114 S425 RS: Homeless Veterans’ Reintegration Programs Reauthorization Act of 2015 U.S. Senate 2015-02-10 text/xml EN Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
IICalendar No. 716114th CONGRESS2d SessionS. 425[Report No. 114–395]IN THE SENATE OF THE UNITED STATESFebruary 10, 2015Mr. Boozman (for himself, Mr. Tester, Mr. Inhofe, and Mr. Schumer) introduced the following bill; which was read twice and referred to the Committee on Veterans' AffairsDecember 7, 2016Reported by Mr. Isakson, with an amendment and an amendment to the titleStrike out all after the enacting clause and insert the part printed in italicA BILLTo amend title 38, United States Code, to provide for a five-year extension to the homeless veterans reintegration programs and to provide clarification regarding eligibility for services under such programs.
1.
Short title
This Act may be cited as the Homeless Veterans’ Reintegration Programs Reauthorization Act of 2015.
2.
Reauthorization of Department of Veterans Affairs homeless veterans reintegration programs
(a)
Five-Year extension of homeless veterans reintegration programs
Section 2021(e)(F) of title 38, United States Code, is amended by striking 2015 and inserting 2020. (b)
Five-Year extension of homeless women veterans and homeless veterans with children reintegration grant program
Section 2021A(f)(1) of such title is amended by striking 2015 and inserting 2020. (c)
Clarification of eligibility for services under homeless veterans reintegration programs
Section 2021(a) of such title is amended by striking reintegration of homeless veterans into the labor force. and inserting the following: reintegration into the labor force of— (1)homeless veterans; (2)veterans participating in the Department of Veterans Affairs supported housing program for which rental assistance is provided pursuant to section 8(o)(19) of the United States Housing Act of 1937 (42 U.S.C. 1437f(o)(19)); (3)Indians who are veterans and receiving assistance under the Native American Housing Assistance and Self Determination Act of 1996 (25 U.S.C. 4101 et seq.); and (4)veterans who are transitioning from being incarcerated..
1.
Short title; table of contents
(a)
Short title
This Act may be cited as the Veterans Homeless Programs, Caregiver Services, and Other Improvements Act of 2015. (b)
Table of contents
The table of contents for this Act is as follows: Sec. 1. Short title; table of contents. TITLE I—Benefits Sec. 101. Expedited payment of survivors benefits. Sec. 102. Increase in special pension for Medal of Honor recipients. TITLE II—Education matters Sec. 201. Restoration of entitlement to Post-9/11 Educational Assistance for veterans affected by closures of educational institutions. Sec. 202. Modification and improvement of transfer of unused Post-9/11 Educational Assistance to family members. Sec. 203. Codification and improvement of election process for Post-9/11 Educational Assistance. Sec. 204. Centralized reporting of veteran enrollment by certain groups, districts, and consortiums of educational institutions. Sec. 205. Improved role of State approving agencies in administration of veterans educational benefits. Sec. 206. Modification of criteria used to approve courses for purposes of veterans educational benefits. Sec. 207. Surveys for compliance of educational institutions and training establishments with requirements relating to administration of veterans educational benefits. Sec. 208. Modification of requirements for approval for purposes of educational assistance provided by Department of Veterans Affairs of programs designed to prepare individuals for licensure or certification. Sec. 209. Expansion of Yellow Ribbon G.I. Education Enhancement Program. Sec. 210. Consideration of certain time spent receiving medical care from Secretary of Defense as active duty for purposes of eligibility for Post-9/11 Educational Assistance. TITLE III—Homeless veterans matters Sec. 301. Expansion of definition of homeless veteran for purposes of benefits under the laws administered by the Secretary of Veterans Affairs. Sec. 302. Increased per diem payments for transitional housing assistance that becomes permanent housing for homeless veterans. Sec. 303. Expansion of Department of Veterans Affairs authority to provide dental care to homeless veterans. Sec. 304. Clarification of eligibility for services under homeless veterans reintegration programs. Sec. 305. Program to improve retention of housing by formerly homeless veterans and veterans at risk of becoming homeless. Sec. 306. Pilot program on provision of intensive case management interventions to homeless veterans who receive the most health care from the Department of Veterans Affairs. Sec. 307. Establishment of National Center on Homelessness Among Veterans. Sec. 308. Partnerships with public and private entities to provide legal services to homeless veterans and veterans at risk of homelessness. Sec. 309. Administrative improvements to grant and per diem programs of Department of Veterans Affairs. Sec. 310. Repeal of requirement for annual reports on assistance to homeless veterans. Sec. 311. Comptroller General of the United States study on homeless veterans programs of Department of Veterans Affairs. Sec. 312. Requirement for Department of Veterans Affairs to assess comprehensive service programs for homeless veterans. Sec. 313. Report on outreach relating to increasing the amount of housing available to veterans. TITLE IV—Health care matters Sec. 401. Short title. Subtitle A—Employment of directors and health care providers Sec. 411. Extension of period for increase in graduate medical education residency positions at medical facilities of the Department of Veterans Affairs. Sec. 412. Modification of hours of employment for physicians and physician assistants employed by the Department of Veterans Affairs. Sec. 413. Requirement that physician assistants employed by the Department of Veterans Affairs receive competitive pay. Sec. 414. Establishment of positions of Directors of Veterans Integrated Service Networks in Office of Under Secretary for Health of Department of Veterans Affairs and modification of qualifications for Medical Directors. Sec. 415. Pay for Medical Directors and Directors of Veterans Integrated Service Networks. Sec. 416. Additional requirements for hiring of health care providers by Department of Veterans Affairs. Sec. 417. Provision of information on health care providers of Department of Veterans Affairs to State medical boards. Sec. 418. Report on compliance by Department of Veterans Affairs with reviews of health care providers leaving the Department or transferring to other facilities. Subtitle B—Opioid therapy and pain management Sec. 421. Guidelines on management of opioid therapy by Department of Veterans Affairs and Department of Defense and implementation of such guidelines by Department of Veterans Affairs. Sec. 422. Improvement of opioid safety measures by Department of Veterans Affairs. Sec. 423. Enhancement of joint working group on pain management of the Department of Veterans Affairs and the Department of Defense. Sec. 424. Establishment of pain management boards of Department of Veterans Affairs. Sec. 425. Review, investigation, and report on use of opioids in treatment by Department of Veterans Affairs. Subtitle C—Patient advocacy Sec. 431. Establishment of Office of Patient Advocacy of the Department of Veterans Affairs. Sec. 432. Community meetings on improving care from Department of Veterans Affairs. Sec. 433. Improvement of awareness of patient advocacy program and patient bill of rights of Department of Veterans Affairs. Sec. 434. Comptroller General Report on Patient Advocacy Program of Department of Veterans Affairs. Subtitle D—Complementary and integrative health Sec. 441. Expansion of research and education on and delivery of complementary and integrative health to veterans. Sec. 442. Pilot program on integration of complementary and integrative health within Department of Veterans Affairs medical centers. Subtitle E—Family caregivers Sec. 451. Expansion of family caregiver program of Department of Veterans Affairs. Sec. 452. Implementation of information technology system of Department of Veterans Affairs to assess and improve the family caregiver program. Sec. 453. Modifications to annual evaluation report on caregiver program of Department of Veterans Affairs. Sec. 454. Advisory committee on caregiver policy. Sec. 455. Comprehensive study on seriously injured veterans and their caregivers. Subtitle F—Health care agreements Sec. 461. Authorization of agreements between the Department of Veterans Affairs and non-Department extended care providers. Sec. 462. Modification of authority to enter into agreements with State homes to provide nursing home care. TITLE V—Other matters Sec. 501. Extension of temporary increase in number of judges on United States Court of Appeals for Veterans Claims. Sec. 502. Repeal inapplicability of modification of basic allowance for housing to benefits under laws administered by Secretary of Veterans Affairs. Sec. 503. Department of Veterans Affairs program of internal audits. Sec. 504. Improvement of training for managers.
<enum>I</enum><header>Benefits</header> <section id="id0F51DBBA813F488CA2DE67E6FA1E4783" section-type="subsequent-section"><enum>101.</enum><header>Expedited payment of survivors benefits</header> <subsection id="idC79D0C36DCEB436A9CB9DAE3622525AB"><enum>(a)</enum><header>In general</header><text>Section 5101(a)(1) of title 38, United States Code, is amended—</text> <paragraph id="id83770EBFF3DE4A2B830E9333FA1D3F21"><enum>(1)</enum><text>by striking <quote>A specific</quote> and inserting <quote>(A) Except as provided in subparagraph (B), a specific</quote>; and</text> </paragraph><paragraph id="idAD799518440340BD840DC58FD8E54CFF"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id4CD29420B5B04280BF556AEBD7BC2782" reported-display-style="italic" style="OLC"> <subparagraph id="ida46c85e9a1e24050bf6342ecb53fe385" indent="up2"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="id54E36F2B37A94D438128BF2994849E98"><enum>(i)</enum><text>The Secretary may pay benefits under chapters 13 and 15 and sections 2302, 2307, and 5121 of this title to a survivor of a veteran who has not filed a formal claim if the Secretary determines that the record contains sufficient evidence to establish the entitlement of the survivor to such benefits.</text> </clause><clause changed="added" committee-id="SSVA00" id="id84366DEB0F5B47689DAE4ADCC9664D7B" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text>For purposes of this subparagraph and section 5110 of this title, the date on which the Secretary is notified of the death of the veteran shall be treated as the date of the receipt of the survivor's application for benefits described in clause (i).</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idde45033cf8464060b168cf546bdcb217"><enum>(b)</enum><header>Effective date</header><text>The amendments made by subsection (a) shall apply with respect to claims for benefits based on a death occurring on or after the date of the enactment of this Act.</text> </subsection></section><section commented="no" display-inline="no-display-inline" id="idA89276840AA54F11A4F2C55EAB604A6A" section-type="subsequent-section"><enum>102.</enum><header display-inline="yes-display-inline">Increase in special pension for Medal of Honor recipients</header> <subsection commented="no" display-inline="no-display-inline" id="idB7E6B0BDADEA48A7B8C0A8FF58D5C9B9"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1562(a) of title 38, United States Code, is amended by striking <quote>$1,000</quote> and inserting <quote>$3,000</quote>.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="id78FA82C82E1D4110BCC1450AE2ABEE2B"><enum>(b)</enum><header>Effective date</header> <paragraph commented="no" display-inline="no-display-inline" id="id8EDE7B48039A45D6BAE711D86A3A37AD"><enum>(1)</enum><header>In general</header><text>The amendment made by subsection (a) shall take effect on the date that is—</text> <subparagraph commented="no" display-inline="no-display-inline" id="id2BD71808AB0D4664B3E96ABF230D014C"><enum>(A)</enum><text>except as provided in subparagraph (B), one year after the date of the enactment of this Act; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idCC42100C254A46C383104D8DDE7F55DE"><enum>(B)</enum><text>in the case that the date that is one year after the date of the enactment of this Act is not the first day of a month, the first day of the first month beginning after the date that is one year after the date of the enactment of this Act.</text> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id5655F6034E1C405B8BA14603847A9881"><enum>(2)</enum><header>Delay of annual cost of living adjustment</header> <subparagraph commented="no" display-inline="no-display-inline" id="idEB0E6511A22D47908A444812F311335B"><enum>(A)</enum><header>In general</header><text>The Secretary shall not make an increase pursuant to section 1562(e) of such title effective December 1, 2016, if the amendment made by subsection (a) takes effect before such date.</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id6D1F78A5B5194A5C9F2CDD56A9906B26"><enum>(B)</enum><header>Resumption</header><text>In the case that the Secretary, pursuant to subparagraph (A), does not make an increase pursuant to section 1562(e) of such title effective December 1, 2016, the Secretary shall resume making increases pursuant to such section with the first such increase effective December 1, 2017.</text> </subparagraph></paragraph></subsection></section><enum>II</enum><header>Education matters</header> <section id="id2b9e300129ed4b97a4b70cf365a48c13"><enum>201.</enum><header>Restoration of entitlement to Post-9/11 Educational Assistance for veterans affected by closures of educational institutions</header> <subsection id="id2a882bb8dc0f47339c25a35f3db5e2a5"><enum>(a)</enum><header>Educational assistance</header> <paragraph id="id2B1E293C85694E7AA1E5522333004C0B"><enum>(1)</enum><header>In general</header><text>Section 3312 of title 38, United States Code, is amended by adding at the end the following new subsection:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id8ecf499c00b246a8b1b6427404ad88af" reported-display-style="italic" style="OLC"> <subsection id="id7559015eff8546d9b3809ac726527034"><enum>(d)</enum><header>Discontinuation of education due to closure of educational institution</header> <paragraph id="id9118af09c35142748a9b659ab9cb901b"><enum>(1)</enum><header>In general</header><text>Any payment of educational assistance described in paragraph (2) shall not—</text> <subparagraph id="idc1d648452efc4d20957f236e36d0bdc6"><enum>(A)</enum><text>be charged against any entitlement to educational assistance of the individual concerned under this chapter; or</text> </subparagraph><subparagraph id="idaedfb5a048e1453891877045dd996ead"><enum>(B)</enum><text>be counted against the aggregate period for which section 3695 of this title limits the individual’s receipt of educational assistance under this chapter.</text> </subparagraph></paragraph><paragraph id="idea99607276a64e59bd7721f0d7d1f77d"><enum>(2)</enum><header>Description of payment of educational assistance</header><text>Subject to paragraph (3), the payment of educational assistance described in this paragraph is the payment of such assistance to an individual for pursuit of a course or courses under this chapter if the Secretary finds that the individual—</text> <subparagraph id="id523b36b0285b4ef699c256c74bee488f"><enum>(A)</enum><text>was forced to discontinue such course pursuit as a result of a permanent closure of an educational institution; and</text> </subparagraph><subparagraph id="idbbade5e1b7ad450c8712defe4cc2aa54"><enum>(B)</enum><text>did not receive credit, or lost training time, toward completion of the program of education being pursued at the time of such closure.</text> </subparagraph></paragraph><paragraph id="ide8488d6f24d04e479ddd3bc16dc396a5"><enum>(3)</enum><header>Period for which payment not charged</header><text>The period for which, by reason of this subsection, educational assistance is not charged against entitlement or counted toward the applicable aggregate period under section 3695 of this title shall not exceed the aggregate of—</text> <subparagraph id="id41F005D829DD45AC8C96031A6F249789"><enum>(A)</enum><text>the portion of the period of enrollment in the course or courses from which the individual failed to receive credit or with respect to which the individual lost training time, as determined under paragraph (2)(B), and</text> </subparagraph><subparagraph id="idA484CF3BB4674A97AFDA12D1DFDEC711"><enum>(B)</enum><text>the period by which a monthly stipend is extended under section 3680(a)(2)(B) of this title.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph><paragraph id="id55F3E8CC1BF14F488B2431DA6979B3A2"><enum>(2)</enum><header>Applicability</header><text>Subsection (d) of such section, as added by paragraph (1), shall apply with respect to courses and programs of education discontinued as described in paragraph (2) of such subsection in fiscal year 2015 or any fiscal year thereafter.</text> </paragraph></subsection><subsection id="id6e6d23efab1d4f99b22cd54444e2dd33"><enum>(b)</enum><header>Monthly housing stipend</header> <paragraph id="id23BD47CCC35F4FE7AA1485DF4CE8BF3F"><enum>(1)</enum><header>In general</header><text>Section 3680(a) of such title is amended—</text> <subparagraph id="id86540B0FEB8E43C2BE8837262A8EB2B3"><enum>(A)</enum><text>by striking the matter after paragraph (3)(B);</text> </subparagraph><subparagraph id="idC24E9A9103814D269CA592227E8CBC22"><enum>(B)</enum><text>in paragraph (3), by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively;</text> </subparagraph><subparagraph id="id4D27CBFDF8044EE7AAC0C05C2EC133FB"><enum>(C)</enum><text>by redesignating paragraphs (1) through (3) as subparagraphs (A) through (C), respectively;</text> </subparagraph><subparagraph id="id53BC9F81CF2D40709B671E9BDC37C393"><enum>(D)</enum><text>in the matter before subparagraph (A), as redesignated, in the first sentence, by striking <quote>Payment of</quote> and inserting <quote>(1) Except as provided in paragraph (2), payment of</quote>; and</text> </subparagraph><subparagraph id="id23B3390551954C7BA8C6D7F7E69E56D7"><enum>(E)</enum><text>by adding at the end the following new paragraph (2):</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idDA1F562A1ED04817BB7EF4A67EB019FE" reported-display-style="italic" style="OLC"> <paragraph id="idA4E5D53BF2234025A6AB7587C80203FA" indent="up1"><enum>(2)</enum><text>Notwithstanding paragraph (1), the Secretary may, pursuant to such regulations as the Secretary shall prescribe, continue to pay allowances to eligible veterans and eligible persons enrolled in courses set forth in paragraph (1)(A)—</text> <subparagraph id="id871e90d0534c4380bd94090c3e356e40"><enum>(A)</enum><text>during periods when schools are temporarily closed under an established policy based on an Executive order of the President or due to an emergency situation, except that the total number of weeks for which allowances may continue to be so payable in any 12-month period may not exceed four weeks; or</text> </subparagraph><subparagraph id="id0af2ab6008ca44c7aff9ef1bbb520ee2"><enum>(B)</enum><text>solely for the purpose of awarding a monthly housing stipend described in section 3313 of this title, during periods following a permanent school closure, except that payment of such a stipend may only be continued until the earlier of—</text> <clause id="idE05382578E134E95B558EBD9CDFD9746"><enum>(i)</enum><text>the date of the end of the term, quarter, or semester during which the school closure occurred; and</text> </clause><clause id="id9216A8A13CCC41E1ABF4854770E2161B"><enum>(ii)</enum><text>the date that is 4 months after the date of the school closure.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id92F4ED054E4D4E7FA94A3FCA59FCB7FA"><enum>(2)</enum><header>Conforming amendment</header><text>Paragraph (1)(C)(ii) of such section, as redesignated, is amended by striking <quote>described in subclause (A) of this clause</quote> and inserting <quote>described in clause (i)</quote>.</text> </paragraph></subsection></section><section id="H0AC775BFAD5341D0BB67AF68FD935CA4" section-type="subsequent-section"><enum>202.</enum><header>Modification and improvement of transfer of unused Post-9/11 Educational Assistance to family members</header> <subsection id="H2174AC9CF4344D2389E04F0AF510E143"><enum>(a)</enum><header>Eligibility requirements</header><text display-inline="yes-display-inline">Subsection (b)(1) of section 3319 of title 38, United States Code, is amended—</text> <paragraph id="H23D153F6086F47A7845AC37CA438005B"><enum>(1)</enum><text>by striking <quote>six years</quote> and inserting <quote>ten years</quote>; and</text> </paragraph><paragraph id="H080655F6CF8F4DE3BB2A6AA67034B12C"><enum>(2)</enum><text>by striking <quote>four more years</quote> and inserting <quote>two more years</quote>.</text> </paragraph></subsection><subsection id="H59C7688A3D024642A1F614E8FAD8F2A9"><enum>(b)</enum><header>Commencement of use</header><text>Subsection (g)(1)(A) of such section is amended by striking <quote>six years</quote> and inserting <quote>ten years</quote>.</text> </subsection><subsection id="H158CDF73F4F44C91B6B43B0049C1363C"><enum>(c)</enum><header>Rate of payment</header><text>Subsection (h)(3)(B) of such section is amended by inserting before the period at the end the following: <quote>, except that the amount of the monthly stipend described in subsection (c)(1)(B) or (g)(3)(A)(ii) of section 3313, as the case may be, shall be payable in an amount equal to 50 percent of the amount of such stipend that would otherwise be payable under this chapter to the individual making the transfer</quote>.</text> </subsection><subsection id="H87F0B76FD1954C6BB7D99624237788E8"><enum>(d)</enum><header>Technical correction</header><text>Such section is further amended by striking <quote>armed forces</quote> each place it appears and inserting <quote>Armed Forces</quote>.</text> </subsection><subsection id="H3E5220A6A8824A72BF7B623B1C0D247D"><enum>(e)</enum><header>Applicability</header><text>The amendments made by subsections (a) through (c) shall apply with respect to an election to transfer entitlement under section 3319 of title 38, United States Code, that is made on or after the date that is 180 days after the date of the enactment of this Act.</text> </subsection></section><section display-inline="no-display-inline" id="HBE7559FF7F804A7BB19943665ED1DD2B" section-type="subsequent-section"><enum>203.</enum><header>Codification and improvement of election process for Post-9/11 Educational Assistance</header> <subsection id="H56C88D57D23644008EE51645D33A3DC2"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Subchapter III of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/33">chapter 33</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="H7BDB641CEE1943E4AAD18C9249C1B84B" reported-display-style="italic" style="USC"> <section id="HA165183679BF439CB734CA74A1716030"><enum>3326.</enum><header>Election to receive educational assistance</header> <subsection id="H30F31BA97C7946B7B07837D7E3BD4554"><enum>(a)</enum><header>Individuals eligible to elect participation in post-9/11 educational assistance</header><text>An individual may elect to receive educational assistance under this chapter if such individual—</text> <paragraph id="H378F25F4171A43B8A614FD7B9460F627"><enum>(1)</enum><text>as of August 1, 2009—</text> <subparagraph id="H02A8B06CF64645DDB0261FE5CEC66544"><enum>(A)</enum><text>is entitled to basic educational assistance under chapter 30 of this title and has used, but retains unused, entitlement under that chapter;</text> </subparagraph><subparagraph id="H709F011570B340AD9046A170E43A29A2"><enum>(B)</enum><text>is entitled to educational assistance under chapter 107, 1606, or 1607 of title 10 and has used, but retains unused, entitlement under the applicable chapter;</text> </subparagraph><subparagraph id="H2E63E885A8BE47089C13ED28E239525F"><enum>(C)</enum><text>is entitled to basic educational assistance under chapter 30 of this title but has not used any entitlement under that chapter;</text> </subparagraph><subparagraph id="H594BC3110376463D98BD90181D200F09"><enum>(D)</enum><text>is entitled to educational assistance under chapter 107, 1606, or 1607 of title 10 but has not used any entitlement under such chapter;</text> </subparagraph><subparagraph id="HDF8963733EAB47569749FE59FE28F204"><enum>(E)</enum><text>is a member of the Armed Forces who is eligible for receipt of basic educational assistance under chapter 30 of this title and is making contributions toward such assistance under section 3011(b) or 3012(c) of this title; or</text> </subparagraph><subparagraph id="H5DF5941D71FA42AB8B4E663B81967DF8"><enum>(F)</enum><text>is a member of the Armed Forces who is not entitled to basic educational assistance under chapter 30 of this title by reason of an election under section 3011(c)(1) or 3012(d)(1) of this title; and</text> </subparagraph></paragraph><paragraph id="H30C3129FD3DC4DAA927175DDAE154052"><enum>(2)</enum><text>as of the date of the individual’s election under this paragraph, meets the requirements for entitlement to educational assistance under this chapter.</text> </paragraph></subsection><subsection id="HC6E28F90EEB3426B8CD8EC0C1AC837CE"><enum>(b)</enum><header>Cessation of contributions toward GI bill</header><text>Effective as of the first month beginning on or after the date of an election under subsection (a) of an individual described by paragraph (1)(E) of that subsection, the obligation of the individual to make contributions under section 3011(b) or 3012(c) of this title, as applicable, shall cease, and the requirements of such section shall be deemed to be no longer applicable to the individual.</text> </subsection><subsection id="HC0EF0401C8DA456884A354AD401E6112"><enum>(c)</enum><header>Revocation of remaining transferred entitlement</header> <paragraph id="H30D3D168747B48DFBAC06A9A18358D58"><enum>(1)</enum><header>Election to revoke</header><text>If, on the date an individual described in paragraph (1)(A) or (1)(C) of subsection (a) makes an election under that subsection, a transfer of the entitlement of the individual to basic educational assistance under section 3020 of this title is in effect and a number of months of the entitlement so transferred remain unutilized, the individual may elect to revoke all or a portion of the entitlement so transferred that remains unutilized.</text> </paragraph><paragraph id="H346C008B6DF94C8D8436516198395C47"><enum>(2)</enum><header>Availability of revoked entitlement</header><text>Any entitlement revoked by an individual under this paragraph shall no longer be available to the dependent to whom transferred, but shall be available to the individual instead for educational assistance under chapter 33 of this title in accordance with the provisions of this section.</text> </paragraph><paragraph id="H76E30233B0454ECD93FD98F8C5B67BCA"><enum>(3)</enum><header>Availability of unrevoked entitlement</header><text>Any entitlement described in paragraph (1) that is not revoked by an individual in accordance with that paragraph shall remain available to the dependent or dependents concerned in accordance with the current transfer of such entitlement under section 3020 of this title.</text> </paragraph></subsection><subsection id="H4463CDBCA8C149279B69A63141DAC811"><enum>(d)</enum><header>Post-9/11 educational assistance</header> <paragraph id="H82053CFADF5C4042BDE3F25B13768470"><enum>(1)</enum><header>In general</header><text>Subject to paragraph (2) and except as provided in subsection (e), an individual making an election under subsection (a) shall be entitled to educational assistance under this chapter in accordance with the provisions of this chapter, instead of basic educational assistance under chapter 30 of this title, or educational assistance under chapter 107, 1606, or 1607 of title 10, as applicable.</text> </paragraph><paragraph id="HFED71E293B9247D5A5BCA3FDB583B5D9"><enum>(2)</enum><header>Limitation on entitlement for certain individuals</header><text>In the case of an individual making an election under subsection (a) who is described by paragraph (1)(A) of that subsection, the number of months of entitlement of the individual to educational assistance under this chapter shall be the number of months equal to—</text> <subparagraph id="HCCA82599353248CC9EC546C949346D45"><enum>(A)</enum><text>the number of months of unused entitlement of the individual under chapter 30 of this title, as of the date of the election, plus</text> </subparagraph><subparagraph id="HA50477A8DC46467CB18A09ACF232153B"><enum>(B)</enum><text>the number of months, if any, of entitlement revoked by the individual under subsection (c)(1).</text> </subparagraph></paragraph></subsection><subsection id="H899B50F161ED43B09556C0A3414E0C40"><enum>(e)</enum><header>Continuing entitlement to educational assistance not available under 9/11 assistance program</header> <paragraph id="HD701D747C7304F0F8A6A8F53657E65B6"><enum>(1)</enum><header>In general</header><text>In the event educational assistance to which an individual making an election under subsection (a) would be entitled under chapter 30 of this title, or chapter 107, 1606, or 1607 of title 10, as applicable, is not authorized to be available to the individual under the provisions of this chapter the individual shall remain entitled to such educational assistance in accordance with the provisions of the applicable chapter.</text> </paragraph><paragraph id="H3713AD771DF34D0C94C66FB9302E011C"><enum>(2)</enum><header>Charge for use of entitlement</header><text>The utilization by an individual of entitlement under paragraph (1) shall be chargeable against the entitlement of the individual to educational assistance under this chapter at the rate of one month of entitlement under this chapter for each month of entitlement utilized by the individual under paragraph (1) (as determined as if such entitlement were utilized under the provisions of chapter 30 of this title, or chapter 107, 1606, or 1607 of title 10, as applicable).</text> </paragraph></subsection><subsection id="HA112D8837F0C46A3B49FC07D2F9A2383"><enum>(f)</enum><header>Additional post-9/11 assistance for members having made contributions toward GI bill</header> <paragraph id="HF423AEC016694B30ABF653BEA2E5F992"><enum>(1)</enum><header>Additional assistance</header><text>In the case of an individual making an election under subsection (a) who is described by subparagraph (A), (C), or (E) of paragraph (1) of that subsection, the amount of educational assistance payable to the individual under this chapter as a monthly stipend payable under paragraph (1)(B) of section 3313(c) of this title, or under paragraphs (2) through (7) of that section (as applicable), shall be the amount otherwise payable as a monthly stipend under the applicable paragraph increased by the amount equal to—</text> <subparagraph id="HEDFD22694F354A65BBC5CC8FB3822AFF"><enum>(A)</enum><text>the total amount of contributions toward basic educational assistance made by the individual under section 3011(b) or 3012(c) of this title, as of the date of the election, multiplied by</text> </subparagraph><subparagraph id="H1CEB7822C0974FA4ACD0D5662CBD2BBC"><enum>(B)</enum><text>the fraction—</text> <clause id="H1E5F9EC9F857442FA28C66B05165C6A0"><enum>(i)</enum><text>the numerator of which is—</text> <subclause id="H647824B17ACF41AAA1AF27FBF03269DF"><enum>(I)</enum><text display-inline="yes-display-inline">the number of months of entitlement to basic educational assistance under chapter 30 of this title remaining to the individual at the time of the election; plus</text> </subclause><subclause id="H7A88081543E24ABD80D67183CC269074"><enum>(II)</enum><text>the number of months, if any, of entitlement under chapter 30 revoked by the individual under subsection (c)(1); and</text> </subclause></clause><clause id="H052D8F04115642EB9CAB1C60C165E288"><enum>(ii)</enum><text>the denominator of which is 36 months.</text> </clause></subparagraph></paragraph><paragraph id="H3B231918C5DE4A98A320A89D972C4E86"><enum>(2)</enum><header>Months of remaining entitlement for certain individuals</header><text display-inline="yes-display-inline">In the case of an individual covered by paragraph (1) who is described by subsection (a)(1)(E), the number of months of entitlement to basic educational assistance remaining to the individual for purposes of paragraph (1)(B)(i)(II) shall be 36 months.</text> </paragraph><paragraph id="HE29DE0BA88F142CC83C81C1F9085FB07"><enum>(3)</enum><header>Timing of payment</header><text>The amount payable with respect to an individual under paragraph (1) shall be paid to the individual together with the last payment of the monthly stipend payable to the individual under paragraph (1)(B) of section 3313(c) of this title, or under paragraphs (2) through (7) of that section (as applicable), before the exhaustion of the individual’s entitlement to educational assistance under this chapter.</text> </paragraph></subsection><subsection id="HF6B64976DA5A4970BBFCC83A0204B316"><enum>(g)</enum><header>Continuing entitlement to additional assistance for critical skills or speciality and additional service</header><text>An individual making an election under subsection (a)(1) who, at the time of the election, is entitled to increased educational assistance under section 3015(d) of this title, or section 16131(i) of title 10, or supplemental educational assistance under subchapter III of chapter 30 of this title, shall remain entitled to such increased educational assistance or supplemental educational assistance in the utilization of entitlement to educational assistance under this chapter, in an amount equal to the quarter, semester, or term, as applicable, equivalent of the monthly amount of such increased educational assistance or supplemental educational assistance payable with respect to the individual at the time of the election.</text> </subsection><subsection id="H94D5C1A1910549CF8B39EDE9571475E0"><enum>(h)</enum><header>Alternative election by Secretary</header> <paragraph id="HF86BD23C49D1417A86F1F1B678DEB09F"><enum>(1)</enum><header>In general</header><text>In the case of an individual who, on or after January 1, 2016, submits to the Secretary an election under this section that the Secretary determines is clearly against the interests of the individual, or who fails to make an election under this section, the Secretary may make an alternative election on behalf of the individual that the Secretary determines is in the best interests of the individual.</text> </paragraph><paragraph id="HE50F0726B1B6456B8945894B41D343BA"><enum>(2)</enum><header>Notice</header><text display-inline="yes-display-inline">If the Secretary makes an election on behalf of an individual under this subsection, the Secretary shall notify the individual by not later than seven days after making such election and shall provide the individual with a 30-day period, beginning on the date of the individual’s receipt of such notice, during which the individual may modify or revoke the election made by the Secretary on the individual’s behalf. The Secretary shall include, as part of such notice, a clear statement of why the alternative election made by the Secretary is in the best interests of the individual as compared to the election submitted by the individual. The Secretary shall provide the notice required under this paragraph by electronic means whenever possible.</text> </paragraph></subsection><subsection id="H1EC2BF24583D4D3685C007555F950169"><enum>(i)</enum><header>Irrevocability of elections</header><text>An election under subsection (a) or (c)(1) is irrevocable.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="H83E2912C08B8454590819B9F08FC892C"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by adding at the end the following new item:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="H0D231D00EF3C4B3FA55895373E03F719" reported-display-style="italic" style="USC"><toc changed="added" committee-id="SSVA00" regeneration="no-regeneration" reported-display-style="italic"><toc-entry level="section">3326. Election to receive educational assistance.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="H2DEA80B8125641F9B8CD046104C5B52F"><enum>(c)</enum><header>Conforming repeal</header><text display-inline="yes-display-inline">Subsection (c) of section 5003 of the Post-9/11 Veterans Educational Assistance Act of 2008 (<external-xref legal-doc="public-law" parsable-cite="pl/110/252">Public Law 110–252</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/3301">38 U.S.C. 3301</external-xref> note) is hereby repealed.</text> </subsection></section><section display-inline="no-display-inline" id="H73E42FBC103C4132AA21C1B6F71E9CE6" section-type="subsequent-section"><enum>204.</enum><header>Centralized reporting of veteran enrollment by certain groups, districts, and consortiums of educational institutions</header> <subsection id="H452B1BF695974B35A664AC53AA584854"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 3684(a) of title 38, United States Code, is amended—</text> <paragraph id="H3D82371299EB4F5FA127C0FC1B2AE799"><enum>(1)</enum><text>in paragraph (1), by inserting <quote>32, 33,</quote> after <quote>31,</quote>; and</text> </paragraph><paragraph id="H8E41DDEF7373490DB3627E184A64D8B5"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="HB2309E4146C84D72A860F287F66B1EDA" reported-display-style="italic" style="USC"> <paragraph display-inline="no-display-inline" id="H7D289E7C5A9C4714863A31F07EE2A3D7" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">For purposes of this subsection, the term <term>educational institution</term> may include a group, district, or consortium of separately accredited educational institutions located in the same State that are organized in a manner that facilitates the centralized reporting of the enrollments in such group, district, or consortium of institutions.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection id="HE17DEB2EB9AD4E30981DAD89A503B208"><enum>(b)</enum><header>Effective date</header><text display-inline="yes-display-inline">The amendments made by subsection (a) shall apply with respect to reports submitted on or after the date of the enactment of this Act.</text> </subsection></section><section id="H914259345B9F4E2FB737FDF3F62831AB"><enum>205.</enum><header>Improved role of State approving agencies in administration of veterans educational benefits</header> <subsection id="HAAD575792D5348BBA65012C5713F7471"><enum>(a)</enum><header>Approval of certain courses</header><text display-inline="yes-display-inline">Section 3672(b)(2)(A) of title 38, United States Code, is amended by striking <quote>the following</quote> and all that follows through the colon and inserting the following: <quote>a program of education is deemed to be approved for purposes of this chapter if a State approving agency determines that the program is one of the following programs:</quote>.</text> </subsection><subsection id="H50CDEFC136FB4215BFB1620B8249EF49"><enum>(b)</enum><header>Approval of other courses</header><text display-inline="yes-display-inline">Section 3675 of such title amended—</text> <paragraph id="H04A6CEA2923E41CDA01F89EC928A76B0"><enum>(1)</enum><text>in subsection (a)(1)—</text> <subparagraph id="HC999B30F86754DF09D320027CBFB4876"><enum>(A)</enum><text>by striking <quote>The Secretary or a State approving agency</quote> and inserting <quote>A State approving agency, or the Secretary when acting in the role of a State approving agency,</quote>; and</text> </subparagraph><subparagraph id="HD46DAFCA545840AC814F52BA8E6ACC38"><enum>(B)</enum><text>by striking <quote>offered by proprietary for-profit educational institutions</quote> and inserting <quote>not covered by section 3672 of this title</quote>; and</text> </subparagraph></paragraph><paragraph id="H65F92216886145D69ABC9A2DAC93DE1B"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (b)—</text> <subparagraph id="id7308B3A60D2B4804AFDBADE6C9B8FE5F"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(A)</added-phrase></enum><text display-inline="yes-display-inline">in the matter before paragraph (1), by striking <quote>the Secretary or the State approving agency</quote> and inserting <quote>the State approving agency, or the Secretary when acting in the role of a State approving agency,</quote>; and</text> </subparagraph><subparagraph id="id40581AACFDED4930B423174A2C94868E"><enum>(B)</enum><text>in paragraph (1), by striking <quote>the Secretary or the State approving agency</quote> and inserting <quote>the State approving agency, or the Secretary when acting in the role of a State approving agency</quote>.</text> </subparagraph></paragraph></subsection></section><section id="HA9C2ED8F88414E5493B13B29666B1853"><enum>206.</enum><header>Modification of criteria used to approve courses for purposes of veterans educational benefits</header> <subsection commented="no" id="H8E6BA148824048DCA84FED3653EA0239"><enum>(a)</enum><header>Nonaccredited courses</header><text display-inline="yes-display-inline">Section 3676(c)(14) of title 38, United States Code, is amended by inserting before the period the following: <quote>if the Secretary, in consultation with the State approving agency and pursuant to regulations prescribed to carry out this paragraph, determines such criteria are necessary and treat public, private, and proprietary for-profit educational institutions equitably</quote>.</text> </subsection><subsection commented="no" id="H5AB1A236D91142ABA64EDEE8779EAC8A"><enum>(b)</enum><header>Accredited courses</header><text display-inline="yes-display-inline">Section 3675(b)(3) of such title is amended by striking <quote>and (3)</quote> and inserting <quote>(3), and (14)</quote>.</text> </subsection><subsection id="HFEA8F18D9AF44C0391C8AC5EE4B702B7"><enum>(c)</enum><header>Application</header><text display-inline="yes-display-inline">The amendment made by subsection (a) shall apply with respect to—</text> <paragraph id="H0B5E7AE03F274973BFA366B0D62F5A0E"><enum>(1)</enum><text>criteria developed pursuant to paragraph (14) of subsection (c) of section 3676 of title 38, United States Code, on or after January 1, 2013; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="HE2C89A4E99D14C7E8CA201F16D7DAD03"><enum>(2)</enum><text>an investigation conducted under such subsection that is covered by a reimbursement of expenses paid by the Secretary of Veterans Affairs to a State pursuant to section 3674 of such title on or after October 1, 2015.</text> </paragraph></subsection></section><section id="HE026B0C992F24CB2824A3F8C6588B11C"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">207.</added-phrase></enum><header>Surveys for compliance of educational institutions and training establishments with requirements relating to administration of veterans educational benefits</header> <subsection id="H686B35EB83D448DA9BB4BA3869387171"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 3693 of title 38, United States Code, is amended—</text> <paragraph id="H6A5A8511023A482785DEF45633B6D474"><enum>(1)</enum><text>by striking subsection (a) and inserting the following new subsection (a):</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="HF8B4AB809E3E4C37AF8D5E03A5307547" reported-display-style="italic" style="USC"> <subsection id="H4E598D1BF56F44159A5C0F567C25C832"><enum>(a)</enum><paragraph commented="no" display-inline="yes-display-inline" id="HB3F03F168A764524BD07399502F7A25C"><enum>(1)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id3EF6A09D61CD4C4D814C53DF86274C18"><enum>(A)</enum><text display-inline="yes-display-inline">Except as provided in subsection (b), the Secretary shall conduct an annual compliance survey of educational institutions and training establishments offering one or more courses approved for the enrollment of eligible veterans or persons if at least 20 such veterans or persons are enrolled in any such course.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id00FE0CB8AEDA4D0188AF73D0166F6A06" indent="up2" reported-display-style="italic"><enum>(B)</enum><text display-inline="yes-display-inline">The Secretary shall—</text> <clause id="HAD9FAFCED43E4306ABEE1BBF9E3527ED"><enum>(i)</enum><text>design the compliance surveys to ensure that such institutions or establishments, as the case may be, and approved courses are in compliance with all applicable provisions of chapters 30 through 36 of this title;</text> </clause><clause id="H765607399A1C438A995A266FAA8C3216"><enum>(ii)</enum><text display-inline="yes-display-inline">survey each such educational institution and training establishment not less than once during every two-year period; and</text> </clause><clause id="HE170494EB7DB4D6BBA8C53A0A04F9B29"><enum>(iii)</enum><text>assign not fewer than one education compliance specialist to work on compliance surveys in any year for each 40 compliance surveys required to be made under this section for such year.</text> </clause></subparagraph></paragraph><paragraph changed="added" committee-id="SSVA00" id="HC8BF9036161541B783BCDA95F75CD7F9" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary, in consultation with the State approving agencies, shall—</text> <subparagraph id="HE3723A71B9C94594BD7658069A3601F6"><enum>(A)</enum><text>annually determine the parameters of the surveys required under paragraph (1); and</text> </subparagraph><subparagraph id="H7B7CE70E7DC446D9B8D59246A5AD9539"><enum>(B)</enum><text display-inline="yes-display-inline">not later than September 1 of each year, make available to the State approving agencies a list of the educational institutions and training establishments that will be surveyed during the fiscal year following the date of making such list available.</text></subparagraph></paragraph></subsection><after-quoted-block>; and</after-quoted-block></quoted-block> </paragraph><paragraph id="H346F16283D9B4A848CB2A852878DCFEA"><enum>(2)</enum><text>by adding at the end the following new subsection:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="H40BC930AE61343BD8CBC6C6A9AFFB576" reported-display-style="italic" style="USC"> <subsection id="HA16FD0DC27B049A9B02961A3DFF3FA55"><enum>(c)</enum><text>In this section, the terms <term>educational institution</term> and <term>training establishment</term> have the meaning given such terms in section 3452 of this title.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection id="H8C293B352B004CFEAB52DEA0EC708E58"><enum>(b)</enum><header>Conforming amendments</header><text display-inline="yes-display-inline">Subsection (b) of such section is amended—</text> <paragraph id="H7C512643ADDF4E98B4C225C7F0448CA3"><enum>(1)</enum><text>by striking <quote>subsection (a) of this section for an annual compliance survey</quote> and inserting <quote>subsection (a)(1) for a compliance survey</quote>;</text> </paragraph><paragraph id="HF9AD6A1F09AD47AE80D84753C87B60D9"><enum>(2)</enum><text>by striking <quote>institution</quote> and inserting <quote>educational institution or training establishment</quote>; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="H7EEC00A5BF4543419ED6EAAB4BD62F90"><enum>(3)</enum><text>by striking <quote>institution's demonstrated record of compliance</quote> and inserting <quote>record of compliance of such institution or establishment</quote>.</text> </paragraph></subsection></section><section id="H97A901643D7840CF80DE3A998CF9793F"><enum>208.</enum><header>Modification of requirements for approval for purposes of educational assistance provided by Department of Veterans Affairs of programs designed to prepare individuals for licensure or certification</header> <subsection id="H3DDC7CB2EEE3492EA7FD073056A20AD2"><enum>(a)</enum><header>Approval of non-Accredited courses</header><text>Subsection (c) of section 3676 of title 38, United States Code, as amended by section 206, is further amended—</text> <paragraph id="H458B00F13BE147A88F92E3DFE4A98A52"><enum>(1)</enum><text>by redesignating paragraph (14) as paragraph (16); and</text> </paragraph><paragraph id="HAE1344F0ED004FDB94B3F4F20647D15C"><enum>(2)</enum><text>by inserting after paragraph (13) the following new paragraphs:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="HA38588C9E7CF4C1FA3C02D3BC5CC7256" reported-display-style="italic" style="USC"> <paragraph id="H2D42620D8E6E47DEA309F95A19C8DFE9"><enum>(14)</enum><text display-inline="yes-display-inline">In the case of a course designed to prepare an individual for licensure or certification in a State, the course—</text> <subparagraph id="id4B9A3E55E3B54C87A92E8606F6128DF5"><enum>(A)</enum><text display-inline="yes-display-inline">meets any instructional curriculum licensure or certification requirements of such State; and</text> </subparagraph><subparagraph id="idF2F5F19362DB40869067CA1DE3EDEE13"><enum>(B)</enum><text display-inline="yes-display-inline">in the case of a course designed to prepare an individual for licensure to practice law in a State, is accredited by an accrediting agency or association recognized by the Secretary of Education under subpart 2 of part H of title IV of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1099b">20 U.S.C. 1099b</external-xref>).</text> </subparagraph></paragraph><paragraph id="HDB545BE35627463CA76686603DA64EE2"><enum>(15)</enum><text>In the case of a course designed to prepare an individual for employment pursuant to standards developed by a board or agency of a State in an occupation that requires approval, licensure, or certification, the course—</text> <subparagraph id="idF9D85D8EE4A14EB9B1F1B6FA43F35F6C"><enum>(A)</enum><text>meets such standards; and</text> </subparagraph><subparagraph id="idA00AE3FD00284D8291EF8EF875FC03FF"><enum>(B)</enum><text>in the case of a course designed to prepare an individual for licensure to practice law in a State, is accredited by an accrediting agency or association recognized by the Secretary of Education under subpart 2 of part H of title IV of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1099b">20 U.S.C. 1099b</external-xref>).</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection id="H0651075A3F51493F9CFEDC13F8F1152A"><enum>(b)</enum><header>Exceptions</header><text>Such section is further amended by adding at the end the following new subsection:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="HE175771489B74FFB8E10AF0990E59983" reported-display-style="italic" style="OLC"> <subsection id="H4CC4321E2F7442FE8C7176C97A170D1C"><enum>(f)</enum><paragraph commented="no" display-inline="yes-display-inline" id="id23E9D09F108B4BEEA964C7B112621AAB"><enum>(1)</enum><text>The Secretary may waive the requirements of paragraph (14) or (15) of subsection (c) in the case of a course of education offered by an educational institution (either accredited or not accredited) if the Secretary determines all of the following:</text> <subparagraph changed="added" committee-id="SSVA00" id="H5925DBD8AD6C4977ADD7D0E7B9CDDBD1" indent="up1" reported-display-style="italic"><enum>(A)</enum><text>The course did not meet the requirements of such paragraph at any time during the two-year period preceding the date of the waiver.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="H8EF19842C0C747FDB86EB3002A839100" indent="up1" reported-display-style="italic"><enum>(B)</enum><text display-inline="yes-display-inline">The waiver furthers the purposes of the educational assistance programs administered by the Secretary or would further the education interests of individuals eligible for assistance under such programs.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="HBF1B5FB0F0E74DBC982250E2A9094FD0" indent="up1" reported-display-style="italic"><enum>(C)</enum><text display-inline="yes-display-inline">The educational institution does not provide any commission, bonus, or other incentive payment based directly or indirectly on success in securing enrollments or financial aid to any persons or entities engaged in any student recruiting or admission activities or in making decisions regarding the award of student financial assistance, except for the recruitment of foreign students residing in foreign countries who are not eligible to receive Federal student assistance.</text> </subparagraph></paragraph><paragraph changed="added" committee-id="SSVA00" id="id03E6B60ACB1B4798B3694830CFF3969A" indent="up1" reported-display-style="italic"><enum>(2)</enum><text display-inline="yes-display-inline">Not later than 30 days after the date on which the Secretary issues a waiver under paragraph (1), the Secretary shall submit to Congress notice of such waiver and a justification for issuing such waiver.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="H3326EBEC2B414731BD15B97680BDFF9B"><enum>(c)</enum><header>Approval of accredited courses</header><text display-inline="yes-display-inline">Section 3675(b)(3) of such title, as amended by section 206, is further amended—</text> <paragraph id="HFEC5733BBA5440B1AA8C5CA7922D7633"><enum>(1)</enum><text>by striking <quote>and (14)</quote> and inserting <quote>(14), (15), and (16)</quote>; and</text> </paragraph><paragraph id="H7F1BBE02A5D84676A0A283DBC6B2F777"><enum>(2)</enum><text>by inserting before the period at the end the following: <quote>(or, with respect to such paragraphs (14) and (15), the requirements under such paragraphs are waived pursuant to subsection (f)(1) of section 3676 of this title)</quote>.</text> </paragraph></subsection><subsection id="H782D4B785ED44BCFA94739DC37FD9ECC"><enum>(d)</enum><header>Approval of accredited standard college degree programs offered at public or not-for-profit educational institutions</header><text>Section 3672(b)(2) of such title is amended—</text> <paragraph id="idEE2E102C2BD34504899C286004DEF8B1"><enum>(1)</enum><text>in subparagraph (A)(i), by striking <quote>An accredited</quote> and inserting <quote>Except as provided in subparagraph (C), an accredited</quote>; and</text> </paragraph><paragraph id="id0BC614FD7A8448C498251352167D713D"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id807352C441C04209A44988610CBC364A" reported-display-style="italic" style="OLC"> <subparagraph id="id0EDF85C3BFDE452F95B668C4CB33647C" indent="up2"><enum>(C)</enum><text>A course that is described in both subparagraph (A)(i) of this paragraph and in paragraph (14) or (15) of section 3676(c) of this title shall not be deemed to be approved for purposes of this chapter unless—</text> <clause id="id00D7160F877640CC9C01410421F4AD17"><enum>(i)</enum><text>a State approving agency, or the Secretary when acting in the role of a State approving agency, determines that the course meets the applicable criteria in such paragraphs; or</text> </clause><clause id="id599AE9E9E07B4B9A9518C589F480BDEC"><enum>(ii)</enum><text>the Secretary issues a waiver for such course under section 3676(f)(1) of this title.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection id="H61630D3403ED4646B0B50311EA2F740A"><enum>(e)</enum><header>Disapproval of courses</header><text>Section 3679 of such title is amended by adding at the end the following new subsection:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="H69C08507C143474B9461E9F523F98C24" reported-display-style="italic" style="USC"> <subsection commented="no" display-inline="no-display-inline" id="H484643E953B24690B1D9439E4913F450"><enum>(d)</enum><text display-inline="yes-display-inline">Notwithstanding any other provision of this chapter, the Secretary or the applicable State approving agency shall disapprove a course of education described in paragraph (14) or (15) of section 3676(c) of this title unless the educational institution providing the course of education—</text> <paragraph commented="no" display-inline="no-display-inline" id="id1F5F2DF6C03F4E3EA2289354D11C2E6C"><enum>(1)</enum><text display-inline="yes-display-inline">publicly discloses any conditions or additional requirements, including training, experience, or examinations, required to obtain the license, certification, or approval for which the course of education is designed to provide preparation; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id41EF4C6692914C99BFFBC1B1FD65B06E"><enum>(2)</enum><text display-inline="yes-display-inline">makes each disclosure required by paragraph (1) in a manner that the Secretary considers prominent.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" display-inline="no-display-inline" id="H657AEAA8EE4D4DBE92162E23F2517472"><enum>(f)</enum><header>Applicability</header><text display-inline="yes-display-inline">If after enrollment in a course of education that is subject to disapproval by reason of an amendment made by this Act, an individual pursues one or more courses of education at the same educational institution while remaining continuously enrolled (other than during regularly scheduled breaks between courses, semesters, or terms) at that institution, any course so pursued by the individual at that institution while so continuously enrolled shall not be subject to disapproval by reason of such amendment.</text> </subsection></section><section id="idD992DE8197F843C2B5FA3CC328BC623A" section-type="subsequent-section"><enum>209.</enum><header>Expansion of Yellow Ribbon G.I. Education Enhancement Program</header> <subsection id="idD1EDDA723F4A48F1A3E1501E9C57D528"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 3317(a) of title 38, United States Code, is amended by striking <quote>in paragraphs (1) and (2)</quote> and inserting <quote>in paragraphs (1), (2), and (9)</quote>.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="idAEDE841B6DBA4CAEADFE4DBB34C6788B"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall apply with respect to academic years beginning after the date that is one year after the date of the enactment of this Act.</text> </subsection></section><section id="id8979cf53ae8f4d5d836944b7a3c04442"><enum>210.</enum><header>Consideration of certain time spent receiving medical care from Secretary of Defense as active duty for purposes of eligibility for Post-9/11 Educational Assistance</header> <subsection id="id9a76239d37094752b411102a2b40a0e2"><enum>(a)</enum><header>In general</header><text>Section 3301(1)(B) of title 38, United States Code, is amended by inserting <quote>12301(h),</quote> after <quote>12301(g),</quote>.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="id34b6bfd8d4df4077a1e38f95390e069f"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall take effect on the date that is one year after the date of the enactment of this Act and shall apply with respect to assistance provided under chapter 33 of such title on and after the date that is one year after the date of the enactment of this Act.</text> </subsection></section><enum>III</enum><header>Homeless veterans matters</header> <section commented="no" display-inline="no-display-inline" id="id3DA22D07769B4C95AEF15EB7BCE177EE" section-type="subsequent-section"><enum>301.</enum><header display-inline="yes-display-inline">Expansion of definition of homeless veteran for purposes of benefits under the laws administered by the Secretary of Veterans Affairs</header><text display-inline="no-display-inline">Section 2002(1) of title 38, United States Code, is amended by striking <quote>in section 103(a) of the McKinney-Vento Homeless Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/42/11302">42 U.S.C. 11302(a)</external-xref>)</quote> and inserting <quote>in subsection (a) or (b) of section 103 of the McKinney-Vento Homeless Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/42/11302">42 U.S.C. 11302</external-xref>)</quote>.</text> </section><section commented="no" display-inline="no-display-inline" id="id6D0FDD7F95064A40AFDA94999E2CBBDF" section-type="subsequent-section"><enum>302.</enum><header display-inline="yes-display-inline">Increased per diem payments for transitional housing assistance that becomes permanent housing for homeless veterans</header><text display-inline="no-display-inline">Section 2012(a)(2) of title 38, United States Code, is amended—</text> <paragraph commented="no" display-inline="no-display-inline" id="id7935029A5D2644EB9E81DE241D8242C2"><enum>(1)</enum><text display-inline="yes-display-inline">by redesignating subparagraphs (B) through (D) as subparagraphs (C) through (E), respectively;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id42F41EBAC7994A06BA33DB0E4AC31896"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (C), as redesignated, by striking <quote>in subparagraph (D)</quote> and inserting <quote>in subparagraph (E)</quote>;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idD248DD8BFF9D438EAFAB72DD3A5BEB26"><enum>(3)</enum><text display-inline="yes-display-inline">in subparagraph (D), as redesignated, by striking <quote>under subparagraph (B)</quote> and inserting <quote>under subparagraph (C)</quote>;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idC0873024367246E3B6B6C9516CD43920"><enum>(4)</enum><text display-inline="yes-display-inline">in subparagraph (E), as redesignated, by striking <quote>in subparagraphs (B) and (C)</quote> and inserting <quote>in subparagraphs (C) and (D)</quote>; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id5E96E3543595489180EE660A01B84378"><enum>(5)</enum><text display-inline="yes-display-inline">in subparagraph (A)—</text> <subparagraph commented="no" display-inline="no-display-inline" id="idE38A2696C7D547A499797056D6C85A18"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>The rate</quote> and inserting <quote>Except as otherwise provided in subparagraph (B), the rate</quote>; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id94F81D203F3B430B8D03084B8B243710"><enum>(B)</enum><text display-inline="yes-display-inline">by striking <quote>under subparagraph (B)</quote> and all that follows through the end and inserting the following: “under subparagraph (C).</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idB1E1AF9D44374554AE61696741BBFB94" reported-display-style="italic" style="OLC"> <subparagraph commented="no" display-inline="no-display-inline" id="idE8F60A93950743B18FD6DCD4F5FB1025" indent="up2"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="idAEA318D66DBB449F916023CEBBA4C215"><enum>(i)</enum><text display-inline="yes-display-inline">Except as provided in clause (ii), in no case may the rate determined under this paragraph exceed the rate authorized for State homes for domiciliary care under subsection (a)(1)(A) of section 1741 of this title, as the Secretary may increase from time to time under subsection (c) of that section.</text> </clause><clause changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id862CD772F79642CA88B9B90A36285E21" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text display-inline="yes-display-inline">In the case of services furnished to a homeless veteran who is placed in housing that will become permanent housing for the veteran upon termination of the furnishing of such services to such veteran, the maximum rate of per diem authorized under this section is 150 percent of the rate described in clause (i).</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph></section><section commented="no" display-inline="no-display-inline" id="id890D332355D4484F877FCFEE2DBBA670" section-type="subsequent-section"><enum>303.</enum><header display-inline="yes-display-inline">Expansion of Department of Veterans Affairs authority to provide dental care to homeless veterans</header> <subsection commented="no" display-inline="no-display-inline" id="id55DF5A6307C14003A04AAE3C4CDE1874"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(a)</added-phrase></enum><header>In general</header><text display-inline="yes-display-inline">Subsection (b) of section 2062 of title 38, United States Code, is amended to read as follows:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id4F1F77F2A7A84539B0508D54CD186D9F" reported-display-style="italic" style="OLC"> <subsection commented="no" display-inline="no-display-inline" id="idF66562F191164A978A6BBB68559B597C"><enum>(b)</enum><header display-inline="yes-display-inline">Eligible veterans</header><paragraph commented="no" display-inline="yes-display-inline" id="id351D3DB61F1D4F56AAF0C81E88D6C8C3"><enum>(1)</enum><text display-inline="yes-display-inline">Subsection (a) applies to a veteran who—</text> <subparagraph changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id4A8F8FC230B64E618A089C619E9DA2D8" indent="up1" reported-display-style="italic"><enum>(A)</enum><text display-inline="yes-display-inline">is enrolled for care under section 1705(a) of this title; and</text> </subparagraph><subparagraph changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id7A92E34812B34C74A5327161DF28A367" indent="up1" reported-display-style="italic"><enum>(B)</enum><text display-inline="yes-display-inline">for a period of 60 consecutive days, is receiving—</text> <clause commented="no" display-inline="no-display-inline" id="id8B78B012C16A486B82FDF64E4E44146F"><enum>(i)</enum><text display-inline="yes-display-inline">assistance under section 8(o) of the United States Housing Act of 1937 (<external-xref legal-doc="usc" parsable-cite="usc/42/1437f">42 U.S.C. 1437f(o)</external-xref>); or</text> </clause><clause commented="no" display-inline="no-display-inline" id="id30D6AADB93A14F7E901DD1EC8C6D24BD"><enum>(ii)</enum><text display-inline="yes-display-inline">care (directly or by contract) in any of the following settings:</text> <subclause commented="no" display-inline="no-display-inline" id="idcbc7b7e802394bbfbd37b1518ada6f1f"><enum>(I)</enum><text display-inline="yes-display-inline">A domiciliary under section 1710 of this title.</text> </subclause><subclause commented="no" display-inline="no-display-inline" id="idbc5040635b8e4eefa3936dff25be3b7a"><enum>(II)</enum><text display-inline="yes-display-inline">A therapeutic residence under section 2032 of this title.</text> </subclause><subclause commented="no" display-inline="no-display-inline" id="ida874404fc138418185719207430a3753"><enum>(III)</enum><text display-inline="yes-display-inline">Community residential care coordinated by the Secretary under section 1730 of this title.</text> </subclause><subclause commented="no" display-inline="no-display-inline" id="iddb414b821625447d9cf039fb345720fd"><enum>(IV)</enum><text display-inline="yes-display-inline">A setting for which the Secretary provides funds for a grant and per diem provider.</text> </subclause></clause></subparagraph></paragraph><paragraph changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id49568bd4f87e4157a653f8c4f1f522e4" indent="up1" reported-display-style="italic"><enum>(2)</enum><text display-inline="yes-display-inline">For purposes of paragraph (1), in determining whether a veteran has received assistance or care for a period of 60 consecutive days, the Secretary may disregard breaks in the continuity of assistance or care for which the veteran is not responsible.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" display-inline="no-display-inline" id="idE69FE43B003946718ED4FA16E6F3A713"><enum>(b)</enum><header>Effective date</header><text>Subsection (a) shall take effect on the date that is one year after the date of the enactment of this Act.</text> </subsection></section><section commented="no" display-inline="no-display-inline" id="ideac98b05-ae0f-4d3b-bf1b-70e990db9e20"><enum>304.</enum><header display-inline="yes-display-inline">Clarification of eligibility for services under homeless veterans reintegration programs</header><text display-inline="no-display-inline">Section 2021(a) of title 38, United States Code, is amended by striking <quote>reintegration of homeless veterans into the labor force.</quote> and inserting the following: <quote>reintegration into the labor force of—</quote></text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id111ff9eb-e88e-46c5-be05-39bb461b8caf" reported-display-style="italic" style="OLC"> <paragraph commented="no" display-inline="no-display-inline" id="id80ab806e-095d-4143-87e0-30ea6aebf783"><enum>(1)</enum><text display-inline="yes-display-inline">homeless veterans;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id17ea5089-45a2-4bdb-a392-2949a3808628"><enum>(2)</enum><text display-inline="yes-display-inline">veterans participating in the Department of Veterans Affairs supported housing program for which rental assistance is provided pursuant to section 8(o)(19) of the United States Housing Act of 1937 (<external-xref legal-doc="usc" parsable-cite="usc/42/1437f">42 U.S.C. 1437f(o)(19)</external-xref>);</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idd0207943-f67a-4f4f-9e30-62632e3babad"><enum>(3)</enum><text display-inline="yes-display-inline">Indians who are veterans and receiving assistance under the Native American Housing Assistance and Self Determination Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/25/4101">25 U.S.C. 4101 et seq.</external-xref>); and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id769a3f08-1ce1-4de1-b9e9-b333675f11ee"><enum>(4)</enum><text display-inline="yes-display-inline">veterans who are transitioning from being incarcerated.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </section><section id="id7F34FC4D31944BD482E807DF001D4DEC"><enum>305.</enum><header>Program to improve retention of housing by formerly homeless veterans and veterans at risk of becoming homeless</header> <subsection id="id152970E22CD7428888EC95445B129988"><enum>(a)</enum><header>Program required</header> <paragraph commented="no" display-inline="no-display-inline" id="id4C37B2B4A3904899A0E742F1F0EF2949"><enum>(1)</enum><header>In general</header><text>Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/20">chapter 20</external-xref> of title 38, United States Code, is amended—</text> <subparagraph commented="no" display-inline="no-display-inline" id="idC75C65EA5DAA49EC842EEB53B9122814"><enum>(A)</enum><text>by redesignating section 2013 as section 2014; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id8CF478450CE2494A97747725465840BE"><enum>(B)</enum><text>by inserting after section 2012 the following new section 2013:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idE82F4287AC2E4D04B5D2D71FBD736053" reported-display-style="italic" style="USC"> <section commented="no" display-inline="no-display-inline" id="idF77C8DAE574848ABB662724DAB05158A"><enum>2013.</enum><header>Program to improve retention of housing by formerly homeless veterans and veterans at risk of becoming homeless</header> <subsection id="id280ACB62E6A44660B2CD1E4DF7B0B10B"><enum>(a)</enum><header>Program required</header><text>The Secretary shall carry out a program under which the Secretary shall provide case management services to improve the retention of housing by veterans who were previously homeless and are transitioning to permanent housing and veterans who are at risk of becoming homeless.</text> </subsection><subsection id="id8C20691C58BA403BBE5B10EED3946149"><enum>(b)</enum><header>Grants</header><paragraph commented="no" display-inline="yes-display-inline" id="idE5048A54C2E94135A81E27AAAC3CD42F"><enum>(1)</enum><text>The Secretary shall carry out the program through the award of grants.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="idA6B7938A9D9C485FB6891C673D0C6919" indent="up1" reported-display-style="italic"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id2BE6D292B77949988B0C1158DBF069D5"><enum>(A)</enum><text>In awarding grants under paragraph (1), the Secretary shall give priority to organizations that demonstrate a capability to provide case management services as described in subsection (a), particularly organizations that are successfully providing or have successfully provided transitional housing services using amounts provided by the Secretary under sections 2012 and 2061 of this title.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id685A8A77BE934AB99138F7ED1480A513" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>In giving priority under subparagraph (A), the Secretary shall give extra priority to an organization described in such subparagraph that—</text> <clause id="idBB10A7B2F87049B0A841D9DDDCDBC3C3"><enum>(i)</enum><text>voluntarily stops receiving amounts provided by the Secretary under sections 2012 and 2061 of this title; and</text> </clause><clause id="idCDEF33E4ED914F3B9632C756CE8BF6EB"><enum>(ii)</enum><text>converts a facility that the organization used to provide transitional housing services into a facility that the organization uses to provide permanent housing that meets housing quality standards established under section 8(o)(8)(B) of the United States Housing Act of 1937 (<external-xref legal-doc="usc" parsable-cite="usc/42/1437f">42 U.S.C. 1437f(o)(8)(B)</external-xref>).</text> </clause></subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id1207736DD1BD4B6BA87C11012D9463A5" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>In any case in which a facility, with respect to which a person received a grant for construction, rehabilitation, or acquisition under section 2011 of this title, is converted as described in subparagraph (B)(ii), such conversion shall be considered to have been carried out pursuant to the needs of the Department and such person shall not be considered in non-compliance with the terms of such grant by reason of such conversion.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="id87DFD82E2252421CBC7A498B8F6282C1"><enum>(2)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 20 of such title is amended by striking the item relating to section 2013 and inserting the following new items:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id3D69898BBD3B4A06886B7CFAE52E16D7" reported-display-style="italic" style="OLC"><toc changed="added" committee-id="SSVA00" reported-display-style="italic"><toc-entry bold="off" level="section">2013. Program to improve retention of housing by formerly homeless veterans and veterans at risk of becoming homeless.</toc-entry><toc-entry bold="off" level="section">2014. Authorization of appropriations.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id1EEEBB54BED84E6BA34F965A1A0A3602"><enum>(b)</enum><header>Regulations</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall prescribe regulations to carry out section 2013 of such title, as added by subsection (a)(1)(B).</text> </subsection><subsection id="idD7EC2D706EC8457BA72DC9326F6982CA"><enum>(c)</enum><header>Report</header> <paragraph id="id0EE9099B0AE149B281A17CC1C69CA96D"><enum>(1)</enum><header>In general</header><text>Not later than June 1, 2019, 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 program required by section 2013 of such title, as added by subsection (a)(1)(B).</text> </paragraph><paragraph id="idA0703EBA76AB4CCC9B4769F157F4D085"><enum>(2)</enum><header>Contents</header><text>The report submitted under paragraph (1) shall include assessments of the following:</text> <subparagraph id="idC54C22F737504EAF951C900DAB0BD9C2"><enum>(A)</enum><text>The percentage of veterans who received case management services under the program who were able to retain permanent housing by the end of the program, disaggregated by each recipient of a grant under such section.</text> </subparagraph><subparagraph id="id0ADBEEB03AA544BB82991D9B2B70DBC7"><enum>(B)</enum><text>The percentage of veterans who received case management services under the program who were not in permanent housing at the end of the program, disaggregated by housing status and reason for failing to retain permanent housing under the program.</text> </subparagraph><subparagraph id="id7781A14AD1604E0D961A91F6ADE5F166"><enum>(C)</enum><text>The use by veterans who received case management services under the program of housing assistance furnished by the Department of Veterans Affairs, including a comparison of the use of such assistance by such veterans before and after receiving such services.</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id05E0E9E94EAF497F8A8F024BA19ED2A3"><enum>(D)</enum><text>An assessment of the employment status of veterans who received case management services under the program, including a comparison of the employment status of such veterans before and after receiving such services.</text> </subparagraph></paragraph></subsection></section><section id="id39FDF0970AE840A0AF379DA1F3C69667"><enum>306.</enum><header>Pilot program on provision of intensive case management interventions to homeless veterans who receive the most health care from the Department of Veterans Affairs</header> <subsection id="id472DBD600D524BAA93A466FADF1A8E45"><enum>(a)</enum><header>Pilot program required</header><text>Not later than September 1, 2016, the Secretary of Veterans Affairs shall commence a pilot program to assess the feasibility and advisability of providing intensive case management interventions to covered veterans.</text> </subsection><subsection id="idBDA2288D0D82482382A5A44EF19BB38A"><enum>(b)</enum><header>Covered veterans</header><text>For purposes of the pilot program, a covered veteran is a veteran who is enrolled in—</text> <paragraph id="idECE07643D06D40C8A7C35489427A7CEB"><enum>(1)</enum><text>the homeless registry of the Department; and</text> </paragraph><paragraph id="id8BD001D0735148AFBB5718C9CF9BC3F2"><enum>(2)</enum><text>the system of annual patient enrollment established and operated by the Secretary under section 1705(a) of title 38, United States Code.</text> </paragraph></subsection><subsection id="idBCC4FE6A148740B5AE6B19E80729FFD0"><enum>(c)</enum><header>Location</header> <paragraph id="id3DDE154E454743C2A6D5DD95A26B3FC0"><enum>(1)</enum><header>In general</header><text>The Secretary shall carry out the pilot program at not fewer than six locations selected by the Secretary for purposes of the pilot program as follows:</text> <subparagraph id="id7DAAB1DEAB9C4445A05ACC51EFC19667"><enum>(A)</enum><text>Not fewer than three locations in cities that have the largest populations of homeless veterans in the United States.</text> </subparagraph><subparagraph id="idB3F9DB31486741F3B28E461AEED419EC"><enum>(B)</enum><text>Not fewer than three locations in suburban or rural settings.</text> </subparagraph></paragraph><paragraph id="id98CEC4BF7E554B30AF90866801268051"><enum>(2)</enum><header>Interaction and coordination with community organizations</header><text>In selecting locations under paragraph (1), the Secretary shall only select locations in areas in which the Secretary determines that there is a high degree of interaction and coordination between the Department and community organizations that provide housing and social services for veterans, such as outreach, employment, and financial assistance for homeless veterans, veterans at risk of becoming homeless, and low-income veterans.</text> </paragraph></subsection><subsection id="id76F5286E6BEB4952AE3DC2703E04EBED"><enum>(d)</enum><header>Provision of intensive case management interventions</header> <paragraph id="id6742357DFF024B4BA3B1D50E816C35F7"><enum>(1)</enum><header>Minimum number of veterans to receive interventions</header><text>In carrying out the program at each location selected under subsection (c), the Secretary shall provide intensive case management interventions to not fewer than 20 covered veterans at each such location who the Secretary determines are the covered veterans at such location who receive the most health care and related services furnished by the Department of Veterans Affairs.</text> </paragraph><paragraph id="id5EC4DA49C1B949429CA923A942C21D3A"><enum>(2)</enum><header>Nature of interventions</header><text>The intensive case management interventions provided to covered veterans under paragraph (1) shall include assistance with gaining and maintaining access to such housing and services, including benefits and services to which covered veterans may be entitled or eligible under the laws administered by the Secretary, as may be necessary to improve the stability of their housing and the appropriateness of the health care that they receive.</text> </paragraph></subsection><subsection id="id2B28DD332C344B5B93743F23C8B3BAD0"><enum>(e)</enum><header>Report</header> <paragraph id="idB7810B6601DD41CE8CDF9AA281C0AD87"><enum>(1)</enum><header>In general</header><text>Not later than December 1, 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 pilot program carried out under this section.</text> </paragraph><paragraph id="id1E0EDBD421AA41C5A5326F4E651E69B4"><enum>(2)</enum><header>Contents</header><text>The report submitted under paragraph (1) shall include assessments of the following:</text> <subparagraph id="idFC7338CB8C4D4517BD58BDEB4C743DF9"><enum>(A)</enum><text>The types and frequencies of intensive case management interventions provided under the pilot program.</text> </subparagraph><subparagraph id="id2DECC41B64BF4DFD8A29E6DD368D5FE2"><enum>(B)</enum><text>The housing status of each veteran who received an intensive case management intervention under the pilot program.</text> </subparagraph><subparagraph id="id0ACCC75084EE4722873CC07BD023D569"><enum>(C)</enum><text>The employment status of each veteran who received an intensive case management intervention under the pilot program, including a comparison of the employment status of such veteran before and after receiving such intervention.</text> </subparagraph><subparagraph id="idE7864B58FCF1477EAD97AB475C1D555E"><enum>(D)</enum><text>The use by veterans who received intensive case management interventions under the pilot program of health care and related services furnished by the Department of Veterans Affairs and the costs incurred by the Department in furnishing such care and services, including a comparison of the use by such veterans of such care and services and the costs incurred from furnishing such care and services before and after receiving such interventions.</text> </subparagraph><subparagraph id="idCC29428182A44FBA8A3844ADD3F8A12A"><enum>(E)</enum><text>The number of veterans who received intensive case management interventions under the pilot program, disaggregated by whether the intensive case management intervention was provided in a location described in subparagraph (A) or (B) of subsection (c)(1).</text> </subparagraph><subparagraph id="id0472011F1BA74676A3058C008DCD3349"><enum>(F)</enum><text>The costs incurred by the Department in carrying out the pilot program, disaggregated by provision of intensive case management interventions in locations described in subparagraphs (A) and (B) of such subsection.</text> </subparagraph><subparagraph id="id2773CE8D23A64C92B3EA755080F9F8C8"><enum>(G)</enum><text>An estimate of the costs the Department would have incurred for the provision of health care and associated services to covered veterans but for the provision of intensive case management interventions under the pilot program, disaggregated by provision of intensive case management interventions in locations described in subparagraphs (A) and (B) of subsection (c)(1).</text> </subparagraph></paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="idBF234D2C862140C9B420A4D982E7F90B"><enum>307.</enum><header>Establishment of National Center on Homelessness Among Veterans</header> <subsection commented="no" display-inline="no-display-inline" id="id76C194AF8DE04C068B684F3672FDB9BB"><enum>(a)</enum><header>In general</header><text>Subchapter VII of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/20">chapter 20</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idC161F9A145954AE49FC2986D8B5F8D62" reported-display-style="italic" style="USC"> <section commented="no" display-inline="no-display-inline" id="idB1A2E2DD88CA4DD381B1F940C2AC487E"><enum>2067.</enum><header>National Center on Homelessness Among Veterans</header> <subsection commented="no" display-inline="no-display-inline" id="id3F65C16EC0D4406AB37616498B2CC605"><enum>(a)</enum><header>In general</header><paragraph commented="no" display-inline="yes-display-inline" id="id22CB76D47134446885AE26CDECC4FBED"><enum>(1)</enum><text>The Secretary shall establish and operate a center to carry out the functions described in subsection (b).</text> </paragraph><paragraph changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id2EA86140B29F47A1BC97885ADC70F215" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The center established under paragraph (1) shall be known as the <quote>National Center on Homelessness Among Veterans</quote>.</text> </paragraph><paragraph changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id9A211927192245AA81F905752CD4B463" indent="up1" reported-display-style="italic"><enum>(3)</enum><text>To the degree practicable, the Secretary shall operate the center established under paragraph (1) independently of the other programs of the Department that address homelessness among veterans.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idAE14E52CDCD54F289990EC01B5B5568A"><enum>(b)</enum><header>Functions</header><text>The functions described in this subsection are as follows:</text> <paragraph id="id1137a5ed4f7e4cd6b54ec590d15b1574"><enum>(1)</enum><text>To carry out and promote research into the causes and contributing factors to veteran homelessness.</text> </paragraph><paragraph id="idC040D061CF564131828220D0563458F6"><enum>(2)</enum><text>To assess the effectiveness of programs of the Department to meet the needs of homeless veterans.</text> </paragraph><paragraph id="idea200a47bff147d3a688cc2efc049f7e"><enum>(3)</enum><text>To identify and disseminate best practices with regard to housing stabilization, income support, employment assistance, community partnerships, and such other matters as the Secretary considers appropriate with respect to addressing veteran homelessness.</text> </paragraph><paragraph id="id5f27fc6e14464e2896ca5305da140e98"><enum>(4)</enum><text>To integrate evidence-based and best practices, policies, and programs into programs of the Department for homeless veterans and veterans at risk of homelessness and to ensure that the staff of the Department and community partners can implement such practices, policies, and programs.</text> </paragraph><paragraph id="ide245fa53ef85428198723d9ec9201155"><enum>(5)</enum><text>To serve as a resource center for, and promote and seek to coordinate the exchange of information regarding, all research and training activities carried out by the Department and by other Federal and non-Federal entities with respect to veteran homelessness.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" display-inline="no-display-inline" id="id50A27F805F094ED89E97093E7384224B"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 20 of such title is amended by inserting after the item relating to section 2066 the following new item:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id4F248C0AB136462BA9513B15B510D16B" reported-display-style="italic" style="OLC"><toc changed="added" committee-id="SSVA00" reported-display-style="italic"><toc-entry bold="off" level="section">2067. National Center on Homelessness Among Veterans.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection></section><section commented="no" display-inline="no-display-inline" id="id55C43DA6EE7B458B8756EBA7EFD736AC" section-type="subsequent-section"><enum>308.</enum><header display-inline="yes-display-inline">Partnerships with public and private entities to provide legal services to homeless veterans and veterans at risk of homelessness</header> <subsection commented="no" display-inline="no-display-inline" id="id4306ecc01374487ea82404ad0637eeb9"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/20">Chapter 20</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/2022">section 2022</external-xref> the following new section:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="ide13d8b6744a94f6fbf165ade82691e33" reported-display-style="italic" style="USC"> <section commented="no" display-inline="no-display-inline" id="id44b8d5c09a794f238025f928d276d684" section-type="subsequent-section"><enum>2022A.</enum><header display-inline="yes-display-inline">Partnerships with public and private entities to provide legal services to homeless veterans and veterans at risk of homelessness</header> <subsection commented="no" display-inline="no-display-inline" id="id1292180006634ddb81aaa9d115fb2931"><enum>(a)</enum><header display-inline="yes-display-inline">Partnerships authorized</header><text display-inline="yes-display-inline">Subject to the availability of funds for that purpose, the Secretary may enter into partnerships with public or private entities to fund a portion of the general legal services specified in subsection (c) that are provided by such entities to homeless veterans and veterans at risk of homelessness.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="id031f45b16bb34c7faebe1ab3f85661d0"><enum>(b)</enum><header display-inline="yes-display-inline">Locations</header><paragraph commented="no" display-inline="yes-display-inline" id="id30969076EEB149C484969619EC88645F"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary shall ensure that, to the extent practicable, partnerships under this section are made with entities equitably distributed across the geographic regions of the United States, including rural communities, tribal lands of the United States, Native Americans, and tribal organizations.</text> </paragraph><paragraph changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="idAF6D05D7811B479AA7FEA744A829CBA5" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>In this subsection, the terms <term>Native American</term> and <term>tribal organization</term> have the meanings given such terms in section 3765 of this title.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idafe415bfd36149b492afe8618ab12b82"><enum>(c)</enum><header display-inline="yes-display-inline">Legal services</header><text display-inline="yes-display-inline">Legal services specified in this subsection include legal services provided by public or private entities that address the needs of homeless veterans and veterans at risk of homelessness, such as the following:</text> <paragraph commented="no" display-inline="no-display-inline" id="idaf2f9dd12cb7494f90d1d4519a9fb204"><enum>(1)</enum><text display-inline="yes-display-inline">Legal services related to housing, including eviction defense and representation in landlord-tenant cases.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idbdf9d90a72534a01ad9e0042aee02075"><enum>(2)</enum><text display-inline="yes-display-inline">Legal services related to family law, including assistance in court proceedings for child support, divorce, and estate planning.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idfd821f4fc1fb47cb872d46a7a589043e"><enum>(3)</enum><text display-inline="yes-display-inline">Legal services related to income support, including assistance in obtaining public benefits.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id36C58C66D8314630992EC06EEFBFE13D"><enum>(4)</enum><text display-inline="yes-display-inline">Legal services related to criminal defense, including defense in matters symptomatic of homelessness, such as outstanding warrants, fines, and driver's license revocation, to reduce recidivism and facilitate the overcoming of reentry obstacles in employment or housing.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id9da052b790c24844b9d3bd5725ba37bf"><enum>(d)</enum><header display-inline="yes-display-inline">Consultation</header><text display-inline="yes-display-inline">In developing and carrying out partnerships under this section, the Secretary shall, to the extent practicable, consult with public and private entities—</text> <paragraph commented="no" display-inline="no-display-inline" id="id00b91ff164f749ca9c40827069143d69"><enum>(1)</enum><text display-inline="yes-display-inline">for assistance in identifying and contacting organizations described in subsection (c); and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id4dc9cc03994c43b599c3f244e990c284"><enum>(2)</enum><text display-inline="yes-display-inline">to coordinate appropriate outreach relationships with such organizations.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id80856D1E58E6469BAADC933B08BE780C"><enum>(e)</enum><header display-inline="yes-display-inline">Reports</header><text display-inline="yes-display-inline">The Secretary may require entities that have entered into partnerships under this section to submit to the Secretary periodic reports on legal services provided to homeless veterans and veterans at risk of homelessness pursuant to such partnerships.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" display-inline="no-display-inline" id="idDCB6FA6E38C74F78A46689E7E5AC5EEC"><enum>(b)</enum><header display-inline="yes-display-inline">Clerical amendment</header><text display-inline="yes-display-inline">The table of sections at the beginning of chapter 20 of such title is amended by adding after the item relating to section 2022 the following new item:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id96DA8A1067484073A7B064692685CB22" reported-display-style="italic" style="OLC"><toc changed="added" committee-id="SSVA00" reported-display-style="italic"><toc-entry bold="off" level="section">2022A. Partnerships with public and private entities to provide legal services to homeless veterans and veterans at risk of homelessness.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection></section><section id="id2EBDF2092E1D4A2C821DE35B22DEE6FA"><enum>309.</enum><header>Administrative improvements to grant and per diem programs of Department of Veterans Affairs</header><text display-inline="no-display-inline">Section 2012 of title 38, United States Code, is amended—</text> <paragraph id="idE6DD976D7A374AA783CD47375C771BCD"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a)(1), in the matter before subparagraph (A), by inserting <quote>and except as otherwise provided in this section</quote> after <quote>such purpose</quote>; and</text> </paragraph><paragraph id="id707F5FF9B21747D795D3E984ED05C4C6"><enum>(2)</enum><text display-inline="yes-display-inline">by adding at the end the following new subsection:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id244FEFE491B04B53B590A53536F174EA" reported-display-style="italic" style="OLC"> <subsection id="id37C02E2B35984FD39097BBB468EAEBF9"><enum>(e)</enum><header>Review and conditional renewal</header><paragraph commented="no" display-inline="yes-display-inline" id="id45F812C3BDC241CF93DAAB622DA1ABE9"><enum>(1)</enum><text>Each year, the Secretary shall review each grant recipient and eligible entity that received a per diem payment under this section for a service furnished to a veteran during the one-year period preceding the review to evaluate the performance of the grant recipient or eligible entity during that period with respect to—</text> <subparagraph changed="added" committee-id="SSVA00" id="id32CBC7D31F68421091CFC5F71570150B" indent="up1" reported-display-style="italic"><enum>(A)</enum><text>the success of the grant recipient or eligible entity in assisting veterans to obtain, transition into, and retain permanent housing; and</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id82DA756E26FD491F954CFC2EF88827A1" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>increasing the income of veterans, whether by helping veterans obtain employment or by helping veterans obtain income-related benefits to which such veterans may be eligible or entitled.</text> </subparagraph></paragraph><paragraph changed="added" committee-id="SSVA00" id="idAEB2D9EF338D4008B770FAEAD3C3644A" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>For any grant recipient or eligible entity whose performance was evaluated for a year under paragraph (1), the Secretary may only provide per diem under this section to that grant recipient or eligible entity in the following year if the Secretary determines that such performance merits continued receipt of per diem under this section.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="id4B6D4F2B4A5F4BBB8B9F0A6610293FAE" indent="up1" reported-display-style="italic"><enum>(3)</enum><text>The Secretary shall establish uniform performance targets throughout the United States for all grant recipients and eligible entities that receive per diem payments under this section for purposes of evaluating the performance of each such grant recipient and eligible entity under this subsection.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></section><section commented="no" display-inline="no-display-inline" id="idFC9C0B45DE244BABBF9CC815009A0243" section-type="subsequent-section"><enum>310.</enum><header display-inline="yes-display-inline">Repeal of requirement for annual reports on assistance to homeless veterans</header> <subsection commented="no" display-inline="no-display-inline" id="idF0CE417A262040B79E8768CA5CBDEB57"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Section 2065 of title 38, United States Code, is hereby repealed.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="id378E8A9277B144C59A375DC2BC2708BB"><enum>(b)</enum><header display-inline="yes-display-inline">Clerical amendment</header><text display-inline="yes-display-inline">The table of sections at the beginning of chapter 20 of such title is amended by striking the item relating to section 2065.</text> </subsection></section><section commented="no" display-inline="no-display-inline" id="id14E7E6ADD4704FF290CF2777E45392B0"><enum>311.</enum><header>Comptroller General of the United States study on homeless veterans programs of Department of Veterans Affairs</header> <subsection id="iddc8b14b2b608400ebcf5fb6d44157832"><enum>(a)</enum><header>In general</header><text>Not later than 270 days after the date of the enactment of this Act, the Comptroller General of the United States shall complete a study of programs of the Department of Veterans Affairs that provide assistance to homeless veterans.</text> </subsection><subsection id="id7514b799734e46dca03c0130efce2111"><enum>(b)</enum><header>Elements</header><text>The study required by subsection (a) shall include the following:</text> <paragraph id="id8a3172922e6d4001ad9aef9ae1b02ad9"><enum>(1)</enum><text>An assessment of whether programs described in subsection (a) are meeting the needs of veterans who are eligible for assistance provided by such programs, including any gaps or duplication in the provision of services.</text> </paragraph><paragraph id="id6c3ed53c04af41aa8ee2914543fc1cc4"><enum>(2)</enum><text>A review of recent efforts of the Secretary of Veterans Affairs to improve the privacy, safety, and security of female veterans receiving assistance from such programs.</text> </paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id0E1D07C1D08241ADABD284AB88E319A3" section-type="subsequent-section"><enum>312.</enum><header display-inline="yes-display-inline">Requirement for Department of Veterans Affairs to assess comprehensive service programs for homeless veterans</header> <subsection commented="no" display-inline="no-display-inline" id="idFD755BDB2C524453AB8D9D756D628BD3"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall—</text> <paragraph commented="no" display-inline="no-display-inline" id="id4A50A807594742EEB522057D8A62A444"><enum>(1)</enum><text display-inline="yes-display-inline">assess and measure the capacity of programs for which entities receive grants under section 2011 of title 38, United States Code, or per diem payments under section 2012 or 2061 of such title; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id6CB9254E0B224920BD40AEC8771B3EBA"><enum>(2)</enum><text>assess such programs with respect to—</text> <subparagraph commented="no" display-inline="no-display-inline" id="id00CC4B17612C4A5C99F1D83BFB1CD1C3"><enum>(A)</enum><text>how well they achieve their stated goals at a national level;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id0ADF855544FD456C9D069852B8BE5C23"><enum>(B)</enum><text>placements in permanent housing;</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idC6E760A8BC3E44729422D01D76368BFE"><enum>(C)</enum><text>placements in employment; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idCCE7F8E733D448C99F98236F84EF35F8"><enum>(D)</enum><text>increases in the regular income of participants in the programs.</text> </subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id122C101FD41A4286A324CD9880D83BE3"><enum>(b)</enum><header display-inline="yes-display-inline">Assessment at national and local levels</header><text display-inline="yes-display-inline">In assessing and measuring under subsection (a)(1), the Secretary shall develop and use tools to examine the capacity of programs described in such subsection at both the national and local level in order to assess the following:</text> <paragraph commented="no" display-inline="no-display-inline" id="id17C9E2EC13A047E5BB899748EAA05336"><enum>(1)</enum><text display-inline="yes-display-inline">Whether sufficient capacity exists to meet the needs of homeless veterans in each geographic area.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id1227595A367548558BB807509AE2F1B6"><enum>(2)</enum><text display-inline="yes-display-inline">Whether existing capacity meets the needs of the subpopulations of homeless veterans located in each geographic area.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id49EE062B6B9D4B7BB3F3FC87130FD38C"><enum>(3)</enum><text display-inline="yes-display-inline">The amount of capacity that recipients of grants under sections 2011 and 2061 and per diem payments under section 2012 of such title have to provide services for which the recipients are eligible to receive per diem under section 2012(a)(2)(B)(ii) of title 38, United States Code, as added by section 302(5)(B).</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id9C2C9F9F77184A56A46D007A04B9C24A"><enum>(c)</enum><header>Consideration of other resources</header><text display-inline="yes-display-inline">In assessing and measuring programs under subsection (a)(1), the Secretary shall consider the availability to such programs of resources made available to such programs and to homeless veterans, including resources provided by the Department of Veterans Affairs and by entities other than the Department.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="idF838BCC228E548619C71A1AA055B4ACA"><enum>(d)</enum><header display-inline="yes-display-inline">Use of information</header><text display-inline="yes-display-inline">The Secretary shall use the information collected under this section as follows:</text> <paragraph commented="no" display-inline="no-display-inline" id="idf60635926cd04035a0eac540279dbde3"><enum>(1)</enum><text display-inline="yes-display-inline">To set specific goals to ensure that programs described in subsection (a) are effectively serving the needs of homeless veterans.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idf8e9a95332b742859f01858da9420334"><enum>(2)</enum><text display-inline="yes-display-inline">To assess whether programs described in subsection (a) are meeting goals set under paragraph (1).</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id763ba44f76074da8b581bb4246eccce4"><enum>(3)</enum><text display-inline="yes-display-inline">To inform funding allocations for programs described in subsection (a).</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idb641e2ddd7f641ef94f325f72a05744a"><enum>(4)</enum><text display-inline="yes-display-inline">To improve the referral of homeless veterans to programs described in subsection (a).</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id637163D715274BC2AAAF82B7CA9081BF"><enum>(e)</enum><header display-inline="yes-display-inline">Report</header><text display-inline="yes-display-inline">Not later than 180 days after the date on which the assessment required by subsection (a) is completed, 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 such assessment and such recommendations for legislative and administrative action as the Secretary may have to improve the programs and per diem payments described in subsection (a).</text> </subsection></section><section commented="no" display-inline="no-display-inline" id="idA02B5C8950F74E79AB3A48AE2D2571BE"><enum>313.</enum><header>Report on outreach relating to increasing the amount of housing available to veterans</header><text display-inline="no-display-inline">Not later than one year 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 describing and assessing the outreach conducted by the Secretary to realtors, landlords, property management companies, and developers to educate them about the housing needs of veterans and the benefits of having veterans as tenants.</text> </section><enum>IV</enum><header>Health care matters</header> <section changed="added" id="idFCEDFAD3B23644BE8D887AF280DD5E89" reported-display-style="italic"><enum>401.</enum><header>Short title</header><text display-inline="no-display-inline">This title may be cited as the <quote><short-title>Jason Simcakoski Memorial Act</short-title></quote>.</text> </section><subtitle changed="added" id="id226F7912671B4E9BAD7EBB6BA2764C54" reported-display-style="italic" style="OLC"><enum>A</enum><header>Employment of directors and health care providers</header> <section changed="added" committee-id="SSVA00" id="idB55B00273D9248BF938A3BC9B8922990" reported-display-style="italic"><enum>411.</enum><header>Extension of period for increase in graduate medical education residency positions at medical facilities of the Department of Veterans Affairs</header> <subsection id="id9274FD68164844FAACF25C2BC1353F9F"><enum>(a)</enum><header>In general</header><text>Paragraph (2) of section 301(b) of the Veterans Access, Choice, and Accountability Act of 2014 (<external-xref legal-doc="public-law" parsable-cite="pl/113/146">Public Law 113–146</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/7302">38 U.S.C. 7302</external-xref> note) is amended—</text> <paragraph id="id237F3DF8EBD74F3BBDCE19A9AF6B719A"><enum>(1)</enum><text>in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC">Five-year</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Ten-year</header-in-text></quote>; and</text> </paragraph><paragraph id="id45EE4D0027BB43F38EA2E2CDA314A07A"><enum>(2)</enum><text>in subparagraph (A), by striking <quote>5-year period</quote> and inserting <quote>10-year period</quote>.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idC3D7FE7EA54741E9B2269723664035F6"><enum>(b)</enum><header>Report</header><text>Paragraph (3)(A) of such section is amended by striking <quote>until 2019</quote> and inserting <quote>until 2024</quote>.</text> </subsection></section><section changed="added" committee-id="SSVA00" id="idAC4ADDDFDA934CE18CC9285F97457C0D" reported-display-style="italic"><enum><added-phrase reported-display-style="italic">412.</added-phrase></enum><header>Modification of hours of employment for physicians and physician assistants employed by the Department of Veterans Affairs</header><text display-inline="no-display-inline">Section 7423(a) of title 38, United States Code, is amended—</text> <paragraph id="id5EDF0B81E2DE4770AD869EA7F63D7421"><enum>(1)</enum><text>by striking <quote>(a) The hours</quote> and inserting <quote>(a)(1) Except as provided in paragraph (2), the hours</quote>; and</text> </paragraph><paragraph id="id4CBC2D7F02A947CA929A34C92DA08382"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idC1C660413A6048CA868AE141A8B88DA5" reported-display-style="italic" style="OLC"> <paragraph commented="no" display-inline="no-display-inline" id="id087D501AD2CE4C6FBA3C3FF0924FAD93" indent="up1"><enum>(2)</enum><text>The Secretary may modify the hours of employment for a physician or physician assistant appointed in the Administration under any provision of this chapter on a full-time basis to be more than or less than 80 hours in a biweekly pay period if the total hours of employment for such employee in a calendar year does not exceed 2,080 hours.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></section><section changed="added" committee-id="SSVA00" id="id42F32A568058464D9A83997D4EDC609D" reported-display-style="italic"><enum><added-phrase reported-display-style="italic">413.</added-phrase></enum><header>Requirement that physician assistants employed by the Department of Veterans Affairs receive competitive pay</header> <subsection id="id51AEE790779D4A87B7C38CE9ADB1AD88"><enum><added-phrase reported-display-style="italic">(a)</added-phrase></enum><header>In general</header><text display-inline="yes-display-inline">Section 7451(a)(2) of title 38, United States Code, is amended—</text> <paragraph id="idBFA0415AEAE94774A410F91847537AA0"><enum>(1)</enum><text>by redesignating subparagraph (B) as subparagraph (C);</text> </paragraph><paragraph id="id8763DA0795484A2E8F17FF32A3BFB2D5"><enum>(2)</enum><text>by inserting after subparagraph (A) the following new subparagraph (B):</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id39AE1BCE6D0A4B89BF75439E5D812CF1" reported-display-style="italic" style="OLC"> <subparagraph id="id209D1435F6D241E4A54DF09602E65345" indent="up1"><enum>(B)</enum><text>Physician assistant.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idE700CD02513F4D0D80D8A8A4A1668330"><enum>(3)</enum><text>in subparagraph (C), as redesignated by paragraph (1), by striking <quote>and registered nurse</quote> and inserting <quote>registered nurse, and physician assistant</quote>.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id32225E39463C440381DB4E13B6354E4A"><enum><added-phrase reported-display-style="italic">(b)</added-phrase></enum><header>Effective date</header><text>The amendments made by subsection (a) shall take effect on the date that is one year after the date of the enactment of this Act.</text> </subsection></section><section changed="added" committee-id="SSVA00" id="idEF7B90FB1FF347B2BE24D10D291E44AC" reported-display-style="italic"><enum><added-phrase reported-display-style="italic">414.</added-phrase></enum><header>Establishment of positions of Directors of Veterans Integrated Service Networks in Office of Under Secretary for Health of Department of Veterans Affairs and modification of qualifications for Medical Directors</header><text display-inline="no-display-inline">Section 7306(a)(4) of title 38, United States Code, is amended—</text> <paragraph id="idB3FCD9D2F9FD43188F234CA539C3BA23"><enum>(1)</enum><text display-inline="yes-display-inline">by inserting <quote>and Directors of Veterans Integrated Service Networks</quote> after <quote>Such Medical Directors</quote>; and</text> </paragraph><paragraph id="idC318C630A7BE426ABAF50DE949FCC238"><enum>(2)</enum><text display-inline="yes-display-inline">by striking <quote>, who shall be either a qualified doctor of medicine or a qualified doctor of dental surgery or dental medicine</quote>.</text> </paragraph></section><section changed="added" committee-id="SSVA00" id="idC629FC2D98DC47D786B3AA21F8B85E17" reported-display-style="italic"><enum><added-phrase reported-display-style="italic">415.</added-phrase></enum><header>Pay for Medical Directors and Directors of Veterans Integrated Service Networks</header> <subsection id="id4008D5A391D641C38E111101DBA8DC47"><enum>(a)</enum><header>In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/74">Chapter 74</external-xref> of title 38, United States Code, is amended by adding at the end the following new subchapter:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id8744F50E5D674EE08A0900AC90804948" reported-display-style="italic" style="USC"> <subchapter id="id3AF6C7F039EE40F99B380F4E7E751530" style="OLC"><enum>VII</enum><header>Pay for Medical Directors and Directors of Veterans Integrated Service Networks</header> <section id="id304a435ea712474e83af70f7f7b352f2"><enum>7481.</enum><header>Pay for Medical Directors and Directors of Veterans Integrated Service Networks</header> <subsection id="id8080d9632f224b5ebbf3573ffcea47bb"><enum>(a)</enum><header>Elements of pay</header><text>Pay for a Medical Director or Director of a Veterans Integrated Service Network appointed under section 7306(a)(4) of this title (in this section referred to as a <quote>Director</quote>) shall consist of basic pay set forth under section 7404(a) of this title and market pay determined under subsection (b).</text> </subsection><subsection id="idc6dcd6e6c9f94dfdb3b2946ef986b605"><enum>(b)</enum><header>Market pay</header><paragraph commented="no" display-inline="yes-display-inline" id="id9758DEFFA4EF4AC68DE7567BC2AB3021"><enum>(1)</enum><text>Each Director is eligible for market pay determined under this subsection.</text> </paragraph><paragraph changed="added" commented="no" committee-id="SSVA00" id="idb34b84c71dbf4bbbba5d236cd3f1361b" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The amount of market pay payable to a Director under this section shall be determined by the Secretary on a case-by-case basis and shall consist of pay intended to reflect needs of the Department with respect to the recruitment and retention (as determined by the Secretary) of such Director.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="id6bd9f184040b42f09f7708c5893fd6ce" indent="up1" reported-display-style="italic"><enum>(3)</enum><text>In determining the amount of market pay payable to a Director under this section, the Secretary shall—</text> <subparagraph id="id7413b3934d5245fa97722a1eac8e0d40"><enum>(A)</enum><text>consult not less than two national surveys on pay for hospital directors, medical facility directors, or other similar positions, whether prepared by private, public, or quasi-public entities, to make a general assessment of the range of potential pay for the Director; and</text> </subparagraph><subparagraph id="id5933dbbfbbc0447babad4ad59ab7b101"><enum>(B)</enum><text>take into account—</text> <clause id="id7af10217a91747059f6a0e63e4cfafa4"><enum>(i)</enum><text>the experience of the Director in managing facilities or program offices of the Department, including the complexity of such facilities or offices;</text> </clause><clause id="idf1fd57925e1541f0aaf92e5cc9b15ff8"><enum>(ii)</enum><text>the complexity of the facility or facilities to be managed by the Director;</text> </clause><clause id="id618707121e4c489f8a036ae46ddcb5df"><enum>(iii)</enum><text>the labor market, in such geographic area as the Secretary considers relevant, for hospital directors, medical facility directors, and other similar positions;</text> </clause><clause id="id4d49ba3d6efd4a66986bc5a0c7e30a47"><enum>(iv)</enum><text>the experience of the Director in managing medical facilities for other Federal agencies, private entities, or non-profit entities; and</text> </clause><clause id="id38ab32e9b2284c39ace23630accee3e8"><enum>(v)</enum><text>such other considerations as the Secretary considers appropriate.</text> </clause></subparagraph></paragraph><paragraph changed="added" committee-id="SSVA00" id="id91e79bf5e15b4c248a4d8673802c5f5b" indent="up1" reported-display-style="italic"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id46ECDD48A6DD46A7BF76A6395A4C380D"><enum>(A)</enum><text>The Secretary shall evaluate the amount of market pay payable to a Director under this section not less frequently than once every two years and may adjust the market pay payable to such Director as a result of such evaluation.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id26699D108FAC4617BB7307CC2E01BE3E" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>A Director whose market pay is evaluated under subparagraph (A) shall receive written notice of the results of such evaluation.</text> </subparagraph></paragraph></subsection><subsection id="idb6b29b31516446a4b5fd6277b385f693"><enum>(c)</enum><header>Requirements and limitations on total pay</header><paragraph commented="no" display-inline="yes-display-inline" id="id892942B30BCF47FFAB4D54214EB1C2C0"><enum>(1)</enum> <text>Not less frequently than once every two years, the Secretary shall set forth a Department-wide minimum and maximum amount for total annual pay under subsection (a) that may be paid to a Director and shall publish each such amount in the Federal Register.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="idF63DF453F0F34F379397464B9AED9FA4" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The minimum and maximum amounts set forth under paragraph (1) shall take effect not earlier than the date that is 60 days after the publication of such amounts under such paragraph.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="id79AB56E8332A45CCA3BB56EE00246C3B" indent="up1" reported-display-style="italic"><enum>(3)</enum><text>The sum of the basic pay set forth under section 7404(a) of this title and market pay determined under subsection (b) for a Director for a calendar year—</text> <subparagraph id="id000330A03AE945F1A4281F7FA7FD7241"><enum>(A)</enum><text>may not be less than the most recent minimum amount set forth under paragraph (1) before the beginning of such calendar year; and</text> </subparagraph><subparagraph id="id05102E0B26EB44D2BE2FD44015196DF4"><enum>(B)</enum><text>may not be more than the most recent maximum amount set forth under such paragraph before the beginning of such calendar year.</text> </subparagraph></paragraph><paragraph changed="added" committee-id="SSVA00" id="idDAB0CBF9D5554464A4BCF111B16CA4D3" indent="up1" reported-display-style="italic"><enum>(4)</enum><text>The total amount of compensation paid to a Director under this title in any calendar year may not exceed the amount of annual compensation (excluding expenses) of the President under section 102 of title 3.</text> </paragraph><paragraph changed="added" commented="no" committee-id="SSVA00" id="idC05990B57590414AA572C9A425865E17" indent="up1" reported-display-style="italic"><enum>(5)</enum><text>The Secretary may not delegate to an officer or employee of the Department the requirement of the Secretary to set forth a Department-wide minimum and maximum amount under paragraph (1).</text> </paragraph></subsection><subsection id="idba6819cfe5ef49f2a6dfb2a4f3009e15"><enum>(d)</enum><header>Treatment of pay</header><text>Pay under this section shall be considered pay for all purposes, including retirement benefits under chapters 83 and 84 of title 5 and other benefits.</text> </subsection><subsection id="id75b5febd0cd045ecab233c579315a344"><enum>(e)</enum><header>Ancillary effects of decreases in pay</header><paragraph commented="no" display-inline="yes-display-inline" id="id4E6B36C569C542F2B07740D4537C5069"><enum>(1)</enum> <text>A decrease in pay of a Director resulting from an adjustment in the amount of market pay of the Director under subsection (b) shall not be treated as an adverse action.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="id6760c6f9ca944a4697530f1cc97ebf81" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>A decrease in the amount of pay of a Director resulting from an involuntary reassignment in connection with a disciplinary action taken against the Director is not subject to appeal or judicial review.</text> </paragraph></subsection></section></subchapter><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="id46D60FE679364CE787926B0AE33FF92A"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 74 of such title is amended by adding at the end the following:</text> <quoted-block changed="added" committee-id="SSVA00" id="idfdb4671c-353e-459a-98e8-6be206b1710a" reported-display-style="italic" style="OLC"><toc changed="added" committee-id="SSVA00" reported-display-style="italic"><toc-entry idref="id3AF6C7F039EE40F99B380F4E7E751530" level="subchapter">Subchapter VII. Pay for Medical Directors and Directors of Veterans Integrated Service Networks</toc-entry> <toc-entry idref="id304a435ea712474e83af70f7f7b352f2" level="section">7481. Pay for Medical Directors and Directors of Veterans Integrated Service Networks.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="idA747D0C40C1E4F31AFDBC6E07161051E"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on the date that is one year after the date of the enactment of this Act.</text> </subsection></section><section changed="added" id="id12133B22D3CE415482B726F28137B3DD" reported-display-style="italic"><enum><added-phrase reported-display-style="italic">416.</added-phrase></enum><header>Additional requirements for hiring of health care providers by Department of Veterans Affairs</header> <subsection id="idC12EC82BB4624D4DAEA54330D200C2DC"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall, as part of the hiring process for each health care provider considered for a position at the Department of Veterans Affairs after the date of the enactment of this Act, require from the medical board of each State in which the health care provider holds or has held a medical license—</text> <paragraph id="id0FBAED4558644C308F94B1F2AA959770"><enum>(1)</enum><text display-inline="yes-display-inline">information on any violation of the requirements of the medical license of the health care provider; and</text> </paragraph><paragraph id="id171541E3D252452A8CF70350037CF167"><enum>(2)</enum><text display-inline="yes-display-inline">information on whether the health care provider has entered into any settlement agreement for a disciplinary charge relating to the practice of medicine by the health care provider.</text> </paragraph></subsection><subsection id="id69A0192144F54EC7BFDA73F7A3E1D1F9"><enum>(b)</enum><header>Regulations</header><text>The Secretary shall prescribe regulations to carry out this section.</text> <pagebreak></pagebreak></subsection></section><section changed="added" id="id4A2F6B7516364A6A87B78F310FE5AE44" reported-display-style="italic"><enum><added-phrase reported-display-style="italic">417.</added-phrase></enum><header>Provision of information on health care providers of Department of Veterans Affairs to State medical boards</header> <subsection id="id34BC5CF3CC154ADDB995FC5F61CCB55F"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Notwithstanding section 552a of title 5, United States Code, the Secretary of Veterans Affairs shall, with respect to each health care provider of the Department of Veterans Affairs that has violated a requirement of their medical license, provide to the medical board of each State in which the health care provider is licensed or practices all relevant information contained in the State Licensing Board Reporting File or any successor file of the Department with respect to such violation.</text> </subsection><subsection id="id4F0E9FDCD9C7406389AA191C1C5AF9D9"><enum>(b)</enum><header>No request required</header><text>The Secretary shall provide the information required in subsection (a) to a medical board described in such subsection notwithstanding that such board may not have formally requested such information from the Department.</text> </subsection></section><section changed="added" id="id399893690B4541C18E17EDFA16A6DCA5" reported-display-style="italic"><enum><added-phrase reported-display-style="italic">418.</added-phrase></enum><header>Report on compliance by Department of Veterans Affairs with reviews of health care providers leaving the Department or transferring to other facilities</header><text display-inline="no-display-inline">Not later than two years 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 compliance by the Department of Veterans Affairs with the policy of the Department—</text> <paragraph id="id0103A17245F94543B7624E7D9AEDC917"><enum>(1)</enum><text display-inline="yes-display-inline">to conduct a review of each health care provider of the Department who transfers to another medical facility of the Department or leaves the Department to determine whether there are any concerns, complaints, or allegations of violations relating to the medical practice of the health care provider; and</text> </paragraph><paragraph id="idECAD4C8743CC412E8FDC4BA82351527E"><enum>(2)</enum><text>to take appropriate action with respect to any such concern, complaint, or allegation.</text> </paragraph></section></subtitle><subtitle changed="added" id="id92B8E473B086498EACC5F946239C5AFA" reported-display-style="italic" style="OLC"><enum>B</enum><header>Opioid therapy and pain management</header> <section id="idDAAD69EB530D45D6A06CC73D02917A07"><enum>421.</enum><header>Guidelines on management of opioid therapy by Department of Veterans Affairs and Department of Defense and implementation of such guidelines by Department of Veterans Affairs</header> <subsection id="idDA959D515F514BDD90A864CA08C66865"><enum>(a)</enum><header>Guidelines</header> <paragraph id="idC7E0C70346BC40258B4F629D93CAA776"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs and the Secretary of Defense shall jointly update the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain to include the following:</text> <pagebreak></pagebreak><subparagraph commented="no" display-inline="no-display-inline" id="id96d8ee6cff4c4dbebf5f947af79e00d3"><enum>(A)</enum><text display-inline="yes-display-inline">Except as provided in paragraph (2), guidelines developed by the Centers for Disease Control and Prevention for safely prescribing opioids for the treatment of chronic, non-cancer pain in outpatient settings upon the release of such guidelines by the Centers for Disease Control and Prevention.</text> </subparagraph><subparagraph id="id4c2c78cade4d4aa8a26cf8799e5a253e"><enum>(B)</enum><text>Enhanced guidance with respect to absolute contraindications for opioid therapy, including guidance with respect to the following:</text> <clause id="idc6f58e7d34624f21bda15c80afafb1b5"><enum>(i)</enum><text>The coadministration of drugs that are capable of inducing a life-limiting drug-drug interaction, including benzodiazepines.</text> </clause><clause id="id021ad2a4755a4e29a9f2530a3ba11b2c"><enum>(ii)</enum><text>The treatment of patients with current acute psychiatric instability or substance use disorder or patients at risk of suicide.</text> </clause><clause id="idaaf76d52daab4c5181836c3ac90758a2"><enum>(iii)</enum><text>The use of opioid therapy to treat patients without any pain, including to treat mental health disorders other than opioid use disorder.</text> </clause></subparagraph><subparagraph id="ide2b913d77349446dbcc116937ece4579"><enum>(C)</enum><text>Enhanced guidance with respect to the treatment of patients with behaviors or comorbidities, such as post-traumatic stress disorder, psychiatric disorders, or a history of substance abuse or addiction, that require consultation or comanagement of opioid therapy with one or more specialists in pain management, mental health, or addictions.</text> </subparagraph><subparagraph id="id971ef38c1c3c4aaabb51f3e812b889d1"><enum>(D)</enum><text>Enhanced guidance with respect to the conduct by health care providers of an effectiveness assessment for patients receiving opioid therapy, including patients on long-term opioid therapy, to determine—</text> <clause id="id4960253EF60A403E8B38128F7C9A3F0D"><enum>(i)</enum><text>whether opioid therapy is meeting the expected goals of the patient and health care provider of relieving pain and improving function; and</text> </clause><clause id="id1A80F36825FA46BEA2F7723E19227753"><enum>(ii)</enum><text>whether opioid therapy should be continued.</text> </clause></subparagraph><subparagraph id="id5e0133ddc0fc4d40ab16860760c7077b"><enum>(E)</enum><text>Requirements that each health care provider of the Department of Veterans Affairs, before initiating opioid therapy to treat a patient, use the Opioid Therapy Risk Report tool of the Department, including by accessing the most recent patient information from the prescription drug monitoring program of each State, as required to be included in such tool under section 422(d)(1), to assess the risk for adverse outcomes of opioid therapy for the patient, including the concurrent use of controlled substances such as benzodiazepines, as part of the comprehensive assessment conducted by the health care provider.</text> </subparagraph><subparagraph id="id7F5B4210D66248EF88540CD08339F668"><enum>(F)</enum><text>Guidelines to govern the methodologies used by health care providers of the Department of Veterans Affairs and the Department of Defense to safely titrate and taper opioid therapy when adjusting or discontinuing the use of opioid therapy, including—</text> <clause id="idBA621B2233A744E7A962CF82A19873C2"><enum>(i)</enum><text>prescription of the lowest effective dose based on patient need;</text> </clause><clause id="id940424485758428584493306CDDDEA3E"><enum>(ii)</enum><text>use of opioids only for a limited period of time; and</text> </clause><clause id="idCCA938B1BB4E4061AAA1710BBFB83053"><enum>(iii)</enum><text>augmentation of opioid therapy with other pain management therapies and modalities.</text> </clause></subparagraph><subparagraph id="id296d36204d244a3f95a7e6ba1d98b556"><enum>(G)</enum><text>Guidelines with respect to appropriate case management for patients receiving opioid therapy who transition between inpatient and outpatient health care settings, which may include the use of care transition plans.</text> </subparagraph><subparagraph id="ide7893a2c6c154aee93d90af0998cb182"><enum>(H)</enum><text>Enhanced recommendations with respect to the use of routine and random urine drug tests for all patients before and during opioid therapy to help prevent substance abuse, dependence, and diversion, including requirements—</text> <clause id="idDDF22F755C19476FB42111CB7FAD9BF8"><enum>(i)</enum><text>that such tests occur not less frequently than once each year; and</text> </clause><clause id="idE407501029B8479D8F757A8A61D06349"><enum>(ii)</enum><text>that health care providers appropriately interpret and respond to the results from such tests to tailor pain therapy, safeguards, and risk management strategies to each patient.</text> </clause></subparagraph><subparagraph id="idf613e212e4414240a473c76ca2248cd6"><enum>(I)</enum><text>Guidance that health care providers discuss with patients, before initiating opioid therapy, options for pain management therapies without the use of opioids and options to augment opioid therapy with other clinical and complementary and integrative health services to minimize opioid dependence.</text> </subparagraph></paragraph><paragraph id="idDC7B7FB1ED06464386000287E03FCB8D"><enum>(2)</enum><header>Treatment of certain guidelines developed after deadline</header><text>If the Centers for Disease Control and Prevention release the guidelines described in paragraph (1)(A) after the date on which the Secretary of Veterans Affairs and the Secretary of Defense jointly update the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, as required under paragraph (1), the Secretary of Veterans Affairs and the Secretary of Defense shall jointly modify such updated clinical practice guideline to include the guidelines described in paragraph (1)(A).</text> </paragraph></subsection><subsection id="idED7B9076B27A415B9D360F53A8946B5C"><enum>(b)</enum><header>Consultation before update</header><text>Before updating the clinical practice guideline under subsection (a), the Secretary of Veterans Affairs and the Secretary of Defense shall jointly consult with the Pain Management Working Group of the Health Executive Committee of the Department of Veterans Affairs-Department of Defense Joint Executive Committee established under section 320 of title 38, United States Code.</text> </subsection><subsection id="ida5a19ffcabb84d96a58912dd155d8268"><enum>(c)</enum><header>Controlled substance defined</header><text>In this section, the term <term>controlled substance</term> has the meaning given that term in section 102 of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/802">21 U.S.C. 802</external-xref>).</text> </subsection></section><section commented="no" display-inline="no-display-inline" id="id57FB62B097584B20A2B67B3D024AB2BF"><enum><added-phrase reported-display-style="italic">422.</added-phrase></enum><header>Improvement of opioid safety measures by Department of Veterans Affairs</header> <subsection id="idb8ef864bc927457bb8d27ce9b0824b93"><enum>(a)</enum><header>Expansion of Opioid Safety Initiative</header><text>Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall expand the Opioid Safety Initiative of the Department of Veterans Affairs to include all medical facilities of the Department.</text> </subsection><subsection id="id6f9b7baf87134829b2922a545242ea71"><enum>(b)</enum><header>Pain management education and training</header> <paragraph id="id380849CFD1A54FC5838CFB4EF0948A21"><enum>(1)</enum><header>In general</header><text>In carrying out the Opioid Safety Initiative of the Department, the Secretary shall require all employees of the Department responsible for prescribing opioids to receive education and training described in paragraph (2).</text> </paragraph><paragraph id="id602bc96a9cae4660831ccef5376b5c17"><enum>(2)</enum><header>Education and training</header><text>Education and training described in this paragraph is education and training on pain management and safe opioid prescribing practices for purposes of safely and effectively managing patients with chronic pain and includes education and training on the following:</text> <subparagraph id="id17627e1fecc54ddfb53305b1ed690cd8"><enum>(A)</enum><text>The implementation of and full compliance with the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, including any update to such guideline.</text> </subparagraph><subparagraph id="id9ECD8D3478F640FC97125FA45A3DD369"><enum>(B)</enum><text>The use of evidence-based pain management therapies, including cognitive-behavioral therapy, non-opioid alternatives, and non-drug approaches to managing pain and related health conditions including complementary and integrative health services.</text> </subparagraph><subparagraph id="id844219745c3249fc8f510d08ee73a1d8"><enum>(C)</enum><text>Screening and identification of patients with substance use disorder, including drug-seeking behavior, before prescribing opioids, assessment of the risk potential for patients developing an addiction, and referral of patients to appropriate addiction treatment professionals if addiction is identified or strongly suspected.</text> </subparagraph><subparagraph id="idf857b716996048cf8c78ec5cece8c33a"><enum>(D)</enum><text>Communication with patients on the potential harm associated with the use of opioids and other controlled substances, including the need to safely store and dispose of supplies relating to the use of opioids and other controlled substances.</text> </subparagraph><subparagraph id="id4c4ef77350a149f08a8573cc3ac0d255"><enum>(E)</enum><text>Such other education and training as the Secretary considers appropriate to ensure that veterans receive safe, high-quality pain management care from the Department.</text> </subparagraph></paragraph><paragraph id="idd6f6250981a64dba9129d25bfd694865"><enum>(3)</enum><header>Use of existing program</header><text>In providing education and training described in paragraph (2), the Secretary shall use the Interdisciplinary Chronic Pain Management Training Team Program of the Department.</text> </paragraph></subsection><subsection id="id58662acd32164d63a3a7f59c107b8549"><enum>(c)</enum><header>Pain management teams</header> <paragraph id="id795FA39F0B56403D87F54CEEAFD04CAA"><enum>(1)</enum><header>In general</header><text>In carrying out the Opioid Safety Initiative of the Department, each medical facility of the Department shall identify and designate a pain management team of health care professionals, which may include board certified pain medicine specialists, responsible for coordinating and overseeing therapy at such facility for patients experiencing acute and chronic pain that is non-cancer related.</text> </paragraph><paragraph id="id6D486620862243D39B2879F583D7C476"><enum>(2)</enum><header>Establishment of protocols</header> <subparagraph id="id042578990A664846BF050BF382E9AECF"><enum>(A)</enum><header>In general</header><text>The director of each Veterans Integrated Service Network shall establish protocols for the designation of pain management teams at each medical facility within that Veterans Integrated Service Network.</text> </subparagraph><subparagraph id="id379B7C56E4DB4A16A73FC9B80E227E1B"><enum>(B)</enum><header>Consultation on prescription of opioids</header><text>Each protocol established for a medical facility under subparagraph (A) shall ensure that any health care provider without expertise in prescribing analgesics or who has not completed the education and training under subsection (b), such as a mental health care provider, does not prescribe opioids to a patient unless that health care provider—</text> <clause id="id1BAAE2413197479E99301546CC47F248"><enum>(i)</enum><text>consults with a health care provider with pain management expertise or who is on the pain management team of the medical facility; and</text> </clause><clause id="id5D915E9DF3184533B6932FF2D9B52D75"><enum>(ii)</enum><text>refers the patient to that pain management team for any subsequent prescriptions and related therapy.</text> </clause></subparagraph></paragraph><paragraph id="id54cc2bf801744a11a2b29fed5dd825c0"><enum>(3)</enum><header>Report</header> <subparagraph id="id9EC0AB3C6755495EAD3D6D2355CDC661"><enum>(A)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the head of each medical facility of the Department shall submit to the director of the Veterans Integrated Service Network in which the medical facility is located a report identifying the health care professionals that have been designated as members of the pain management team at the medical facility.</text> </subparagraph><subparagraph id="idAB47033C2532423E890C49272F2DD612"><enum>(B)</enum><header>Elements</header><text>Each report submitted under subparagraph (A) with respect to a medical facility of the Department shall include—</text> <clause id="id28532A037F1A4ADCA365B403294ECFAB"><enum>(i)</enum><text>a certification as to whether all members of the pain management team at the medical facility have completed the education and training required under subsection (b); and</text> </clause><clause id="idBAD7F01AC813422289931E115744AFC1"><enum>(ii)</enum><text>a plan for the management and referral of patients to such pain management team if health care providers without expertise in prescribing analgesics prescribe opioid medications to treat acute and chronic pain that is non-cancer related.</text> </clause></subparagraph></paragraph></subsection><subsection id="id0ee8afa9eab64d99b1250011045e916c"><enum>(d)</enum><header>Tracking and monitoring of opioid use</header> <paragraph id="idD5991C2C514649059578EF2B5C8E75BE"><enum>(1)</enum><header>Prescription drug monitoring programs of States</header><text>In carrying out the Opioid Safety Initiative and the Opioid Therapy Risk Report tool of the Department, the Secretary shall—</text> <subparagraph id="idADA67B56B91E4D9884BAC6AEB3AA464A"><enum>(A)</enum><text>ensure access by health care providers of the Department to information on controlled substances, including opioids and benzodiazepines, prescribed to veterans who receive care outside the Department through the prescription drug monitoring program of each State, including by seeking to enter into memoranda of understanding with States to allow such access;</text> </subparagraph><subparagraph id="id476FF72F575F40DA87A482A5FB65A517"><enum>(B)</enum><text>include such information in the Opioid Therapy Risk Report; and</text> </subparagraph><subparagraph id="id8bbe32b81b02417581469efeef286efb"><enum>(C)</enum><text>require health care providers of the Department to submit to the prescription drug monitoring program of each State information on prescriptions of controlled substances received by veterans in that State under the laws administered by the Secretary.</text> </subparagraph></paragraph><paragraph id="id5F8EBD882C714157A0D6E00BBEA147AF"><enum>(2)</enum><header>Report on tracking of data on opioid use</header><text>Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the feasibility and advisability of improving the Opioid Therapy Risk Report tool of the Department to allow for more advanced real-time tracking of and access to data on—</text> <subparagraph id="id72BCB6C9DAB74FE1B8E33AA8AC6FD720"><enum>(A)</enum><text>the key clinical indicators with respect to the totality of opioid use by veterans;</text> </subparagraph><subparagraph id="id84ff31f148a84770abc849c98ff01e86"><enum>(B)</enum><text>concurrent prescribing by health care providers of the Department of opioids in different health care settings, include data on concurrent prescribing of opioids to treat mental health disorders other than opioid use disorder; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id94DF47367C1B4680AA4435A0307D1721"><enum>(C)</enum><text>mail-order prescriptions of opioids prescribed to veterans under the laws administered by the Secretary.</text> </subparagraph></paragraph></subsection><subsection id="id100f3a971c1e4db2b8b6b5b5fc4fe79a"><enum>(e)</enum><header>Availability of opioid receptor antagonists</header> <paragraph id="id9FF02325827B4B72A56E09C7EF7FA2AF"><enum>(1)</enum><header>Increased availability and use</header> <subparagraph id="id2AC4B769A3A9407392C91E92487D5672"><enum>(A)</enum><header>In general</header><text>The Secretary shall increase the availability of opioid receptor antagonists approved by the Food and Drug Administration, such as naloxone, to veterans.</text> </subparagraph><subparagraph id="id4B880A200F7A42518E2B409EF97FF658"><enum>(B)</enum><header>Availability, training, and distribution</header><text>In carrying out subparagraph (A), the Secretary shall, not later than 90 days after the date of the enactment of this Act—</text> <clause id="id6add2b7453144caa998a29cfe1b06f54"><enum>(i)</enum><text>equip each pharmacy of the Department with opioid receptor antagonists approved by the Food and Drug Administration to be dispensed to outpatients as needed; and</text> </clause><clause id="idec12ae7fdc9d48bc810e0bc6b85eef60"><enum>(ii)</enum><text>expand the Overdose Education and Naloxone Distribution program of the Department to ensure that all veterans in receipt of health care under the laws administered by the Secretary who are at risk of opioid overdose may access such opioid receptor antagonists and training on the proper administration of such opioid receptor antagonists.</text> </clause></subparagraph><subparagraph id="id73E8A023ECC140AF8FEDE8CBBB4AC488"><enum>(C)</enum><header>Veterans who are at risk</header><text>For purposes of subparagraph (B), veterans who are at risk of opioid overdose include—</text> <clause id="id156445E2AE254056BEAB2D24193AC3E1"><enum>(i)</enum><text>veterans receiving long-term opioid therapy;</text> </clause><clause id="idF34598A01436486D8901D713EEABDFCE"><enum>(ii)</enum><text>veterans receiving opioid therapy who have a history of substance use disorder or prior instances of overdose; and</text> </clause><clause id="id697A93398E72460FB8203C23D75539F1"><enum>(iii)</enum><text>veterans who are at risk as determined by a health care provider who is treating the veteran.</text> </clause></subparagraph></paragraph><paragraph id="id16d07e8f370842039a86ac176451bead"><enum>(2)</enum><header>Report</header><text>Not later than 120 days after the date of the enactment of this Act, 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 compliance with paragraph (1) that includes an assessment of any remaining steps to be carried out by the Department to comply with such paragraph.</text> </paragraph></subsection><subsection id="id9BCE86251C1F45B982878032F18C5465"><enum>(f)</enum><header>Inclusion of certain information and capabilities in Opioid Therapy Risk Report tool</header> <paragraph id="id8719FAEF426E4892A1A6D06C489CEC0A"><enum>(1)</enum><header>Information</header><text>The Secretary shall include in the Opioid Therapy Risk Report tool of the Department—</text> <subparagraph id="idF934C3B818204996A08415A6039E3731"><enum>(A)</enum><text>information on the most recent time the tool was accessed by a health care provider of the Department with respect to each veteran; and</text> </subparagraph><subparagraph id="idF87428F46A63490F8DA733C9804F26AF"><enum>(B)</enum><text>information on the results of the most recent urine drug test for each veteran.</text> </subparagraph></paragraph><paragraph id="idC33CE593C2E642AD883329D3087B13F6"><enum>(2)</enum><header>Capabilities</header><text>The Secretary shall include in the Opioid Therapy Risk Report tool the ability of health care providers of the Department to determine whether a health care provider of the Department prescribed opioids to a veteran without checking the information in the tool with respect to the veteran.</text> </paragraph></subsection><subsection id="id5982C9F8DBA84297A1F2A1C2881B7D8F"><enum>(g)</enum><header>Notification of risk in computerized health record</header><text>The Secretary shall modify the Computerized Patient Record System of the Department to ensure that any health care provider that accesses the record of a veteran, regardless of the reason the veteran seeks care from the health care provider, will be immediately notified whether the veteran—</text> <paragraph id="idAEF9E84E94A14BD2A6F990C199447E3D"><enum>(1)</enum><text>is receiving opioid therapy and has a history of substance use disorder or prior instances of overdose;</text> </paragraph><paragraph id="id276C53EE343A4670AE6F6138AD4101A8"><enum>(2)</enum><text>has a history of opioid abuse; or</text> </paragraph><paragraph id="id7A0A9D8F4BB34B7A8DAFC378CD3AA8AB"><enum>(3)</enum><text>is at risk of becoming an opioid abuser as determined by a health care provider who is treating the veteran.</text> </paragraph></subsection><subsection id="id79BEC329C9DC480F91605E159351EA59"><enum>(h)</enum><header>Controlled substance defined</header><text>In this section, the term <term>controlled substance</term> has the meaning given that term in section 102 of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/802">21 U.S.C. 802</external-xref>).</text> </subsection></section><section id="id02e5e49b121f49f4aec78483b2f63f60"><enum><added-phrase reported-display-style="italic">423.</added-phrase></enum><header>Enhancement of joint working group on pain management of the Department of Veterans Affairs and the Department of Defense</header> <subsection id="id0E7A22BEC4874C4E86D1BF0DA28567E4"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs and the Secretary of Defense shall ensure that the Pain Management Working Group of the Health Executive Committee of the Department of Veterans Affairs-Department of Defense Joint Executive Committee established under section 320 of title 38, United States Code, includes a focus on the following:</text> <paragraph id="id537B49EE8E1B4A37B50E6EFF0575191D"><enum>(1)</enum><text>The opioid prescribing practices of health care providers of each Department.</text> </paragraph><paragraph id="id547EF5B4339A475F9F1E614BC31E85DA"><enum>(2)</enum><text>The ability of each Department to manage acute and chronic pain among individuals receiving health care from that Department, including training health care providers with respect to pain management.</text> </paragraph><paragraph id="id86359ECAD4554DF98291BF373866933D"><enum>(3)</enum><text>The use by each Department of complementary and integrative health in treating such individuals.</text> </paragraph><paragraph id="id1651D879EBDB47F0B1E4A9D9E03597A2"><enum>(4)</enum><text>The concurrent use by health care providers of each Department of opioids and prescription drugs to treat mental health disorders, including benzodiazepines.</text> </paragraph><paragraph id="idEEC9AC2ED9584A0BA353DAA55D28BDB6"><enum>(5)</enum><text>The practice by health care providers of each Department of prescribing opioids to treat mental health disorders.</text> </paragraph><paragraph id="id3ecfd63c78404994bffc74cf8f9b47ae"><enum>(6)</enum><text>The coordination in coverage of and consistent access to medications prescribed for patients transitioning from receiving health care from the Department of Defense to receiving health care from the Department of Veterans Affairs.</text> </paragraph><paragraph id="idf717da70862d4943bf51a1893b592c4c"><enum>(7)</enum><text>The ability of each Department to identify and treat substance use disorders among individuals receiving health care from that Department.</text> </paragraph></subsection><subsection id="id7892a3b2365a49f5b3a3c42beb81b4a2"><enum>(b)</enum><header>Coordination and consultation</header><text>The Secretary of Veterans Affairs and the Secretary of Defense shall ensure that the working group described in subsection (a)—</text> <paragraph id="id9D69D86FCA4A4317B06C25B90F37DD54"><enum>(1)</enum><text>coordinates the activities of the working group with other relevant working groups established under section 320 of title 38, United States Code, including the working groups on evidence based practice, patient safety, pharmacy, and psychological health;</text> </paragraph><paragraph id="idC1ABEB465D2B460C9056AAD4EBCF5186"><enum>(2)</enum><text>consults with other relevant Federal agencies, including the Centers for Disease Control and Prevention, with respect to the activities of the working group; and</text> </paragraph><paragraph id="id42898DFC72AA49FBBDE4C48F15701488"><enum>(3)</enum><text>consults with the Department of Veterans Affairs and the Department of Defense with respect to, reviews, and comments on the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, or any successor guideline, before any update to the guideline is released.</text> </paragraph></subsection><subsection id="id28DAD2A32658461A8D9EF1BA788E4899"><enum>(c)</enum><header>Consultation</header><text>The Secretary of Veterans Affairs and the Secretary of Defense shall ensure that the working group described in subsection (a) is able to meaningfully consult with respect to the updated guideline required under subsection (a) of section 421, as required by subsection (b) of such section, not later than one year after the date of the enactment of this Act.</text> </subsection></section><section id="HD276606BC0E6440DB693B3535C717164"><enum><added-phrase reported-display-style="italic">424.</added-phrase></enum><header>Establishment of pain management boards of Department of Veterans Affairs</header> <subsection id="H63472896DB4C4D988AC636B680753A1B"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/73">chapter 73</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text> <quoted-block changed="added" display-inline="no-display-inline" id="HA906B4299DE047BF888F26486C182E59" reported-display-style="italic" style="USC"> <section id="H8AB48CCD92124256934C67533168C9D3"><enum>7309A.</enum><header>Pain management boards</header> <subsection id="HDB62594A237A4FA69855A2ADB3054318"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">The Secretary shall establish in each Veterans Integrated Service Network a Pain Management Board (in this section referred to as a <quote>Board</quote>).</text> </subsection><subsection id="H59200F4478F046A2A4A397B917E9F9EC"><enum>(b)</enum><header>Activities</header> <paragraph commented="no" display-inline="yes-display-inline" id="HD865605BE2D94C47B2415235A1AA905E"><enum>(1)</enum> <text>Each Board may—</text> <subparagraph changed="added" id="id69CC5C04979A4D5299A600E7CAAA4FED" indent="up1" reported-display-style="italic"><enum>(A)</enum><text>consult with health care professionals and other employees of the Department located in the Veterans Integrated Service Network covered by the Board, patients who are being treated at medical facilities of the Department located in such Veterans Integrated Service Network, and family members of such patients with respect to the pain management resources and best practices of the Department;</text> </subparagraph><subparagraph changed="added" id="idC3CD24D632C5478B8A8F17F98D66B5F8" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>oversee compliance by the health care professionals and other employees of the Department with the best practices of the Department, including by issuing recommendations to improve compliance with those best practices;</text> </subparagraph><subparagraph changed="added" id="id413FECAD63784B318E937317A08F5FAF" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>provide oversight of the pain management practices of the pain management teams of each medical facility of the Department and the health care professionals and other employees of the Department that are located in the Veterans Integrated Service Network covered by the Board;</text> </subparagraph><subparagraph changed="added" id="id8582B3331F604AFAB728A50A39AF9967" indent="up1" reported-display-style="italic"><enum>(D)</enum><text>host educational events, as the Board considers appropriate, for individuals specified in subparagraph (A) on pain management and treatment that may include the sharing of updated research and best practices from medical experts, other health care systems, and such other Federal agencies as the Board considers necessary to carry out this subparagraph; and</text> </subparagraph><subparagraph changed="added" id="id37E8C0A81AB9441A8774F90D3787CFD4" indent="up1" reported-display-style="italic"><enum>(E)</enum><text>host public events, as the Board considers appropriate, during which health care professionals discuss and share best practices on pain management and complementary and integrative health.</text> </subparagraph></paragraph><paragraph changed="added" id="idB93C894D77BE4225BC34D846C5B3F025" indent="up1" reported-display-style="italic"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id582AA41636964CE68949F14F7C402AE3"><enum>(A)</enum><text>Each Board may provide treatment recommendations for patients with complex clinical pain who are being treated at a medical facility of the Department located in the Veterans Integrated Service Network covered by the Board, and assist in facilitating communication between such patients and their health care providers, regardless of whether such treatment is on an in-patient or out-patient basis, and for whom a request for such recommendations, subject to subparagraph (C), has been made by an individual described in subparagraph (B).</text> </subparagraph><subparagraph changed="added" id="HFED6087594D74FAEA8D592602288DDE0" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>An individual described in this subparagraph is one of the following individuals:</text> <clause id="HC21F87FF1D1C419DB3EA4900E0E315BA"><enum>(i)</enum><text>The patient.</text> </clause><clause id="H4728F219D67A4EEBBE5309F7C66A2320"><enum>(ii)</enum><text display-inline="yes-display-inline">The spouse of the patient.</text> </clause><clause id="H485E95769D6D40CD81905119ECF785FC"><enum>(iii)</enum><text>A family member of the patient or another individual if such family member or individual has been designated by the patient to make health care decisions for the patient or to receive health care information with respect to the patient.</text> </clause><clause id="H93EA1A37068B4E35993CAB2AD8FD152D"><enum>(iv)</enum><text>A physician of the patient.</text> </clause><clause id="H216670EE3025483DB3E8B461AD24E170"><enum>(v)</enum><text>An employee of the medical facility of the Department described in subparagraph (A).</text> </clause></subparagraph><subparagraph changed="added" id="idFD6C3B2ADB154F7DAEDA629ED6002A01" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>An individual described in subparagraph (B) may not request treatment recommendations under subparagraph (A) unless the individual—</text> <clause id="id61202BFECE284F658DD64E6C8D4CB9FD"><enum>(i)</enum><text>has requested treatment recommendations from the pain management team of the medical facility of the Department at which the patient is receiving treatment; and</text> </clause><clause id="idB198CE9BD0934402B34E53D8F91925FC"><enum>(ii)</enum><text>has received treatment recommendations from such team and is not satisfied with those treatment recommendations.</text> </clause></subparagraph><subparagraph changed="added" id="idBFA1C8F12C2F4F92B3B3AF29F0085F41" indent="up1" reported-display-style="italic"><enum>(D)</enum><text>Treatment recommendations provided under subparagraph (A) shall assist the patient and health care provider in determining the best treatment plan for the patient and shall not dictate the treatment plan used by the health care provider.</text> </subparagraph></paragraph><paragraph changed="added" display-inline="no-display-inline" id="H9F46DB714B39413686015FA1637C5306" indent="up1" reported-display-style="italic"><enum>(3)</enum><text display-inline="yes-display-inline">Based on treatment recommendations developed under paragraph (2)(A), consultations conducted under paragraph (1)(A), and educational and public events hosted under subparagraphs (D) and (E) of paragraph (1), each Board may provide to health care professionals of the Department located in the Veterans Integrated Service Network covered by the Board recommendations on the best practices regarding pain management in cases of complex clinical pain.</text> </paragraph><paragraph changed="added" id="H7CC6B8E1306E40238A0413D19B67EDEC" indent="up1" reported-display-style="italic"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id5521FEB1822848F2B1579786D84D84C5"><enum>(A)</enum> <text display-inline="yes-display-inline">Not later than January 31 of each year, 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 that contains comprehensive information from each Board (with all personally identifiable information of patients redacted) on pain management practices carried out in the Veterans Integrated Service Network covered by the Board.</text> </subparagraph><subparagraph changed="added" id="idE5C0BCF1C590475EBEA884B4E31D2D29" indent="up1" reported-display-style="italic"><enum>(B)</enum><text display-inline="yes-display-inline">Each report submitted by the Secretary under subparagraph (A) shall include, for the year preceding the submittal of the report—</text> <clause id="id0ABD2A28618047749810EF27EF3A5C0A"><enum>(i)</enum><text display-inline="yes-display-inline">a summary and explanation of the treatment recommendations provided under paragraph 2(A) during such year; and</text> </clause><clause id="id16FAC39664484633B3983C50245CF40B"><enum>(ii)</enum><text>the recommendations for best practices provided to health care professionals under paragraph (3) during such year.</text> </clause></subparagraph></paragraph><paragraph changed="added" commented="no" id="HCACC78D3A7DD47B59ED1686F7713A410" indent="up1" reported-display-style="italic"><enum>(5)</enum><text display-inline="yes-display-inline">The Federal Advisory Committee Act (5 U.S.C. App.) shall not apply to any Board.</text> </paragraph></subsection><subsection id="H345022F0FBA74FD0BBA991C2A3D6A0AA"><enum>(c)</enum><header>Membership</header> <paragraph commented="no" display-inline="yes-display-inline" id="HC6C6C0FB7F4B4AA883BFDB5AD39356F6"><enum>(1)</enum><text>Each Board shall include the following individuals appointed by the Secretary:</text> <subparagraph changed="added" id="H1B85F67B1261419EAFFD9AEC02281A81" indent="up1" reported-display-style="italic"><enum>(A)</enum><text>A board certified pain medicine specialist.</text> </subparagraph><subparagraph changed="added" id="H3C5E7A1008624A15B46059175392DB87" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>A trained and qualified member of the primary care team of a medical facility of the Department with experience in pain care, such as a nurse practitioner.</text> </subparagraph><subparagraph changed="added" id="H2C9975589F38497380AC1969603C8361" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>A pain psychologist.</text> </subparagraph><subparagraph changed="added" id="H9D3B7AB853C447F2BC02D3FBC4C4640B" indent="up1" reported-display-style="italic"><enum>(D)</enum><text>A pain social worker.</text> </subparagraph><subparagraph changed="added" id="id4DA3DDA91B904969920DD5982A2CE8B9" indent="up1" reported-display-style="italic"><enum>(E)</enum><text>A clinical pharmacist.</text> </subparagraph><subparagraph changed="added" id="HF3EA116BE3E64186A9D9792ADF6EB20A" indent="up1" reported-display-style="italic"><enum>(F)</enum><text display-inline="yes-display-inline">A pain point of contact for a Veterans Integrated Service Network.</text> </subparagraph><subparagraph changed="added" id="HC56AAEC2AE1142E5BABB30CE2CB0EF92" indent="up1" reported-display-style="italic"><enum>(G)</enum><text>A physician with addiction and psychopharmacology expertise and experience.</text> </subparagraph><subparagraph changed="added" id="H715C1196F1284063B9AE4719BBF1F484" indent="up1" reported-display-style="italic"><enum>(H)</enum><text>An allied health care professional.</text> </subparagraph><subparagraph changed="added" id="id7F4C2B9EA743460A8DB114947D7D51B7" indent="up1" reported-display-style="italic"><enum>(I)</enum><text>A clinician with expertise in complementary and integrative health.</text> </subparagraph><subparagraph changed="added" id="idB54861C3905742CC82BE99A34A759E52" indent="up1" reported-display-style="italic"><enum>(J)</enum><text>A clinical behavioral therapist.</text> </subparagraph><subparagraph changed="added" id="id999B424D8B824FB58212CDA872B5E448" indent="up1" reported-display-style="italic"><enum>(K)</enum><text>A patient advocate.</text> </subparagraph><subparagraph changed="added" id="idEA70B782BCD84555ABD77591A49594B1" indent="up1" reported-display-style="italic"><enum>(L)</enum><text>A representative of the labor interests of employees of the Department who are responsible for prescribing drugs.</text> </subparagraph><subparagraph changed="added" id="HC4CC6B79AF3F4DA99DD083A23FDDCE93" indent="up1" reported-display-style="italic"><enum>(M)</enum><text>Two current or former clinical patients who are representative of the demographic of patients served by the Veterans Integrated Service Network covered by the Board.</text> </subparagraph><subparagraph changed="added" id="HEA027905DA7D474A8B0F24E85F3544A3" indent="up1" reported-display-style="italic"><enum>(N)</enum><text>A family member of a current or former clinical patient who is representative of the demographic of patients served by the Veterans Integrated Service Network covered by the Board.</text> </subparagraph></paragraph><paragraph changed="added" id="id8882FEDEF71749F3A737715877DC0EE6" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary shall determine the terms of service of the members of each Board, taking into consideration the clinical duties of members who are employees of the Department.</text> </paragraph><paragraph changed="added" id="H2AA0578C216E48DB83F588A525169063" indent="up1" reported-display-style="italic"><enum>(3)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id40A0D105879E40C390BB65CC3613E2E9"><enum>(A)</enum><text display-inline="yes-display-inline">Members of each Board shall serve without pay and, except as provided in subparagraph (B), members who are full-time officers or employees of the United States may not receive additional pay, allowances, or benefits by reason of their service on the Board.</text> </subparagraph><subparagraph changed="added" id="id3E509FABDCB745559F89E70AF37374BB" indent="up1" reported-display-style="italic"><enum>(B)</enum><text display-inline="yes-display-inline">Members may receive travel expenses, including per diem in lieu of subsistence, for travel in connection with their duties as members of the Board.</text> </subparagraph><subparagraph changed="added" id="idE5714FD156F445E093B83C20E5AC6E38" indent="up1" reported-display-style="italic"><enum>(C)</enum><clause commented="no" display-inline="yes-display-inline" id="id637ECB6C25394289BB2C4744F7ECF340"><enum>(i)</enum><text display-inline="yes-display-inline">Except as provided in clause (ii), any member who has clinical duties as an officer or employee of the United States shall be relieved of such duties during periods in which such relief is necessary for the member to carry out the duties of the Board.</text> </clause><clause changed="added" id="id548223133920407FB4097FFBE5163217" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text>The Secretary shall ensure that carrying out the duties of the Board does not prevent any member who has clinical duties as an employee of the Department from furnishing direct clinical care as appropriate to maintain quality patient care.</text> </clause></subparagraph></paragraph></subsection><subsection id="id0FFDFE78214D411FBC44CCD194CA010B"><enum>(d)</enum><header>Participation of certain members</header><paragraph commented="no" display-inline="yes-display-inline" id="id04A15DCA814C46ABB657BE1FAB2ACEEC"><enum>(1)</enum><text>In carrying out the activities of a Board under subsection (b), any member appointed under subsection (c)(1) solely based on qualifications under subparagraph (K), (L), (M), or (N) of subsection (c)(1)—</text> <subparagraph changed="added" id="id2C0A2FCCE5B649ECB41A51D5AB361B0E" indent="up1" reported-display-style="italic"><enum>(A)</enum><text>may not have access to specific information identifying a patient and other confidential information relating to a patient; and</text> </subparagraph><subparagraph changed="added" id="id902E2521335E49788958ECEA32CE5038" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>except as provided in paragraph (2), may not participate in providing treatment recommendations under subsection (b)(2)(A).</text> </subparagraph></paragraph><paragraph changed="added" id="id91E0B131BEC6403C94F7E289A53B790B" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>In carrying out the activities of the Board under subsection (b), a member appointed under subsection (c)(1) solely based on qualifications under subparagraph (K) of subsection (c)(1) may be present during the provision of treatment recommendations under subsection (b)(2)(A) with the consent and upon the request of the patient for which such treatment recommendations are provided for purposes of representing the interests of the patient.</text> </paragraph></subsection><subsection id="id626DC0109D86410FB3119A23A6638623"><enum>(e)</enum><header>Employment protections</header><text>No adverse personnel action may be made against an employee of the Department in connection with a communication by the employee with a member of a Board relating to the activities of the Board under subsection (b) and any such communication shall be covered by the employment and whistleblower protections otherwise applicable to communications by employees of the Department.</text> </subsection><subsection id="idCBD29F7D593649E4B0E7DB3D51F21CDF"><enum>(f)</enum><header>Resources of Department</header><text>The Secretary shall make available to each Board the resources and personnel of the Department necessary for the Board to carry out the activities of the Board under subsection (b), including resources and personnel of the General Counsel of the Department.</text> </subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="HFA4EE7EFCB9841D98D16EC501E3E96D2"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 73 of such title is amended by inserting after the item relating to section 7309 the following new item:</text> <quoted-block changed="added" display-inline="no-display-inline" id="HD1928014A23E474781164C09BB5FE7BB" reported-display-style="italic" style="USC"> <toc changed="added" regeneration="no-regeneration" reported-display-style="italic"> <toc-entry level="section">7309A. Pain management boards.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="id83535ADA56BC48BAA41349E4FAA414E1"><enum>(c)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on the date that is one year after the date of the enactment of this Act.</text> </subsection></section><section commented="no" display-inline="no-display-inline" id="idC11763BC708F49BB8002FA2E311DD571"><enum><added-phrase reported-display-style="italic">425.</added-phrase></enum><header>Review, investigation, and report on use of opioids in treatment by Department of Veterans Affairs</header> <subsection id="id9477CA5181344641A8B6D2FC372B78BB"><enum>(a)</enum><header>Independent review</header> <paragraph id="idE8C23F4774B344AFB5BEE71E24521F7F"><enum>(1)</enum><header>In general</header><text>Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall enter into a contract with an independent entity with expertise in assessing clinical prescribing practices to conduct an independent review of the Opioid Safety Initiative of the Department of Veterans Affairs and the opioid prescribing practices of health care providers of the Department.</text> </paragraph><paragraph id="idD8AE7915B7A84C04A84E1E51DE053E09"><enum>(2)</enum><header>Report</header> <subparagraph id="id85F481C42E56469EA896058DB5062ACB"><enum>(A)</enum><header>In general</header><text>Not later than 30 days after completing the independent review under paragraph (1), the independent entity that carried out such review shall submit to the Secretary, the Committee on Veterans’ Affairs of the Senate, and the Committee on Veterans’ Affairs of the House of Representatives a report on the findings and recommendations of the independent entity with respect to such review.</text> </subparagraph><subparagraph id="id593AE8E41CDE493F9F6A80A6307DD56F"><enum>(B)</enum><header>Elements</header><text>The report submitted under subparagraph (A) by the independent entity described in such subparagraph—</text> <clause id="idAC4E61545984467BBFC6971CA4F0F5CA"><enum>(i)</enum><text>shall include—</text> <subclause id="id6840A800D35F46D19E4FFACFA18D7FAD"><enum>(I)</enum><text>recommendations on such improvements to the Opioid Safety Initiative of the Department as the independent entity considers appropriate;</text> </subclause><subclause id="idE6EBDEC7C256413BB9A1EBEF295481E6"><enum>(II)</enum><text>information with respect to—</text> <item id="id99C3C6D0B25344DF993DFB64C01BFCD9"><enum>(aa)</enum><text>deaths resulting from sentinel events involving veterans prescribed opioids by a health care provider of the Department;</text> </item><item id="id340181C6C199498F99622A765CF8205F"><enum>(bb)</enum><text>overall prescription rates and prescription indications of opioids at all medical facilities of the Department to treat non-cancer, non-palliative, and non-hospice care patients, including whether such prescription rates for each medical facility or health care provider of the Department conflicts with or is otherwise inconsistent with the standards of appropriate and safe care with respect to such prescription rates;</text> </item><item id="id10cd80a2785b434aa853734131fbef35"><enum>(cc)</enum><text>the prescription rates and prescription indications of benzodiazepines and opioids concomitantly by health care providers of the Department, including whether such prescription rates for each medical facility or health care provider of the Department conflicts with or is otherwise inconsistent with the standards of appropriate and safe care with respect to such prescription rates;</text> </item><item id="id30c0872469cb4ee3aac5731b4b2779ba"><enum>(dd)</enum><text>the practice by health care providers of the Department of prescribing opioids to treat patients without any pain, including to treat patients with mental health disorders other than opioid use disorder; and</text> </item><item id="ided7a516ecce44450bebd53141accacb9"><enum>(ee)</enum><text>the effectiveness of opioid therapy for patients receiving such therapy, including the effectiveness of long-term opioid therapy; and</text> </item></subclause><subclause id="id843BCC77E9484525B8F5478858E56BA2"><enum>(III)</enum><text>an assessment of the compliance of the Department with the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, as updated under section 421(a); and</text> </subclause></clause><clause commented="no" display-inline="no-display-inline" id="id8c84eca99ab94f8e9a9bac38dc869647"><enum>(ii)</enum><text>may include recommendations with respect to whether the Department should implement policies relating to performance management, such as written warnings or performance improvement plans, for health care providers of the Department that are—</text> <subclause commented="no" display-inline="no-display-inline" id="id7657B23C7E944BAFA10835EE901C9884"><enum>(I)</enum><text>not practicing at a level meeting or exceeding the minimum level standard of care established by the Department; and</text> </subclause><subclause commented="no" display-inline="no-display-inline" id="id59D371A907954D559CE1EB192F2A4D8F"><enum>(II)</enum><text>not following the enhanced guidance with respect to absolute contraindications for opioid therapy set forth in the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, as updated under section 421(a).</text> </subclause></clause></subparagraph></paragraph></subsection><subsection id="id6773a60c198849d29b8f2c42be287d14"><enum>(b)</enum><header>Annual review, investigation, and report on opioid therapy</header> <paragraph id="idfc3e446eeea34912b266058ffa6c2d15"><enum>(1)</enum><header>Annual review of prescription rates</header><text>Not later than one year after the date of the enactment of this Act, and not less frequently than annually thereafter, the Secretary of Veterans Affairs shall, with respect to each medical facility of the Department of Veterans Affairs, collect and review information on opioids prescribed by health care providers at the facility to treat non-cancer, non-palliative, and non-hospice care patients, including information on—</text> <subparagraph id="id04CA5B815F03497192E2BEFC01F35E75"><enum>(A)</enum><text>the prescription rate at which each health care provider at the facility prescribed benzodiazepines and opioids concurrently to such patients and the aggregate such prescription rate for all health care providers at the facility;</text> </subparagraph><subparagraph id="id5c739e39d9c14588bfc16abe78856c5b"><enum>(B)</enum><text>the prescription rate at which each health care provider at the facility prescribed benzodiazepines or opioids to such patients to treat conditions for which opioids or benzodiazepines are not an approved treatment and the aggregate such prescription rate for all health care providers at the facility;</text> </subparagraph><subparagraph id="id30f74e8aa5294d3bb120175a182558b4"><enum>(C)</enum><text>the prescription rate at which each health care provider at the facility prescribed or dispensed mail-order prescriptions of opioids to such patients while such patients were being treated with opioids on an inpatient-basis and the aggregate such prescription rate for all health care providers at the facility; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idA4CAEC49FE3F4A20986FBE73FBB8E08F"><enum>(D)</enum><text>the prescription rate at which each health care provider at the facility prescribed opioids to such patients who were also concurrently prescribed opioids by a health care provider that is not a health care provider of the Department and the aggregate such prescription rate for all health care providers at the facility.</text> </subparagraph></paragraph><paragraph id="id38F645A3BA87485D84008C291412D84F"><enum>(2)</enum><header>Investigation of prescription rates</header> <text>If the Secretary determines that a prescription rate described in paragraph (1) with respect to a health care provider or medical facility of the Department conflicts with or is otherwise inconsistent with the standards of appropriate and safe care, the Secretary shall—</text> <subparagraph id="id98BB075D4DF945C688BCB8C90D40BE5B"><enum>(A)</enum><text>include information relating to such determination, prescription rate, and health care provider or medical facility, as the case may be, in the report submitted under paragraph (3)(F);</text> </subparagraph><subparagraph id="idFE9921403FF64EDCA40F8A83AD91A854"><enum>(B)</enum><text>through the Office of the Medical Inspector of the Veterans Health Administration, conduct a full investigation of the health care provider or medical facility, as the case may be; and</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id1D813A8F5AEF43CAA7BE8345CDA37708"><enum>(C)</enum><text>immediately notify the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and each Member of the Senate and the House of Representatives who represents the area in which the health care provider or medical facility, as the case may be, is located.</text> </subparagraph></paragraph><paragraph id="id7B56A851CEC7461587C53D2193CC1F44"><enum>(3)</enum><header>Report on opioid therapy</header><text>Not later than one year after the date of the enactment of this Act, and not less frequently than annually thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report that contains, for the one year period preceding the submittal of the report, the following:</text> <subparagraph id="id9b02417b648b4b3f82160d11af902a3f"><enum>(A)</enum><text>The number of patients and the percentage of the patient population of the Department of Veterans Affairs who were prescribed benzodiazepines and opioids concurrently by a health care provider of the Department.</text> </subparagraph><subparagraph id="id124c24355f9a4d879edf8c98042f507a"><enum>(B)</enum><text>The number of patients and the percentage of the patient population of the Department without any pain who were prescribed opioids by a health care provider of the Department, including those who were prescribed benzodiazepines and opioids concurrently.</text> </subparagraph><subparagraph id="id0e33afa42d0c451fa373dbb92b554b16"><enum>(C)</enum><text>The number of non-cancer, non-palliative, and non-hospice care patients and the percentage of such patients who were treated with opioids by a health care provider of the Department on an inpatient-basis and who also received prescription opioids by mail from the Department while being treated on an inpatient-basis.</text> </subparagraph><subparagraph id="idD147AEDF55D84673BF8EE0F8CED9199F"><enum>(D)</enum><text>The number of non-cancer, non-palliative, and non-hospice care patients and the percentage of such patients who were prescribed opioids concurrently by a health care provider of the Department and a health care provider that is not a health care provider of the Department.</text> </subparagraph><subparagraph id="idC08B9C5EB1DF4D1EB3969622268B96DE"><enum>(E)</enum><text>With respect to each medical facility of the Department, the number of times a pharmacist at the facility overrode a critical drug interaction warning with respect to an interaction between opioids and another medication before dispensing a medication to a veteran.</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idB77BC95297A445358BD5EE82D007D27C"><enum>(F)</enum><text display-inline="yes-display-inline">The results of the review conducted under paragraph (1) (including a summary of such review at the Veterans Integrated Service Network level) and the investigation conducted under paragraph (2) (including information described in paragraph (2)(A)), compiled in such a manner as the Secretary determines appropriate to ensure that the information is easily accessible.</text> </subparagraph><subparagraph id="idFC0468143298474E9C77760A553F4C9C"><enum>(G)</enum><text>An assessment of the compliance of the Department with the VA/DOD Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain, including any update to such guideline.</text> </subparagraph></paragraph></subsection><subsection commented="no" id="idEE5035CE7F2847E1A43A0E841A7CC2EC"><enum>(c)</enum><header>Prescription rate defined</header><text>In this section, the term <term>prescription rate</term> means, with respect to a health care provider or medical facility of the Department, each of the following:</text> <paragraph id="id31909b59f0ff423eb8f64c15d7935a02"><enum>(1)</enum><text>The number of patients treated with opioids by the health care provider or at the medical facility, as the case may be, divided by the total number of pharmacy users of that health care provider or at that medical facility.</text> </paragraph><paragraph id="id136F592EA1DC4937AF4198116E509F94"><enum>(2)</enum><text>The average number of morphine equivalents per day prescribed by the health care provider or at the medical facility, as the case may be, to patients being treated with opioids.</text> </paragraph><paragraph id="id19393991175E457CAD77AD19F9B2AD73"><enum>(3)</enum><text>Of the patients being treated with opioids by the health care provider or at the medical facility, as the case may be, the average number of prescriptions of opioids per patient.</text> </paragraph></subsection></section></subtitle><subtitle changed="added" id="id2F491C54F8AE4036AFEFD0BEF92B0876" reported-display-style="italic" style="OLC"><enum>C</enum><header>Patient advocacy</header> <section id="id673540CB06CF4AA2BD0ED9A2C35A4E20"><enum>431.</enum><header>Establishment of Office of Patient Advocacy of the Department of Veterans Affairs</header> <subsection id="id27F55E403B1C4A2EACFBB63DE7DAF66B"><enum>(a)</enum><header>In general</header><text>Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/73">chapter 73</external-xref> of title 38, United States Code, as amended by section 424(a), is further amended by adding at the end the following new section:</text> <quoted-block changed="added" display-inline="no-display-inline" id="id38239381B75B4CC2AD16CBCA72B32ECA" reported-display-style="italic" style="USC"> <section id="id6E3FA9FC30FD40828B47B4E3817EC446"><enum>7309B.</enum><header>Office of Patient Advocacy</header> <subsection id="id39d54c38f93a422684899181f1552eec"><enum>(a)</enum><header>Establishment</header><text>There is established in the Department within the Office of the Under Secretary for Health an office to be known as the <quote>Office of Patient Advocacy</quote> (in this section referred to as the <quote>Office</quote>).</text> </subsection><subsection id="id44d3b7deaa72463b9ae46a93ac1c0e32"><enum>(b)</enum><header>Head</header><paragraph commented="no" display-inline="yes-display-inline" id="id73AEFD19F9DE45ADAA32F26D59260778"><enum>(1)</enum><text>The Director of the Office of Patient Advocacy shall be the head of the Office.</text> </paragraph><paragraph changed="added" id="id91C26F98269E410FBB9E1A9226E71956" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Director of the Office of Patient Advocacy shall be appointed by the Under Secretary for Health from among individuals qualified to perform the duties of the position and shall report directly to the Under Secretary for Health.</text> </paragraph></subsection><subsection id="id120d4f8860c64f0daee1bdedd688a32c"><enum>(c)</enum><header>Function</header><paragraph commented="no" display-inline="yes-display-inline" id="idF9A17FA61D75472A9526CB014BD735E8"><enum>(1)</enum><text>The function of the Office is to carry out the Patient Advocacy Program of the Department.</text> </paragraph><paragraph changed="added" id="id35ED39519709427F993C335C9EC0B53E" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>In carrying out the Patient Advocacy Program of the Department, the Director shall ensure that patient advocates of the Department—</text> <subparagraph id="idE0703304AA5C47F4BC08AC0353B326D8"><enum>(A)</enum><text>advocate on behalf of veterans with respect to health care received and sought by veterans under the laws administered by the Secretary;</text> </subparagraph><subparagraph id="id4F74F69C6E2D481E84D3979478B66ED4"><enum>(B)</enum><text>carry out the responsibilities specified in subsection (d); and</text> </subparagraph><subparagraph id="id896DCD1352A844A5A3AF0208190CFBB2"><enum>(C)</enum><text>receive training in patient advocacy.</text> </subparagraph></paragraph></subsection><subsection id="id05CBB5C05CF243C8A75DFC939EF54860"><enum>(d)</enum><header>Patient advocacy responsibilities</header><text>The responsibilities of each patient advocate at a medical facility of the Department are the following:</text> <paragraph id="id449a92416dfd4b3c96ade2d69a0523ee"><enum>(1)</enum><text>To resolve complaints by veterans with respect to health care furnished under the laws administered by the Secretary that cannot be resolved at the point of service or at a higher level easily accessible to the veteran.</text> </paragraph><paragraph id="id9750b4a6a7584206bf0308c8a71b6a32"><enum>(2)</enum><text>To present at various meetings and to various committees the issues experienced by veterans in receiving such health care at such medical facility.</text> </paragraph><paragraph id="id52884b8d955545fda8d018882ee16f52"><enum>(3)</enum><text>To express to veterans their rights and responsibilities as patients in receiving such health care.</text> </paragraph><paragraph id="id03f8d3e730be411e8dfe4160b13676d9"><enum>(4)</enum><text>To manage the Patient Advocate Tracking System of the Department at such medical facility.</text> </paragraph><paragraph id="idf6fcd51e81364dc488ec2e7d1d84245d"><enum>(5)</enum><text>To compile data at such medical facility of complaints made by veterans with respect to the receipt of such health care at such medical facility and the satisfaction of veterans with such health care at such medical facility to determine whether there are trends in such data.</text> </paragraph><paragraph id="id352e80b1e5da407db4a5827b9f0a803a"><enum>(6)</enum><text>To ensure that a process is in place for the distribution of the data compiled under paragraph (5) to appropriate leaders, committees, services, and staff of the Department.</text> </paragraph><paragraph id="ide106b360de9e4bc3a36b6ffe9cc1525d"><enum>(7)</enum><text>To identify, not less frequently than quarterly, opportunities for improvements in the furnishing of such health care to veterans at such medical facility based on complaints by veterans.</text> </paragraph><paragraph id="idb1aace6275f4451688cb8eead4dc6208"><enum>(8)</enum><text>To ensure that any significant complaint by a veteran with respect to such health care is brought to the attention of appropriate staff of the Department to trigger an assessment of whether there needs to be a further analysis of the problem at the facility-wide level.</text> </paragraph><paragraph id="id1caf03354b34427295a2224f73c805c3"><enum>(9)</enum><text>To support any patient advocacy programs carried out by the Department.</text> </paragraph><paragraph id="id4d60742a13e7458883ec47115507acdf"><enum>(10)</enum><text>To ensure that all appeals and final decisions with respect to the receipt of such health care are entered into the Patient Advocate Tracking System of the Department.</text> </paragraph><paragraph id="ida079d9697afd42419b64a728394c4095"><enum>(11)</enum><text>To understand all laws, directives, and other rules with respect to the rights and responsibilities of veterans in receiving such health care, including the appeals processes available to veterans.</text> </paragraph><paragraph id="id7b0131dab2c9447f8a624c1568d9e2aa"><enum>(12)</enum><text>To ensure that veterans receiving mental health care, or the surrogate decision makers for such veterans, are aware of the rights of veterans to seek representation from systems established under section 103 of the Protection and Advocacy for Mentally Ill Individuals Act of 1986 (<external-xref legal-doc="usc" parsable-cite="usc/42/10803">42 U.S.C. 10803</external-xref>) to protect and advocate the rights of individuals with mental illness and to investigate incidents of abuse and neglect of such individuals.</text> </paragraph><paragraph id="id1aad38498b01499e86c1afcb0c2ea15b"><enum>(13)</enum><text>To fulfill requirements established by the Secretary with respect to the inspection of controlled substances.</text> </paragraph><paragraph id="id0c73c5e60a184daf9bdd17d4d89d9724"><enum>(14)</enum><text>To document potentially threatening behavior and report such behavior to appropriate authorities.</text> </paragraph></subsection><subsection id="id3DD5A2AF23C74820A8264EED2D6A56B7"><enum>(e)</enum><header>Training</header><text>In providing training to patient advocates under subsection (c)(2)(C), the Director shall ensure that such training is consistent throughout the Department.</text> </subsection><subsection id="id1329F13799EE4F22BDAE28CC39D4B17C"><enum>(f)</enum><header>Controlled substance defined</header><text>In this section, the term <term>controlled substance</term> has the meaning given that term in section 102 of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/802">21 U.S.C. 802</external-xref>).</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="id56A4F50BFEEF48EE8E1FA524A7588F35"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 73 of such title, as amended by section 424(b), is further amended by adding after the item relating to section 7309A the following new item:</text> <quoted-block changed="added" id="id17d9e79c-20ff-4275-ad5f-8eea9bb0a765" reported-display-style="italic" style="OLC"><toc changed="added" reported-display-style="italic"><toc-entry idref="id6E3FA9FC30FD40828B47B4E3817EC446" level="section">7309B. Office of Patient Advocacy.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="id824FF6FC69CE4EA5BA48A9E4856E005F"><enum>(c)</enum><header>Date fully operational</header><text>The Secretary of Veterans Affairs shall ensure that the Office of Patient Advocacy established in section 7309B of title 38, United States Code, as added by subsection (a), is fully operational not later than the date that is one year after the date of the enactment of this Act.</text> </subsection></section><section id="idEE90788F7C1C42BEBEBC75D65F4552E8"><enum><added-phrase reported-display-style="italic">432.</added-phrase></enum><header>Community meetings on improving care from Department of Veterans Affairs</header> <subsection id="id2208ce366cde4d02968524e8a95fe518"><enum>(a)</enum><header>Community meetings</header> <paragraph id="id3B38F8CA82B74A3D806283810134142E"><enum>(1)</enum><header>Medical centers</header><text>Not later than 90 days after the date of the enactment of this Act, and not less frequently than once every 90 days thereafter, each medical center of the Department of Veterans Affairs shall host a community meeting open to the public on improving health care from the Department.</text> </paragraph><paragraph id="id94ac008b8404432bb3c86d4c93d0cd1b"><enum>(2)</enum><header>Community based outpatient clinics</header><text>Not later than one year after the date of the enactment of this Act, and not less frequently than annually thereafter, each community based outpatient clinic of the Department shall host a community meeting open to the public on improving health care from the Department.</text> </paragraph></subsection><subsection id="idF9DBD1A99B514D1A8F68BC502F9614AB"><enum>(b)</enum><header>Attendance by Director of Veterans Integrated Service Network or designee</header> <paragraph id="idAC70A4CBF3484EDC9CC151280C2CC050"><enum>(1)</enum><header>In general</header><text>Subject to paragraph (2), each community meeting hosted by a medical center or community based outpatient clinic under subsection (a) shall be attended by the Director of the Veterans Integrated Service Network in which the medical center or community based outpatient clinic, as the case may be, is located, or an employee designated by the Director who works in the office of the Director .</text> </paragraph><paragraph id="idF380C6347CA640C4B4131F6287F8E5D4"><enum>(2)</enum><header>Attendance by Director</header><text>Each Director of a Veterans Integrated Service Network shall attend not less than one community meeting under subsection (a) hosted by each medical center located in the Veterans Integrated Service Network each year.</text> </paragraph></subsection><subsection id="id6f19fadd18d04adeb7c2f1ffa57a9515"><enum>(c)</enum><header>Notice</header><text>Each medical center or community based outpatient clinic hosting a community meeting shall send timely notice of the community meeting to the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and each Member of the Senate and the House of Representatives who represents the area in which the medical facility is located.</text> </subsection></section><section id="idab28c8833363475599eb6bc7164eac54"><enum><added-phrase reported-display-style="italic">433.</added-phrase></enum><header>Improvement of awareness of patient advocacy program and patient bill of rights of Department of Veterans Affairs</header><text display-inline="no-display-inline">Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall, in as many prominent locations as appropriate to be seen by the largest percentage of patients and family members of patients at each medical facility of the Department of Veterans Affairs—</text> <paragraph id="id13350126eb82499697a1a3464794d2c9"><enum>(1)</enum><text>display the purposes of the Patient Advocacy Program of the Department and the contact information for the patient advocate at such medical facility; and</text> </paragraph><paragraph id="idfb354ecbab3e40589cbc0cdd5290e5a8"><enum>(2)</enum><text>display the rights and responsibilities of—</text> <subparagraph id="idE5CBC8E265D84DEFB595D9114DB49265"><enum>(A)</enum><text>patients and family members of patients at such medical facility; and</text> </subparagraph><subparagraph id="idB2A5B41CB8F0464E8A1D0E6CDA8DFE71"><enum>(B)</enum><text>with respect to community living centers and other residential facilities of the Department, residents and family members of residents at such medical facility.</text> </subparagraph></paragraph></section><section id="id02cc7a266bee4d11934210804bfeec39"><enum><added-phrase reported-display-style="italic">434.</added-phrase></enum><header>Comptroller General Report on Patient Advocacy Program of Department of Veterans Affairs</header> <subsection id="id4b1c73b71be84bd88c88520e1fdae7db"><enum>(a)</enum><header>In general</header><text>Not later than three years after the date of the enactment of this Act, the Comptroller General of the United States 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 Patient Advocacy Program of the Department of Veterans Affairs (in this section referred to as the <quote>Program</quote>) as carried out under the Office of Patient Advocacy of the Department established in section 7309B of title 38, United States Code, as added by section 431(a).</text> </subsection><subsection id="idbf626c31d4d64755a7f1da42fbefbfa1"><enum>(b)</enum><header>Elements</header><text>The report required by subsection (a)—</text> <paragraph id="id3b343aa0079f44409d7066a33c1c38bb"><enum>(1)</enum><text>shall include—</text> <subparagraph id="id1db3bf6948394df68e604772eb40fb4d"><enum>(A)</enum><text>such recommendations and proposals for improving or modifying the Program as the Comptroller General considers appropriate; and</text> </subparagraph><subparagraph id="id62893bfcec8c44328c9cb027a17fb091"><enum>(B)</enum><text>such other information with respect to the Program as the Comptroller General considers appropriate; and</text> </subparagraph></paragraph><paragraph id="idefc0b026a37b49bb8cb14905dd56f797"><enum>(2)</enum><text>may include—</text> <subparagraph id="idc9c104264b75433ea84e25f09a89ef45"><enum>(A)</enum><text>a description of the Program, including—</text> <clause id="id4dc6c85db2404e4ea7eb42b2d9045f85"><enum>(i)</enum><text>the purposes of the Program;</text> </clause><clause id="idf4913d06c4a44a789e7b355b08ee8f01"><enum>(ii)</enum><text>the activities carried out under the Program; and</text> </clause><clause id="idfa7a065d3b844659974d3beacc94cb6f"><enum>(iii)</enum><text>the sufficiency of the Program in achieving the purposes of the Program;</text> </clause></subparagraph><subparagraph id="idb999907b27f84df8ad9cfbb4fcffe1ec"><enum>(B)</enum><text>an assessment of the sufficiency of staffing of employees of the Department responsible for carrying out the Program;</text> </subparagraph><subparagraph id="id97019a7dc0394fba81df264d4fcf9098"><enum>(C)</enum><text>an assessment of the sufficiency of the training of such employees; and</text> </subparagraph><subparagraph id="id5ed661df75024df99b6a1caa4c9418e7"><enum>(D)</enum><text>an assessment of—</text> <clause id="id3D959C6FDC8548228A04E413E4FCB9D7"><enum>(i)</enum><text>awareness of the Program among veterans and their family members; and</text> </clause><clause commented="no" display-inline="no-display-inline" id="idE46F99BBBB104914A76FC7F9F3DA7ED2"><enum>(ii)</enum><text>the use of the Program by veterans and their family members.</text> </clause></subparagraph></paragraph></subsection></section></subtitle><subtitle changed="added" id="id36462EDDF55B41AD88B31BD9E65924C9" reported-display-style="italic"><enum>D</enum><header>Complementary and integrative health</header> <section id="id8B8914EC2E0644078C184EE17605383E"><enum>441.</enum><header>Expansion of research and education on and delivery of complementary and integrative health to veterans</header> <subsection id="id7f883221d470436e819591eea69bb7c8"><enum>(a)</enum><header>Development of plan To expand research, education, and delivery</header><text>Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall develop a plan to expand materially and substantially the scope of the effectiveness of research and education on, and delivery and integration of, complementary and integrative health services into the health care services provided to veterans.</text> </subsection><subsection id="id61EF167543EA4251929E15E3B0448DDC"><enum>(b)</enum><header>Elements</header><text>The plan required by subsection (a) shall provide for the following:</text> <paragraph id="id18d9513619084f2098c25a3170de7e24"><enum>(1)</enum><text>Research on the following:</text> <subparagraph id="idF2E3CBD178C04EAF94087E5AD4B77C6C"><enum>(A)</enum><text>The effectiveness of various complementary and integrative health services, including the effectiveness of such services integrated with clinical therapies.</text> </subparagraph><subparagraph id="idD702B4DEE0214AEA8D0DAE0C3208D461"><enum>(B)</enum><text>Approaches to integrating complementary and integrative health services into other health care services provided by the Department.</text> </subparagraph></paragraph><paragraph id="idA110FE9E3F8C412086639F891FAA4CEC"><enum>(2)</enum><text>Education and training for health care professionals of the Department on the following:</text> <subparagraph id="idD72694146626400E916DDB58E968787B"><enum>(A)</enum><text>complementary and integrative health services selected by the Secretary for purposes of the plan.</text> </subparagraph><subparagraph id="idAE484A17CCCF436F81DEE6FCCD5D3B64"><enum>(B)</enum><text>Appropriate uses of such services.</text> </subparagraph><subparagraph id="id21465F6D6C814119914E72F979459AE3"><enum>(C)</enum><text>Integration of such services into the delivery of health care to veterans.</text> </subparagraph></paragraph><paragraph id="id5ad07d834d944e62aa1cd9c92f3c29f7"><enum>(3)</enum><text>Research, education, and clinical activities on complementary and integrative health at centers of innovation at medical centers of the Department.</text> </paragraph><paragraph id="id4F7BB205238648D5887B30ACFADC56FB"><enum>(4)</enum><text>Identification or development of metrics and outcome measures to evaluate the effectiveness of the provision and integration of complementary and integrative health services into the delivery of health care to veterans.</text> </paragraph><paragraph id="id2f78b31a4a444dac989b005d75a856e6"><enum>(5)</enum><text>Integration and delivery of complementary and integrative health services with other health care services provided by the Department.</text> </paragraph></subsection><subsection id="id55DC924F521448F8B8A3AFA70E423C8C"><enum>(c)</enum><header>Consultation</header> <paragraph id="id00CAC8CFB0224E5D8421435D436419C2"><enum>(1)</enum><header>In general</header><text>In carrying out subsection (a), the Secretary shall consult with the following:</text> <subparagraph id="id50f3194b32dc43998fdff845c589581e"><enum>(A)</enum><text>The Director of the National Center for Complementary and Integrative Health of the National Institutes of Health.</text> </subparagraph><subparagraph id="id0cda4f0a32a5411ba8aa4fe8a0d427b0"><enum>(B)</enum><text>The Commissioner of Food and Drugs.</text> </subparagraph><subparagraph id="id344ade56b5254079b396e3d0ee1db7ac"><enum>(C)</enum><text>Institutions of higher education, private research institutes, and individual researchers with extensive experience in complementary and integrative health and the integration of complementary and integrative health practices into the delivery of health care.</text> </subparagraph><subparagraph id="id96adfec7fae14f518cfc2a40e0c77857"><enum>(D)</enum><text>Nationally recognized providers of complementary and integrative health.</text> </subparagraph><subparagraph id="idfd9ad395493a4e868876cb76aab74c02"><enum>(E)</enum><text>Such other officials, entities, and individuals with expertise on complementary and integrative health as the Secretary considers appropriate.</text> </subparagraph></paragraph><paragraph id="idADFEDD5B6A924D9DB00B5055FF113999"><enum>(2)</enum><header>Scope of consultation</header><text>The Secretary shall undertake consultation under paragraph (1) in carrying out subsection (a) with respect to the following:</text> <subparagraph id="id99c6495d22f94ad3b39df6964530136b"><enum>(A)</enum><text>To develop the plan.</text> </subparagraph><subparagraph id="id6224319e25a6470b8d5de86a761edfb8"><enum>(B)</enum><text>To identify specific complementary and integrative health practices that, on the basis of research findings or promising clinical interventions, are appropriate to include as services to veterans.</text> </subparagraph><subparagraph id="id5b2d97b82463498594ddcba9127c740e"><enum>(C)</enum><text>To identify barriers to the effective provision and integration of complementary and integrative health services into the delivery of health care to veterans, and to identify mechanisms for overcoming such barriers.</text> </subparagraph></paragraph></subsection><subsection id="id481F8F1F7361445A88DE5756EAC4D065"><enum>(d)</enum><header>Complementary and integrative health defined</header><text>In this section, the term <term>complementary and integrative health</term> has the meaning given that term by the National Institutes of Health.</text> </subsection></section><section id="id67312e0292d346d2a87aa91ddc4aec4e"><enum><added-phrase reported-display-style="italic">442.</added-phrase></enum><header>Pilot program on integration of complementary and integrative health within Department of Veterans Affairs medical centers</header> <subsection id="id9d3a433895d9447d96865a9bd79b45ff"><enum>(a)</enum><header>Pilot program required</header><text>Not later than 180 days after the completion of the development of the plan under section 441, the Secretary of Veterans Affairs shall—</text> <paragraph id="id4F6D5D7CB1E54965A4C7D15DF049DC01"><enum>(1)</enum><text>carry out, through the Office of Patient Centered Care and Cultural Transformation of the Department of Veterans Affairs, a pilot program to assess the feasibility and advisability of integrating the delivery of complementary and integrative health services selected by the Secretary with other health care services provided by the Department for veterans with mental health conditions, chronic pain conditions, other chronic conditions, and such other conditions as the Secretary determines appropriate; and</text> </paragraph><paragraph id="idE00BA3D5D4164E4286BC8CE5F64EA02E"><enum>(2)</enum><text>in developing the pilot program—</text> <subparagraph id="id797E18A7B54D4A88A5BD045D3E2AF5A7"><enum>(A)</enum><text>use the plan developed under section 441; and</text> </subparagraph><subparagraph id="idAE1A0F99DB0A4605A91BE5D59AFC1293"><enum>(B)</enum><text>identify and, to the extent practicable, resolve barriers to the provision of complementary and integrative health services selected by the Secretary and the integration of those services with other health care services provided by the Department.</text> </subparagraph></paragraph></subsection><subsection id="idB295A97EE6F945E3B34528BD1D3B4144"><enum>(b)</enum><header>Duration of pilot program</header><text>The Secretary shall carry out the pilot program during the three-year period beginning on the date that is 180 days after the completion of the development of the plan under section 441.</text> </subsection><subsection id="id2135322a44da4370bd1e274216668eb4"><enum>(c)</enum><header>Locations</header> <paragraph id="ide67259fbeb3e4c81895d42ecc3b0027d"><enum>(1)</enum><header>In general</header><text>The Secretary shall carry out the pilot program at not fewer than 15 medical centers of the Department.</text> </paragraph><paragraph id="id4B1D25AC247E4D68B481BA882D4D7C4D"><enum>(2)</enum><header>Polytrauma centers</header><text>Not less than two of the medical centers designated under paragraph (1) shall be located at polytrauma rehabilitation centers of the Department.</text> </paragraph><paragraph id="id932FB1AE2F284CDAB3F725B4E999C83B"><enum>(3)</enum><header>Medical centers with prescription rate of opioids that conflicts with care standards</header> <subparagraph id="id133FACE8ED4C41B6A41802D22577FABD"><enum>(A)</enum><header>In general</header><text>In selecting medical centers under paragraph (1), the Secretary shall give priority to medical centers of the Department at which there is a prescription rate of opioids that conflicts with or is otherwise inconsistent with the standards of appropriate and safe care.</text> </subparagraph><subparagraph commented="no" id="id422D32A27B42490091F32489D56F420E"><enum>(B)</enum><header>Prescription rate defined</header><text>In this paragraph, the term <term>prescription rate</term> means, with respect to a medical center of the Department, each of the following:</text> <clause id="id1B5276FE2E534D42B097A93F43895554"><enum>(i)</enum><text>The number of patients treated with opioids at the medical center divided by the total number of pharmacy users at the medical center.</text> </clause><clause id="idD403F3D8BF55498C88A66F7110C27AC3"><enum>(ii)</enum><text>The average number of morphine equivalents per day prescribed at the medical center to patients being treated with opioids.</text> </clause><clause commented="no" display-inline="no-display-inline" id="idC23F434036C94754B1E5DF2798B0EACF"><enum>(iii)</enum><text>Of the patients being treated with opioids at the medical center, the average number of prescriptions of opioids per patient.</text> </clause></subparagraph></paragraph><paragraph id="id78c4eaea46e141f7b3365f62539ffe4e"><enum>(4)</enum><header>Selection of locations</header><text>In carrying out the pilot program, the Secretary shall select locations that include the following areas:</text> <subparagraph id="ide0524c62c76e427587d8b062fab2ad11"><enum>(A)</enum><text>Rural areas.</text> </subparagraph><subparagraph id="id47c19eade8494a599120eab96b9338fa"><enum>(B)</enum><text>Areas that are not in close proximity to an active duty military installation.</text> </subparagraph><subparagraph id="idae889602caa04877bba5a04f9c9b852a"><enum>(C)</enum><text>Areas representing different geographic locations, such as census tracts established by the Bureau of the Census.</text> </subparagraph></paragraph></subsection><subsection id="id717D79CE0374495B8046A6445071C951"><enum>(d)</enum><header>Provision of services</header><text>Under the pilot program, the Secretary shall provide covered services to covered veterans by integrating complementary and integrative health services with other services provided by the Department at the medical centers designated under subsection (c)(1).</text> </subsection><subsection id="id113da0a9a6c749bf8197620c8e9bfb26"><enum>(e)</enum><header>Covered veterans</header><text>For purposes of the pilot program, a covered veteran is any veteran who—</text> <paragraph id="idf909d2580e4d41a6b6ecbbee0cf51cca"><enum>(1)</enum><text>has a mental health condition diagnosed by a clinician of the Department;</text> </paragraph><paragraph id="idCF5853B52DFB43988366373634AFC39C"><enum>(2)</enum><text>experiences chronic pain;</text> </paragraph><paragraph id="idB49A797D667B4443B1E42C1046308D08"><enum>(3)</enum><text>has a chronic condition being treated by a clinician of the Department; or</text> </paragraph><paragraph id="idEC1762AF98A043EFBC96CD14D5004CF3"><enum>(4)</enum><text>is not described in paragraph (1), (2), or (3) and requests to participate in the pilot program or is referred by a clinician of the Department who is treating the veteran.</text> </paragraph></subsection><subsection id="id7472ca90faad482bbc4a834b40193ea2"><enum>(f)</enum><header>Covered services</header> <paragraph id="idADB60F1503164BAC81FF54F4A1A06524"><enum>(1)</enum><header>In general</header><text>For purposes of the pilot program, covered services are services consisting of complementary and integrative health services as selected by the Secretary.</text> </paragraph><paragraph id="id20B0D080AB2E4239BB6AF827A5799D1D"><enum>(2)</enum><header>Administration of services</header><text>Covered services shall be administered under the pilot program as follows:</text> <subparagraph id="ida4880c37328f4c30801e03e978cb72a2"><enum>(A)</enum><text>Covered services shall be administered by professionals or other instructors with appropriate training and expertise in complementary and integrative health services who are employees of the Department or with whom the Department enters into an agreement to provide such services.</text> </subparagraph><subparagraph id="id0c6f61d6b81d47b9bb72415ced9be908"><enum>(B)</enum><text>Covered services shall be included as part of the Patient Aligned Care Teams initiative of the Office of Patient Care Services, Primary Care Program Office, in coordination with the Office of Patient Centered Care and Cultural Transformation.</text> </subparagraph><subparagraph id="idE6877ED7D35742A38313B20BF0E3A543"><enum>(C)</enum><text>Covered services shall be made available to—</text> <clause id="idD5E5FB63E0AF4B04BCD21CE5D1800492"><enum>(i)</enum><text>covered veterans who have received conventional treatments from the Department for the conditions for which the covered veteran seeks complementary and integrative health services under the pilot program; and</text> </clause><clause id="idB4A10EFC8D28431F9FE742332BBBBD12"><enum>(ii)</enum><text>covered veterans who have not received conventional treatments from the Department for such conditions.</text> </clause></subparagraph></paragraph></subsection><subsection id="id9cd6bbb85fba4bf782b65b492c243e39"><enum>(g)</enum><header>Voluntary participation</header><text>The participation of a veteran in the pilot program shall be at the election of the veteran and in consultation with a clinician of the Department.</text> </subsection><subsection id="id6ce073dc377c4f48b4975c420b64b778"><enum>(h)</enum><header>Report</header> <paragraph id="id5F51249BE759462AB1CE2A67DC6D77F7"><enum>(1)</enum><header>In general</header><text>Not later than three years after the date of the commencement of the pilot program, 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 pilot program.</text> </paragraph><paragraph id="id29B2427A4554444D97AD31E31ED89043"><enum>(2)</enum><header>Elements</header><text>The report submitted under paragraph (1) shall include the following:</text> <subparagraph id="id8B79D714CE304066BBDD0BDFC04075EF"><enum>(A)</enum><text>The findings and conclusions of the Secretary with respect to the pilot program, including with respect to—</text> <clause id="id26EDED89BE1F4CC7AA818548FDE8E519"><enum>(i)</enum><text>the use and efficacy of the complementary and integrative health services established under the pilot program;</text> </clause><clause id="id123AD9BC7EA0404D94717A80490BD2C8"><enum>(ii)</enum><text>the outreach conducted by the Secretary to inform veterans and community organizations about the pilot program; and</text> </clause><clause id="idDBE6AAFD5C0546D5AFCAB36E93F25EED"><enum>(iii)</enum><text>an assessment of the benefit of the pilot program to covered veterans in mental health diagnoses, pain management, and treatment of chronic illness.</text> </clause></subparagraph><subparagraph id="idDFBEB334EE4A48CE9A8C009FF035D40C"><enum>(B)</enum><text>Barriers identified under subsection (a)(2)(B) that were not resolved.</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="idFD49EAA710524D96BD95062F64A90EB1"><enum>(C)</enum><text>Such recommendations for the continuation or expansion of the pilot program as the Secretary considers appropriate.</text> </subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idCD3ACCED9A034E80B421383918DC933A"><enum>(i)</enum><header>Complementary and integrative health defined</header><text>In this section, the term <term>complementary and integrative health</term> shall have the meaning given that term in section 441(d).</text> </subsection></section></subtitle><subtitle changed="added" committee-id="SSVA00" id="id067B5B2E53DC49E0A6F5900C7348DFF0" reported-display-style="italic" style="OLC"><enum>E</enum><header>Family caregivers</header> <section id="id515cc17bf9354c98bd4a9ffb9b164a8b"><enum>451.</enum><header>Expansion of family caregiver program of Department of Veterans Affairs</header> <subsection id="id2e9c0b675ec845ddac6de0c63d4e8b72"><enum>(a)</enum><header>Family caregiver program</header> <paragraph id="id73DBEF357E9648788A2BA7FEFD21C053"><enum>(1)</enum><header>Expansion of eligibility</header> <subparagraph id="idA493E6113AD9451285BC4FD9B9FBC136"><enum>(A)</enum><header>In general</header><text>Subsection (a)(2)(B) of section 1720G of title 38, United States Code, is amended to read as follows:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id07029C60A3EC4ECF8DC474F35E879DF8" reported-display-style="italic" style="OLC"> <subparagraph id="id49622d4a1e804bf7bc0da4fec0ef3954" indent="up1"><enum>(B)</enum><text>for assistance provided under this subsection—</text> <clause id="id38F1559C81474A36B3EE6AEECFCE469A"><enum>(i)</enum><text>before the date on which the Secretary submits to Congress a certification that the Department has fully implemented the information technology system required by section 452(a) of the <short-title>Jason Simcakoski Memorial Act</short-title>, has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service on or after September 11, 2001;</text> </clause><clause id="id2507644DFC714FAF9D02F292E338A0B0"><enum>(ii)</enum><text>during the two-year period beginning on the date specified in clause (i), has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service—</text> <subclause id="id7796C7E165644BBFBADC44FF1DEF7ADB"><enum>(I)</enum><text>on or before May 7, 1975; or</text> </subclause><subclause id="idAE50D2DB6F984A2483BBB17D1A7EE626"><enum>(II)</enum><text>on or after September 11, 2001; or</text> </subclause></clause><clause id="id6BB0AB00CFCF424CA5A416C887E53B7C"><enum>(iii)</enum><text>after the date that is two years after the date specified in clause (i), has a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service; and</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph><subparagraph id="id6BF64AB06B934ECB9C476937A7B7F093"><enum>(B)</enum><header>Publication in Federal Register</header><text>Not later than 30 days after the date on which the Secretary of Veterans Affairs submits to Congress the certification described in subsection (a)(2)(B)(i) of section 1720G of such title, as amended by subparagraph (A) of this paragraph, the Secretary shall publish the date specified in such subsection in the Federal Register.</text> </subparagraph></paragraph><paragraph id="idEBF9941EB37843D3AE0674592C6AC9CE"><enum>(2)</enum><header>Expansion of needed services in eligibility criteria</header><text>Subsection (a)(2)(C) of such section is amended—</text> <subparagraph id="idCCCDEED2A6B1424EB49506603A640924"><enum>(A)</enum><text>in clause (ii), by striking <quote>; or</quote> and inserting a semicolon;</text> </subparagraph><subparagraph id="id8476F69C3F814B52B6F34A883B8E9EF4"><enum>(B)</enum><text>by redesignating clause (iii) as clause (iv); and</text> </subparagraph><subparagraph id="id7EA683F98FE4471DB654CDA9501D9E3D"><enum>(C)</enum><text>by inserting after clause (ii) the following new clause (iii):</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id8AE9AB0D62D949179D666E567A4C9C63" reported-display-style="italic" style="OLC"> <clause commented="no" display-inline="no-display-inline" id="id18C18AADBCD34BDE88D8C190C4F00793" indent="up1"><enum>(iii)</enum><text>a need for regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired; or</text></clause><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="id364598F2D455404A902C80427D57D8F6"><enum>(3)</enum><header>Expansion of services provided</header><text>Subsection (a)(3)(A)(ii) of such section is amended—</text> <subparagraph id="idDEF11ECEB07F43CBA9FF8DBD5ED6756E"><enum>(A)</enum><text>in subclause (IV), by striking <quote>; and</quote> and inserting a semicolon;</text> </subparagraph><subparagraph id="id4B22C8A3BA404ED9A5DB13E808446E78"><enum>(B)</enum><text>in subclause (V), by striking the period at the end and inserting <quote>; and</quote>; and</text> </subparagraph><subparagraph id="id12ACC07CEAC9458292969BA9B9BF85F4"><enum>(C)</enum><text>by adding at the end the following new subclause:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idE093D31BAF9E42D88953943F17B6C566" reported-display-style="italic" style="OLC"> <subclause commented="no" id="id63564CDAFB0C4794B4CE61218347942D" indent="up2"><enum>(VI)</enum><text>through the use of contracts with, or the provision of grants to, public or private entities—</text> <item commented="no" id="idC2022163A9624C778F8D990767548E6B"><enum><added-phrase reported-display-style="italic">(aa)</added-phrase></enum><text>financial planning services relating to the needs of injured veterans and their caregivers; and</text> </item><item commented="no" id="id7BC12F99F6D3430FA55198DA4078037E"><enum><added-phrase reported-display-style="italic">(bb)</added-phrase></enum><text>legal services, including legal advice and consultation, relating to the needs of injured veterans and their caregivers.</text></item></subclause><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="id8299A7A7296D43B0963294FE9128F606"><enum>(4)</enum><header>Modification of stipend calculation</header><text>Subsection (a)(3)(C) of such section is amended—</text> <subparagraph id="id975BEFA4504349CE88E11D240EED77DF"><enum>(A)</enum><text>by redesignating clause (iii) as clause (iv); and</text> </subparagraph><subparagraph id="id650C2488FC514E519383AB42F5DAF790"><enum>(B)</enum><text>by inserting after clause (ii) the following new clause (iii):</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id3C513E03E1CC46348E8D163C572A6967" reported-display-style="italic" style="OLC"> <clause id="idF5B324BC81AE460C8C802E5402029402" indent="up3"><enum>(iii)</enum><text>In determining the amount and degree of personal care services provided under clause (i) with respect to an eligible veteran whose need for personal care services is based in whole or in part on a need for supervision or protection under paragraph (2)(C)(ii) or regular instruction or supervision under paragraph (2)(C)(iii), the Secretary shall take into account the following:</text> <subclause id="id71F7A9009FBF41C69BBBE6644F90FF32"><enum>(I)</enum><text>The assessment by the family caregiver of the needs and limitations of the veteran.</text> </subclause><subclause id="id9C252164BB2E4E278212D0D22DFD1279"><enum>(II)</enum><text>The extent to which the veteran can function safely and independently in the absence of such supervision, protection, or instruction.</text> </subclause><subclause id="id7FAE3F417B484B419B06569D1654353F"><enum>(III)</enum><text>The amount of time required for the family caregiver to provide such supervision, protection, or instruction to the veteran.</text></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block> </subparagraph></paragraph><paragraph id="id2104ACD49D2944889B76B9FA36E3A4F8"><enum>(5)</enum><header>Periodic evaluation of need for certain services</header><text>Subsection (a)(3) of such section is amended by adding at the end the following new subparagraph:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idE8730E2C93514273B67F5ECA2E31876E" reported-display-style="italic" style="OLC"> <subparagraph id="id9986E31418954B6DA1D75DA2C5131F09" indent="up2"><enum>(D)</enum><text>In providing instruction, preparation, and training under subparagraph (A)(i)(I) and technical support under subparagraph (A)(i)(II) to each family caregiver who is approved as a provider of personal care services for an eligible veteran under paragraph (6), the Secretary shall periodically evaluate the needs of the eligible veteran and the skills of the family caregiver of such veteran to determine if additional instruction, preparation, training, or technical support under those subparagraphs is necessary.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id9AB3E9755D6943EB9251706E5BDDE5AF"><enum>(6)</enum><header>Use of primary care teams</header><text>Subsection (a)(5) of such section is amended, in the matter preceding subparagraph (A), by inserting <quote>(in collaboration with the primary care team for the eligible veteran to the maximum extent practicable)</quote> after <quote>evaluate</quote>.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id42DA787A132B441A8ED9BF09B036E891"><enum>(7)</enum><header display-inline="yes-display-inline">Assistance for family caregivers</header><text display-inline="yes-display-inline">Subsection (a) of such section is amended by adding at the end the following new paragraph:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id886C27A56F714447B1748AF692B99EA7" reported-display-style="italic" style="OLC"> <paragraph id="idA19DB06C085748AC8B9EDEF939109E4D" indent="up1"><enum>(11)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="idFD051B6ECC0E4070ADBEF76D4F9895F4"><enum>(A)</enum><text>In providing assistance under this subsection to family caregivers of eligible veterans, the Secretary may enter into contracts, provider agreements, and memoranda of understanding with Federal agencies, States, and private, nonprofit, and other entities to provide such assistance to such family caregivers.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id36E34DE8367C42939DDF01D069E5D5C2" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>The Secretary may provide assistance under this paragraph only if such assistance is reasonably accessible to the family caregiver and is substantially equivalent or better in quality to similar services provided by the Department.</text> </subparagraph><subparagraph changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id3274BEF12A94424D8D35A32338CEB3AF" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>The Secretary may provide fair compensation to Federal agencies, States, and other entities that provide assistance under this paragraph.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection><subsection id="id43D909F8CA654E5C8EA176490002A078"><enum>(b)</enum><header>Modification of definition of personal care services</header><text>Subsection (d)(4) of such section is amended—</text> <paragraph id="id0CF249A0FB0E46E8898973DBE158C766"><enum>(1)</enum><text>in subparagraph (A), by striking <quote>independent</quote>;</text> </paragraph><paragraph id="id849DE7C128824D2B9560FA6D90DD7E2E"><enum>(2)</enum><text>by redesignating subparagraph (B) as subparagraph (D); and</text> </paragraph><paragraph id="id27E6B47F41334D9C99FEEB8271F285A1"><enum>(3)</enum><text>by inserting after subparagraph (A) the following new subparagraphs:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="idC3687BCF4B6F49FB9D3380E4441B44DE" reported-display-style="italic" style="OLC"> <subparagraph id="id20D12C4456F940C4AA7A4B5855AC2CDF"><enum>(B)</enum><text>Supervision or protection based on symptoms or residuals of neurological or other impairment or injury.</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id05FEF71F8AFB4A2DA18AE25B94536B81"><enum>(C)</enum><text>Regular or extensive instruction or supervision without which the ability of the veteran to function in daily life would be seriously impaired.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection></section><section id="id2ba21f09883641c8bcae425823164656"><enum><added-phrase reported-display-style="italic">452.</added-phrase></enum><header>Implementation of information technology system of Department of Veterans Affairs to assess and improve the family caregiver program</header> <subsection id="id59FF20AFEC1148269463144EC129E4B7"><enum>(a)</enum><header>Implementation of new system</header> <paragraph id="id8EE47F09155E4DB482A18F61AB2C56E0"><enum>(1)</enum><header>In general</header><text>Not later than December 31, 2016, the Secretary of Veterans Affairs shall implement an information technology system that fully supports the Program and allows for data assessment and comprehensive monitoring of the Program.</text> </paragraph><paragraph id="id0B2A24F0131D451E99B7512A0C4F0A7F"><enum>(2)</enum><header>Elements of system</header><text>The information technology system required to be implemented under paragraph (1) shall include the following:</text> <subparagraph id="id7AE03FCFBEE948599F55EC98CCF26A8A"><enum>(A)</enum><text>The ability to easily retrieve data that will allow all aspects of the Program (at the medical center and aggregate levels) and the workload trends for the Program to be assessed and comprehensively monitored.</text> </subparagraph><subparagraph id="id3a5bb948f7084f40930dec8febcc181d"><enum>(B)</enum><text>The ability to manage data with respect to a number of caregivers that is more than the number of caregivers that the Secretary expects to apply for the Program.</text> </subparagraph><subparagraph id="id21f5fa53ce2643e1870d58e84d43157d"><enum>(C)</enum><text>The ability to integrate the system with other relevant information technology systems of the Veterans Health Administration.</text> </subparagraph></paragraph></subsection><subsection id="id7792b9c534ac4bb5b94c2b9148ddf0e3"><enum>(b)</enum><header>Assessment of Program</header> <text>Not later than 180 days after implementing the system described in subsection (a), the Secretary shall, through the Under Secretary for Health, use data from the system and other relevant data to conduct an assessment of how key aspects of the Program are structured and carried out.</text> </subsection><subsection id="idB97D0085920441A1A8AEA330C240254A"><enum>(c)</enum><header>Ongoing monitoring of and modifications to Program</header> <paragraph id="id781A5BFD21564077AE63395E3F09F5C3"><enum>(1)</enum><header>Monitoring</header><text>The Secretary shall use the system implemented under subsection (a) to monitor and assess the workload of the Program, including monitoring and assessment of data on—</text> <subparagraph id="id6AE4952610904C01865577333E6E8B9E"><enum>(A)</enum><text>the status of applications, appeals, and home visits in connection with the Program; and</text> </subparagraph><subparagraph id="idA44C3ED59A514D8984B507861CA673FF"><enum>(B)</enum><text>the use by caregivers participating in the Program of other support services under the Program such as respite care.</text> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id474DB2D265C3485F9486673B0B69B533"><enum>(2)</enum><header display-inline="yes-display-inline">Modifications</header><text display-inline="yes-display-inline">Based on the monitoring and assessment conducted under paragraph (1), the Secretary shall identify and implement such modifications to the Program as the Secretary considers necessary to ensure the Program is functioning as intended and providing veterans and caregivers participating in the Program with services in a timely manner.</text> </paragraph></subsection><subsection id="id5A6053C0BB2C49B8B41BE11246D98EAF"><enum>(d)</enum><header>Reports</header> <paragraph id="id02F127BCFF564D878B3275475340B23E"><enum>(1)</enum><header>Initial report</header> <subparagraph id="id6E9C733528014FFD88BAA21B6A13A178"><enum><added-phrase reported-display-style="italic">(A)</added-phrase></enum><header>In general</header><text>Not later than 90 days after the date of the enactment of this Act, the Secretary shall submit to the Committee on Veterans' Affairs of the Senate, the Committee on Veterans' Affairs of the House of Representatives, and the Comptroller General of the United States a report that includes—</text> <clause id="id9D6A21C9805849AF875B762C739C90B1"><enum><added-phrase reported-display-style="italic">(i)</added-phrase></enum><text>the status of the planning, development, and deployment of the system required to be implemented under subsection (a), including any changes in the timeline for the implementation of the system; and</text> </clause><clause commented="no" display-inline="no-display-inline" id="idA5FE17F846B24BD3A3FA6D5024393785"><enum><added-phrase reported-display-style="italic">(ii)</added-phrase></enum><text>an assessment of the needs of family caregivers of veterans described in subparagraph (B), the resources needed for the inclusion of such family caregivers in the Program, and such changes to the Program as the Secretary considers necessary to ensure the successful expansion of the Program to include such family caregivers.</text> </clause></subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id3F7F222E59154F88A0D0AD25E5809125"><enum><added-phrase reported-display-style="italic">(B)</added-phrase></enum><header display-inline="yes-display-inline">Veterans described</header><text display-inline="yes-display-inline">Veterans described in this subparagraph are veterans who are eligible for the Program under clause (ii) or (iii) of section 1720G(a)(2)(B) of title 38, United States Code, as amended by section 451(a)(1) of this Act, solely due to a serious injury (including traumatic brain injury, psychological trauma, or other mental disorder) incurred or aggravated in the line of duty in the active military, naval, or air service before September 11, 2001.</text> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id7918D10F95DC4DDFB7EB6883F56672C3"><enum>(2)</enum><header>Notification by Comptroller General</header><text>The Comptroller General shall review the report submitted under paragraph (1) and notify the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives with respect to the progress of the Secretary in—</text> <subparagraph id="id4ea7695bd5374194b9c8f62db451e953"><enum>(A)</enum><text>fully implementing the system required under subsection (a); and</text> </subparagraph><subparagraph id="id62b292d3976a45c78ee97e7138c04422"><enum>(B)</enum><text>implementing a process for using such system to monitor and assess the Program under subsection (c)(1) and modify the Program as considered necessary under subsection (c)(2).</text> </subparagraph></paragraph><paragraph commented="no" display-inline="no-display-inline" id="id95171ad3341c4b1b906838471ce36077"><enum>(3)</enum><header display-inline="yes-display-inline">Final report</header> <subparagraph commented="no" display-inline="no-display-inline" id="idE287BE382A2E46F19729FF7C57908D98"><enum>(A)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Not later than December 31, 2017, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate, the Committee on Veterans’ Affairs of the House of Representatives, and the Comptroller General a report on the implementation of subsections (a) through (c).</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id04B77E9430CD4374A172330C8FEF47D2"><enum>(B)</enum><header>Elements</header><text display-inline="yes-display-inline">The report required by subparagraph (A) shall include the following:</text> <clause commented="no" display-inline="no-display-inline" id="id784BF05D9491452E9CEED459A85522E5"><enum>(i)</enum><text>A certification by the Secretary with respect to whether the information technology system described in subsection (a) has been implemented.</text> </clause><clause commented="no" display-inline="no-display-inline" id="id4B162DA940A445DCA557D832EEA4D11B"><enum>(ii)</enum><text>A description of how the Secretary has implemented such system.</text> </clause><clause commented="no" display-inline="no-display-inline" id="idE262223FAACE4DDFBD58CDB992DE0B12"><enum>(iii)</enum><text>A description of the modifications to the Program, if any, that were identified and implemented under subsection (c)(2).</text> </clause><clause commented="no" display-inline="no-display-inline" id="id460A0C179CE44571AE2B33F9A6F7FB6A"><enum>(iv)</enum><text>A description of how the Secretary is using such system to monitor the workload of the Program.</text> </clause></subparagraph></paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="idD6948EC6EA26443594EB60E555DBD4F4"><enum>(e)</enum><header>Definitions</header><text>In this section:</text> <paragraph commented="no" display-inline="no-display-inline" id="idCBCD22494E6F498DA8D71DCA67354C68"><enum>(1)</enum><header>Active military, naval, or air service</header><text>The term <term>active military, naval, or air service</term> has the meaning given that term in section 101 of title 38, United States Code.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idC566BF23409F4D639B53A94616FCD875"><enum>(2)</enum><header>Program</header><text>The term <term>Program</term> means the program of comprehensive assistance for family caregivers under section 1720G(a) of title 38, United States Code, as amended by section 451 of this Act.</text> </paragraph></subsection></section><section commented="no" display-inline="no-display-inline" id="id2F2081057B064A80B62951D9D29FB47A"><enum><added-phrase reported-display-style="italic">453.</added-phrase></enum><header>Modifications to annual evaluation report on caregiver program of Department of Veterans Affairs</header> <subsection commented="no" display-inline="no-display-inline" id="idE08C1CC3D34042DFA70CBFA5B3D52491"><enum>(a)</enum><header>Barriers to care and services</header><text>Subparagraph (A)(iv) of section 101(c)(2) of the Caregivers and Veterans Omnibus Health Services Act of 2010 (<external-xref legal-doc="public-law" parsable-cite="pl/111/163">Public Law 111–163</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1720G">38 U.S.C. 1720G</external-xref> note) is amended by inserting <quote>, including a description of any barriers to accessing and receiving care and services under such programs</quote> before the semicolon.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="idB36A8743CDF44E51A0879080164B3BAF"><enum>(b)</enum><header>Sufficiency of training for family caregiver program</header><text>Subparagraph (B) of such section is amended—</text> <paragraph commented="no" display-inline="no-display-inline" id="idDD5FC97F0727403597C72937E79551BA"><enum>(1)</enum><text>in clause (i), by striking <quote>; and</quote> and inserting a semicolon;</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id9F8F06CEF8D2432484BC69EA03776E32"><enum>(2)</enum><text>in clause (ii), by striking the period at the end and inserting <quote>; and</quote>; and</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id570F0B792B794BA298A86A06F22E51A6"><enum>(3)</enum><text>by adding at the end the following new clause:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id01CE0A36A6C1474BB1F2BDC1463017BF" reported-display-style="italic" style="OLC"> <clause commented="no" display-inline="no-display-inline" id="idCB642E68B76B45EAB56E8BD89B90AD5B"><enum>(iii)</enum><text>an evaluation of the sufficiency and consistency of the training provided to family caregivers under such program in preparing family caregivers to provide care to veterans under such program.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block> </paragraph></subsection></section><section id="id8FF8332229A847649540451481388CF8"><enum><added-phrase reported-display-style="italic">454.</added-phrase></enum><header>Advisory committee on caregiver policy</header> <subsection id="id8FB1042125DB4B8C9D748DFBBA725624"><enum>(a)</enum><header>Establishment</header><text>There is established in the Department of Veterans Affairs an advisory committee on policies relating to caregivers of veterans (in this section referred to as the <quote>Committee</quote>).</text> </subsection><subsection id="idF22DAD43C1094824AB675BA2C7FAA29C"><enum>(b)</enum><header>Composition</header><text>The Committee shall be composed of the following:</text> <paragraph id="id552C59595AF846C9B9FE1B179D7E27F5"><enum>(1)</enum><text>A chair selected by the Secretary of Veterans Affairs.</text> </paragraph><paragraph id="idED930391000B4697A77403BC2A969B50"><enum>(2)</enum><text>A representative from each of the following agencies or organizations selected by the head of such agency or organization:</text> <subparagraph id="idB930C6EFD8E74D2098EFD80CBBF8DB8F"><enum>(A)</enum><text>The Department of Veterans Affairs.</text> </subparagraph><subparagraph id="idEEBAC57BE1974B3E9191FCCFD62F0083"><enum>(B)</enum><text>The Department of Defense.</text> </subparagraph><subparagraph id="id7A9798AAF4574F5683B7320BBC25FED8"><enum>(C)</enum><text>The Department of Health and Human Services.</text> </subparagraph><subparagraph id="id76F440F8490849C7830ED4631CE182D4"><enum>(D)</enum><text>The Department of Labor.</text> </subparagraph><subparagraph id="id4D25F82FF0B0492D925F04919CEC8D9B"><enum>(E)</enum><text>The Centers for Medicare and Medicaid Services.</text> </subparagraph></paragraph><paragraph id="idB8B01A6C533B4DABACEF8C0239247A65"><enum>(3)</enum><text>Not less than seven individuals who are not employees of the Federal Government selected by the Secretary from among the following individuals:</text> <subparagraph id="id1EBCEC8D64FE47BBA2F0CC1A11779951"><enum>(A)</enum><text>Academic experts in fields relating to caregivers.</text> </subparagraph><subparagraph id="id7FA2C9C29E4F42ACA8BDA4911C528809"><enum>(B)</enum><text>Clinicians.</text> </subparagraph><subparagraph id="id4CEEA5DD150244E4A9A6B13133A832D4"><enum>(C)</enum><text>Caregivers.</text> </subparagraph><subparagraph id="id234C3BF1DE2B43E8AD1B3A670598F99D"><enum>(D)</enum><text>Individuals in receipt of caregiver services.</text> </subparagraph><subparagraph id="idF3128EE627444F808615542BDFA3A169"><enum>(E)</enum><text>Such other individuals with expertise that is relevant to the duties of the Committee as the Secretary considers appropriate.</text> </subparagraph></paragraph></subsection><subsection id="id683CD8008A5A40FB863E5953E69B5756"><enum>(c)</enum><header>Duties</header><text>The duties of the Committee are as follows:</text> <paragraph id="id124088c2d22349f2bbb465d59177a670"><enum>(1)</enum><text>To regularly review and recommend policies of the Department of Veterans Affairs relating to caregivers of veterans.</text> </paragraph><paragraph id="id96539d8328dc42d98a5c1abaca87df6a"><enum>(2)</enum><text>To examine and advise the implementation of such policies.</text> </paragraph><paragraph id="id4239c44bc04e4ae89ac6fd43bbdfdb55"><enum>(3)</enum><text>To evaluate the effectiveness of such policies.</text> </paragraph><paragraph id="idcc52674483c24e23adceefae79c918ed"><enum>(4)</enum><text>To recommend standards of care for caregiver services and respite care services provided to a caregiver or veteran by a non-profit or private sector entity.</text> </paragraph><paragraph id="id4c42530d18b3475aa0e8b48b74fbb4e1"><enum>(5)</enum><text>To develop recommendations for legislative or administrative action to enhance the provision of services to caregivers and veterans, including eliminating gaps in such services and eliminating disparities in eligibility for such services.</text> </paragraph><paragraph id="idd69dcd74b74343f2951feaa8b3553605"><enum>(6)</enum><text>To make recommendations on coordination with State and local agencies and relevant non-profit organizations on maximizing the use and effectiveness of resources for caregivers of veterans.</text> </paragraph></subsection><subsection id="idf6cefbd8e8d64e34ade555d96a501054"><enum>(d)</enum><header>Reports</header> <paragraph id="id29FD67DA15624590A86D815F6AC6CDA0"><enum>(1)</enum><header>Annual report to Secretary</header> <subparagraph id="idE7FB96FA4B974F4DA96ACCC9FC91A98A"><enum>(A)</enum><header>In general</header><text>Not later than December 31, 2016, and not less frequently than annually thereafter until the termination date specified in subsection (e), the chair of the Committee shall submit to the Secretary a report on policies and services of the Department of Veterans Affairs relating to caregivers of veterans.</text> </subparagraph><subparagraph id="id49509B6696684EF184B1E7B84AC4BDE8"><enum>(B)</enum><header>Elements</header><text>Each report required by subparagraph (A) shall include the following:</text> <clause id="idbc29baa4029c4558985af765546afa01"><enum>(i)</enum><text>An assessment of the policies of the Department relating to caregivers of veterans and services provided pursuant to such policies as of the date of submittal of the report.</text> </clause><clause id="id6d92d27c953f45f49ab484b83e7d6853"><enum>(ii)</enum><text>A description of any recommendations made by the Committee to improve the coordination of services for caregivers of veterans between the Department and the entities specified in subparagraphs (B) through (E) of subsection (b)(2) and to eliminate barriers to the effective use of such services, including with respect to eligibility criteria.</text> </clause><clause id="idb3f43121c44c4a15ac1ff62159562c48"><enum>(iii)</enum><text>An evaluation of the effectiveness of the Department in providing services for caregivers of veterans.</text> </clause><clause id="idec63f6d198ca4b29a4c8aae40c7a376d"><enum>(iv)</enum><text>An evaluation of the quality and sufficiency of services for caregivers of veterans available from non-governmental organizations.</text> </clause><clause id="idd4b1d35205724b5caf70c735e1b43bda"><enum>(v)</enum><text>A description of any gaps identified by the Committee in care or services provided by caregivers to veterans and recommendations for legislative or administrative action to address such gaps.</text> </clause><clause id="id13f9940876a446f8a08487e8cf1de922"><enum>(vi)</enum><text>Such other matters or recommendations as the chair considers appropriate.</text> </clause></subparagraph></paragraph><paragraph id="id6e1d0aa6fcdb4b258ef5ece700d8f830"><enum>(2)</enum><header>Transmittal to Congress</header><text>Not later than 90 days after the receipt of a report under paragraph (1), the Secretary shall transmit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a copy of such report, together with such comments and recommendations concerning such report as the Secretary considers appropriate.</text> </paragraph></subsection><subsection id="id8874dc2a6aba44b2a75f9b965d2efab2"><enum>(e)</enum><header>Termination</header><text>The Committee shall terminate on December 31, 2021.</text> </subsection></section><section id="idC25F5C19B9A24B2BB04C6F001E4DFF23"><enum><added-phrase reported-display-style="italic">455.</added-phrase></enum><header>Comprehensive study on seriously injured veterans and their caregivers</header> <subsection id="id1E20C42948DD45749E52BD9E34E71FBB"><enum>(a)</enum><header>Study required</header><text>During the period specified in subsection (d), the Secretary of Veterans Affairs shall provide for the conduct by an independent entity of a comprehensive study on the following:</text> <paragraph id="idA4CE02B0688C44CF926133F2F43D9B54"><enum>(1)</enum><text>Veterans who have incurred a serious injury or illness, including a mental health injury or illness.</text> </paragraph><paragraph id="id8A93A27834234B5DAE039B5820EA6E4C"><enum>(2)</enum><text>Individuals who are acting as caregivers for veterans.</text> </paragraph></subsection><subsection commented="no" id="idDB006D45CDB842738AE1EF14FA405590"><enum>(b)</enum><header>Elements</header><text>The comprehensive study required by subsection (a) shall include the following with respect to each veteran included in such study:</text> <paragraph commented="no" id="id1234E7D54EBE48139C4B842656CB2615"><enum>(1)</enum><text>The health of the veteran and, if applicable, the impact of the caregiver of such veteran on the health of such veteran.</text> </paragraph><paragraph commented="no" id="id726B95FFD86D4D4586091C66008EA17F"><enum>(2)</enum><text>The employment status of the veteran and, if applicable, the impact of the caregiver of such veteran on the employment status of such veteran.</text> </paragraph><paragraph commented="no" id="id30D7F5B7B6594B009A15175DF21EEB58"><enum>(3)</enum><text>The financial status and needs of the veteran.</text> </paragraph><paragraph commented="no" id="id6FBF1FE878794122890D46465AC13CFB"><enum>(4)</enum><text>The use by the veteran of benefits available to such veteran from the Department of Veterans Affairs.</text> </paragraph><paragraph commented="no" id="idA04EBC10A81D495D866EA69A1BE9CDE5"><enum>(5)</enum><text>Such other information as the Secretary considers appropriate.</text> </paragraph></subsection><subsection id="id676D7E6C52CF481AB01CE2E566727CF5"><enum>(c)</enum><header>Contract</header><text>The Secretary shall enter into a contract with an appropriate independent entity to conduct the study required by subsection (a).</text> </subsection><subsection id="id4F3FB91813004ECC8CF8225197B999C8"><enum>(d)</enum><header>Period specified</header><text>The period specified in this subsection is the one-year period beginning on the date that is four years after the date specified in section 1720G(a)(2)(B)(i) of title 38, United States Code, as amended by section 451(a)(1) of this Act.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="id35504E96DDBF4567A38DD6560E1DB34E"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(e)</added-phrase></enum><header>Report</header><text>Not later than 30 days after the end of the period specified in subsection (d), 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 subsection (a).</text> </subsection></section></subtitle><subtitle changed="added" id="id89A555DBE4984364BD9C5819D7A8E581" reported-display-style="italic" style="OLC"><enum>F</enum><header>Health care agreements</header> <section changed="added" committee-id="SSVA00" id="idfb5e4c62f18845b88d5220fff67d4642" reported-display-style="italic"><enum>461.</enum><header>Authorization of agreements between the Department of Veterans Affairs and non-Department extended care providers</header> <subsection id="id25d1cdd1dff44cb6aa116bfe3fe1c800"><enum>(a)</enum><header>In general</header><text>Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, is amended by adding after section 1703 the following new section:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id9CFC7D61EDB447E8951A047D9E749578" reported-display-style="italic" style="USC"> <section id="ide89384570eea4b22a134b29e82fe6be2"><enum>1703A.</enum><header>Veterans Extended Care Agreements with certain health care providers</header> <subsection id="id82f615fb6fe441869d9ac981c773d447"><enum>(a)</enum><header>Agreements to furnish extended care</header><paragraph commented="no" display-inline="yes-display-inline" id="idA5CF5AF8E3F84ADB9E7E89B47E122728"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>In addition to the authority of the Secretary under this chapter to furnish extended care at facilities of the Department and under contracts or sharing agreements entered into under authorities other than this section, the Secretary may furnish extended care through the use of agreements entered into under this section. An agreement entered into under this section may be referred to as a <quote>Veterans Extended Care Agreement</quote>.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="idAA6012948B424D8B9248A9DCF7A728BA" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary may enter into agreements to furnish extended care under this section with eligible providers that are certified under subsection (d) if the Secretary is not feasibly able to furnish extended care at facilities of the Department.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="ida91affd129274554bd3286569b49f45e" indent="up1" reported-display-style="italic"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(3)</added-phrase></enum><text>An eligible provider, at its discretion, may opt to enter into an agreement under this section instead of a contract or sharing agreement under authorities other than this section.</text> </paragraph></subsection><subsection commented="no" display-inline="no-display-inline" id="id27F80AB533794A80BB504EF98A4F3192"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(b)</added-phrase></enum><header>Receipt of extended care</header><paragraph commented="no" display-inline="yes-display-inline" id="id9C0483FC2447475DAD072547557CBC16"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>Eligibility of a veteran for extended care under this section shall be determined as if such care were furnished in a facility of the Department and provisions of this title applicable to veterans receiving extended care in a facility of the Department shall apply to veterans receiving such care under this section.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="id5a79d1cbf76d49089173f3b113c334a6" indent="up1" reported-display-style="italic"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(2)</added-phrase></enum><text>In carrying out this section, the Secretary—</text> <subparagraph id="id6560D838657A48528EFAD76B39CEB611"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(A)</added-phrase></enum><text>may not direct veterans seeking extended care to health care providers that have entered into contracts or sharing agreements under authorities other than this section; and</text> </subparagraph><subparagraph id="id1F906F0EEA7B45B1A46BFBD21CFB80AF"><enum>(B)</enum><text>shall ensure that veterans have the option to determine whether to receive extended care from a health care provider described in subparagraph (A) or an eligible provider that has entered into an agreement under this section.</text> </subparagraph></paragraph></subsection><subsection id="id1b397007031249b0969bc4da60ab3fa1"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(c)</added-phrase></enum><header>Eligible providers</header><text>For purposes of this section, an eligible provider is one of the following:</text> <paragraph id="idc59d457d3ddb4a35b419610ab2e5642a"><enum>(1)</enum><text>A provider of services that has enrolled and entered into a provider agreement under section 1866(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395cc">42 U.S.C. 1395cc(a)</external-xref>).</text> </paragraph><paragraph id="idEAD8097B45A2482EAF7C542A9AF6FA69"><enum>(2)</enum><text>A physician or supplier that has enrolled and entered into a participation agreement under section 1842(h) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395u">42 U.S.C. 1395u(h)</external-xref>).</text> </paragraph><paragraph id="id8e486664caa44a87882ef30379441dd2"><enum>(3)</enum><text>A provider of items and services receiving payment under a State plan under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) or a waiver of such a plan.</text> </paragraph><paragraph id="idf98565a7b3f24e799fbd326f72e42980"><enum>(4)</enum><text>A provider that is—</text> <subparagraph id="id36FC4C85593A4817BEAD6DD825B96586"><enum>(A)</enum><text>an Aging and Disability Resource Center, an area agency on aging, or a State agency (as defined in section 102 of the Older Americans Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/42/3002">42 U.S.C. 3002</external-xref>)); or</text> </subparagraph><subparagraph id="id50371691863146F4A880E6D599194414"><enum>(B)</enum><text>a center for independent living (as defined in section 702 of the Rehabilitation Act of 1973 (<external-xref legal-doc="usc" parsable-cite="usc/29/796a">29 U.S.C. 796a</external-xref>)).</text> </subparagraph></paragraph><paragraph id="id4eecc6ae596e4308b2079c8834076c6d"><enum>(5)</enum><text>Such other health care providers as the Secretary considers appropriate for purposes of this section.</text> </paragraph></subsection><subsection id="id7377beb599c64b5a9cad0fa9fdc64c52"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(d)</added-phrase></enum><header>Certification of eligible providers</header><paragraph commented="no" display-inline="yes-display-inline" id="id42E129168EC143659566B14FD8C45F51"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>The Secretary shall establish a process for the certification of eligible providers under this section that shall, at a minimum, set forth the following.</text> <subparagraph changed="added" committee-id="SSVA00" id="idC47BBDC171C9423DA84CCB08C690FB32" indent="up1" reported-display-style="italic"><enum>(A)</enum><text>Procedures for the submittal of applications for certification and deadlines for actions taken by the Secretary with respect to such applications.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="idA0E6907D8C4D4E06835DEB80DD7EB1FF" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>Standards and procedures for approval and denial of certification, duration of certification, revocation of certification, and recertification.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id17125865FA57408CBEB1E9494B8A4406" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>Procedures for assessing eligible providers based on the risk of fraud, waste, and abuse of such providers similar to the level of screening under section 1866(j)(2)(B) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395cc">42 U.S.C. 1395cc(j)(2)(B)</external-xref>) and the standards set forth under section 9.104 of title 48, Code of Federal Regulations, or any successor regulation.</text> </subparagraph></paragraph><paragraph changed="added" committee-id="SSVA00" id="id723F9F96E62045018BCFEDDFF82B36D6" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary shall deny or revoke certification to an eligible provider under this subsection if the Secretary determines that the eligible provider is currently—</text> <subparagraph id="idCD54171E2BFD472F86E9036E00B367DE"><enum>(A)</enum><text>excluded from participation in a Federal health care program (as defined in section 1128B(f) of the Social Security Act (42 U.S.C. 1320a–7b(f))) under section 1128 or 1128A of the Social Security Act (42 U.S.C. 1320a–7 and 1320a–7a); or</text> </subparagraph><subparagraph id="idA8DAE00329384147A23738993E4DD802"><enum>(B)</enum><text>identified as an excluded source on the list maintained in the System for Award Management, or any successor system.</text> </subparagraph></paragraph></subsection><subsection id="id793f1958c43c4780ae1e7b4bc6cf0739"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(e)</added-phrase></enum><header>Terms of agreements</header><text>Each agreement entered into with an eligible provider under this section shall include provisions requiring the eligible provider to do the following:</text> <paragraph id="idfb1c92f06af04876bab6b0526f83efe6"><enum>(1)</enum><text>To accept payment for extended care furnished under this section at rates established by the Secretary for purposes of this section, which shall be, to the extent practicable, the rates paid by the United States for such care to providers of services and suppliers under the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>).</text> </paragraph><paragraph id="id42c28111ae6c41f1a44fd070c71a5731"><enum>(2)</enum><text>To accept payment under paragraph (1) as payment in full for extended care furnished under this section and to not seek any payment for such care from the recipient of such care.</text> </paragraph><paragraph id="idf5c3ea83130d46cba9256b6de886c387"><enum>(3)</enum><text>To furnish under this section only the extended care authorized by the Department under this section unless the eligible provider receives prior written consent from the Department to furnish extended care outside the scope of such authorization.</text> </paragraph><paragraph id="id7b7aee38c33e4adc88724cf1c138bf95"><enum>(4)</enum><text>To bill the Department for extended care furnished under this section in accordance with a methodology established by the Secretary for purposes of this section.</text> </paragraph><paragraph id="id67f2edbf92914e0e894efafa9f9f4b5d"><enum>(5)</enum><text>Not to seek to recover or collect from a health-plan contract or third party, as those terms are defined in section 1729 of this title, for any extended care for which payment is made by the Department under this section.</text> </paragraph><paragraph id="idbb3d49b0c66248ae8c5c2ac38f34633a"><enum>(6)</enum><text>To provide medical records for veterans furnished extended care under this section to the Department in a time frame and format specified by the Secretary for purposes of this section.</text> </paragraph><paragraph id="id83fe8e54d9e342eb95562653f9f3705f"><enum>(7)</enum><text>To meet such other terms and conditions, including quality of care assurance standards, as the Secretary may specify for purposes of this section.</text> </paragraph></subsection><subsection id="ida306496402ce4551b2d8b9cc6aa4da40"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(f)</added-phrase></enum><header>Termination of agreements</header><paragraph commented="no" display-inline="yes-display-inline" id="idE40F926AAD404D30AE10CF281BCD8236"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>An eligible provider may terminate an agreement with the Secretary under this section at such time and upon such notice to the Secretary as the Secretary may specify for purposes of this section.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="idC5F66D923F61435DBA9D2173DD33B698" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary may terminate an agreement with an eligible provider under this section at such time and upon such notice to the eligible provider as the Secretary may specify for purposes of this section, if the Secretary—</text> <subparagraph id="id2AADBC6C425C44D99C86F8D73A7894D0"><enum>(A)</enum><text>determines that the eligible provider failed to comply substantially with the provisions of the agreement or with the provisions of this section and the regulations prescribed thereunder;</text> </subparagraph><subparagraph id="id063A9792C6604A11863AD6FAB4B45E05"><enum>(B)</enum><text>determines that the eligible provider is—</text> <clause id="id84A9A4707652497E8B986937E608AFC4"><enum>(i)</enum><text>excluded from participation in a Federal health care program (as defined in section 1128B(f) of the Social Security Act (42 U.S.C. 1320a–7b(f))) under section 1128 or 1128A of the Social Security Act (42 U.S.C. 1320a–7 and 1320a–7a); or</text> </clause><clause id="id0EEC6773CA484871A013523A5E925C14"><enum>(ii)</enum><text>identified as an excluded source on the list maintained in the System for Award Management, or any successor system;</text> </clause></subparagraph><subparagraph id="id24A6D592DD1E4FB984FCA0D77BF83E32"><enum>(C)</enum><text>ascertains that the eligible provider has been convicted of a felony or other serious offense under Federal or State law and determines that the continued participation of the eligible provider would be detrimental to the best interests of veterans or the Department; or</text> </subparagraph><subparagraph id="id2591E4B6839F43CA973EA014C00C60F2"><enum>(D)</enum><text>determines that it is reasonable to terminate the agreement based on the health care needs of a veteran or veterans.</text> </subparagraph></paragraph></subsection><subsection id="id66F16CDBB7A74B43A42EBBE321080DC4"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(g)</added-phrase></enum><header>Periodic review of certain agreements</header><paragraph commented="no" display-inline="yes-display-inline" id="id20D473A7573540BBAFEC221C790BC852"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>Not less frequently than once every two years, the Secretary shall review each Veterans Extended Care Agreement of material size entered into during the two-year period preceding the review to determine whether it is feasible and advisable to furnish the extended care furnished under such agreement at facilities of the Department or through contracts or sharing agreements entered into under authorities other than this section.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="idEADE74FC3C0A42F0A0652E270696B30F" indent="up1" reported-display-style="italic"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id2A6B68B178874C9AB2001EAAEF933122"><enum>(A)</enum><text>Subject to subparagraph (B), a Veterans Extended Care Agreement is of material size as determined by the Secretary for purposes of this section.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id66C7AE78D8DC49A2A51D3DAC4E6B91A3" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>A Veterans Extended Care Agreement entered into after September 30, 2016, is of material size if the purchase of extended care under the agreement exceeds $1,000,000 annually. The Secretary may adjust such amount to account for changes in the cost of health care based upon recognized health care market surveys and other available data and shall publish any such adjustments in the Federal Register.</text> </subparagraph></paragraph></subsection><subsection id="id02d6b8bb19664b3c819040af6a8907a9"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(h)</added-phrase></enum><header>Exclusion of certain Federal contracting provisions</header><paragraph commented="no" display-inline="yes-display-inline" id="idCFCC3E3604D64CE8ADD49BC4B5F16BBC"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>An agreement under this section may be entered into without regard to any law that would require the Secretary to use competitive procedures in selecting the party with which to enter into the agreement.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="id163565353B874737AE1520852BB6208E" indent="up1" reported-display-style="italic"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="idFFBB7DC273494A26857F32BE5B91D3AF"><enum>(A)</enum><text>Except as provided in subparagraph (B) and unless otherwise provided in this section or regulations prescribed pursuant to this section, an eligible provider that enters into an agreement under this section is not subject to, in the carrying out of the agreement, any law that providers of services and suppliers under the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>) are not subject to.</text> </subparagraph><subparagraph changed="added" committee-id="SSVA00" id="id60FC3030B9BB49C99CBB0C66019BCE5D" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>Notwithstanding subparagraph (A), an eligible provider that enters into an agreement under this section shall be subject to all laws regarding integrity, ethics, fraud, or that subject a person to civil or criminal penalties as if such laws were incorporated into its provider agreements.</text> </subparagraph></paragraph></subsection><subsection id="id0f69d95297424c88a8f80dfbddb822bf"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(i)</added-phrase></enum><header>Quality of care</header><text>The Secretary shall establish through regulation a system or systems for—</text> <paragraph id="id3480F41FEA71403DAEC3118C1AB16542"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>monitoring the quality of extended care furnished to veterans under this section; and</text> </paragraph><paragraph id="idA8E835D106384E248043B461E1839EBF"><enum>(2)</enum><text>assessing the quality of extended care furnished by an eligible provider under this section prior to the renewal of a Veterans Extended Care Agreement with the eligible provider.</text> </paragraph></subsection><subsection id="idd2a0948bcc79464b8a098ebd47871e5b"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(j)</added-phrase></enum><header>Dispute resolution</header><paragraph commented="no" display-inline="yes-display-inline" id="id4910220DB15744DEBBD49288D82A130C"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(1)</added-phrase></enum><text>The Secretary shall establish administrative procedures for eligible providers with which the Secretary has entered an agreement under this section to present any dispute arising under or related to the agreement.</text> </paragraph><paragraph changed="added" committee-id="SSVA00" id="id935D522D48C74A8DA25A50CBC3CA6179" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>Before using any dispute resolution mechanism under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/41/71">chapter 71</external-xref> of title 41 with respect to a dispute arising under an agreement under this section, an eligible provider must first exhaust the administrative procedures established by the Secretary under paragraph (1).</text> </paragraph></subsection><subsection id="id6D4A94F256E14F31A250A89C00B764C7"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(k)</added-phrase></enum><header>Sunset</header><text>The Secretary may not furnish extended care through the use of an agreement entered into under this section after the date that is two years after the date of the enactment of the <short-title>Jason Simcakoski Memorial Act</short-title>.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection id="id9cfa566a0bb34a2895e54515e4b21341"><enum>(b)</enum><header>Regulations</header><text>The Secretary of Veterans Affairs shall prescribe an interim final rule to carry out section 1703A of such title, as added by subsection (a), not later than one year after the date of the enactment of this Act.</text> </subsection><subsection id="iddeb24b40e17c43d98815bcf696ea3d81"><enum>(c)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 17 of such title is amended by inserting after the item related to section 1703 the following new item:</text> <quoted-block changed="added" committee-id="SSVA00" display-inline="no-display-inline" id="id231F46E4F6B14596A5F13D6A5245A906" reported-display-style="italic" style="OLC"><toc changed="added" committee-id="SSVA00" reported-display-style="italic"><toc-entry bold="off" level="section">1703A. Veterans Extended Care Agreements with certain health care providers.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection></section><section changed="added" id="id00c2a8e4bc784d1695972f892c2e8770" reported-display-style="italic"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">462.</added-phrase></enum><header>Modification of authority to enter into agreements with State homes to provide nursing home care</header> <subsection id="id0372ac6355cf4584be3bfb79bcde096e"><enum>(a)</enum><header>Use of agreements</header> <paragraph id="id38DC266B1F424ABAB7F68D8BF9E188A1"><enum>(1)</enum><header>In general</header><text>Paragraph (1) of section 1745(a) of title 38, United States Code, is amended, in the matter preceding subparagraph (A), by striking <quote>a contract (or agreement under section 1720(c)(1) of this title)</quote> and inserting <quote>an agreement</quote>.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="idBDE41AA857544541B27DF0F4E6F60346"><enum>(2)</enum><header>Payment</header><text>Paragraph (2) of such section is amended by striking <quote>contract (or agreement)</quote> each place it appears and inserting <quote>agreement</quote>.</text> </paragraph></subsection><subsection id="id17acf5fa52e04957a90383a2a84d7f58"><enum>(b)</enum><header>Exclusion of certain Federal contracting provisions</header><text>Such section is amended by adding at the end the following new paragraphs:</text> <quoted-block changed="added" display-inline="no-display-inline" id="idC2647F9152774D5A81244C490CB0D7C4" reported-display-style="italic" style="OLC"> <paragraph id="idb90f85e6bd374a4ea67b27be41bab4ce" indent="up1"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id6652DD9E9D1346038ECD5C0E51FCB906"><enum>(A)</enum><text>An agreement under paragraph (1) may be entered into without regard to any law that would require the Secretary to use competitive procedures in selecting the party with which to enter into the agreement.</text> </subparagraph><subparagraph changed="added" id="id650222d0314b469e95421edb81d6a854" indent="up1" reported-display-style="italic"><enum>(B)</enum><clause commented="no" display-inline="yes-display-inline" id="id854219DA41404510AF8CA190C051AAA9"><enum>(i)</enum><text>Except as provided in clause (ii) and unless otherwise provided in this section or regulations prescribed pursuant to this section, a State home that enters into an agreement under paragraph (1) is not subject to, in the carrying out of the agreement, any law that a provider described in subparagraph (C) is not subject to under the original Medicare fee-for-service program under parts A and B of title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>) or the Medicaid program under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>).</text> </clause><clause changed="added" id="id43bba0b529b643e4849870160b076648" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text>Notwithstanding clause (i), a State home that enters into an agreement under paragraph (1) shall be subject to all laws regarding integrity, ethics, fraud, or that subject a person to civil or criminal penalties as if such laws were incorporated into its provider agreements.</text> </clause></subparagraph><subparagraph changed="added" id="id434a29fc38b741f49ccec66a26019b21" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>A provider described in this subparagraph is one of the following:</text> <clause id="id17aced89e144429690dce5b2d9001e71"><enum>(i)</enum><text>A provider of services that has enrolled and entered into a provider agreement under section 1866(a) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395cc">42 U.S.C. 1395cc(a)</external-xref>).</text> </clause><clause id="id9d980c3d292b4001975504695403e08c"><enum>(ii)</enum><text>A physician or supplier that has enrolled and entered into a participation agreement under section 1842(h) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395u">42 U.S.C. 1395u(h)</external-xref>).</text> </clause><clause id="id368a2130e4e04def938307d943c98241"><enum>(iii)</enum><text>A provider of items and services receiving payment under a State plan under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) or a waiver of such a plan.</text> </clause></subparagraph></paragraph><paragraph id="id925DB619592043BCAD91692EB3A06EC2" indent="up1"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(5)</added-phrase></enum><text>The Secretary may not furnish nursing home care under an agreement entered into under paragraph (1) after the date that is two years after the date of the enactment of the <short-title>Jason Simcakoski Memorial Act</short-title>.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" display-inline="no-display-inline" id="id02F5A488DDD7422FA5D40CF4576D79EE"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(c)</added-phrase></enum><header display-inline="yes-display-inline">Effective date</header><text display-inline="yes-display-inline">The amendments made by this section shall apply to agreements entered into under section 1745(a) of such title on and after the date that is 30 days after the date of the enactment of this Act.</text> </subsection></section></subtitle><enum>V</enum><header>Other matters</header> <section changed="added" committee-id="SSVA00" id="id4D09ECE49E5A4DA2AA9E10EAF646A293" reported-display-style="italic"><enum>501.</enum><header>Extension of temporary increase in number of judges on United States Court of Appeals for Veterans Claims</header> <subsection id="idD3567C588565483085B29F8753699DB6"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Subsection (i)(2) of section 7253 of title 38, United States Code, is amended by striking <quote>January 1, 2013</quote> and inserting <quote>January 1, 2021</quote>.</text> </subsection><subsection id="id30DBB300DBC949C58E073DF86D50C2CB"><enum>(b)</enum><header>Report</header> <paragraph id="idDDB4DD33829146B7B3AC46910BA06283"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than June 30, 2020, the chief judge of the United States Court of Appeals for Veterans Claims 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 temporary expansions of the Court under section 7253 of title 38, United States Code.</text> </paragraph><paragraph id="id2549B6609A914C75B9D1CB6F4810B847"><enum>(2)</enum><header>Contents</header><text display-inline="yes-display-inline">The report required by paragraph (1) shall include the following:</text> <subparagraph id="id1b079bbf4390427db52fd068db9c56b2"><enum>(A)</enum><text>An assessment of the effect of the expansions on ensuring appeals are handled in a timely manner.</text> </subparagraph><subparagraph id="id6cbd372c655648e38313d0d55a4d690e"><enum>(B)</enum><text>A description of the ways in which the complexity levels of the appeals acted on by the Court may have changed based on service during recent conflicts compared to those based on service from previous eras.</text> </subparagraph><subparagraph commented="no" display-inline="no-display-inline" id="id29ac6a85b132498ca5e1b19ce78421e4"><enum>(C)</enum><text>A recommendation on whether the number of judges should be adjusted at the end of the temporary expansion period, including statistics, projections, trend analyses, and other information to support the recommendation.</text> </subparagraph></paragraph></subsection></section><section changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id7D5C82D18C6547B68BE02E9B25D1C55D" reported-display-style="italic"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">502.</added-phrase></enum><header>Repeal inapplicability of modification of basic allowance for housing to benefits under laws administered by Secretary of Veterans Affairs</header> <subsection commented="no" display-inline="no-display-inline" id="id2A9602F9C4554E959DD65FB813EA3421"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(a)</added-phrase></enum><header>Repeal</header><text>Subsection (b) of section 604 of the Carl Levin and Howard P. <quote>Buck</quote> McKeon National Defense Authorization Act for Fiscal Year 2015 (<external-xref legal-doc="public-law" parsable-cite="pl/113/291">Public Law 113–291</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/37/403">37 U.S.C. 403</external-xref> note) is repealed.</text> </subsection><subsection commented="no" display-inline="no-display-inline" id="idF713F16290D3482DB22844C9C27EEAFF"><enum>(b)</enum><header>Effective date</header><text>The amendment made by subsection (a) shall take effect on January 1, 2016.</text> </subsection></section><section changed="added" commented="no" id="idE67F3326AC6C440EB01E3402D8C60FF4" reported-display-style="italic"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">503.</added-phrase></enum><header>Department of Veterans Affairs program of internal audits</header> <subsection commented="no" id="idA5B39AF4DFDE422C92DC448B8004F159"><enum>(a)</enum><header>In general</header><text>Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/5">chapter 5</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/527">section 527</external-xref> the following new section:</text> <quoted-block changed="added" display-inline="no-display-inline" id="id971942E29B0E4D37AD8D72B1D8505EFA" reported-display-style="italic" style="USC"> <section commented="no" id="idC89F3085A46C4BE6805F0084F64E37C5"><enum>527A.</enum><header>Program of internal audits</header> <subsection commented="no" id="id483389A502034AB08BFD3C046E64805E"><enum>(a)</enum><header>Program required</header><paragraph commented="no" display-inline="yes-display-inline" id="idAE229971FF3D4DFFB1EFEDCC63CC76D2"><enum>(1)</enum><text>The Secretary shall carry out a program of internal audits and self-analysis to improve the furnishing of benefits and health care to veterans and their families.</text> </paragraph><paragraph changed="added" commented="no" id="idC05DB94FF6714FDFB11A4C7A9A731D79" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary shall carry out the program required by paragraph (1) through an office the Secretary shall establish for purposes of the program within the office of the Secretary that is interdisciplinary and independent of—</text> <subparagraph commented="no" id="idC21F2987FF404FFF8599FAF25B2A37E3"><enum>(A)</enum><text>the other offices within the office of the Secretary; and</text> </subparagraph><subparagraph commented="no" id="idD9428B2B9895442783956EFF87EA97E3"><enum>(B)</enum><text>the covered administrations (or functions of such administrations), staff organizations, and staff offices identified under subsection (b)(1)(A).</text> </subparagraph></paragraph></subsection><subsection commented="no" id="id6751D7F71B654DF28383698DE4AB298D"><enum>(b)</enum><header>Program requirements</header><paragraph commented="no" display-inline="yes-display-inline" id="id91A2ECD0DDB84D868912CA53D9A97962"><enum>(1)</enum><text>In carrying out the program required by subsection (a), the Secretary shall—</text> <subparagraph changed="added" commented="no" id="id3383CD8FC4B046869684C87AF2F2366B" indent="up1" reported-display-style="italic"><enum>(A)</enum><text>conduct periodic risk assessments of the Department to identify those covered administrations (or functions of such administrations), staff organizations, and staff offices of the Department the audit of which would lead towards the greatest improvement in the furnishing of benefits and health care to veterans and their families;</text> </subparagraph><subparagraph changed="added" commented="no" id="idC31D679E667947C4BE5AD51A782EED3D" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>develop plans that are informed by the risk assessments conducted under paragraph (1) to conduct internal audits of the covered administrations (or functions of such administrations), staff organizations, and staff offices identified under subparagraph (A); and</text> </subparagraph><subparagraph changed="added" commented="no" id="id1BC0D827AB5A4C34A9F8462578B150BE" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>conduct internal audits in accordance with the plans developed pursuant to subparagraph (B).</text> </subparagraph></paragraph><paragraph changed="added" commented="no" id="idDA9DAECF13554BA898DBD5AD26D49BF3" indent="up1" reported-display-style="italic"><enum>(2)</enum><text>The Secretary shall carry out under the program required by subsection (a) an audit of not fewer than five covered administrations (or functions of such administrations), staff organizations, or staff offices of the Department each year.</text> </paragraph><paragraph changed="added" commented="no" id="id67F1DD092210460ABCB752CFB9766794" indent="up1" reported-display-style="italic"><enum>(3)</enum><text>In identifying covered administrations (or functions of such administrations), staff organizations, and staff offices of the Department under paragraph (1)(A), the Secretary shall accord priority to the covered administrations and functions of such administrations.</text> </paragraph><paragraph changed="added" commented="no" id="id7C7A8C092FC241F599DBE611C31FA5FB" indent="up1" reported-display-style="italic"><enum>(4)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id135BCFE46AA347B1B702485C68FAAADA"><enum>(A)</enum><text>For purposes of this subsection, the covered administrations of the Department are the following:</text> <clause changed="added" commented="no" id="idDAA9B0211018430BA967B3395E37DF75" indent="up1" reported-display-style="italic"><enum>(i)</enum><text>The National Cemetery Administration.</text> </clause><clause changed="added" commented="no" id="id847916CD6EB94ABAB11F1249D76AC31E" indent="up1" reported-display-style="italic"><enum>(ii)</enum><text>The Veterans Benefits Administration.</text> </clause><clause changed="added" commented="no" id="idB38ABA4A00E348E1816CB928C6780145" indent="up1" reported-display-style="italic"><enum>(iii)</enum><text>The Veterans Health Administration.</text> </clause></subparagraph><subparagraph changed="added" commented="no" id="id70323279C65345F5BB7386FF27FCC7A4" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>For purposes this subsection, the covered staff organizations of the Department are the following:</text> <clause commented="no" id="idaac77865b080479e80105be9b81d7ed2"><enum>(i)</enum><text>The Office of Acquisition, Logistics, and Construction.</text> </clause><clause commented="no" id="idb79fe2abfcf540da9801ede95cc5b887"><enum>(ii)</enum><text>The Advisory Committee Management Office.</text> </clause><clause commented="no" id="ida928b68dce4b49dabe7422aebb6b4d17"><enum>(iii)</enum><text>The Board of Veterans' Appeals.</text> </clause><clause commented="no" id="idf91c8316f299422e950c18a734278ae4"><enum>(iv)</enum><text>The Center for Faith-Based and Neighborhood Partnerships.</text> </clause><clause commented="no" id="idb44821f53a8a48bbab43f18151c5544a"><enum>(v)</enum><text>The Center for Minority Veterans.</text> </clause><clause commented="no" id="ide3b6c64f47d44839b0e890eb305ac5d0"><enum>(vi)</enum><text>The Center for Women Veterans.</text> </clause><clause commented="no" id="id5279203d3d8d4f3790ccc4ec7b194002"><enum>(vii)</enum><text>The Office of General Counsel.</text> </clause><clause commented="no" id="idc39a64f2cdd74234a023a1f780a67865"><enum>(viii)</enum><text>The Office of Regulation Policy and Management.</text> </clause><clause commented="no" id="id539a6264660747e98649e96abddad079"><enum>(ix)</enum><text>The Office of Employment Discrimination Complaint Adjudication.</text> </clause><clause commented="no" id="id6a37e20860814ce7af08132e65bb0063"><enum>(x)</enum><text>The Office of Interagency Care and Benefits Coordination.</text> </clause><clause commented="no" id="idfdbc92c3f33141caaefdfcb668a35827"><enum>(xi)</enum><text>The Office of Small and Disadvantaged Business Utilization.</text> </clause><clause commented="no" id="idf2807bef7d3348de9730d8b86f883fb9"><enum>(xii)</enum><text>The Office of Survivors Assistance.</text> </clause><clause commented="no" id="idcb4605bea33b4139805f4fe0a9c7221c"><enum>(xiii)</enum><text>The Veterans' Service Organizations Liaison.</text> </clause></subparagraph><subparagraph changed="added" commented="no" id="id877EC4C2E0DA49AEAFAE77EB7AB162B8" indent="up1" reported-display-style="italic"><enum>(C)</enum><text>For purposes of this subsection, the covered staff offices of the Department are the following:</text> <clause commented="no" id="ida181fc15f9bf4a3795abe3e25535faf2"><enum>(i)</enum><text>The office of the Assistant Secretary for Congressional and Legislative Affairs.</text> </clause><clause commented="no" id="id35cf7833e6d8420f83e15d6bcc21233f"><enum>(ii)</enum><text>The office of the Assistant Secretary for Human Resources and Administration.</text> </clause><clause commented="no" id="id58bcb251d36045efaa11f9a299346223"><enum>(iii)</enum><text>The office of the Assistant Secretary for Information and Technology.</text> </clause><clause commented="no" id="idaa933f02c70143ba86aa48e15621c3c3"><enum>(iv)</enum><text>The Office of Management.</text> </clause><clause commented="no" id="id194840e574a34afa8d97022df3c65b84"><enum>(v)</enum><text>The office of the Assistant Secretary for Operations, Security, and Preparedness.</text> </clause><clause commented="no" id="id795da8cf0602492aaca0151a1ef2b654"><enum>(vi)</enum><text>The office of the Assistant Secretary for Policy and Planning.</text> </clause><clause commented="no" id="idca7652a4f91d4872a2e5e50bd0f1dac5"><enum>(vii)</enum><text>The office of the Assistant Secretary for Public and Intergovernmental Affairs.</text> </clause></subparagraph></paragraph></subsection><subsection commented="no" id="idB938615A4490425B857DE209EA151783"><enum>(c)</enum><header>Reports</header><paragraph commented="no" display-inline="yes-display-inline" id="id32425BC655914842BB0CD99668AA3259"><enum>(1)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id006BC6F91F1A430F8EF2CBD7BD70BB6D"><enum>(A)</enum><text>Not later than 90 days after completing an audit under the program required by subsection (a), the Secretary shall submit to the appropriate committees of Congress a report on the audit.</text> </subparagraph><subparagraph changed="added" commented="no" id="id341475C58E014C4580B069DA360EE76E" indent="up2" reported-display-style="italic"><enum>(B)</enum><text>Each report submitted under subparagraph (A) with respect to an audit shall include the following:</text> <clause commented="no" id="id1654BA50884646A0AC970B6D3BD3364F"><enum>(i)</enum><text>A summary of the audit.</text> </clause><clause commented="no" id="id488B435A39014816924D27247234F0EF"><enum>(ii)</enum><text>The findings of the Secretary with respect to the audit.</text> </clause><clause commented="no" id="idF6A93C29737F4A35B8058B34CEDA43F3"><enum>(iii)</enum><text>Such recommendations as the Secretary may have for legislative or administrative action to improve the furnishing of benefits and health care to veterans and their families.</text> </clause><clause commented="no" id="idE72B18BAA2EB4943B11E0D09650319AD"><enum>(iv)</enum><text>Plans to carry out the recommendations submitted under clause (iii), including timelines for completion of such plans.</text> </clause></subparagraph></paragraph><paragraph changed="added" commented="no" id="idDEA48747E13047FE888C8D3D866075C2" indent="up1" reported-display-style="italic"><enum>(2)</enum><subparagraph commented="no" display-inline="yes-display-inline" id="id025BE20DD1AB4F8893A47CE9D8D1AA74"><enum>(A)</enum><text>Not later than September 1 of each year, the Secretary shall submit to the appropriate committees of Congress a report on the administration of this section.</text> </subparagraph><subparagraph changed="added" commented="no" id="id889CD976B724479B9A4A0E9F54070DCE" indent="up1" reported-display-style="italic"><enum>(B)</enum><text>Each report submitted under subparagraph (A) shall include the following:</text> <clause commented="no" id="id1B2614D4727B4CB2BDF89EA59BD91389"><enum>(i)</enum><text>A detailed description of each matter for which a recommendation was submitted under clause (iii) of paragraph (1)(B) and with respect to which plans that were submitted under clause (iv) of such paragraph have not been completed.</text> </clause><clause commented="no" id="id0D887BB714974EA0A502E1F232CCFB2E"><enum>(ii)</enum><text>A plan for the conduct of audits under this section during the first fiscal year beginning after the fiscal year in which the report is submitted, which shall include the following:</text> <subclause commented="no" id="id978904891308480694A55A3171E97D58"><enum>(I)</enum><text>A description of any risk assessments the Secretary plans to conduct in such fiscal year.</text> </subclause><subclause commented="no" id="id5B66B526D9FC4B28B1A598789FB73BEA"><enum>(II)</enum><text>A summary of each audit the Secretary plans to conduct in such fiscal year, including a description of the subject matter of the audit and identification of the administration, office, or function to be audited.</text> </subclause></clause></subparagraph></paragraph><paragraph changed="added" commented="no" id="id1F7D6C4F5F4B4587ADC1764CE1DDF404" indent="up1" reported-display-style="italic"><enum>(3)</enum><text>In this subsection, the term <term>appropriate committees of Congress</term> includes—</text> <subparagraph commented="no" id="idBBCD0AF8FC244078923EBACEDB98B921"><enum>(A)</enum><text>the Committee on Veterans' Affairs, the Committee on Appropriations, and the Committee on Homeland Security and Governmental Affairs of the Senate; and</text> </subparagraph><subparagraph commented="no" id="id7BA6CDA6A2CB4B99B729B8206E1A5AA0"><enum>(B)</enum><text>the Committee on Veterans' Affairs, the Committee on Appropriations, and the Committee on Oversight and Government Reform of the House of Representatives.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block> </subsection><subsection commented="no" id="id8805903F11164D73ADF983F6143C62C6"><enum>(b)</enum><header>First risk assessment</header><text>The Secretary of Veterans Affairs shall complete the first risk assessment required by section 527A(b)(1)(A) of such title, as added by subsection (a), by not later than 180 days after the date of the enactment of this Act.</text> </subsection><subsection commented="no" id="id4BC7F93FBE7C4070A7D64703CD324725"><enum>(c)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 5 of such title is amended by inserting after the item relating to section 527 the following new item:</text> <quoted-block changed="added" display-inline="no-display-inline" id="idCD610A005848448E9D95ECA71421904E" reported-display-style="italic" style="OLC"><toc changed="added" reported-display-style="italic"><toc-entry bold="off" level="section">527A. Program of internal audits.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block> </subsection></section><section changed="added" commented="no" committee-id="SSVA00" display-inline="no-display-inline" id="id2FDA22314F98496283546540856385C9" reported-display-style="italic"><enum>504.</enum><header>Improvement of training for managers</header><text display-inline="no-display-inline">The Secretary of Veterans Affairs shall provide to each employee of the Department of Veterans Affairs who is employed by the Department in a managerial position periodic training on the following:</text> <paragraph commented="no" display-inline="no-display-inline" id="idA2EC3D508D6B4486A3F146313C217FFD"><enum>(1)</enum><text>The rights of whistleblowers and how to address a report by an employee of a hostile work environment, reprisal, or harassment.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id64D0EF8F9F84411CBBC5DB3B809DA0CA"><enum>(2)</enum><text>How to effectively motivate, manage, and reward the employees who report to the manager.</text> </paragraph><paragraph commented="no" display-inline="no-display-inline" id="id4B517051586B434989E69F3FACA45B76"><enum>(3)</enum><text>How to effectively manage employees who are performing at an unacceptable level and access assistance from the human resources office of the Department and the Office of the General Counsel of the Department with respect to those employees.</text></paragraph></section>Amend the title so as to read: A bill to amend title 38, United States Code, to improve the benefits and health care provided by the Department of Veterans Affairs, and for other purposes..December 7, 2016Reported with an amendment and an amendment to the title