary as a result of the review and such 
        recommendations as the Secretary considers appropriate in light 
        of the review.
SEC. 506. <<NOTE: 38 USC 523 note.>> PILOT PROGRAM ON USE OF 
                        COMMUNITY-BASED ORGANIZATIONS AND LOCAL 
                        AND STATE GOVERNMENT ENTITIES TO ENSURE 
                        THAT VETERANS RECEIVE CARE AND BENEFITS 
                        FOR WHICH THEY ARE ELIGIBLE.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall 
carry out a pilot program to assess the feasibility and advisability of 
using community-based organizations and local and State government 
entities--
            (1) to increase the coordination of community, local, State, 
        and Federal providers of health care and benefits for veterans 
        to assist veterans who are transitioning from military service 
        to civilian life in such transition;
            (2) to increase the availability of high quality medical and 
        mental health services to veterans transitioning from military 
        service to civilian life;
            (3) to provide assistance to families of veterans who are 
        transitioning from military service to civilian life to help 
        such families adjust to such transition; and
            (4) to provide outreach to veterans and their families to 
        inform them about the availability of benefits and connect them 
        with appropriate care and benefit programs.

    (b) Duration of Program.--The pilot program shall be carried out 
during the 2-year period beginning on the date that is 180 days after 
the date of the enactment of this Act.
    (c) Program Locations.--
            (1) In general.--The pilot program shall be carried out at 
        five locations selected by the Secretary for purposes of the 
        pilot program.
            (2) Considerations.--In selecting locations for the pilot 
        program, the Secretary shall consider the advisability of 
        selecting locations in--

[[Page 124 STAT. 1161]]

                    (A) rural areas;
                    (B) areas with populations that have a high 
                proportion of minority group representation;
                    (C) areas with populations that have a high 
                proportion of individuals who have limited access to 
                health care; and
                    (D) areas that are not in close proximity to an 
                active duty military installation.

    (d) Grants.--The Secretary shall carry out the pilot program through 
the award of grants to community-based organizations and local and State 
government entities.
    (e) Selection of Grant Recipients.--
            (1) In general.--A community-based organization or local or 
        State government entity seeking a grant under the pilot program 
        shall submit to the Secretary an application therefor in such 
        form and in such manner as the Secretary considers appropriate.
            (2) Elements.--Each application submitted under paragraph 
        (1) shall include the following:
                    (A) A description of the consultations, if any, with 
                the Department of Veterans Affairs in the development of 
                the proposal under the application.
                    (B) A plan to coordinate activities under the pilot 
                program, to the greatest extent possible, with the 
                local, State, and Federal providers of services for 
                veterans to reduce duplication of services and to 
                enhance the effect of such services.

    (f) Use of Grant Funds.--The Secretary shall prescribe appropriate 
uses of grant funds received under the pilot program.
    (g) Report on Program.--
            (1) In general.--Not later than 180 days after the 
        completion of the pilot program, the Secretary shall submit to 
        Congress a report on the pilot program.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) The findings and conclusions of the Secretary 
                with respect to the pilot program.
                    (B) An assessment of the benefits to veterans of the 
                pilot program.
                    (C) The recommendations of the Secretary as to the 
                advisability of continuing the pilot program.
SEC. 507. SPECIALIZED RESIDENTIAL CARE AND REHABILITATION FOR 
                        CERTAIN VETERANS.

    Section 1720 is amended by adding at the end the following new 
subsection:
    ``(g) The Secretary may contract with appropriate entities to 
provide specialized residential care and rehabilitation services to a 
veteran of Operation Enduring Freedom or Operation Iraqi Freedom who the 
Secretary determines suffers from a traumatic brain injury, has an 
accumulation of deficits in activities of daily living and instrumental 
activities of daily living, and because of these deficits, would 
otherwise require admission to a nursing home even though such care 
would generally exceed the veteran's nursing needs.''.

[[Page 124 STAT. 1162]]

SEC. 508. EXPANDED STUDY ON THE HEALTH IMPACT OF PROJECT SHIPBOARD 
                        HAZARD AND DEFENSE.

    (a) In General. <<NOTE: Deadline.>> --Not later than 90 days after 
the date of the enactment of this Act, the Secretary of Veterans Affairs 
shall enter into a contract with the Institute of Medicine of the 
National Academies to conduct an expanded study on the health impact of 
Project Shipboard Hazard and Defense (Project SHAD).

    (b) Covered Veterans.--The study required by subsection (a) shall 
include, to the extent practicable, all veterans who participated in 
Project Shipboard Hazard and Defense.
    (c) Use of Existing Studies.--The study required by subsection (a) 
may use results from the study covered in the report titled ``Long-Term 
Health Effects of Participation in Project SHAD'' of the Institute of 
Medicine of the National Academies.
SEC. 509. USE OF NON-DEPARTMENT FACILITIES FOR REHABILITATION OF 
                        INDIVIDUALS WITH TRAUMATIC BRAIN INJURY.

    Section 1710E is amended--
            (1) by redesignating subsection (b) as subsection (c);
            (2) by inserting after subsection (a) the following new 
        subsection (b):

    ``(b) Covered Individuals.--The care and services provided under 
subsection (a) shall be made available to an individual--
            ``(1) who is described in section 1710C(a) of this title; 
        and
            ``(2)(A) to whom the Secretary is unable to provide such 
        treatment or services at the frequency or for the duration 
        prescribed in such plan; or
            ``(B) for whom the Secretary determines that it is optimal 
        with respect to the recovery and rehabilitation for such 
        individual.''; and
            (3) by adding at the end the following new subsection:

    ``(d) Standards.--The Secretary may not provide treatment or 
services as described in subsection (a) at a non-Department facility 
under such subsection unless such facility maintains standards for the 
provision of such treatment or services established by an independent, 
peer-reviewed organization that accredits specialized rehabilitation 
programs for adults with traumatic brain injury.''.
SEC. 510. <<NOTE: 38 USC 1712 note.>> PILOT PROGRAM ON PROVISION 
                        OF DENTAL INSURANCE PLANS TO VETERANS AND 
                        SURVIVORS AND DEPENDENTS OF VETERANS.

    (a) Pilot Program Required.--The Secretary of Veterans Affairs shall 
carry out a pilot program to assess the feasibility and advisability of 
providing a dental insurance plan to veterans and survivors and 
dependents of veterans described in subsection (b).
    (b) Covered Veterans and Survivors and Dependents.--The veterans and 
survivors and dependents of veterans described in this subsection are as 
follows:
            (1) Any veteran who is enrolled in the system of annual 
        patient enrollment under section 1705 of title 38, United States 
        Code.
            (2) Any survivor or dependent of a veteran who is eligible 
        for medical care under section 1781 of such title.

[[Page 124 STAT. 1163]]

    (c) Duration of Program.--The pilot program shall be carried out 
during the 3-year period beginning on the date that is 270 days after 
the date of the enactment of this Act.
    (d) Locations.--The pilot program shall be carried out in such 
Veterans Integrated Services Networks as the Secretary considers 
appropriate for purposes of the pilot program.
    (e) Administration.--The Secretary shall contract with a dental 
insurer to administer the dental insurance plan provided under the pilot 
program.
    (f) Benefits.--The dental insurance plan under the pilot program 
shall provide such benefits for dental care and treatment as the 
Secretary considers appropriate for the dental insurance plan, including 
diagnostic services, preventative services, endodontics and other 
restorative services, surgical services, and emergency services.
    (g) Enrollment.--
            (1) Voluntary.--Enrollment in the dental insurance plan 
        under the pilot program shall be voluntary.
            (2) Minimum period.--Enrollment in the dental insurance plan 
        shall be for such minimum period as the Secretary shall 
        prescribe for purposes of this section.

    (h) Premiums.--
            (1) In general.--Premiums for coverage under the dental 
        insurance plan under the pilot program shall be in such amount 
        or amounts as the Secretary shall prescribe to cover all costs 
        associated with the pilot program.
            (2) Annual adjustment.--The Secretary shall adjust the 
        premiums payable under the pilot program for coverage under the 
        dental insurance plan on an annual basis. Each individual 
        covered by the dental insurance plan at the time of such an 
        adjustment shall be notified of the amount and effective date of 
        such adjustment.
            (3) Responsibility for payment.--Each individual covered by 
        the dental insurance plan shall pay the entire premium for 
        coverage under the dental insurance plan, in addition to the 
        full cost of any copayments.

    (i) Voluntary Disenrollment.--
            (1) In general.--With respect to enrollment in the dental 
        insurance plan under the pilot program, the Secretary shall--
                    (A) <<NOTE: Time period.>> permit the voluntary 
                disenrollment of an individual in the dental insurance 
                plan if the disenrollment occurs during the 30-day 
                period beginning on the date of the enrollment of the 
                individual in the dental insurance plan; and
                    (B) permit the voluntary disenrollment of an 
                individual in the dental insurance plan for such 
                circumstances as the Secretary shall prescribe for 
                purposes of this subsection, but only to the extent such 
                disenrollment does not jeopardize the fiscal integrity 
                of the dental insurance plan.
            (2) Allowable circumstances.--The circumstances prescribed 
        under paragraph (1)(B) shall include the following:
                    (A) If an individual enrolled in the dental 
                insurance plan relocates to a location outside the 
                jurisdiction of the dental insurance plan that prevents 
                use of the benefits under the dental insurance plan.

[[Page 124 STAT. 1164]]

                    (B) If an individual enrolled in the dental 
                insurance plan is prevented by a serious medical 
                condition from being able to obtain benefits under the 
                dental insurance plan.
                    (C) Such other circumstances as the Secretary shall 
                prescribe for purposes of this subsection.
            (3) Establishment of procedures.--The Secretary shall 
        establish procedures for determinations on the permissibility of 
        voluntary disenrollments under paragraph (1)(B). Such procedures 
        shall ensure timely determinations on the permissibility of such 
        disenrollments.

    (j) Relationship to Dental Care Provided by Secretary.--Nothing in 
this section shall affect the responsibility of the Secretary to provide 
dental care under section 1712 of title 38, United States Code, and the 
participation of an individual in the dental insurance plan under the 
pilot program shall not affect the individual's entitlement to 
outpatient dental services and treatment, and related dental appliances, 
under that section.
    (k) Regulations.--The dental insurance plan under the pilot program 
shall be administered under such regulations as the Secretary shall 
prescribe.
SEC. 511. PROHIBITION ON COLLECTION OF COPAYMENTS FROM VETERANS 
                        WHO ARE CATASTROPHICALLY DISABLED.

    (a) In General.--Subchapter III of chapter 17 is amended by adding 
at the end the following new section:
``Sec. 1730A. Prohibition on collection of copayments from 
                    catastrophically disabled veterans

    ``Notwithstanding subsections (f) and (g) of section 1710 and 
section 1722A(a) of this title or any other provision of law, the 
Secretary may not require a veteran who is catastrophically disabled, as 
defined by the Secretary, to make any copayment for the receipt of 
hospital care or medical services under the laws administered by the 
Secretary.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 17 is amended by inserting after the item relating to section 
1730 the following new item:

``1730A. Prohibition on collection of copayments from catastrophically 
           disabled veterans.''.

SEC. 512. HIGHER PRIORITY STATUS FOR CERTAIN VETERANS WHO ARE 
                        MEDAL OF HONOR RECIPIENTS.

    Section 1705(a)(3) is amended by inserting ``veterans who were 
awarded the medal of honor under section 3741, 6241, or 8741 of title 10 
or section 491 of title 14,'' after ``the Purple Heart,''.
SEC. 513. HOSPITAL CARE, MEDICAL SERVICES, AND NURSING HOME CARE 
                        FOR CERTAIN VIETNAM-ERA VETERANS EXPOSED 
                        TO HERBICIDE AND VETERANS OF THE PERSIAN 
                        GULF WAR.

    Section 1710(e) is amended--
            (1) in paragraph (3)--
                    (A) by striking ``subsection (a)(2)(F)--'' and all 
                that follows through ``(C) in the case'' and inserting 
                ``subsection (a)(2)(F) in the case''; and
                    (B) by redesignating clauses (i) and (ii) of the 
                former subparagraph (C) as subparagraphs (A) and (B) of 
                such paragraph (3) and by realigning the margin of such 
                new subparagraphs two ems to the left; and

[[Page 124 STAT. 1165]]

            (2) in paragraph (1)(C)--
                    (A) by striking ``paragraphs (2) and (3)'' and 
                inserting ``paragraph (2)''; and
                    (B) by inserting after ``on active duty'' the 
                following: ``between August 2, 1990, and November 11, 
                1998,''.
SEC. 514. ESTABLISHMENT OF DIRECTOR OF PHYSICIAN ASSISTANT 
                        SERVICES IN VETERANS HEALTH 
                        ADMINISTRATION.

    (a) In General.--Section 7306(a) is amended by striking paragraph 
(9) and inserting the following new paragraph (9):
            ``(9) The Director of Physician Assistant Services, who 
        shall--
                    ``(A) serve in a full-time capacity at the Central 
                Office of the Department;
                    ``(B) be a qualified physician assistant; and
                    ``(C) be responsible and report directly to the 
                Chief Patient Care Services Officer of the Veterans 
                Health Administration on all matters relating to the 
                education and training, employment, appropriate use, and 
                optimal participation of physician assistants within the 
                programs and initiatives of the Administration.''.

    (b) <<NOTE: 38 USC 7306 note.>> Deadline for Implementation.--The 
Secretary of Veterans Affairs shall ensure that an individual is serving 
as the Director of Physician Assistant Services under paragraph (9) of 
section 7306(a) of title 38, United States Code, as amended by 
subsection (a), by not later than 120 days after the date of the 
enactment of this Act.
SEC. 515. COMMITTEE ON CARE OF VETERANS WITH TRAUMATIC BRAIN 
                        INJURY.

    (a) Establishment of Committee.--Subchapter II of chapter 73 is 
amended by inserting after section 7321 the following new section:
``Sec. 7321A. Committee on Care of Veterans with Traumatic Brain 
                    Injury

    ``(a) Establishment.--The Secretary shall establish in the Veterans 
Health Administration a committee to be known as the `Committee on Care 
of Veterans with Traumatic Brain Injury'. The Under Secretary for Health 
shall appoint employees of the Department with expertise in the care of 
veterans with traumatic brain injury to serve on the committee.
    ``(b) Responsibilities of Committee.--The committee shall assess, 
and carry out a continuing assessment of, the capability of the Veterans 
Health Administration to meet effectively the treatment and 
rehabilitation needs of veterans with traumatic brain injury. In 
carrying out that responsibility, the committee shall--
            ``(1) evaluate the care provided to such veterans through 
        the Veterans Health Administration;
            ``(2) identify systemwide problems in caring for such 
        veterans in facilities of the Veterans Health Administration;
            ``(3) identify specific facilities within the Veterans 
        Health Administration at which program enrichment is needed to 
        improve treatment and rehabilitation of such veterans; and
            ``(4) identify model programs which the committee considers 
        to have been successful in the treatment and rehabilitation of 
        such veterans and which should be implemented more widely in or 
        through facilities of the Veterans Health Administration.

[[Page 124 STAT. 1166]]

    ``(c) Advice and Recommendations.--The committee shall--
            ``(1) advise the Under Secretary regarding the development 
        of policies for the care and rehabilitation of veterans with 
        traumatic brain injury; and
            ``(2) make recommendations to the Under Secretary--
                    ``(A) for improving programs of care of such 
                veterans at specific facilities and throughout the 
                Veterans Health Administration;
                    ``(B) for establishing special programs of education 
                and training relevant to the care of such veterans for 
                employees of the Veterans Health Administration;
                    ``(C) regarding research needs and priorities 
                relevant to the care of such veterans; and
                    ``(D) regarding the appropriate allocation of 
                resources for all such activities.

    ``(d) Annual Report.--Not later than June 1, 2010, and each year 
thereafter, 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 this section. 
Each such report shall include the following for the calendar year 
preceding the year in which the report is submitted:
            ``(1) A list of the members of the committee.
            ``(2) The assessment of the Under Secretary for Health, 
        after review of the findings of the committee, regarding the 
        capability of the Veterans Health Administration, on a 
        systemwide and facility-by-facility basis, to meet effectively 
        the treatment and rehabilitation needs of veterans with 
        traumatic brain injury.
            ``(3) The plans of the committee for further assessments.
            ``(4) The findings and recommendations made by the committee 
        to the Under Secretary for Health and the views of the Under 
        Secretary on such findings and recommendations.
            ``(5) A description of the steps taken, plans made (and a 
        timetable for the execution of such plans), and resources to be 
        applied toward improving the capability of the Veterans Health 
        Administration to meet effectively the treatment and 
        rehabilitation needs of veterans with traumatic brain injury.''.

    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 73 is amended by inserting after the item relating to section 
7321 the following new item:

``7321A. Committee on Care of Veterans with Traumatic Brain Injury.''.

SEC. 516. INCREASE IN AMOUNT AVAILABLE TO DISABLED VETERANS FOR 
                        IMPROVEMENTS AND STRUCTURAL ALTERATIONS 
                        FURNISHED AS PART OF HOME HEALTH SERVICES.

    (a) Increase.--Section 1717(a)(2) is amended by striking 
subparagraphs (A) and (B) and inserting the following:
            ``(A) in the case of medical services furnished under 
        section 1710(a)(1) of this title, or for a disability described 
        in section 1710(a)(2)(C) of this title--
                    ``(i) in the case of a veteran who first applies for 
                benefits under this paragraph before the date of the 
                Caregivers and Veterans Omnibus Health Services Act of 
                2010, $4,100; or
                    ``(ii) in the case of a veteran who first applies 
                for benefits under this paragraph on or after the date 
                of the

[[Page 124 STAT. 1167]]

                Caregivers and Veterans Omnibus Health Services Act of 
                2010, $6,800; and
            ``(B) in the case of medical services furnished under any 
        other provision of section 1710(a) of this title--
                    ``(i) in the case of a veteran who first applies for 
                benefits under this paragraph before the date of the 
                Caregivers and Veterans Omnibus Health Services Act of 
                2010, $1,200; or
                    ``(ii) in the case of a veteran who first applies 
                for benefits under this paragraph on or after the date 
                of the Caregivers and Veterans Omnibus Health Services 
                Act of 2010, $2,000.''.

    (b) <<NOTE: 38 USC 1717 note.>> Construction.--A veteran who 
exhausts such veteran's eligibility for benefits under section 
1717(a)(2) of such title before the date of the enactment of this Act, 
is not entitled to additional benefits under such section by reason of 
the amendments made by subsection (a).
SEC. 517. EXTENSION OF STATUTORILY DEFINED COPAYMENTS FOR CERTAIN 
                        VETERANS FOR HOSPITAL CARE AND NURSING 
                        HOME CARE.

    Subparagraph (B) of section 1710(f)(2) is amended to read as 
follows:
                    ``(B) before September 30, 2012, an amount equal to 
                $10 for every day the veteran receives hospital care and 
                $5 for every day the veteran receives nursing home 
                care.''.
SEC. 518. EXTENSION OF AUTHORITY TO RECOVER COST OF CERTAIN CARE 
                        AND SERVICES FROM DISABLED VETERANS WITH 
                        HEALTH-PLAN CONTRACTS.

    Subparagraph (E) of section 1729(a)(2) is amended to read as 
follows:
                    ``(E) for which care and services are furnished 
                before October 1, 2012, under this chapter to a veteran 
                who--
                          ``(i) has a service-connected disability; and
                          ``(ii) is entitled to care (or payment of the 
                      expenses of care) under a health-plan contract.''.

                 TITLE VI--DEPARTMENT PERSONNEL MATTERS

SEC. 601. ENHANCEMENT OF AUTHORITIES FOR RETENTION OF MEDICAL 
                        PROFESSIONALS.

    (a) Secretarial Authority To Extend Title 38 Status to Additional 
Positions.--
            (1) In general.--Paragraph (3) of section 7401 is amended by 
        striking ``and blind rehabilitation outpatient specialists.'' 
        and inserting the following: ``blind rehabilitation outpatient 
        specialists, and such other classes of health care occupations 
        as the Secretary considers necessary for the recruitment and 
        retention needs of the Department subject to the following 
        requirements:
                    ``(A) Such other classes of health care 
                occupations--
                          ``(i) are not occupations relating to 
                      administrative, clerical, or physical plant 
                      maintenance and protective services;

[[Page 124 STAT. 1168]]

                          ``(ii) that would otherwise receive basic pay 
                      in accordance with the General Schedule under 
                      section 5332 of title 5;
                          ``(iii) provide, as determined by the 
                      Secretary, direct patient care services or 
                      services incident to direct patient services; and
                          ``(iv) would not otherwise be available to 
                      provide medical care or treatment for veterans.
                    ``(B) <<NOTE: Deadline. Notification.>> Not later 
                than 45 days before the Secretary appoints any personnel 
                for a class of health care occupations that is not 
                specifically listed in this paragraph, the Secretary 
                shall submit to the Committee on Veterans' Affairs of 
                the Senate, the Committee on Veterans' Affairs of the 
                House of Representatives, and the Office of Management 
                and Budget notice of such appointment.
                    ``(C) Before submitting notice under subparagraph 
                (B), the Secretary shall solicit comments from any labor 
                organization representing employees in such class and 
                include such comments in such notice.''.
            (2) Appointment of nurse assistants.--Such paragraph is 
        further amended by inserting ``nurse assistants,'' after 
        ``licensed practical or vocational nurses,''.

    (b) Probationary Periods for Registered Nurses.--Section 7403(b) is 
amended--
            (1) in paragraph (1), by striking ``Appointments'' and 
        inserting ``Except as otherwise provided in this subsection, 
        appointments'';
            (2) by redesignating paragraph (2) as paragraph (4); and
            (3) by inserting after paragraph (1) the following new 
        paragraphs:

    ``(2) With respect to the appointment of a registered nurse under 
this chapter, paragraph (1) shall apply with respect to such appointment 
regardless of whether such appointment is on a full-time basis or a 
part-time basis.
    ``(3) An appointment described in subsection (a) on a part-time 
basis of a person who has previously served on a full-time basis for the 
probationary period for the position concerned shall be without a 
probationary period.''.
    (c) Prohibition on Temporary Part-time Registered Nurse Appointments 
in Excess of 2 Years.--Section 7405 is amended by adding at the end the 
following new subsection:
    ``(g)(1) Except as provided in paragraph (3), employment of a 
registered nurse on a temporary part-time basis under subsection (a)(1) 
shall be for a probationary period of two years.
    ``(2) Except as provided in paragraph (3), upon completion by a 
registered nurse of the probationary period described in paragraph (1)--
            ``(A) the employment of such nurse shall--
                    ``(i) no longer be considered temporary; and
                    ``(ii) be considered an appointment described in 
                section 7403(a) of this title; and
            ``(B) the nurse shall be considered to have served the 
        probationary period required by section 7403(b).

    ``(3) This subsection shall not apply to appointments made on a term 
limited basis of less than or equal to three years of--

[[Page 124 STAT. 1169]]

            ``(A) nurses with a part-time appointment resulting from an 
        academic affiliation or teaching position in a nursing academy 
        of the Department;
            ``(B) nurses appointed as a result of a specific research 
        proposal or grant; or
            ``(C) nurses who are not citizens of the United States and 
        appointed under section 7407(a) of this title.''.

    (d) Rate of Basic Pay for Appointees to the Office of the Under 
Secretary for Health Set to Rate of Basic Pay for Senior Executive 
Service Positions.--
            (1) In general.--Section 7404(a) is amended--
                    (A) by striking ``The annual'' and inserting ``(1) 
                The annual'';
                    (B) by striking ``The pay'' and inserting the 
                following:

    ``(2) The pay'';
                    (C) by striking ``under the preceding sentence'' and 
                inserting ``under paragraph (1)''; and
                    (D) by adding at the end the following new 
                paragraph:

    ``(3)(A) The rate of basic pay for a position to which an Executive 
order applies under paragraph (1) and is not described by paragraph (2) 
shall be set in accordance with section 5382 of title 5 as if such 
position were a Senior Executive Service position (as such term is 
defined in section 3132(a) of title 5).
    ``(B) A rate of basic pay for a position may not be set under 
subparagraph (A) in excess of--
            ``(i) in the case the position is not described in clause 
        (ii), the rate of basic pay payable for level III of the 
        Executive Schedule; or
            ``(ii) in the case that the position is covered by a 
        performance appraisal system that meets the certification 
        criteria established by regulation under section 5307(d) of 
        title 5, the rate of basic pay payable for level II of the 
        Executive Schedule.

    ``(C) Notwithstanding the provisions of subsection (d) of section 
5307 of title 5, the Secretary may make any certification under that 
subsection instead of the Office of Personnel Management and without 
concurrence of the Office of Management and Budget.''.
            (2) <<NOTE: 38 USC 7404 note.>> Effective date.--The 
        amendments made by paragraph (1) shall take effect on the first 
        day of the first pay period beginning after the day that is 180 
        days after the date of the enactment of this Act.

    (e) Special Incentive Pay for Department Pharmacist Executives.--
Section 7410 is amended--
            (1) by striking ``The Secretary may'' and inserting the 
        following:

    ``(a) In General.--The Secretary may''; and
            (2) by adding at the end the following new subsection:

    ``(b) Special Incentive Pay for Department Pharmacist Executives.--
(1) In order to recruit and retain highly qualified Department 
pharmacist executives, the Secretary may authorize the Under Secretary 
for Health to pay special incentive pay of not more than $40,000 per 
year to an individual of the Veterans Health Administration who is a 
pharmacist executive.
    ``(2) In determining whether and how much special pay to provide to 
such individual, the Under Secretary shall consider the following:
            ``(A) The grade and step of the position of the individual.

[[Page 124 STAT. 1170]]

            ``(B) The scope and complexity of the position of the 
        individual.
            ``(C) The personal qualifications of the individual.
            ``(D) The characteristics of the labor market concerned.
            ``(E) Such other factors as the Secretary considers 
        appropriate.

    ``(3) Special incentive pay under paragraph (1) for an individual is 
in addition to all other pay (including basic pay) and allowances to 
which the individual is entitled.
    ``(4) Except as provided in paragraph (5), special incentive pay 
under paragraph (1) for an individual shall be considered basic pay for 
all purposes, including retirement benefits under chapters 83 and 84 of 
title 5, and other benefits.
    ``(5) Special incentive pay under paragraph (1) for an individual 
shall not be considered basic pay for purposes of adverse actions under 
subchapter V of this chapter.
    ``(6) Special incentive pay under paragraph (1) may not be awarded 
to an individual in an amount that would result in an aggregate amount 
of pay (including bonuses and awards) received by such individual in a 
year under this title that is greater than the annual pay of the 
President.''.
    (f) Pay for Physicians and Dentists.--
            (1) Non-foreign cost of living adjustment allowance.--
        Section 7431(b) is amended by adding at the end the following 
        new paragraph:
            ``(5) The non-foreign cost of living adjustment allowance 
        authorized under section 5941 of title 5 for physicians and 
        dentists whose pay is set under this section shall be determined 
        as a percentage of base pay only.''.
            (2) Market pay determinations for physicians and dentists in 
        administrative or executive leadership positions.--Section 
        7431(c)(4)(B)(i) is amended by adding at the end the following: 
        ``The Secretary may exempt physicians and dentists occupying 
        administrative or executive leadership positions from the 
        requirements of the previous sentence.''.
            (3) Exception to prohibition on reduction of market pay.--
        Section 7431(c)(7) is amended by striking ``concerned.'' and 
        inserting ``concerned, unless there is a change in board 
        certification or reduction of privileges.''.

    (g) Adjustment of Pay Cap for Nurses.--Section 7451(c)(2) is amended 
by striking ``level V'' and inserting ``level IV''.
    (h) Exemption for Certified Registered Nurse Anesthetists From 
Limitation on Authorized Competitive Pay.--Section 7451(c)(2) is further 
amended by adding at the end the following new sentence: ``The maximum 
rate of basic pay for a grade for the position of certified registered 
nurse anesthetist pursuant to an adjustment under subsection (d) may 
exceed the maximum rate otherwise provided in the preceding sentence.''.
    (i) Increased Limitation on Special Pay for Nurse Executives.--
Section 7452(g)(2) is amended by striking ``$25,000'' and inserting 
``$100,000''.
    (j) Locality Pay Scale Computations.--
            (1) Education, training, and support for facility directors 
        in wage surveys.--Section 7451(d)(3) is amended by adding at the 
        end the following new subparagraph:

    ``(F) The Under Secretary for Health shall provide appropriate 
education, training, and support to directors of Department health

[[Page 124 STAT. 1171]]

care facilities in the conduct and use of surveys, including the use of 
third-party surveys, under this paragraph.''.
            (2) Information on methodology used in wage surveys.--
        Section 7451(e)(4) is amended--
                    (A) by redesignating subparagraph (D) as 
                subparagraph (E); and
                    (B) by inserting after subparagraph (C) the 
                following new subparagraph (D):
            ``(D) In any case in which the director conducts such a wage 
        survey during the period covered by the report and makes 
        adjustment in rates of basic pay applicable to one or more 
        covered positions at the facility, information on the 
        methodology used in making such adjustment or adjustments.''.
            (3) Disclosure of information to persons in covered 
        positions.--Section 7451(e), as amended by paragraph (2) of this 
        subsection, is further amended by adding at the end the 
        following new paragraph:

    ``(6)(A) <<NOTE: Reports.>> Upon the request of an individual 
described in subparagraph (B) for a report provided under paragraph (4) 
with respect to a Department health-care facility, the Under Secretary 
for Health or the director of such facility shall provide to the 
individual the most current report for such facility provided under such 
paragraph.

    ``(B) An individual described in this subparagraph is--
            ``(i) an individual in a covered position at a Department 
        health-care facility; or
            ``(ii) a representative of the labor organization 
        representing that individual who is designated by that 
        individual to make the request.''.

    (k) Eligibility of Part-Time Nurses for Additional Nurse Pay.--
            (1) In general.--Section 7453 is amended--
                    (A) in subsection (a), by striking ``a nurse'' and 
                inserting ``a full-time nurse or part-time nurse'';
                    (B) in subsection (b)--
                          (i) in the first sentence--
                                    (I) by striking ``on a tour of 
                                duty'';
                                    (II) by striking ``service on such 
                                tour'' and inserting ``such service''; 
                                and
                                    (III) by striking ``of such tour'' 
                                and inserting ``of such service''; and
                          (ii) in the second sentence, by striking ``of 
                      such tour'' and inserting ``of such service'';
                    (C) in subsection (c)--
                          (i) by striking ``on a tour of duty''; and
                          (ii) by striking ``service on such tour'' and 
                      inserting ``such service''; and
                    (D) in subsection (e)--
                          (i) in paragraph (1), by striking ``eight 
                      hours in a day'' and inserting ``eight consecutive 
                      hours''; and
                          (ii) in paragraph (5)(A), by striking ``tour 
                      of duty'' and inserting ``period of service''.
            (2) Exclusion of application of additional nurse pay 
        provisions to certain additional employees.--Paragraph (3) of 
        section 7454(b) is amended to read as follows:

    ``(3) <<NOTE: Time period.>> Employees appointed under section 7408 
of this title performing service on a tour of duty, any part of which is 
within the period commencing at midnight Friday and ending at midnight

[[Page 124 STAT. 1172]]

Sunday, shall receive additional pay in addition to the rate of basic 
pay provided such employees for each hour of service on such tour at a 
rate equal to 25 percent of such employee's hourly rate of basic pay.''.

    (l) Enhanced Authority To Increase Rates of Basic Pay To Obtain or 
Retain Services of Certain Persons.--Section 7455(c) is amended to read 
as follows:
    ``(c)(1) Subject to paragraph (2), the amount of any increase under 
subsection (a) in the minimum rate for any grade may not (except in the 
case of nurse anesthetists, licensed practical nurses, licensed 
vocational nurses, nursing positions otherwise covered by title 5, 
pharmacists, and licensed physical therapists) exceed the maximum rate 
of basic pay (excluding any locality-based comparability payment under 
section 5304 of title 5 or similar provision of law) for the grade or 
level by more than 30 percent.
    ``(2) No rate may be established under this section in excess of the 
rate of basic pay payable for level IV of the Executive Schedule.''.
SEC. 602. LIMITATIONS ON OVERTIME DUTY, WEEKEND DUTY, AND 
                        ALTERNATIVE WORK SCHEDULES FOR NURSES.

    (a) Overtime Duty.--
            (1) In general.--Subchapter IV of chapter 74 is amended by 
        adding at the end the following new section:
``Sec. 7459. Nursing staff: special rules for overtime duty

    ``(a) Limitation.--Except as provided in subsection (c), the 
Secretary may not require nursing staff to work more than 40 hours (or 
24 hours if such staff is covered under section 7456 of this title) in 
an administrative work week or more than eight consecutive hours (or 12 
hours if such staff is covered under section 7456 or 7456A of this 
title).
    ``(b) Voluntary Overtime.--(1) Nursing staff may on a voluntary 
basis elect to work hours otherwise prohibited by subsection (a).
    ``(2) The refusal of nursing staff to work hours prohibited by 
subsection (a) shall not be grounds--
            ``(A) to discriminate (within the meaning of section 704(a) 
        of the Civil Rights Act of 1964 (42 U.S.C. 2000e-3(a))) against 
        the staff;
            ``(B) to dismiss or discharge the staff; or
            ``(C) for any other adverse personnel action against the 
        staff.

    ``(c) Overtime Under Emergency Circumstances.--(1) Subject to 
paragraph (2), the Secretary may require nursing staff to work hours 
otherwise prohibited by subsection (a) if--
            ``(A) the work is a consequence of an emergency that could 
        not have been reasonably anticipated;
            ``(B) the emergency is non-recurring and is not caused by or 
        aggravated by the inattention of the Secretary or lack of 
        reasonable contingency planning by the Secretary;
            ``(C) the Secretary has exhausted all good faith, reasonable 
        attempts to obtain voluntary workers;
            ``(D) the nurse staff have critical skills and expertise 
        that are required for the work; and

[[Page 124 STAT. 1173]]

            ``(E) the work involves work for which the standard of care 
        for a patient assignment requires continuity of care through 
        completion of a case, treatment, or procedure.

    ``(2) Nursing staff may not be required to work hours under this 
subsection after the requirement for a direct role by the staff in 
responding to medical needs resulting from the emergency ends.
    ``(d) Nursing Staff Defined.--In this section, the term `nursing 
staff' includes the following:
            ``(1) A registered nurse.
            ``(2) A licensed practical or vocational nurse.
            ``(3) A nurse assistant appointed under this chapter or 
        title 5.
            ``(4) Any other nurse position designated by the Secretary 
        for purposes of this section.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 74 is amended by inserting after the item 
        relating to section 7458 the following new item:

``7459. Nursing staff: special rules for overtime duty.''.

    (b) Weekend Duty.--Section 7456 is amended--
            (1) by striking subsection (c); and
            (2) by redesignating subsection (d) as subsection (c).

    (c) Alternate Work Schedules.--
            (1) In general.--Section 7456A(b)(1)(A) is amended by 
        striking ``three regularly scheduled'' and all that follows 
        through the period at the end and inserting ``six regularly 
        scheduled 12-hour tours of duty within a 14-day period shall be 
        considered for all purposes to have worked a full 80-hour pay 
        period.''.
            (2) Conforming amendments.--Section 7456A(b) is amended--
                    (A) in the subsection heading, by striking ``36/40'' 
                and inserting ``72/80'';
                    (B) in paragraph (2)(A), by striking ``40-hour basic 
                work week'' and inserting ``80-hour pay period''; and
                    (C) in paragraph (3), by striking ``regularly''.
SEC. 603. REAUTHORIZATION OF HEALTH PROFESSIONALS EDUCATIONAL 
                        ASSISTANCE SCHOLARSHIP PROGRAM.

    (a) In General.--Section 7618 is amended by striking ``December 31, 
1998'' and inserting ``December 31, 2014''.
    (b) Expansion of Eligibility Requirements.--Section 7612(b)(2) is 
amended by striking ``(under section'' and all that follows through ``or 
vocational nurse.'' and inserting the following: ``as an appointee under 
paragraph (1) or (3) of section 7401 of this title.''.
    (c) Additional Program Requirements.--Subchapter II of chapter 76, 
as amended by subsections (a) and (b), is further amended--
            (1) by redesignating section 7618 as section 7619; and
            (2) by inserting after section 7617 the following new 
        section:
``Sec. 7618. Additional program requirements

    ``(a) Program Modification.--Notwithstanding any provision of this 
subchapter, the Secretary shall carry out this subchapter after the date 
of the enactment of this section by modifying the Scholarship Program in 
such a manner that the program and hiring

[[Page 124 STAT. 1174]]

processes are designed to fully employ Scholarship Program graduates as 
soon as possible, if not immediately, upon graduation and completion of 
necessary certifications, and to actively assist and monitor graduates 
to ensure certifications are obtained in a minimal amount of time 
following graduation.
    ``(b) Clinical Tours.--The Secretary shall require participants in 
the Scholarship Program to perform clinical tours in assignments or 
locations determined by the Secretary while the participants are 
enrolled in the course of education or training for which the 
scholarship is provided.
    ``(c) Mentors.--The Secretary shall ensure that at the commencement 
of the period of obligated service of a participant in the Scholarship 
Program, the participant is assigned to a mentor who is employed in the 
same facility where the participant performs such service.''.
    (d) Clerical Amendment.--The table of sections at the beginning of 
chapter 76 is amended by striking the item relating to section 7618 and 
inserting the following new items:

``7618. Additional program requirements.
``7619. Expiration of program.''.

SEC. 604. <<NOTE: 38 USC 7681 note.>> LOAN REPAYMENT PROGRAM FOR 
                        CLINICAL RESEARCHERS FROM DISADVANTAGED 
                        BACKGROUNDS.

    (a) In General.--The Secretary of Veterans Affairs may, in 
consultation with the Secretary of Health and Human Services, use the 
authorities available in section 487E of the Public Health Service Act 
(42 U.S.C. 288-5) for the repayment of the principal and interest of 
educational loans of appropriately qualified health professionals who 
are from disadvantaged backgrounds in order to secure clinical research 
by such professionals for the Veterans Health Administration.
    (b) Limitations.--The exercise by the Secretary of Veterans Affairs 
of the authorities referred to in subsection (a) shall be subject to the 
conditions and limitations specified in paragraphs (2) and (3) of 
section 487E(a) of the Public Health Service Act (42 U.S.C. 288-5(a)(2) 
and (3)).
    (c) Funding.--Amounts for the repayment of principal and interest of 
educational loans under this section shall be derived from amounts 
available to the Secretary of Veterans Affairs for the Veterans Health 
Administration for Medical Services.

                  TITLE VII--HOMELESS VETERANS MATTERS

SEC. 701. PER DIEM GRANT PAYMENTS TO NONCONFORMING ENTITIES.

    Section 2012 is amended by adding at the end the following new 
subsection:
    ``(d) Per Diem Payments to Nonconforming Entities.--(1) The 
Secretary may make funds available for per diem payments under this 
section to the following grant recipients or eligible entities:
            ``(A) Grant recipients or eligible entities that--
                    ``(i) meet each of the transitional and supportive 
                services criteria prescribed by the Secretary pursuant 
                to subsection (a)(1); and

[[Page 124 STAT. 1175]]

                    ``(ii) furnish services to homeless individuals, of 
                which less than 75 percent are veterans.
            ``(B) Grant recipients or eligible entities that--
                    ``(i) meet at least one, but not all, of the 
                transitional and supportive services criteria prescribed 
                by the Secretary pursuant to subsection (a)(1); and
                    ``(ii) furnish services to homeless individuals, of 
                which not less than 75 percent are veterans.
            ``(C) Grant recipients or eligible entities that--
                    ``(i) meet at least one, but not all, of the 
                transitional and supportive services criteria prescribed 
                by the Secretary pursuant to subsection (a)(1); and
                    ``(ii) furnish services to homeless individuals, of 
                which less than 75 percent are veterans.

    ``(2) Notwithstanding subsection (a)(2), in providing per diem 
payments under this subsection, the Secretary shall determine the rate 
of such per diem payments in accordance with the following order of 
priority:
            ``(A) Grant recipients or eligible entities described by 
        paragraph (1)(A).
            ``(B) Grant recipients or eligible entities described by 
        paragraph (1)(B).
            ``(C) Grant recipients or eligible entities described by 
        paragraph (1)(C).

    ``(3) For purposes of this subsection, an eligible entity is a 
nonprofit entity and may be an entity that is ineligible to receive a 
grant under section 2011 of this title, but whom the Secretary 
determines carries out the purposes described in that section.''.

        TITLE VIII--NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

SEC. 801. GENERAL AUTHORITIES ON ESTABLISHMENT OF CORPORATIONS.

    (a) Authorization of Multi-medical Center Research Corporations.--
            (1) In general.--Section 7361 is amended--
                    (A) by redesignating subsection (b) as subsection 
                (e); and
                    (B) by inserting after subsection (a) the following 
                new subsection (b):

    ``(b)(1) Subject to paragraph (2), a corporation established under 
this subchapter may facilitate the conduct of research, education, or 
both at more than one medical center. Such a corporation shall be known 
as a `multi-medical center research corporation'.
    ``(2) The board of directors of a multi-medical center research 
corporation under this subsection shall include the official at each 
Department medical center concerned who is, or who carries out the 
responsibilities of, the medical center director of such center as 
specified in section 7363(a)(1)(A)(i) of this title.
    ``(3) In facilitating the conduct of research, education, or both at 
more than one Department medical center under this subchapter, a multi-
medical center research corporation may administer receipts and 
expenditures relating to such research, education, or both, as 
applicable, performed at the Department medical centers concerned.''.

[[Page 124 STAT. 1176]]

            (2) Expansion of existing corporations to multi-medical 
        center research corporations.--Such section is further amended 
        by adding at the end the following new subsection:

    ``(f) A corporation established under this subchapter may act as a 
multi-medical center research corporation under this subchapter in 
accordance with subsection (b) if--
            ``(1) the board of directors of the corporation approves a 
        resolution permitting facilitation by the corporation of the 
        conduct of research, education, or both at the other Department 
        medical center or medical centers concerned; and
            ``(2) the Secretary approves the resolution of the 
        corporation under paragraph (1).''.

    (b) Restatement and Modification of Authorities on Applicability of 
State Law.--
            (1) In general.--Section 7361 as amended by subsection (a) 
        of this section, is further amended by inserting after 
        subsection (b) the following new subsection (c):

    ``(c) Any corporation established under this subchapter shall be 
established in accordance with the nonprofit corporation laws of the 
State in which the applicable Department medical center is located and 
shall, to the extent not inconsistent with any Federal law, be subject 
to the laws of such State. In the case of any multi-medical center 
research corporation that facilitates the conduct of research, 
education, or both at Department medical centers located in different 
States, the corporation shall be established in accordance with the 
nonprofit corporation laws of the State in which one of such Department 
medical centers is located.''.
            (2) <<NOTE: Repeal.>> Conforming amendment.--Section 7365 is 
        repealed.

    (c) Clarification of Status of Corporations.--Section 7361, as 
amended by this section, is further amended--
            (1) in subsection (a), by striking the second sentence; and
            (2) by inserting after subsection (c) the following new 
        subsection (d):

    ``(d)(1) Except as otherwise provided in this subchapter or under 
regulations prescribed by the Secretary, any corporation established 
under this subchapter, and its officers, directors, and employees, shall 
be required to comply only with those Federal laws, regulations, and 
executive orders and directives that apply generally to private 
nonprofit corporations.
    ``(2) A corporation under this subchapter is not--
            ``(A) owned or controlled by the United States; or
            ``(B) an agency or instrumentality of the United States.''.

    (d) Reinstatement of Requirement for 501(c)(3) Status of 
Corporations.--Subsection (e) of section 7361, as redesignated by 
subsection (a)(1), is further amended by inserting ``section 501(c)(3) 
of'' after ``exempt from taxation under''.
SEC. 802. CLARIFICATION OF PURPOSES OF CORPORATIONS.

    (a) Clarification of Purposes.--Subsection (a) of section 7362 is 
amended in the first sentence--
            (1) by striking ``Any corporation'' and all that follows 
        through ``facilitate'' and inserting ``A corporation established 
        under this subchapter shall be established to provide a flexible 
        funding mechanism for the conduct of approved research and 
        education at one or more Department medical centers and to 
        facilitate functions related to the conduct of''; and

[[Page 124 STAT. 1177]]

            (2) by inserting before the period at the end the following: 
        ``or centers''.

    (b) Modification of Defined Term Relating to Education and 
Training.--Subsection (b) of such section is amended in the matter 
preceding paragraph (1) by striking ``the term `education and training' 
'' and inserting ``the term `education' includes education and training 
and''.
    (c) Repeal of Role of Corporations With Respect to Fellowships.--
Paragraph (1) of subsection (b) of such section is amended by striking 
the flush matter following subparagraph (C).
    (d) Availability of Education for Families of Veteran Patients.--
Paragraph (2) of subsection (b) of such section is amended by striking 
``to patients and to the families'' and inserting ``and includes 
education and training for patients and families''.
SEC. 803. MODIFICATION OF REQUIREMENTS FOR BOARDS OF DIRECTORS OF 
                        CORPORATIONS.

    (a) Requirements for Department Board Members.--Paragraph (1) of 
section 7363(a) is amended to read as follows:
            ``(1) with respect to the Department medical center--
                    ``(A)(i) the director (or directors of each 
                Department medical center, in the case of a multi-
                medical center research corporation);
                    ``(ii) the chief of staff; and
                    ``(iii) as appropriate for the activities of such 
                corporation, the associate chief of staff for research 
                and the associate chief of staff for education; or
                    ``(B) in the case of a Department medical center at 
                which one or more of the positions referred to in 
                subparagraph (A) do not exist, the official or officials 
                who are responsible for carrying out the 
                responsibilities of such position or positions at the 
                Department medical center; and''.

    (b) Requirements for Non-department Board Members.--Paragraph (2) of 
such section is amended--
            (1) by inserting ``not less than two'' before ``members''; 
        and
            (2) by striking ``and who'' and all that follows through the 
        period at the end and inserting ``and who have backgrounds, or 
        business, legal, financial, medical, or scientific expertise, of 
        benefit to the operations of the corporation.''.

    (c) Conflicts of Interest.--Subsection (c) of section 7363 is 
amended by striking ``, employed by, or have any other financial 
relationship with'' and inserting ``or employed by''.
SEC. 804. CLARIFICATION OF POWERS OF CORPORATIONS.

    (a) In General.--Section 7364 is amended to read as follows:
``Sec. 7364. General powers

    ``(a) In General.--(1) A corporation established under this 
subchapter may, solely to carry out the purposes of this subchapter--
            ``(A) accept, administer, retain, and spend funds derived 
        from gifts, contributions, grants, fees, reimbursements, and 
        bequests from individuals and public and private entities;
            ``(B) enter into contracts and agreements with individuals 
        and public and private entities;

[[Page 124 STAT. 1178]]

            ``(C) subject to paragraph (2), set fees for education and 
        training facilitated under section 7362 of this title, and 
        receive, retain, administer, and spend funds in furtherance of 
        such education and training;
            ``(D) reimburse amounts to the applicable appropriation 
        account of the Department for the Office of General Counsel for 
        any expenses of that Office in providing legal services 
        attributable to research and education agreements under this 
        subchapter; and
            ``(E) employ such employees as the corporation considers 
        necessary for such purposes and fix the compensation of such 
        employees.

    ``(2) Fees charged pursuant to paragraph (1)(C) for education and 
training described in that paragraph to individuals who are officers or 
employees of the Department may not be paid for by any funds 
appropriated to the Department.
    ``(3) Amounts reimbursed to the Office of General Counsel under 
paragraph (1)(D) shall be available for use by the Office of the General 
Counsel only for staff and training, and related travel, for the 
provision of legal services described in that paragraph and shall remain 
available for such use without fiscal year limitation.
    ``(b) Transfer and Administration of Funds.--(1) Except as provided 
in paragraph (2), any funds received by the Secretary for the conduct of 
research or education at a Department medical center or centers, other 
than funds appropriated to the Department, may be transferred to and 
administered by a corporation established under this subchapter for such 
purposes.
    ``(2) A Department medical center may reimburse the corporation for 
all or a portion of the pay, benefits, or both of an employee of the 
corporation who is assigned to the Department medical center if the 
assignment is carried out pursuant to subchapter VI of chapter 33 of 
title 5.
    ``(3) A Department medical center may retain and use funds provided 
to it by a corporation established under this subchapter. Such funds 
shall be credited to the applicable appropriation account of the 
Department and shall be available, without fiscal year limitation, for 
the purposes of that account.
    ``(c) Research Projects.--Except for reasonable and usual 
preliminary costs for project planning before its approval, a 
corporation established under this subchapter may not spend funds for a 
research project unless the project is approved in accordance with 
procedures prescribed by the Under Secretary for Health for research 
carried out with Department funds. Such procedures shall include a 
scientific review process.
    ``(d) Education Activities.--Except for reasonable and usual 
preliminary costs for activity planning before its approval, a 
corporation established under this subchapter may not spend funds for an 
education activity unless the activity is approved in accordance with 
procedures prescribed by the Under Secretary for Health.
    ``(e) Policies and Procedures.--The Under Secretary for Health may 
prescribe policies and procedures to guide the spending of funds by 
corporations established under this subchapter that are consistent with 
the purpose of such corporations as flexible funding mechanisms and with 
Federal and State laws and regulations, and executive orders, circulars, 
and directives that apply generally to the receipt and expenditure of 
funds by nonprofit

[[Page 124 STAT. 1179]]

organizations exempt from taxation under section 501(c)(3) of the 
Internal Revenue Code of 1986.''.
    (b) Conforming Amendment.--Section 7362(a), as amended by section 
802(a)(1) of this Act, is further amended by striking the last sentence.
SEC. 805. REDESIGNATION OF SECTION 7364A OF TITLE 38, UNITED 
                        STATES CODE.

    (a) Redesignation.--Section 7364A is redesignated as section 7365.
    (b) Clerical Amendments.--The table of sections at the beginning of 
chapter 73 is amended--
            (1) by striking the item relating to section 7364A; and
            (2) by striking the item relating to section 7365 and 
        inserting the following new item:

``7365. Coverage of employees under certain Federal tort claims laws.''.

SEC. 806. IMPROVED ACCOUNTABILITY AND OVERSIGHT OF CORPORATIONS.

    (a) Additional Information in Annual Reports.--Subsection (b) of 
section 7366 is amended to read as follows:
    ``(b)(1) Each corporation shall submit to the Secretary each year a 
report providing a detailed statement of the operations, activities, and 
accomplishments of the corporation during that year.
    ``(2)(A) A corporation with revenues in excess of $500,000 for any 
year shall obtain an audit of the corporation for that year.
    ``(B) A corporation with annual revenues between $100,000 and 
$500,000 shall obtain an audit of the corporation at least once every 
three years.
    ``(C) Any audit under this paragraph shall be performed by an 
independent auditor.
    ``(3) The corporation shall include in each report to the Secretary 
under paragraph (1) the following:
            ``(A) The most recent audit of the corporation under 
        paragraph (2).
            ``(B) The most recent Internal Revenue Service Form 990 
        `Return of Organization Exempt from Income Tax' or equivalent 
        and the applicable schedules under such form.''.

    (b) Conflict of Interest Policies.--Subsection (c) of such section 
is amended to read as follows:
    ``(c) Each director, officer, and employee of a corporation 
established under this subchapter shall be subject to a conflict of 
interest policy adopted by that corporation.''.
    (c) Establishment of Appropriate Payee Reporting Threshold.--
Subsection (d)(3)(C) of such section is amended by striking ``$35,000'' 
and inserting ``$50,000''.

                TITLE IX--CONSTRUCTION AND NAMING MATTERS

SEC. 901. AUTHORIZATION OF MEDICAL FACILITY PROJECTS.

    (a) Authorization of Fiscal Year 2010 Major Medical Facility 
Projects.--The Secretary of Veterans Affairs may carry out the following 
major medical facility projects in fiscal year 2010, with each project 
to be carried out in the amount specified for such project:

[[Page 124 STAT. 1180]]

            (1) Construction (including acquisition of land) for the 
        realignment of services and closure projects at the Department 
        of Veterans Affairs Medical Center in Livermore, California, in 
        an amount not to exceed $55,430,000.
            (2) Construction (including acquisition of land) for a new 
        medical facility at the Department of Veterans Affairs Medical 
        Center in Louisville, Kentucky, in an amount not to exceed 
        $75,000,000.
            (3) Construction (including acquisition of land) for a 
        clinical expansion for a Mental Health Facility at the 
        Department of Veterans Affairs Medical Center in Dallas, Texas, 
        in an amount not to exceed $15,640,000.
            (4) Construction (including acquisition of land) for a 
        replacement bed tower and clinical expansion at the Department 
        of Veterans Affairs Medical Center in St. Louis, Missouri, in an 
        amount not to exceed $43,340,000.

    (b) Extension of Authorization for Major Medical Facility 
Construction Projects Previously Authorized.--The Secretary of Veterans 
Affairs may carry out the following major medical facility projects in 
fiscal year 2010, as follows with each project to be carried out in the 
amount specified for such project:
            (1) Replacement of the existing Department of Veterans 
        Affairs Medical Center in Denver, Colorado, in an amount not to 
        exceed $800,000,000.
            (2) Construction of Outpatient and Inpatient Improvements in 
        Bay Pines, Florida, in an amount not to exceed $194,400,000.

    (c) Authorization of Appropriations.--
            (1) Authorization of appropriations for construction.--There 
        is authorized to be appropriated to the Secretary of Veterans 
        Affairs for fiscal year 2010, or the year in which funds are 
        appropriated, for the Construction, Major Projects account--
                    (A) $189,410,000 for the projects authorized in 
                subsection (a); and
                    (B) $994,400,000 for the projects authorized in 
                subsection (b).
            (2) Limitation.--The projects authorized in subsections (a) 
        and (b) may only be carried out using--
                    (A) funds appropriated for fiscal year 2010 pursuant 
                to the authorization of appropriations in paragraph (1);
                    (B) funds available for Construction, Major Projects 
                for a fiscal year before fiscal year 2010 that remain 
                available for obligation;
                    (C) funds available for Construction, Major Projects 
                for a fiscal year after fiscal year 2010 that remain 
                available for obligation;
                    (D) funds appropriated for Construction, Major 
                Projects for fiscal year 2010 for a category of activity 
                not specific to a project;
                    (E) funds appropriated for Construction, Major 
                Projects for a fiscal year before 2010 for a category of 
                activity not specific to a project; and
                    (F) funds appropriated for Construction, Major 
                Projects for a fiscal year after 2010 for a category of 
                activity not specific to a project.

[[Page 124 STAT. 1181]]

SEC. 902. DESIGNATION OF MERRIL LUNDMAN DEPARTMENT OF VETERANS 
                        AFFAIRS OUTPATIENT CLINIC, HAVRE, MONTANA.

    (a) Designation.--The Department of Veterans Affairs outpatient 
clinic in Havre, Montana, shall after the date of the enactment of this 
Act be known and designated as the ``Merril Lundman Department of 
Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the outpatient 
clinic referred to in subsection (a) shall be considered to be a 
reference to the Merril Lundman Department of Veterans Affairs 
Outpatient Clinic.
SEC. 903. DESIGNATION OF WILLIAM C. TALLENT DEPARTMENT OF VETERANS 
                        AFFAIRS OUTPATIENT CLINIC, KNOXVILLE, 
                        TENNESSEE.

    (a) Designation.--The Department of Veterans Affairs Outpatient 
Clinic in Knoxville, Tennessee, shall after the date of the enactment of 
this Act be known and designated as the ``William C. Tallent Department 
of Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the outpatient 
clinic referred to in subsection (a) shall be considered to be a 
reference to the William C. Tallent Department of Veterans Affairs 
Outpatient Clinic.
SEC. 904. DESIGNATION OF MAX J. BEILKE DEPARTMENT OF VETERANS 
                        AFFAIRS OUTPATIENT CLINIC, ALEXANDRIA, 
                        MINNESOTA.

    (a) Designation.--The Department of Veterans Affairs outpatient 
clinic in Alexandria, Minnesota, shall after the date of the enactment 
of this Act be known and designated as the ``Max J. Beilke Department of 
Veterans Affairs Outpatient Clinic''.
    (b) References.--Any reference in any law, regulation, map, 
document, record, or other paper of the United States to the outpatient 
clinic referred to in subsection (a) shall be considered to be a 
reference to the Max J. Beilke Department of Veterans Affairs Outpatient 
Clinic.

                         TITLE X--OTHER MATTERS

SEC. 1001. EXPANSION OF AUTHORITY FOR DEPARTMENT OF VETERANS 
                          AFFAIRS POLICE OFFICERS.

    Section 902 is amended--
            (1) in subsection (a)--
                    (A) by amending paragraph (1) to read as follows:

    ``(1) Employees of the Department who are Department police officers 
shall, with respect to acts occurring on Department property--
            ``(A) enforce Federal laws;
            ``(B) enforce the rules prescribed under section 901 of this 
        title;
            ``(C) enforce traffic and motor vehicle laws of a State or 
        local government (by issuance of a citation for violation of 
        such laws) within the jurisdiction of which such Department 
        property is located as authorized by an express grant of 
        authority under applicable State or local law;

[[Page 124 STAT. 1182]]

            ``(D) carry the appropriate Department-issued weapons, 
        including firearms, while off Department property in an official 
        capacity or while in an official travel status;
            ``(E) conduct investigations, on and off Department 
        property, of offenses that may have been committed on property 
        under the original jurisdiction of Department, consistent with 
        agreements or other consultation with affected Federal, State, 
        or local law enforcement agencies; and
            ``(F) carry out, as needed and appropriate, the duties 
        described in subparagraphs (A) through (E) when engaged in 
        duties authorized by other Federal statutes.'';
                    (B) by striking paragraph (2) and redesignating 
                paragraph (3) as paragraph (2); and
                    (C) in paragraph (2), as redesignated by 
                subparagraph (B) of this paragraph, by inserting ``, and 
                on any arrest warrant issued by competent judicial 
                authority'' before the period; and
            (2) by amending subsection (c) to read as follows:

    ``(c) The powers granted to Department police officers designated 
under this section shall be exercised in accordance with guidelines 
approved by the Secretary and the Attorney General.''.
SEC. 1002. UNIFORM ALLOWANCE FOR DEPARTMENT OF VETERANS AFFAIRS 
                          POLICE OFFICERS.

    Section 903 is amended--
            (1) by striking subsection (b) and inserting the following 
        new subsection (b):

    ``(b)(1) The amount of the allowance that the Secretary may pay 
under this section is the lesser of--
            ``(A) the amount currently allowed as prescribed by the 
        Office of Personnel Management; or
            ``(B) estimated costs or actual costs as determined by 
        periodic surveys conducted by the Department.

    ``(2) During any fiscal year no officer shall receive more for the 
purchase of a uniform described in subsection (a) than the amount 
established under this subsection.''; and
            (2) by striking subsection (c) and inserting the following 
        new subsection (c):

    ``(c) The allowance established under subsection (b) shall be paid 
at the beginning of a Department police officer's employment for those 
appointed on or after October 1, 2010. In the case of any other 
Department police officer, an allowance in the amount established under 
subsection (b) shall be paid upon the request of the officer.''.
SEC. 1003. SUBMISSION OF REPORTS TO CONGRESS BY SECRETARY OF 
                          VETERANS AFFAIRS IN ELECTRONIC FORM.

    (a) In General.--Chapter 1 is amended by adding at the end the 
following new section:
``Sec. 118. Submission of reports to Congress in electronic form

    ``(a) In General.--Whenever the Secretary or any other official of 
the Department is required by law to submit to Congress (or any 
committee of either chamber of Congress) a report, the Secretary or 
other official shall submit to Congress (or such committee) a copy of 
the report in an electronic format.

[[Page 124 STAT. 1183]]

    ``(b) Treatment.--The submission of a copy of a report in accordance 
with this section shall be treated as meeting any requirement of law to 
submit such report to Congress (or any committee of either chamber of 
Congress).
    ``(c) Report Defined.--For purposes of this section, the term 
`report' includes any certification, notification, or other 
communication in writing.''.
    (b) Technical and Clerical Amendments.--The table of sections at the 
beginning of chapter 1 is amended--
            (1) by striking the item relating to section 117; and
            (2) by adding at the end the following new items:

``117. Advance appropriations for certain medical care accounts.
``118. Reports to Congress: submission in electronic form.''.

SEC. 1004. DETERMINATION OF BUDGETARY EFFECTS FOR PURPOSES OF 
                          COMPLIANCE WITH STATUTORY PAY-AS-YOU-GO 
                          ACT OF 2010.

     <<NOTE: Incorporation by reference.>> The budgetary effects of this 
Act, for the purpose of complying with the Statutory Pay-As-You-Go Act 
of 2010, shall be determined by reference to the latest statement titled 
``Budgetary Effects of PAYGO Legislation'' for this Act, submitted for 
printing in the Congressional Record by the Chairman of the House Budget 
Committee, provided that such statement has been submitted prior to the 
vote on passage.

    Approved May 5, 2010.

LEGISLATIVE HISTORY--S. 1963:
---------------------------------------------------------------------------

CONGRESSIONAL RECORD:
                                                        Vol. 155 (2009):
                                    Nov. 19, considered and passed 
                                        Senate.
                                                        Vol. 156 (2010):
                                    Apr. 21, considered and passed 
                                        House, amended.
                                    Apr. 22, Senate concurred in House 
                                        amendment.
DAILY COMPILATION OF PRESIDENTIAL DOCUMENTS (2010):
            May 5, Presidential remarks.

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