[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 1963 Enrolled Bill (ENR)]
S.1963
One Hundred Eleventh Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Tuesday,
the fifth day of January, two thousand and ten
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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

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(a) 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:

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TITLE II

-WOMEN VETERANS HEALTH CARE MATTERS

the Department of Veterans Affairs on care for veterans
suffering from sexual trauma and post-traumatic stress
disorder.

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veterans newly separated from service in the Armed Forces.

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separated from service in the Armed Forces.

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TITLE III

-RURAL HEALTH IMPROVEMENTS

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veterans who served in Operation Enduring Freedom and
Operation Iraqi Freedom.

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facilities of the Department of Veterans Affairs.

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inpatient responsibilities at community hospitals in health
professional shortage areas.

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of enhanced contract care authority for health care needs of
certain veterans.

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Operation Enduring Freedom or Operation Iraqi Freedom for
counseling and services through Readjustment Counseling
Service.

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TITLE IV

-MENTAL HEALTH CARE MATTERS

provide referral and other assistance upon request to former
members of the Armed Forces not authorized counseling.

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records of patients lacking decisionmaking capacity.

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TITLE V

-OTHER HEALTH CARE MATTERS

local and State government entities to ensure that veterans
receive care and benefits for which they are eligible.

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veterans and survivors and dependents of veterans.

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certain Vietnam-era veterans exposed to herbicide and veterans
of the Persian Gulf War.

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improvements and structural alterations furnished as part of
home health services.

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veterans for hospital care and nursing home care.

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services from disabled veterans with health-plan contracts.

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TITLE VI

-DEPARTMENT PERSONNEL MATTERS

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TITLE VIII

-NONPROFIT RESEARCH AND EDUCATION CORPORATIONS

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TITLE IX

-CONSTRUCTION AND NAMING MATTERS

Affairs Outpatient Clinic, Knoxville, Tennessee.

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Outpatient Clinic, Alexandria, Minnesota.

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TITLE X

-OTHER MATTERS

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with Statutory Pay-As-You-Go Act of 2010.

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

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TITLE I

-CAREGIVER SUPPORT

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);''.

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(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):
``(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.''.

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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.''.

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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--
(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. 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.
(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.

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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) 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).
``(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.''.

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VETERANS NEWLY SEPARATED FROM SERVICE IN THE ARMED FORCES.
(a) Pilot Program Required.--
(1) In general.--Commencing not later than 180 days after the
date of the enactment of this Act, the Secretary of Veterans
Affairs shall carry out, through the Readjustment Counseling
Service of the Veterans Health Administration, a pilot program to
evaluate the feasibility and advisability of providing
reintegration and readjustment services described in subsection (b)
in group retreat settings to women veterans who are recently
separated from service in the Armed Forces after a prolonged
deployment.
(2) Participation at election of veteran.--The participation of
a veteran in the pilot program under this section shall be at the
election of the veteran.
(b) Covered Services.--The services provided to a woman veteran
under the pilot program shall include the following:
(1) Information on reintegration into the veteran's family,
employment, and community.
(2) Financial counseling.
(3) Occupational counseling.
(4) Information and counseling on stress reduction.
(5) Information and counseling on conflict resolution.
(6) Such other information and counseling as the Secretary
considers appropriate to assist a woman veteran under the pilot
program in reintegration into the veteran's family, 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 of fiscal
years 2010 and 2011, $2,000,000 to carry out the pilot program.

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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) Applicability.--The amendments made by this section shall apply
to appointments made on or after the date of the enactment of this Act.

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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.
(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.

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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.''.
(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.''.

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(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) 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) 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.''.

37adb5cbc5cb3340f6e68c4b131cb30e030518a2a546b1db101ffb1a29f84eda

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--
``(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) 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) 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.--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.
``(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.--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.--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--
``(1) noncompliance by the individual is due to circumstances
beyond the control of the individual; or
``(2) 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.--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.

e018947d54d4aea9630278c412da2048de15548c015e81a5f5a69e5700ed3a48

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.

5553c2ff61d5c9e317b040d6dd83a215b835c98809dd43419ba8acc6924fa883

FOR VETERANS WHO SERVED IN OPERATION ENDURING FREEDOM AND
OPERATION IRAQI FREEDOM.
(a) Program Required.--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) 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.--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) 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
(7) to meet such other requirements as the Secretary shall
require.
(c) Training of Veterans for Provision of Peer-outreach and Peer-
support Services.--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.

2d81b16a66e2533905e5fba288240ce562b820e633cf0a2082e469af04ba7e9d

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) 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) 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 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) 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) Clarification of Relation to Public Transportation in Veterans
Health Administration Handbook.--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.

315abb6a8c40a051aeb3eebd743c91b5a04383633df22496199f494f13ca0219

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.--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--
(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.--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 be specified in
a written agreement entered into by the Secretary and the physician
for purposes of the pilot program.
(3) Treatment of compensation.--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) 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.

e179504945c7e44636fbb82a0afb2eae37ad29bb4eb6b54c72bd8be0032e35aa

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.
(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.

edec65d32af86416a354fa6dd2b608c766d81c288507af264cb6786095e849c8

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.''.

c7d9ba28fc4a1c9c3d567aa1858416395ecc29168c58a4b80ea99198bfe4115e

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.

2e7ea20a8fe313c8be3bf75c769ccf022c1625e5cfc79d4b4eca71d5bafa7f98

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.''.

569b16335c279cc60985ae4bfe25fb624c5fe65debd6f4a749e0a1da09be1ba9

(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.
(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.

3d2c5ae3050a7670b350ef3723c16fc83d4e127a73680e8842bbeddb49c3f7b1

(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.

da8f1ec635ffb1f76e9b4cd9a697838c164f0b480c7457217c6eadf8495a93be

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''.

e8752e8f5bc41ed9f269d803424cbb33e0788264dda709ba3e467452dbfb599c

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.''.

b332e9c0b22f916bdb2f93f36012069152689c677445a337b1007716c22d8bac

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.
``(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.''.

f3771f26ca4e86c0c047b47af53562040c683aaee6d5b41cd24dfd8df96dc144

(a) Enhancement of Quality Management Through Quality Management
Officers.--
(1) In general.--Subchapter II of chapter 73 is amended by
inserting after section 7311 the following new section:
``Sec. 7311A. Quality management officers
``(a) National Quality Management Officer.--(1) The Under Secretary
for Health shall designate an official of the Veterans Health
Administration to act as the principal quality management officer for
the quality-assurance program required by section 7311 of this title.
The official so designated may be known as the `National Quality
Management Officer of the Veterans Health Administration' (in this
section referred to as the `National Quality Management Officer').
``(2) The National Quality Management Officer shall report directly
to the Under Secretary for Health in the discharge of responsibilities
and duties of the Officer under this section.
``(3) The National Quality Management Officer shall be the official
within the Veterans Health Administration who is principally
responsible for the quality-assurance program referred to in paragraph
(1). In carrying out that responsibility, the Officer shall be
responsible for the following:
``(A) Establishing and enforcing the requirements of the
program referred to in paragraph (1).
``(B) Developing an aggregate quality metric from existing data
sources, such as the Inpatient Evaluation Center of the Department,
the National Surgical Quality Improvement Program, and the External
Peer Review Program of the Veterans Health Administration, that
could be used to assess reliably the quality of care provided at
individual Department medical centers and associated community
based outpatient clinics.
``(C) Ensuring that existing measures of quality, including
measures from the Inpatient Evaluation Center, the National
Surgical Quality Improvement Program, System-Wide Ongoing
Assessment and Review reports of the Department, and Combined
Assessment Program reviews of the Office of Inspector General of
the Department, are monitored routinely and analyzed in a manner
that ensures the timely detection of quality of care issues.
``(D) Encouraging research and development in the area of
quality metrics for the purposes of improving how the Department
measures quality in individual facilities.
``(E) Carrying out such other responsibilities and duties
relating to quality management in the Veterans Health
Administration as the Under Secretary for Health shall specify.
``(4) The requirements under paragraph (3) shall include
requirements regarding the following:
``(A) A confidential system for the submittal of reports by
Veterans Health Administration personnel regarding quality
management at Department facilities.
``(B) Mechanisms for the peer review of the actions of
individuals appointed in the Veterans Health Administration in the
position of physician.
``(b) Quality Management Officers for VISNs.--(1) The Regional
Director of each Veterans Integrated Services Network shall appoint an
official of the Network to act as the quality management officer of the
Network.
``(2) The quality management officer for a Veterans Integrated
Services Network shall report to the Regional Director of the Veterans
Integrated Services Network, and to the National Quality Management
Officer, regarding the discharge of the responsibilities and duties of
the officer under this section.
``(3) The quality management officer for a Veterans Integrated
Services Network shall--
``(A) direct the quality management office in the Network; and
``(B) coordinate, monitor, and oversee the quality management
programs and activities of the Administration medical facilities in
the Network in order to ensure the thorough and uniform discharge
of quality management requirements under such programs and
activities throughout such facilities.
``(c) Quality Management Officers for Medical Facilities.--(1) The
director of each Veterans Health Administration medical facility shall
appoint a quality management officer for that facility.
``(2) The quality management officer for a facility shall report
directly to the director of the facility, and to the quality management
officer of the Veterans Integrated Services Network in which the
facility is located, regarding the discharge of the responsibilities
and duties of the quality management officer under this section.
``(3) The quality management officer for a facility shall be
responsible for designing, disseminating, and implementing quality
management programs and activities for the facility that meet the
requirements established by the National Quality Management Officer
under subsection (a).
``(d) Authorization of Appropriations.--(1) Except as provided in
paragraph (2), there are authorized to be appropriated such sums as may
be necessary to carry out this section.
``(2) There 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 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.

b31045c9e7847aa6f02c12c9d61f48ebd97ca3c8ec9a99a7b720140351b44c6d

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--
(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.

84dc6ca49a1281fbf743848655a8809d57d43602755a90938efe14f870e4b2db

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.''.

a0e013c23edc5cef0af0c39aa9a27950d85f6b51b6c764c3abaeecf8cdd569cb

HAZARD AND DEFENSE.
(a) In General.--Not later than 90 days after the date of the
enactment of this Act, the Secretary of Veterans Affairs shall enter
into a contract with the Institute of Medicine of the National
Academies to conduct an expanded study on the health impact of Project
Shipboard Hazard and Defense (Project SHAD).
(b) Covered Veterans.--The study required by subsection (a) shall
include, to the extent practicable, all veterans who participated in
Project Shipboard Hazard and Defense.
(c) 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.

d2a954f95bf0d09b3f4cabbf17303e80a8d8135d7e537ebed6cdf5aa7e3e3f24

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.''.

485cc9d46012b9c750c0b7f846b35935ccf51c56909f6cc85502e73357cb3744

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.
(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) 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.
(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.

96f51301f4d9132ed2a2062d3396261bdfe6f48f2b89031db665e871ab3cfad9

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.''.

958e1664e60d3431d3cf1bba9af612ae84fd0c33e81f47109d04d123528a4a31

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,''.

4486bd11c1114a1c76493d23372dac872c1ce7525d914911e0844b2353f55c2a

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
(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,''.

94efd8d0bd83dc0365cfa4c9eeddbe409d86b47e0a0dfcc63522266e28b9d9c1

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) 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.

3044cc04c8761f41eee5aa04423e42f5bf5e9c3972b4e2aaed47c074760894d7

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.
``(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.''.

6bc4c7189a2a8911af0c43a0d47355b85fd8a47f0649ac4b92455e3e15580e1c

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
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) 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).

1e006f678a7f330de02ac50f7032dc8112f41fa843720474bfa8da93b4cecdc4

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.''.

302bebba164563618acb029d516396a9ee3a8a9857d9b40db9ce13ec6fe68276

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.''.

5717c3f378a547e8f168f19f47dc55d4275c3a3dca5f3ba9151e9d891309f970

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;
``(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) 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--
``(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) 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.
``(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 care
facilities in the conduct and use of surveys, including the use of
third-party surveys, under this paragraph.''.
(2) Information on methodology used in wage surveys.--Section
7451(e)(4) is amended--
(A) by redesignating subparagraph (D) as subparagraph (E);
and
(B) by inserting after subparagraph (C) the following new
subparagraph (D):
``(D) In any case in which the director conducts such a wage
survey during the period covered by the report and makes adjustment
in rates of basic pay applicable to one or more covered positions
at the facility, information on the methodology used in making such
adjustment or adjustments.''.
(3) Disclosure of information to persons in covered
positions.--Section 7451(e), as amended by paragraph (2) of this
subsection, is further amended by adding at the end the following
new paragraph:
``(6)(A) Upon the request of an individual described in
subparagraph (B) for a report provided under paragraph (4) with respect
to a Department health-care facility, the Under Secretary for Health or
the director of such facility shall provide to the individual the most
current report for such facility provided under such paragraph.
``(B) An individual described in this subparagraph is--
``(i) an individual in a covered position at a Department
health-care facility; or
``(ii) a representative of the labor organization representing
that individual who is designated by that individual to make the
request.''.
(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) Employees appointed under section 7408 of this title
performing service on a tour of duty, any part of which is within the
period commencing at midnight Friday and ending at midnight Sunday,
shall receive additional pay in addition to the rate of basic pay
provided such employees for each hour of service on such tour at a rate
equal to 25 percent of such employee's hourly rate of basic pay.''.
(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.''.

306544eba3320fec36f4fda24e8926e8a21c05f5255225699af47981af93c3c2

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
``(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''.

eac141d7e9c95a690a9c0b4bb3abd87652657fa1c46cc03deb1d1e8d6b8b884c

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 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.''.

4ee69d1dfb8e0b2bd9379aff4ab2a5fcd9924853545fcb64705c3834bcb60665

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.

64e548cc1c9faea796a91540d2869a797f8c8c1ad2d32c64367d7052d68074a8

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
``(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.''.

fbfd09d3b223e6252282ee78ab4b053cdbfbd161dad7d15bfa5769360d99d6f8

TITLE VII

-HOMELESS VETERANS MATTERS

(a) Authorization of Multi-medical Center Research Corporations.--
(1) In general.--Section 7361 is amended--
(A) by redesignating subsection (b) as subsection (e); and
(B) by inserting after subsection (a) the following new
subsection (b):
``(b)(1) Subject to paragraph (2), a corporation established under
this subchapter may facilitate the conduct of research, education, or
both at more than one medical center. Such a corporation shall be known
as a `multi-medical center research corporation'.
``(2) The board of directors of a multi-medical center research
corporation under this subsection shall include the official at each
Department medical center concerned who is, or who carries out the
responsibilities of, the medical center director of such center as
specified in section 7363(a)(1)(A)(i) of this title.
``(3) In facilitating the conduct of research, education, or both
at more than one Department medical center under this subchapter, a
multi-medical center research corporation may administer receipts and
expenditures relating to such research, education, or both, as
applicable, performed at the Department medical centers concerned.''.
(2) Expansion of existing corporations to multi-medical center
research corporations.--Such section is further amended by adding
at the end the following new subsection:
``(f) A corporation established under this subchapter may act as a
multi-medical center research corporation under this subchapter in
accordance with subsection (b) if--
``(1) the board of directors of the corporation approves a
resolution permitting facilitation by the corporation of the
conduct of research, education, or both at the other Department
medical center or medical centers concerned; and
``(2) the Secretary approves the resolution of the corporation
under paragraph (1).''.
(b) Restatement and Modification of Authorities on Applicability of
State Law.--
(1) In general.--Section 7361 as amended by subsection (a) of
this section, is further amended by inserting after subsection (b)
the following new subsection (c):
``(c) Any corporation established under this subchapter shall be
established in accordance with the nonprofit corporation laws of the
State in which the applicable Department medical center is located and
shall, to the extent not inconsistent with any Federal law, be subject
to the laws of such State. In the case of any multi-medical center
research corporation that facilitates the conduct of research,
education, or both at Department medical centers located in different
States, the corporation shall be established in accordance with the
nonprofit corporation laws of the State in which one of such Department
medical centers is located.''.
(2) Conforming amendment.--Section 7365 is repealed.
(c) Clarification of Status of Corporations.--Section 7361, as
amended by this section, is further amended--
(1) in subsection (a), by striking the second sentence; and
(2) by inserting after subsection (c) the following new
subsection (d):
``(d)(1) Except as otherwise provided in this subchapter or under
regulations prescribed by the Secretary, any corporation established
under this subchapter, and its officers, directors, and employees,
shall be required to comply only with those Federal laws, regulations,
and executive orders and directives that apply generally to private
nonprofit corporations.
``(2) A corporation under this subchapter is not--
``(A) owned or controlled by the United States; or
``(B) an agency or instrumentality of the United States.''.
(d) Reinstatement of Requirement for 501(c)(3) Status of
Corporations.--Subsection (e) of section 7361, as redesignated by
subsection (a)(1), is further amended by inserting ``section 501(c)(3)
of'' after ``exempt from taxation under''.

7fee3f2f0865c09aa5ebf82a61cda58fbaeba82b9d0010eee376dcbdb8b97169

(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
(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''.

080c4daf9656c3c4b513eafcea4fbb3b07284d66d321b1ebb2d200415537d7f7

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''.

ed8b62da54d692c79be8b4902b845ad106b0de7188ced357b2f2abd2d7a65ba6

(a) In General.--Section 7364 is amended to read as follows:
``Sec. 7364. General powers
``(a) In General.--(1) A corporation established under this
subchapter may, solely to carry out the purposes of this subchapter--
``(A) accept, administer, retain, and spend funds derived from
gifts, contributions, grants, fees, reimbursements, and bequests
from individuals and public and private entities;
``(B) enter into contracts and agreements with individuals and
public and private entities;
``(C) subject to paragraph (2), set fees for education and
training facilitated under section 7362 of this title, and receive,
retain, administer, and spend funds in furtherance of such
education and training;
``(D) reimburse amounts to the applicable appropriation account
of the Department for the Office of General Counsel for any
expenses of that Office in providing legal services attributable to
research and education agreements under this subchapter; and
``(E) employ such employees as the corporation considers
necessary for such purposes and fix the compensation of such
employees.
``(2) Fees charged 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 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.

11007580293575f84436f647e083c990e39729f56cdfa9a06b05f5ebc74ed4d5

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.''.

078d748e669d942ac1fd4982e3984096a4c7a2609f82a961784e60dd33e2ca94

(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''.

b9327fb76d2eb9b327313b388bc88f40d8ac3b5418b8a7428fc2b8f905eb185f

(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:
(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.

b4612f75a0d368680757f217449e4d06f746af386ab571c05268871b8b11c73f

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.

af3da532872f71a22015e17d9488dc1e6c01e92b47e45c529eedd79896abb6dd

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.

1107d35873657f5c6a0a677ffc64d9f4859c5d5c1d05494d28705054494926ca

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.

7c74d9c06d14c3f5f93a511ad6184d7a4dcd0af60a6948c666df02f3b12eca0e

POLICE OFFICERS.
Section 902 is amended--
(1) in subsection (a)--
(A) by amending paragraph (1) to read as follows:
``(1) Employees of the Department who are Department police
officers shall, with respect to acts occurring on Department property--
``(A) enforce Federal laws;
``(B) enforce the rules prescribed under section 901 of this
title;
``(C) enforce traffic and motor vehicle laws of a State or
local government (by issuance of a citation for violation of such
laws) within the jurisdiction of which such Department property is
located as authorized by an express grant of authority under
applicable State or local law;
``(D) carry the appropriate Department-issued weapons,
including firearms, while off Department property in an official
capacity or while in an official travel status;
``(E) conduct investigations, on and off Department property,
of offenses that may have been committed on property under the
original jurisdiction of Department, consistent with agreements or
other consultation with affected 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.''.

0d9e6d3c78135d6d09b019000b674398de1c8fcf31254cb4b8c6beb0537d7d75

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.''.

87c49a21cf5a08139afbc4d33c2cb777039d55ef4d3af4c3a455fcde1b31207e

Caregivers and Veterans Omnibus Health Services Act of 2009 — S. 1963

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