[United States Statutes at Large, Volume 122, 110th Congress, 2nd Session]
[From the U.S. Government Publishing Office, www.gpo.gov]

122 STAT. 4110

Public Law 110-387
110th Congress

An Act


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

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

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

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

TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

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

TITLE II--MENTAL HEALTH RESEARCH

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

TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

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

TITLE IV--HEALTH CARE MATTERS

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

[[Page 4111]]
122 STAT. 4111

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

TITLE V--PAIN CARE

Sec. 501. Comprehensive policy on pain management.

TITLE VI--HOMELESS VETERANS MATTERS

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

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

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

TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

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

TITLE IX--OTHER MATTERS

Sec. 901. Technical amendments.

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

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

[[Page 4112]]
122 STAT. 4112

TITLE I--SUBSTANCE USE DISORDERS AND MENTAL HEALTH CARE

SEC. 101. TRIBUTE TO JUSTIN BAILEY.

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

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

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

[[Page 4113]]
122 STAT. 4113

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

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

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

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

[[Page 4114]]
122 STAT. 4114

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

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

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

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

[[Page 4115]]
122 STAT. 4115

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

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

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

[[Page 4116]]
122 STAT. 4116

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

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

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

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

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

[[Page 4117]]
122 STAT. 4117

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

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

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

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

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

[[Page 4118]]
122 STAT. 4118

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

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

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

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

[[Page 4119]]
122 STAT. 4119

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

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

TITLE II--MENTAL HEALTH RESEARCH

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

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

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

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

[[Page 4120]]
122 STAT. 4120

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

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

TITLE III--ASSISTANCE FOR FAMILIES OF VETERANS

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

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

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

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

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

[[Page 4121]]
122 STAT. 4121

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

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

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

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

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

[[Page 4122]]
122 STAT. 4122

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

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

TITLE IV--HEALTH CARE MATTERS

SEC. 401. VETERANS BENEFICIARY TRAVEL PROGRAM.

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

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

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

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

[[Page 4123]]
122 STAT. 4123

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

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

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

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

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

[[Page 4124]]
122 STAT. 4124

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

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

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

(b) Covered Veterans.--

[[Page 4125]]
122 STAT. 4125

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

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

[[Page 4126]]
122 STAT. 4126

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

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

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

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

[[Page 4127]]
122 STAT. 4127

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

[[Page 4128]]
122 STAT. 4128

with combat injuries established under section 7327 of this
title.

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

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

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

[[Page 4129]]
122 STAT. 4129

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

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

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

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

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

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

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

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

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

[[Page 4130]]
122 STAT. 4130

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

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

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

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

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

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

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

TITLE V--PAIN CARE

SEC. 501. [NOTE: 38 USC 7311 note.] COMPREHENSIVE POLICY ON PAIN
MANAGEMENT.

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

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

[[Page 4131]]
122 STAT. 4131

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

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

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

TITLE VI--HOMELESS VETERANS MATTERS

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

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

[[Page 4132]]
122 STAT. 4132

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

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

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

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

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

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

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

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

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

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

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

[[Page 4133]]
122 STAT. 4133

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

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

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

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

[[Page 4134]]
122 STAT. 4134

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

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

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

[[Page 4135]]
122 STAT. 4135

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

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

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

[[Page 4136]]
122 STAT. 4136

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

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

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

[[Page 4137]]
122 STAT. 4137

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

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

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

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

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

[[Page 4138]]
122 STAT. 4138

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

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

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

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

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

[[Page 4139]]
122 STAT. 4139

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

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

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

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

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

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

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

[[Page 4140]]
122 STAT. 4140

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

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

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

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

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

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

TITLE VIII--EXTENSION OF CERTAIN AUTHORITIES

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

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

[[Page 4141]]
122 STAT. 4141

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

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

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

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

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

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

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

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

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

[[Page 4142]]
122 STAT. 4142

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

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

TITLE IX--OTHER MATTERS

SEC. 901. TECHNICAL AMENDMENTS.

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

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

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

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

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

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

[[Page 4143]]
122 STAT. 4143

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

Approved October 10, 2008.

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

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