118 HR 8371 EH: Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act
U.S. House of Representatives
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EN
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1.Short title; table of contents
(a)This Act may be cited as the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act
. (b)The table of contents for this Act is as follows:
Sec. 1. Short title; table of contents.
Title I—Health Care Matters
Subtitle A—Veterans Community Care Program Matters
Sec. 101. Implementation of provision of care under Veterans Community Care Program upon determination of eligibility by veteran and veteran’s referring clinician.
Sec. 102. Outreach regarding care and services under Veterans Community Care Program.
Sec. 103. Annual review and report on waivers of certain payment rates under Veterans Community Care Program.
Sec. 104. Modification of requirements for standards for quality of care from Department of Veterans Affairs.
Sec. 105. Pilot program to improve administration of care under Veterans Community Care Program.
Sec. 106. Pilot program on consolidating approval process of Department of Veterans Affairs for covered dental care.
Sec. 107. Strategic plan on value-based health care system for Veterans Health Administration; pilot program.
Sec. 108. Plan on adoption of certain health information standards for Department of Veterans Affairs and certain health care providers.
Sec. 109. Report on use of value-based reimbursement models under Veterans Community Care Program.
Sec. 110. Inspector General assessment of implementation of Veterans Community Care Program.
Sec. 111. Comptroller General report on dentistry under Veterans Community Care Program.
Subtitle B—Matters Relating to Nursing Home and Other Long Term Care and Family Caregivers
Sec. 120. Increase of expenditure cap for noninstitutional care alternatives to nursing home care.
Sec. 121. Coordination with Program of All-Inclusive Care for the Elderly.
Sec. 122. Authority for Secretary of Veterans Affairs to award grants or contracts to entities to improve provision of mental health support to family caregivers of veterans.
Sec. 123. Home- and community-based services: programs.
Sec. 124. Coordination with assistance and support services for caregivers.
Sec. 125. Improvements to program of comprehensive assistance for family caregivers.
Sec. 126. Improvements relating to Homemaker and Home Health Aide program.
Sec. 127. Pilot program to furnish assisted living services to certain veterans.
Sec. 128. Provision of medicine, equipment, and supplies available to Department of Veterans Affairs to State homes.
Sec. 129. Recognition of organizations and individuals to assist veterans, family members, and caregivers navigating programs and services of Veterans Health Administration.
Sec. 130. Reviews and other improvements relating to home- and community-based services.
Sec. 131. GAO report on mental health support for caregivers.
Sec. 132. Development of centralized website for program information.
Sec. 133. Definitions.
Subtitle C—Medical Treatment and Other Matters
Sec. 140. Quarterly report on referrals for non-Department of Veterans Affairs health care.
Sec. 141. Elimination of certain requirements for certain Department of Veterans Affairs Assistant Under Secretaries.
Sec. 142. Modification of pay limitation for physicians, podiatrists, optometrists, and dentists of Department of Veterans Affairs.
Sec. 143. Reimbursement of ambulance cost for care for certain rural veterans.
Sec. 144. Pilot program to furnish dental care from the Department of Veterans Affairs to certain veterans diagnosed with ischemic heart disease.
Sec. 145. Documentation of preferences of veterans for scheduling of appointments for health care under laws administered by Secretary of Veterans Affairs.
Sec. 146. Staffing model and performance metrics for certain employees of the Department of Veterans Affairs.
Sec. 147. Online health education portal for veterans enrolled in patient enrollment system of Department of Veterans Affairs.
Sec. 148. Limitation on detail of directors of medical centers of Department of Veterans Affairs to different positions.
Sec. 149. National Veteran Suicide Prevention Annual Report.
Sec. 150. Report on physical infrastructure required by medical facilities of Department of Veterans Affairs to provide dental care services.
Sec. 151. Comptroller General report on certain oral health care programs under laws administered by Secretary of Veterans Affairs.
Sec. 152. Review of workflows associated with processing referrals between facilities of the Veterans Health Administration.
Sec. 153. Plan for timely scheduling of appointments at medical facilities of Department of Veterans Affairs.
Sec. 154. Authorization of appropriations to support initiatives for mobile mammography services for veterans.
Title II—Economic Opportunity Matters
Subtitle A—Educational Assistance
Sec. 201. Temporary expansion of eligibility for Marine Gunnery Sergeant John David Fry Scholarship.
Sec. 202. Removal of expiration on entitlement to Marine Gunnery Sergeant John David Fry Scholarship for surviving spouses.
Sec. 203. Sole liability for transferred educational assistance by an individual who fails to complete a service agreement.
Sec. 204. Notice to educational institutions of risk-based surveys.
Sec. 205. Relationship of participation by an educational institution in certain Federal student financial aid programs to approval of such institution for purposes of Department of Veterans Affairs educational assistance programs.
Sec. 206. Expansion of Department of Veterans Affairs oversight of certain educational institutions.
Sec. 207. Requirement that educational institutions approved for purposes of Department of Veterans Affairs educational assistance programs provide digital official transcripts.
Sec. 208. Payment of full monthly housing stipend for veterans enrolled in final semester using educational assistance under Post-9/11 Educational Assistance Program.
Sec. 209. Modification of rules for approval of commercial driver education programs for purposes of educational assistance programs of the Department of Veterans Affairs.
Sec. 210. Provision of certificates of eligibility and award letters using electronic means.
Sec. 211. Retroactive effective date of law regarding charge to entitlement to educational assistance for individuals who do not transfer credits from certain closed or disapproved programs of education.
Sec. 212. Department of Veterans Affairs high technology program.
Sec. 213. Notice of changes to Department of Veterans Affairs policies and guidance affecting the educational assistance programs of the Department.
Sec. 214. Payment of VA educational assistance via electronic fund transfer to a foreign institution of higher education.
Sec. 215. Improving transparency and accountability of educational institutions for purposes of veterans educational assistance.
Subtitle B—Employment and Training
Sec. 221. Improvements to reemployment rights of members of the Armed Forces.
Sec. 222. Review of investigations manual of Veterans’ Employment and Training Service.
Sec. 223. Warrior Training Advancement Course.
Subtitle C—Home Loans
Sec. 231. Improvements to program for direct housing loans made to Native American veterans by the Secretary of Veterans Affairs.
Sec. 232. Native community development financial institution relending program.
Title III—Disability and Memorial Affairs Matters
Sec. 301. Burial allowance for certain veterans who die at home while in receipt of hospice care furnished by Department of Veterans Affairs.
Sec. 302. Authority for Secretary of Veterans Affairs to award grants to States and Indian Tribes to improve outreach to veterans.
Sec. 303. Definition of surviving spouse.
Sec. 304. Ensuring only licensed health care professionals perform medical disability examinations under certain Department of Veterans Affairs pilot program.
Sec. 305. Provision of information regarding an agent or attorney to a licensed health care professional who performs a medical disability examination under certain Department of Veterans Affairs pilot program.
Sec. 306. Modernization of Department of Veterans Affairs disability benefit questionnaires.
Sec. 307. Department of Veterans Affairs automatic processing of certain claims for temporary disability ratings.
Title IV—Homelessness Matters
Sec. 401. Short title.
Sec. 402. Per diem payments provided by the Secretary of Veterans Affairs for services furnished to homeless veterans.
Sec. 403. Authorization for Secretary of Veterans Affairs to use of certain funds for improved flexibility in assistance to homeless veterans.
Sec. 404. Access to Department of Veterans Affairs telehealth services.
Title V—Oversight and Investigations Matters
Sec. 501. Department of Veterans Affairs employee training regarding Office of Inspector General.
Sec. 502. Annual review of security at covered facilities of the Department of Veterans Affairs.
Sec. 503. Modification of certain housing loan fees.
<enum>I</enum><header>Health Care Matters</header>
<subtitle id="H46C2EB25B3AF4287BC36EE30BA0B0A29"><enum>A</enum><header>Veterans Community Care Program Matters</header>
<section id="H9C6F69D651424286A73CD41DD5C580C3"><enum>101.</enum><header>Implementation of provision of care under Veterans Community Care Program upon determination of eligibility by veteran and veteran’s referring clinician</header>
<subsection id="H9DDF94F9B00644A4A6FAED8461ABA33E"><enum>(a)</enum><header>In general</header><text>During the period specified in subsection (c), the Secretary of Veterans Affairs shall implement section 1703(d)(1)(E) of title 38, United States Code, in compliance with the implementing regulations for such section under section 17.4010(a)(5) of title 38, Code of Federal Regulations, such that the determination of eligibility for care is final and shall be made by the veteran and the veteran’s referring clinician.</text></subsection> <subsection id="HACAAEE5FDC2A4C439DCA07F534F41222"><enum>(b)</enum><header>Correction of errors</header><text>A covered veteran and the referring clinician of such veteran may correct any errors made with respect to a determination described in subsection (a).</text></subsection>
<subsection id="H662536C072614C048F125639841063A6"><enum>(c)</enum><header>Period specified</header><text>The period specified in this subsection is the two-year period beginning on the date that is 90 days after the date of the enactment of this Act.</text></subsection> <subsection id="HE14CC0D1FAB941B6929BAC202407299C"><enum>(d)</enum><header>Report</header><text>Not later than one year and not later than two years after the commencement of the period specified by subsection (c), the Secretary of Veterans Affairs shall submit to Congress a report on the care provided under section 1703(d)(1)(E) of title 38, United States Code, during the one-year period preceding the date of the report, including—</text>
<paragraph id="HE43949A344B24B34AF65C15E673FC38D"><enum>(1)</enum><text>the number of instances of care provided;</text></paragraph> <paragraph id="H1B7AD250FF7D4EFF816B6092C8F303CF"><enum>(2)</enum><text>the type of care provided; and</text></paragraph>
<paragraph id="HEE496AC7738B4C9D8D7AC94854F0D2D7"><enum>(3)</enum><text>the cost of such care.</text></paragraph></subsection> <subsection id="H9A2DDAFDBB364A08B2945709463235CC"><enum>(e)</enum><header>Rule of construction</header><text>Nothing in this section shall be construed to limit the Secretary’s authority to prescribe, amend, or rescind regulations under section 1703 of title 38, United States Code.</text></subsection>
<subsection id="H766346C318F345B9AC9D4C9220448836"><enum>(f)</enum><header>Covered veteran defined</header><text>In this section, the term <quote>covered veteran</quote> has the meaning given that term in section 1703(b) of title 38, United States Code.</text></subsection></section> <section id="H02AA702569D2463A9854E2D1AAD03F7E" commented="no" display-inline="no-display-inline" section-type="subsequent-section"><enum>102.</enum><header>Outreach regarding care and services under Veterans Community Care Program</header> <subsection id="H27C918106348453383D555D1E4429485" commented="no"><enum>(a)</enum><header>Requirement</header><text>Section 1703 of title 38, United States Code, is further amended—</text>
<paragraph id="H86DE008321FA404C84AA4B03D25C20AC" commented="no"><enum>(1)</enum><text>by redesignating subsection (o) as subsection (p); and</text></paragraph> <paragraph id="HEC79E1BFB3D747DA97BF86202A31E3D1" commented="no"><enum>(2)</enum><text>by inserting after subsection (n) the following new subsection (o):</text>
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<subsection id="HAE0B38952B864578B7B10428750A4EBB" commented="no"><enum>(o)</enum><header>Outreach regarding availability of care and services</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H864CF9B26F48423BA02AB7B747A09460"><enum>(1)</enum><text>The Secretary shall conduct outreach to inform veterans of the following:</text> <subparagraph id="HBBB8865AD41248D697E20CD4545A5FA8" commented="no" indent="up1"><enum>(A)</enum><text>The conditions for care or services under subsections (d) and (e).</text></subparagraph>
<subparagraph id="HF639D35FF15A4A0EB5BA934762DCF557" commented="no" indent="up1"><enum>(B)</enum><text>How to request such care or services.</text></subparagraph> <subparagraph id="HB95841EC9624499BB03FEAB92C0B560C" commented="no" indent="up1"><enum>(C)</enum><text>How to appeal a denial of a request for such care or services using the clinical appeals process of the Veterans Health Administration.</text></subparagraph></paragraph>
<paragraph id="H868193A9A8A64D8A8CE4A2C60D2B2425" indent="up1" commented="no"><enum>(2)</enum><text>Upon enrollment of a veteran in the system of annual patient enrollment established and operated under section 1705 of this title, and not less frequently than every two years thereafter, the Secretary shall inform the veteran of information described in paragraph (1).</text></paragraph> <paragraph id="H6C2A7335C05C4D89A1118B014DFEA6B3" indent="up1" commented="no"><enum>(3)</enum><text>The Secretary shall ensure that information described in paragraph (1) is—</text>
<subparagraph id="H935BAE1132174A09A6F3AB6E4D490433"><enum>(A)</enum><text>publicly displayed in each medical facility of the Department;</text></subparagraph> <subparagraph id="HACAB4D1E2B594008AD13F3770ECB5DEC"><enum>(B)</enum><text display-inline="yes-display-inline">prominently displayed on a website of the Department; and</text></subparagraph>
<subparagraph id="H2EC89AC8E84A47AD93D38C245162ED38"><enum>(C)</enum><text display-inline="yes-display-inline">included in other outreach campaigns and activities conducted by the Secretary.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H9ED84B48329A4ACD8E01753C4A19E507" commented="no"><enum>(b)</enum><header>Solid Start program</header><text>Section 6320(a)(2)(A) of title 38, United States Code, is amended by inserting <quote>, including how to enroll in the system of annual patient enrollment established and operated under section 1705 of this title and the ability to seek care and services under sections 1703 and 1710 of this title</quote> before the semicolon.</text></subsection>
<subsection id="HD1941463B6D34CDBA240C54FDB8D7672"><enum>(c)</enum><header>Comptroller General report on outreach</header><text>Not later than two years after the date of the enactment of this Act, the Comptroller General of the United Stats shall submit to Congress a report on the efforts of the Secretary of Veterans Affairs to ensure that veterans are informed of the conditions for eligibility for care and services under section 1703 of title 38, United States Code, including such efforts to conduct outreach pursuant to subsection (q) of such section (as added by subsection (a)).</text></subsection></section> <section id="HD1AE9A24378E43D48331C98ED5901F61" display-inline="no-display-inline" section-type="subsequent-section"><enum>103.</enum><header>Annual review and report on waivers of certain payment rates under Veterans Community Care Program</header> <subsection id="H39EE9AEFA6514C8999C16AC774CCCCE6"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 1703 of title 38, United States Code, is further amended—</text>
<paragraph id="HA9E20B52A65944508F8685D5E806A37C" commented="no"><enum>(1)</enum><text>by redesignating subsection (p) as subsection (q); and</text></paragraph> <paragraph id="HB6CD5F13E0E34BEC8DF5DA37B974C4C0"><enum>(2)</enum><text>by inserting after subsection (p) the following new subsection (q):</text>
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<subsection id="HE2A6E903830F42FA9D79E00459197D4F"><enum>(q)</enum><header>Annual review and report on waivers of payment rates</header>
<paragraph id="HC09C3634752F40BAB3B0BC344185ECCB" display-inline="yes-display-inline"><enum>(1)</enum><text>On an annual basis, the Secretary shall—</text> <subparagraph id="H9637966DCF88416C9E8FCE1BB5890877" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">conduct a review of waivers of payment rates under subsection (i) for Third Party Administrators to identify whether such waivers help to alleviate community-specific challenges, including scarcity of medical services associated with access to health care; and</text></subparagraph>
<subparagraph id="HA2A0E377C8064A798E811227D9E96C6D" indent="up1"><enum>(B)</enum><text>submit to Congress a report on the results of such review.</text></subparagraph></paragraph> <paragraph id="H3DCD5E92A7864FF5B6CF9724B2F8840C" indent="up1"><enum>(2)</enum><text>Each report under paragraph (1)(B) shall include, with respect to the period covered by the report—</text>
<subparagraph id="H852E52979C614B3CA95A9F82324B5604"><enum>(A)</enum><text>a statement, disaggregated by region, of the total number of waivers described in subparagraph (A) of such paragraph requested by Third Party Administrators;</text></subparagraph> <subparagraph id="H7557B15CE2DA403984E7379E9E8E91D9"><enum>(B)</enum><text>a statement of the total number of such waivers that were—</text>
<clause id="H806D0D64600B462DBD25E706C3164AB1"><enum>(i)</enum><text>granted by the Secretary;</text></clause> <clause id="HBB14CFAF93F646A0BD87ACBD1197558A"><enum>(ii)</enum><text>denied by the Secretary; or</text></clause>
<clause id="HE05FEB92AD474CFFAF3057FA13847F69"><enum>(iii)</enum><text>withdrawn by a Third Party Administrator;</text></clause></subparagraph> <subparagraph id="H34D97FD496E949CFA0D51830BBF3C52C"><enum>(C)</enum><text>a description of the process for the review required under paragraph (1);</text></subparagraph>
<subparagraph id="H9D2887050AC74035B383696B8ED08601"><enum>(D)</enum><text>a statement, disaggregated by region, of the average time to process such waivers;</text></subparagraph> <subparagraph id="H792C80D14DAF4662816B009BC9BBA716"><enum>(E)</enum><text>an assessment, disaggregated by region, of the extent to which such waivers that were granted by the Secretary improved access to health care for covered veterans; and</text></subparagraph>
<subparagraph id="H856B2585C78C4201A2B4D970D474814A"><enum>(F)</enum><text>a description of trends, if any, identified by the Secretary with respect to such waivers.</text></subparagraph></paragraph> <paragraph id="H86B4814925204F7BB2882E1BF27A1695" indent="up1"><enum>(3)</enum><text>In this subsection, the term <term>Third Party Administrator</term> has the meaning given such term in section 1703B of this title.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H1AFC1CEFFFC1444EA17BC635DBE94FAF"><enum>(b)</enum><header>Deadline</header><text>The Secretary shall submit the first report required under subsection (q) of section 1703 of such title (as added by subsection (a)) not later than 180 days after the date of the enactment of this Act.</text></subsection></section> <section id="HA55C48C39BC949DF94BA1FC7D4655DDE" commented="no" display-inline="no-display-inline" section-type="subsequent-section"><enum>104.</enum><header>Modification of requirements for standards for quality of care from Department of Veterans Affairs</header> <subsection id="HD416B73A86CF4754B8673674C6BB5911" commented="no"><enum>(a)</enum><header>In general</header><text>Section 1703C of title 38, United States Code, is amended—</text>
<paragraph id="H74AA6A01CC774AB9970F6F3603B7CB1E" commented="no"><enum>(1)</enum><text>in subsection (a)—</text> <subparagraph id="HEAA9F39A874A480B98C48AA08EC9FC10"><enum>(A)</enum><text>in paragraph (2)—</text>
<clause id="H2554B439C3D04D339640BB8A3FB144C5" commented="no"><enum>(i)</enum><text>by striking <quote>In establishing</quote> and inserting <quote><header-in-text level="subparagraph" style="OLC"><enum-in-header>(A)</enum-in-header></header-in-text> In establishing</quote>; and</text></clause> <clause id="H3BD5DE66F6E04ECDB44B8B10A9A8D8C1" commented="no"><enum>(ii)</enum><text>by adding at the end the following new subparagraph:</text>
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<subparagraph id="H2496DCC4877B43C8BB80A0E5849E722A" commented="no" indent="up1"><enum>(B)</enum><text>The Secretary shall ensure that the standards for quality established under paragraph (1) are comparable to industry standards to ensure there is adequate data transference between care furnished by the Department and care furnished by a non-Department provider.</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="H081E89464E5F40A89F363E95BEE0115A"><enum>(B)</enum><text>in paragraph (3), by adding at the end the following new clause:</text>
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<clause id="H096A04832F55406FB2E88678B6211BE7"><enum>(v)</enum><text>Outcomes relating to patient quality of life.</text></clause><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph> <subparagraph id="HC871A57BF8F74E9DBDA2ED48E85A6F4F" commented="no"><enum>(C)</enum><text>in paragraph (4)—</text>
<clause id="H604AFB1A34C64EDF8BE0FD686B12898C" commented="no"><enum>(i)</enum><text>by striking <quote>and the Centers for Medicare & Medicaid Services</quote> and inserting <quote>the Centers for Medicare & Medicaid Services, and the Indian Health Service</quote>; and</text></clause> <clause id="H562B473162824E67AE39FF16D6CFDF21" commented="no"><enum>(ii)</enum><text>by striking <quote>and other nongovernmental entities</quote> and inserting <quote>and other non-governmental entities including Third Party Administrators</quote>; and</text></clause></subparagraph>
<subparagraph id="HCB02E07289DB4A65A4A55B06078D8DEE" commented="no"><enum>(D)</enum><text>by striking paragraph (5) and inserting the following new paragraphs:</text> <quoted-block id="H969E24462CC54046B9EFA473725C8C69" style="OLC"> <paragraph id="H63620276BEA84FD78F734C8F82A83F15" commented="no" indent="up1"><enum>(5)</enum><text>When collecting, considering, and applying data related to patient care for purposes of establishing standards for quality under paragraph (1), the Secretary shall ensure no metric is being over or under analyzed.</text></paragraph>
<paragraph id="HDF5A7B473E614715B14005D414E8BDC6" commented="no" indent="up1"><enum>(6)</enum><text>In establishing standards for quality under paragraph (1), the Secretary shall—</text> <subparagraph id="H09BB120A6D5B458B902E7A3EE0256323" commented="no"><enum>(A)</enum><text>utilize the most up-to-date practices for extracting and analyzing relevant data;</text></subparagraph>
<subparagraph id="H206F4B34ECCE4208A1C1C5B8F0B72D80" commented="no"><enum>(B)</enum><text>utilize all relevant data available to the Secretary;</text></subparagraph> <subparagraph id="H557032CA34C54EBD85C34712ED9631A1" commented="no"><enum>(C)</enum><text>ensure the most efficient use of time and resources related to the use of data scientists employed by the Department; and</text></subparagraph>
<subparagraph id="H9C1EE2D0B0184EFD840B818BC7EF0696" commented="no"><enum>(D)</enum><text>collaborate, as appropriate, with entities specified in paragraph (4).</text></subparagraph></paragraph> <paragraph id="H3E097957B94B476689129AB3CD0E793E" commented="no" indent="up1"><enum>(7)</enum> <subparagraph id="H04D2BFDB58C242588CB58B4B0AF13052" display-inline="yes-display-inline" commented="no"><enum>(A)</enum><text>Not less frequently than once every five years, the Secretary shall update the standards for quality established under paragraph (1) pursuant to the requirements for the establishment of such standards under this subsection.</text></subparagraph>
<subparagraph id="H987D0F8099F5422B8280F473569EDB75" indent="up1" commented="no"><enum>(B)</enum><text>Not later than 30 days after any date on which the Secretary updates, pursuant to subparagraph (A), the standards for quality under paragraph (1), the Secretary shall submit to the appropriate committees of Congress a report on such updated standards for quality.</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H687CEF4B8FB14C938CE13D5289A6D9BB"><enum>(2)</enum><text>in subsection (b)—</text>
<subparagraph id="H79AA2322F12948CAB676F3EEF756C0AF"><enum>(A)</enum><text>in paragraph (1)—</text> <clause id="HBF6FA07C7B5F4B46B541F91415F135D3"><enum>(i)</enum><text>by striking <quote>Not later than 1 year after the date on which the Secretary establishes standards for quality under subsection (a)</quote> and inserting <quote>Not less frequently than once every three years</quote>; and</text></clause>
<clause id="H729C62C156E64900A2B31EC88448A01E"><enum>(ii)</enum><text>by inserting <quote>pursuant to standards for quality under subsection (a)</quote> after <quote>medical facilities of the Department</quote>; and</text></clause></subparagraph> <subparagraph id="HFF26C00037A64596B24D9D72B86BE145"><enum>(B)</enum><text>in paragraph (2), by inserting <quote>or updates</quote> after <quote>establishes</quote>.</text></subparagraph></paragraph></subsection>
<subsection id="HC3731AF9DF7442519CDF94E25AEAA1F2"><enum>(b)</enum><header>Deadline for update</header><text>The Secretary, pursuant to paragraph (7) of section 1703C(a) of title 38, United States Code (as added by subsection (a)), shall make the first update to the standards for quality established under paragraph (1) of such section not later than the date that is five years after the date on which the Secretary submits the report under paragraph (2) of subsection (d).</text></subsection> <subsection id="H86724F49E88A4B6F86C623568FB3E2F9" commented="no"><enum>(c)</enum><header>Report</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the appropriate committees of Congress a report on how the Secretary—</text>
<paragraph id="H338DF1DE6BF9469C88ED8285C58B7CFB" commented="no"><enum>(1)</enum><text>has consulted with entities specified in paragraph (4) of section 1703C(a) of title 38, United States Code, before the date of the enactment of this Act in establishing standards for quality under such section;</text></paragraph> <paragraph id="H791C72701233426B89DEE209BC8AFF16" commented="no"><enum>(2)</enum><text>has continued to consult with those entities on and after such date of enactment; and</text></paragraph>
<paragraph id="H77C6F857D1684E0AA3EAAAF2DE5AD8A5" commented="no"><enum>(3)</enum><text>intends to leverage data sciences to improve standards for quality care furnished by the Department of Veterans Affairs.</text></paragraph></subsection> <subsection id="HB564A0A59B3E4735BE21E7B27A3B1956" commented="no"><enum>(d)</enum><header>Updates to quality care metrics</header> <paragraph id="H042FCBC615054D28B2F2575B135EE38B" commented="no"><enum>(1)</enum><header>Initial report</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the appropriate committees of Congress a report on how the Secretary plans to implement the amendments made by subsections (a).</text></paragraph>
<paragraph id="H7A66F58E8E5E43918F33BB2E2D7F2317" commented="no"><enum>(2)</enum><header>Deadline; summary report</header><text>Not later than two years after the date of the enactment of this Act, the Secretary shall—</text> <subparagraph id="HBEDB7C6F2AC4475A86824AF2AF0D49C8" commented="no"><enum>(A)</enum><text>implement the amendments made by subsection (a), including by updating the standards for quality established under section 1703C of title 38, United States Code; and</text></subparagraph>
<subparagraph id="HF5047316FD8A4ECDA2C93F3D2B1B01B1" commented="no"><enum>(B)</enum><text>submit to the appropriate committees of Congress a report detailing the standards for quality updated pursuant to such amendments.</text></subparagraph></paragraph></subsection> <subsection id="H6ACEC46E50644292A5EBACFDF3877BC0" commented="no"><enum>(e)</enum><header>Audit of quality care metrics</header> <paragraph id="HB9667C8C7C2A49FFA6F2DA38256B642A" commented="no"><enum>(1)</enum><header>In general</header><text>Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall enter into one or more contracts with a non-Department entity described in paragraph (2) to conduct an audit on the quality of care from the Department of Veterans Affairs, including through non-Department health care providers pursuant to section 1703 of title 38 United States Code.</text></paragraph>
<paragraph id="HEDCD9CE537D3415AA4FBE8E2DD5E02D8"><enum>(2)</enum><header>Non-Department entity described</header><text>A non-Department entity described in this paragraph is an entity that—</text> <subparagraph id="H682571DAF3994B79A1F70C9E80E72FAC" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text>specializes in analyzing large-scale organizational data collection and analysis efforts, especially with respect to the health care sector; and</text></subparagraph>
<subparagraph id="HE8542257948445A1B4ED15114A15C0F3" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text>has experience and proven outcomes in optimizing the accuracy and comprehensiveness of data collection and analysis related to the quality of health care services.</text></subparagraph></paragraph> <paragraph id="HA7F9FC813DA7443CB3C45C119CEA732F" commented="no"><enum>(3)</enum><header>Elements</header><text>The audit required under paragraph (1) shall include the following:</text>
<subparagraph id="HA60256F99E6E420F90CB413B67908739" commented="no"><enum>(A)</enum><text>An assessment of the methodology used by the Department to collect and assess data on the quality of care furnished by the Department, including any vulnerabilities in such methodology.</text></subparagraph> <subparagraph id="H703E26AC457F434484CC91CF0EE2153E" commented="no"><enum>(B)</enum><text>An assessment of the accuracy and reliability of the data sources used by the Department to compile data on the quality of care furnished by the Department.</text></subparagraph>
<subparagraph id="H315E4681087D44B49654CDFADD72BFFB" commented="no"><enum>(C)</enum><text>The extent to which the standards the Department uses to assess the quality of care furnished by the Department are—</text> <clause id="H444A988CDE9E4E44ACFABBA9F70F52A3"><enum>(i)</enum><text>comparable with industry standards;</text></clause>
<clause id="H291691926EF5457C82AE104D339FDE00"><enum>(ii)</enum><text>easily accessible to, and understood by—</text> <subclause id="HE6F9D75AA795499D945F8A9FBA1AEC61"><enum>(I)</enum><text>veterans;</text></subclause>
<subclause id="H90DFC433B0014803AD58E5C3E5E11FF9"><enum>(II)</enum><text>employees of the Department; and</text></subclause> <subclause id="HBB09CBC27B284986BB2B3D31FE3189CF"><enum>(III)</enum><text>other individuals, as the private sector entity considers appropriate.</text></subclause></clause></subparagraph>
<subparagraph id="H66BFD12A23BD4F8AB655747E533C2DC6" commented="no"><enum>(D)</enum><text>Any recommendations of such private sector entity with respect to improvements that the Secretary could administer to more accurately capture the quality of care furnished by the Department.</text></subparagraph></paragraph> <paragraph id="H83C348F28B874E4AB8058B5F955C8484" commented="no"><enum>(4)</enum><header>Reports on audit</header> <subparagraph id="HF5B59BB773E842DCA387B6AC98984C93" commented="no"><enum>(A)</enum><header>Report on findings and recommendations</header><text>Not later than 60 days after any date on which a private sector entity described in paragraph (2) completes an audit under paragraph (1), such private sector entity 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 that includes—</text>
<clause id="H82FF60BD743F406E97ED0C6A657E7015"><enum>(i)</enum><text>the findings of such audit; and</text></clause> <clause id="HEB08B940FF2C4E269B4BED38BFBC6A54"><enum>(ii)</enum><text>recommendations of such private sector entity with respect to such audit.</text></clause></subparagraph>
<subparagraph id="H20C7CB3C2FA54C0993A6959D50740657" commented="no"><enum>(B)</enum><header>Report on planned improvements</header><text>Not later than 60 days after any date on which the Secretary receives a report under subparagraph (A), the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on how the Secretary plans to improve the standards for quality of care of the Department.</text></subparagraph></paragraph></subsection> <subsection id="HEDA78B734691400695142FD8636A9155" commented="no"><enum>(f)</enum><header>Appropriate committees of Congress defined</header><text>In this section, the term <term>appropriate committees of Congress</term> has the meaning given such term in section 1703C of title 38, United States Code.</text></subsection></section>
<section id="H5204CA87270F43D3A4B593068B162036" commented="no"><enum>105.</enum><header>Pilot program to improve administration of care under Veterans Community Care Program</header>
<subsection id="H050E156ECD9F4AA9BA621B34106149CB" commented="no"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">Pursuant to section 1703E of title 38, United States Code, the Secretary of Veterans Affairs, acting through the Center for Innovation for Care and Payment established under such section, shall carry out a pilot program to seek to develop and implement a plan—</text> <paragraph id="HDCFD1CB90AEC4030A2F2794FEEEB229B" commented="no"><enum>(1)</enum><text>to provide monetary and non-monetary incentives to a covered health care provider—</text>
<subparagraph id="H67B88FD7818A4CC9A1ADE2FB67FA6F2C" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">to allow the Secretary to see the scheduling system of the provider, to assess the availability of, and to assist in scheduling appointments for, veterans under the Veterans Community Care Program under section 1703 of such title, including through synchronous, asynchronous, and asynchronous assisted digital scheduling;</text></subparagraph> <subparagraph id="H52DE3062F3A54982B8F7CC3455D9AFA8" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">to complete continuing professional educational training available through the VHA TRAIN program (or any successor program or initiative) regarding veteran cultural competency, the opioid safety initiative (or any successor program or initiative), and other subjects determined appropriate by the Secretary;</text></subparagraph>
<subparagraph id="H55CB551C540C4F2CB9062239A2312DD7" commented="no"><enum>(C)</enum><text>to improve methods of accounting for non-Department training that is equivalent or substantially similar to the continuing professional educational training described in subparagraph (B); </text></subparagraph> <subparagraph id="H9582E37C5D9E4699A125BEE03CF55AD1" commented="no"><enum>(D)</enum><text>to improve the rate of the timely return to the Secretary of medical record documentation for care or services provided under the Veterans Community Care Program;</text></subparagraph>
<subparagraph id="H2B1989502E6347478804915721D18B18" commented="no"><enum>(E)</enum><text>to improve the timeliness and quality of the delivery of care and services to veterans under such program; and</text></subparagraph> <subparagraph id="H5773FFF3DF014347A0CC372FBFCD6A44" commented="no"><enum>(F)</enum><text>to achieve other objectives determined appropriate by the Secretary; and</text></subparagraph></paragraph>
<paragraph id="H4927FF9074A34EF6B003F9CEBC82D098" commented="no"><enum>(2)</enum><text>to decrease the rate of no-show appointments under such program.</text></paragraph></subsection> <subsection id="HBF91D0E82C834AE886AA4A91711A59FB" commented="no"><enum>(b)</enum><header>Report</header><text>Not later than one year after the date of the establishment of the pilot program under this section, and annually thereafter during the term of the pilot program, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the pilot program that includes, with respect to the period covered by the report—</text>
<paragraph id="H0BDD151E1BEC45F4A984D8F6EE9D72E8" commented="no"><enum>(1)</enum><text>an assessment of the extent to which—</text> <subparagraph id="H9756684AA176446C8AB4F7A8F34D4708" commented="no"><enum>(A)</enum><text>the system of the Department of Veterans Affairs for scheduling appointments for veterans under the Veterans Community Care Program has improved;</text></subparagraph>
<subparagraph id="H11F5081DFAA54826AE212A17A8C27208" commented="no"><enum>(B)</enum><text>the rate of timely return to the Secretary of medical record documentation described in subparagraph (D) of subsection (a)(1) has improved;</text></subparagraph> <subparagraph id="H9B238F86551A42A2BC9E9F7BD108E903" commented="no"><enum>(C)</enum><text>the timeliness and quality of the delivery of care and services described in subparagraph (E) of such subsection has improved; and</text></subparagraph>
<subparagraph id="HF2F60426D2974BB997873624EE485DDB" commented="no"><enum>(D)</enum><text>the frequency of no-show appointments described in paragraph (2) of such subsection decreased;</text></subparagraph></paragraph> <paragraph id="H447A0EB29FFB4BA7BA163675D7DDF09A" commented="no"><enum>(2)</enum><text>a list of the continuing professional educational training courses under subparagraph (B) of such subsection available to covered health care providers;</text></paragraph>
<paragraph id="H3C18D40BCF7D4CCFA90113BC5BA37435" commented="no"><enum>(3)</enum><text>the rate of participation in such continuing professional education training courses; and</text></paragraph> <paragraph id="H4547E5EC0BF141A6BC05C632925E97A0" commented="no"><enum>(4)</enum><text>any other matter the Secretary determines appropriate.</text></paragraph></subsection>
<subsection id="H578EFD960A494526A2BF73CEBFFFB957" commented="no"><enum>(c)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H18D2CEE08A394446947B33994CFC6ED1" commented="no"><enum>(1)</enum><text>The term <term>covered health care provider</term> means a health care provider—</text>
<subparagraph id="H4159FD87A2D444F299F7ACD4D15D6DEF" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">described in subsection (c) of section 1703 of title 38, United States Code, that furnishes care or services under the Veterans Community Care Program pursuant to a contract or agreement with a Third Party Administrator; or</text></subparagraph> <subparagraph id="H1D7443F250A545D58169C3FA09E50821"><enum>(B)</enum><text display-inline="yes-display-inline">that otherwise furnishes care or services outside of Department facilities pursuant to a contract or agreement with the Secretary of Veterans Affairs.</text></subparagraph></paragraph>
<paragraph id="H3CA1E0219DC34279BCF953195469B89C" commented="no"><enum>(2)</enum><text>The term <term>opioid safety initiative</term> means the programs, processes, and guidelines of the Veterans Health Administration of the Department of Veterans Affairs relating to the management of opioid therapy and chronic pain.</text></paragraph> <paragraph id="HD56043973C074D4A82B834D304572D91" commented="no"><enum>(3)</enum><text>The term <term>Third Party Administrator</term> means an entity that manages a network of health care providers and performs administrative services related to such network under section 1703 of such title.</text></paragraph>
<paragraph id="H0648E5466B514337BF403A9A381DADFE" commented="no"><enum>(4)</enum><text>The term <term>VHA TRAIN program</term> means the free program of the Veterans Health Administration that offers veteran-specific continuing medical education courses.</text></paragraph></subsection></section> <section id="HE48B72C08A6D4D4AA97C1AE9C2FF175F"><enum>106.</enum><header>Pilot program on consolidating approval process of Department of Veterans Affairs for covered dental care</header> <subsection id="HC5316A1233C24A979F4EF84D8D4FCFB8"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs, acting through the Center for Innovation for Care and Payment established under section 1703E of title 38, United States Code, shall carry out a pilot program under which the Secretary shall hire—</text>
<paragraph id="H5771F0C9B0DF4C12AB53D9C325B0847E"><enum>(1)</enum><text>general dentists at medical facilities of the Department of Veterans Affairs to manage approval by the Department of treatment plans requested by dental providers in providing covered dental care; and</text></paragraph> <paragraph id="H8335C6C36FB34192AF131442A0A3F7C6"><enum>(2)</enum><text display-inline="yes-display-inline">dental specialists at Veterans Integrated Service Networks of the Department to manage approval by the Department of treatment plans for specialty dental care requested by dental providers in providing covered dental care.</text></paragraph></subsection>
<subsection id="H290B5EACECBB48F78102D8F0068D13A5"><enum>(b)</enum><header>Locations</header><text>The Secretary shall carry out the pilot program in not fewer than two Veterans Integrated Service Networks of the Department.</text></subsection> <subsection id="H2A95728AB8A54349A7B027EB9CABE5D8"><enum>(c)</enum><header>Reports</header> <paragraph id="HD185BC05332245DC881367FCCB06ADA0"><enum>(1)</enum><header>Initial report</header><text>Not later than one year after the date of the commencement of such pilot program, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the pilot program, that includes—</text>
<subparagraph id="H2F9708AD84884D7B9F5286B65F523E2D"><enum>(A)</enum><text>an identification of the Veterans Integrated Service Networks participating in such pilot program;</text></subparagraph> <subparagraph id="H8EDF145C55F042799444BBE914E3E08C"><enum>(B)</enum><text>a description of the implementation of such pilot program;</text></subparagraph>
<subparagraph id="H3A96F11DA34442C18C847ED3109976B1"><enum>(C)</enum><text>an identification of any barriers or challenges to implementing such pilot program;</text></subparagraph> <subparagraph id="HDCB1F3FA67C844DEBB5A030141C55416" commented="no"><enum>(D)</enum><text>an assessment of the efficacy of hiring general dentists and dental specialists pursuant to such pilot program;</text></subparagraph>
<subparagraph id="HAD0FED5BE9254116B403662206AC799E"><enum>(E)</enum><text>aggregated feedback with respect to such pilot program from dentists of the Department in Veterans Integrated Service Networks participating in such pilot program; and</text></subparagraph> <subparagraph id="H1558E445807A40E48CFB02DE22BA25DF"><enum>(F)</enum><text>aggregated feedback from dental providers providing covered dental care within such Veterans Integrated Service Networks regarding any changes in the timeliness of treatment plan approvals by the Department.</text></subparagraph></paragraph>
<paragraph id="H414F02F1C07E4F4BA484C74ED8604BCC"><enum>(2)</enum><header>Final report</header><text>Not later than 90 days before the date of the completion of such pilot program, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the pilot program that—</text> <subparagraph id="H32E420B05FB147A383E5AB8E53768338"><enum>(A)</enum><text>includes, with respect to the period covered by the report, each element of the report required under paragraph (1) described in subparagraphs (A) through (F) of such paragraph;</text></subparagraph>
<subparagraph id="HC6A61647FA4C4DD98232469EA21741D4"><enum>(B)</enum><text>includes recommendations of the Secretary on whether the pilot program should be—</text> <clause id="HAE21C3D7800C4DF194E997C04835EFA3"><enum>(i)</enum><text>extended;</text></clause>
<clause id="H2BA9F1CCAB4C4BFFA23D98B9F174371A"><enum>(ii)</enum><text>expanded; or</text></clause> <clause id="HA02B26F7C0664843BDAD0945EBEBB8DF"><enum>(iii)</enum><text>adopted throughout the Department; and</text></clause></subparagraph>
<subparagraph id="HE67036972CF741CEBAF453FD206BD673"><enum>(C)</enum><text>indicates whether the Secretary requests action by Congress to make the pilot program permanent.</text></subparagraph></paragraph></subsection> <subsection id="HACB09C49A07D402996983E109DCE224F"><enum>(d)</enum><header>Sunset</header><text>The authority to carry out the pilot program under this section shall terminate on the date that is two years after the date of the enactment of this Act. </text></subsection>
<subsection id="H88A877BBD0FD48E7819965C86265C33E"><enum>(e)</enum><header>Covered dental care defined</header><text>In this section, the term <term>covered dental care</term> means dental care provided—</text> <paragraph id="HD8CFA46652E5413BB6181539B811C09C"><enum>(1)</enum><text>under section 1703 of title 38, United States Code; or</text></paragraph>
<paragraph id="H5EE89B22DC16419EB91F0298D5D3683A"><enum>(2)</enum><text>pursuant to a Veterans Care Agreement under section 1703A of such title.</text></paragraph></subsection></section> <section id="HA9036C9DF0CB4F7BA841EA071745AC43"><enum>107.</enum><header>Strategic plan on value-based health care system for Veterans Health Administration; pilot program</header> <subsection id="HEB4D23DF395D4A4D8AF89AE239CC8241"><enum>(a)</enum><header>Establishment of working group</header> <paragraph id="H28AAA638BFB44441879982D4B0FCAD18"><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 shall—</text>
<subparagraph id="H6BAB95F20F88411CAC4855A6805149FF"><enum>(A)</enum><text>establish a working group on value-based care; and</text></subparagraph> <subparagraph id="HF625DBDB006746F0B0BBAEDA4DB36EA0"><enum>(B)</enum><text>submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate the strategic plan developed by the working group pursuant to subsection (b).</text></subparagraph></paragraph>
<paragraph id="H868BBA543BED4FFA86EBC254820D9613"><enum>(2)</enum><header>Membership</header>
<subparagraph id="H1A525A8FB8844FE9875565693FBA440E"><enum>(A)</enum><header>Required members</header><text>The working group shall include, at a minimum, the following members:</text> <clause id="H3E46FB80A02D4B2E9594519DC139CBA0"><enum>(i)</enum><text>The Under Secretary for Health of the Department of Veterans Affairs.</text></clause>
<clause id="HCCB429AAE550407F9ECA06741B6F7C85"><enum>(ii)</enum><text>The Director of the Office of Mental Health and Suicide Prevention of the Department of Veterans Affairs (or any successor office).</text></clause> <clause id="HF6EF1A7C0B9F4DBBA65D41A6898D65BA"><enum>(iii)</enum><text>The Director of the Office of Integrated Veteran Care of the Department (or any successor office).</text></clause>
<clause id="H5F72CC7BF90C4A8682A4328BCBF2F31D"><enum>(iv)</enum><text>The Director of the Office of Rural Health of the Department (or any successor office).</text></clause> <clause id="H4F0677F3E7064E859EA172C5B1FE7DD5"><enum>(v)</enum><text>The Director of the Office of Connected Care of the Department (or any successor office).</text></clause>
<clause id="H648732A7C2044DC2AADAF19BACFE20FD"><enum>(vi)</enum><text>The Assistant Secretary for the Office of Information Technology (or any successor office).</text></clause> <clause id="HE9150FFFC34A4E448074A0E724DAA981"><enum>(vii)</enum><text>The Chief Officer of the Office of Healthcare Innovation and Learning of the Office of Discovery, Education, and Affiliate Networks of the Veterans Health Administration (or any successor office).</text></clause>
<clause id="HCC386231942E48319BD013713D010FA1"><enum>(viii)</enum><text>An individual designated by the Secretary from the Center for Innovation for Care and Payment of the Department under section 1703E of title 38, United States Code.</text></clause> <clause id="HD5C523F615A44090B6F73C1577F2A6D4"><enum>(ix)</enum><text>An individual designated by the Administrator of the Centers for Medicare & Medicaid Services from the Center for Medicare and Medicaid Innovation.</text></clause>
<clause id="H6EB1A1255D8F4B69B2502EFD8B17D2E8"><enum>(x)</enum><text>An individual designated by the Secretary of Health and Human Services from the Federal Office of Rural Health Policy of the Health Resources and Services Administration.</text></clause> <clause id="HF0971F371E664AC3A905616B4E1253F6"><enum>(xi)</enum><text display-inline="yes-display-inline">The Chief of Human Capital Management for the Veterans Health Administration.</text></clause>
<clause id="H8D378F95FCCD406D9B02E89A17DEC830"><enum>(xii)</enum><text display-inline="yes-display-inline">An individual designated by the Secretary of Defense that is a representative of the Defense Health Agency.</text></clause> <clause id="H38AE49BC94AB4FCEB050D426BC421619"><enum>(xiii)</enum><text display-inline="yes-display-inline">An individual selected by the Secretary of Veterans Affairs from the special medical advisory group established under section 7312 of title 38, United States Code.</text></clause></subparagraph>
<subparagraph id="H9044AD1584E34842B1646DE55743540F"><enum>(B)</enum><header>Optional members</header><text>The Secretary of Veterans Affairs may appoint any of the following individuals as members of the working group:</text> <clause id="HDDC7745BDA2749C3BF3744228600F6E3"><enum>(i)</enum><text>An individual representing the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine.</text></clause>
<clause id="HEA6866A76095493B91C489997BA148AD"><enum>(ii)</enum><text>Three individuals representing a private health care system that has made the transition to value-based care.</text></clause> <clause id="H15F85E5A73E147EEB54315D5D73DAEAC"><enum>(iii)</enum><text>Three individuals representing an organization recognized by the Secretary of Veterans Affairs under section 5902 of title 38, United States Code.</text></clause></subparagraph></paragraph>
<paragraph id="HDED72FCE867B4444A2F771354AC092BA"><enum>(3)</enum><header>Public availability</header><text display-inline="yes-display-inline">All meetings deliberations, and products of the working group shall be made publicly available throughout the duration of the working group, including to individuals representing organizations recognized by the Secretary of Veterans Affairs under section 5902 of title 38, United States Code.</text></paragraph> <paragraph id="HF0ED3A6439CD4EE0A71653A73B2A9CF1"><enum>(4)</enum><header>Exemption from FACA</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/10">Chapter 10</external-xref> of title 5, United States Code, shall not apply to the working group established under paragraph (1).</text></paragraph></subsection>
<subsection id="H723C2D71640D41B486163D6526D9DEFB"><enum>(b)</enum><header>Development of strategic plan</header><text display-inline="yes-display-inline">The working group shall develop a strategic plan to implement value-based care into the Veterans Health Administration that includes the following:</text> <paragraph id="HF626AC45023047F5A2F771E3C2883D2A"><enum>(1)</enum><text>An identification of the state of the Veterans Health Administration as of the date of the enactment of this Act, including an assessment of the current model of health care delivery used by the Veterans Health Administration in medical facilities of the Department of Veterans Affairs.</text></paragraph>
<paragraph id="HF3A271C357604C1E907AE8C0DF52AB12"><enum>(2)</enum><text>An assessment of the capacity needs of the Veterans Health Administration during the five-year period beginning on the date of the enactment of this Act.</text></paragraph> <paragraph id="HF7626B20DF8E4F2BB2473C601E1B85F6"><enum>(3)</enum><text>An analysis of the leadership of the Veterans Health Administration, including an assessment of leadership acumen and ability to implement a clear, shared vision and effective change management and care coordination.</text></paragraph>
<paragraph id="H896F1FEB3AB24DCA9CA4D25DAD453BB2"><enum>(4)</enum><text>An identification of goals for the future of the Veterans Health Administration.</text></paragraph> <paragraph id="HFF7F46003FF744E0819AC8DB9F89D45B"><enum>(5)</enum><text>An identification and classification of the current capabilities, capacity, and gaps in access and quality of the health care system of the Department of Veterans Affairs.</text></paragraph>
<paragraph id="HD90B933190594C7EB01DC8800C60027B"><enum>(6)</enum><text>An analysis of value-based care models, including—</text> <subparagraph id="H3CD0AE3C4C9A466C9A6383F95E8C168F"><enum>(A)</enum><text>a selection of potential models that would best work for the Veterans Health Administration;</text></subparagraph>
<subparagraph id="H0A5FB0C5EF2E464EBFEFA83618868644"><enum>(B)</enum><text>the capacity and capabilities of each such model; and</text></subparagraph> <subparagraph id="HC544A972D5224E6DB3FDFA092D1C16F2"><enum>(C)</enum><text>a thorough justification of the selection of each selected model, including an summary of the ability of such model to improve the metrics described under paragraph (9).</text></subparagraph></paragraph>
<paragraph id="HF3C825AAFAF34022A308BD1230C4FF0A"><enum>(7)</enum><text>A definition of what quality means with respect to—</text> <subparagraph id="H67D3150A016148EC873FB1ADF537EAF0"><enum>(A)</enum><text>access to health care under the laws administered by the Secretary of Veterans Affairs; and</text></subparagraph>
<subparagraph id="H8255B8F1783442DF9A36AB6E64D23479"><enum>(B)</enum><text>delivery of such health care.</text></subparagraph></paragraph> <paragraph id="H36D3A566796E4B26A8040EF3FFE0455A"><enum>(8)</enum><text>A definition of what value means with respect to care furnished by the Veterans Health Administration,</text></paragraph>
<paragraph id="H3F1A5281B78047438CB9307A3D52B38D"><enum>(9)</enum><text>A system for measuring value within the Veterans Health Administration that includes metrics for—</text> <subparagraph id="HEC20624E81AE40E2ADDFDF225E9D147D"><enum>(A)</enum><text>outcomes;</text></subparagraph>
<subparagraph id="H383D90C2EDF5442D938942050BE44A3A"><enum>(B)</enum><text>safety;</text></subparagraph> <subparagraph id="H6A73B44037ED4BAA8C95DCF5BC426976"><enum>(C)</enum><text>service;</text></subparagraph>
<subparagraph id="H80F36F2736D84D68A2C24BB91F27B60D"><enum>(D)</enum><text>access;</text></subparagraph> <subparagraph id="HB4CA141850B64AB19BD3D14A35B1AC4E"><enum>(E)</enum><text>productivity;</text></subparagraph>
<subparagraph id="HBFF0841DA8BB43708956CDCFE9D7B980"><enum>(F)</enum><text>capacity; and</text></subparagraph> <subparagraph id="H898A2A2E385C448282019A0C289FAB31"><enum>(G)</enum><text>total cost of patient care.</text></subparagraph></paragraph>
<paragraph id="HB76517615802498CA88914F6807161DD"><enum>(10)</enum><text display-inline="yes-display-inline">With respect to the system described in subparagraph (H), an analysis of variable value with respect to patient outcomes across different health care types and specialties.</text></paragraph> <paragraph id="HC56B50142E5A483EB4CB675AE0F930BC"><enum>(11)</enum><text>An assessment of—</text>
<subparagraph id="HD0ADAC8E8E7B4141BD2B4C5C41E3D090"><enum>(A)</enum><text display-inline="yes-display-inline">previous or ongoing assessments of the current information technology infrastructure of the Veterans Health Administration, including—</text> <clause id="HC360C631EB7C4BECAC4C9A5741A01992"><enum>(i)</enum><text>such assessments conducted pursuant to the Electronic Health Record Modernization program of the Department of Veterans Affairs; and</text></clause>
<clause id="H4CE4BE05C0B24D7DBA30CDF4FE37EA0A"><enum>(ii)</enum><text>any other ongoing information technology modernization programs of such Department and any unimplemented relevant recommendations from such assessments;</text></clause></subparagraph> <subparagraph id="H2B8CA618F7454413826DD590166CF20B"><enum>(B)</enum><text>the information technology infrastructure of the Veterans Health Administration in effect as of the date of the enactment of this Act;</text></subparagraph>
<subparagraph id="HDAA5B2E3502448279BE375A35D2A94B2"><enum>(C)</enum><text>the value-driven framework of the Department, in effect as of the date of the enactment of this Act, for evaluating health care innovations, and how improvements in such framework could be used to encourage innovation; and</text></subparagraph> <subparagraph id="H91802F85186F42DFBAEBEA1C821B191B"><enum>(D)</enum><text>workforce challenges and needs of the Veterans Health Administration based on—</text>
<clause id="H7E28C972FD6A4CEF986E31CB131AB442"><enum>(i)</enum><text>reviews of workforce assessment data available as of the date of the enactment of this Act; and</text></clause> <clause id="HD37ED388474A484D9DCFAD7DEFCF31ED"><enum>(ii)</enum><text>the findings of—</text>
<subclause id="H8568A1A957CE4ECEA6023545A1C46427"><enum>(I)</enum><text>the report required by section 301(d) 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>);</text></subclause> <subclause id="H33647DCF2F334ABC9E56073FF1AAD2F8"><enum>(II)</enum><text display-inline="yes-display-inline">the reports required by section 505 of the John S. McCain III, Daniel K. Akaka and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (<external-xref legal-doc="public-law" parsable-cite="pl/115/182">Public Law 115–182</external-xref>);</text></subclause>
<subclause id="H2C8207DE0A50480EA023FDD402642D92" commented="no"><enum>(III)</enum><text>the report required by section 301 of the VA Choice and Quality Employment Act of 2017 (<external-xref legal-doc="public-law" parsable-cite="pl/115/46">Public Law 115–46</external-xref>); and</text></subclause> <subclause id="H9E9D58350F0345EABDFCC1384D24E047"><enum>(IV)</enum><text>any comprehensive health care inspection conducted by the Inspector General of the Department of Veterans Affairs as of the date of the enactment of this Act.</text></subclause></clause></subparagraph></paragraph>
<paragraph id="HCC1DD18B62084E90AA1414E4B86CC3B2"><enum>(12)</enum><text>Any recommendations of the working group with respect to improving the information technology infrastructure described in clause (i) of subparagraph (J).</text></paragraph> <paragraph id="H7E8C495898FD444D9041346309B5F21C"><enum>(13)</enum><text>An analysis of how the value-driven framework described in clause (iii) of such subparagraph could be used to improve the model of care delivery by the Department.</text></paragraph>
<paragraph id="H66AB0E7A670D4FE4AD0C3D81E853CD3F"><enum>(14)</enum><text>A description of how a value-based care system would apply to primary care, inpatient and outpatient mental health care, and inpatient and outpatient substance use treatment, spinal cord injury disorder care, and polytrauma care furnished by the Veterans Health Administration. </text></paragraph> <paragraph id="H14763BD55E3F4270988076BF003AD644"><enum>(15)</enum><text>With respect to legislative or administrative action necessary to incorporate value-based care models into the Veterans Health Administration, a description of the estimated timelines, effect on workforce, and costs.</text></paragraph></subsection>
<subsection id="H22F300A861A843668A0C124BC14CE2CA"><enum>(c)</enum><header>Pilot program</header>
<paragraph id="HD6E2F19848B644E7A5D23B91BED5DC08"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 180 days after the submission of the strategic plan pursuant to subsection (b), the Secretary of Veterans Affairs, acting through the Center for Innovation for Care and Payment established under section 1703E of title 38, United States Code, shall commence a three-year pilot program under which the Secretary shall implement the elements of such strategic plan relating to the delivery, by the Veterans Health Administration, of primary care, inpatient and outpatient mental health treatment, inpatient and outpatient substance abuse treatment, spinal cord injury disorder care, and polytrauma care.</text></paragraph> <paragraph id="H8B6B3A73BF8D4562B3B192341DFDC8E7"><enum>(2)</enum><header>Locations</header><text>The Secretary shall carry out such pilot program in four Veterans Integrated Service Networks that are geographically dispersed and shall include the following:</text>
<subparagraph id="HC04771B813F84E11865A9276FA251285"><enum>(A)</enum><text>A Veterans Integrated Service Network that predominately serves veterans in rural and highly rural areas.</text></subparagraph> <subparagraph id="HC0EC5D6CE4734114B71207774FD9C1FA"><enum>(B)</enum><text>A Veterans Integrated Service Network that predominately serves veterans in urban areas.</text></subparagraph>
<subparagraph id="H813D0BD5EDDF4052A5376FA6C7E47D3F"><enum>(C)</enum><text>A Veterans Integrated Service Network that has a high rate of suicide among veterans.</text></subparagraph> <subparagraph id="H670D66EF21BA4F389C23587974D51658"><enum>(D)</enum><text>A Veterans Integrated Service Network that has a high rate of substance use disorder among veterans.</text></subparagraph>
<subparagraph id="H31E316A3C1F5422FB1E9411BF96750C2"><enum>(E)</enum><text>A Veterans Integrated Service Network that has access or productivity challenges.</text></subparagraph></paragraph> <paragraph id="H4D573D5D3EAC486B90D2BA38370258CD"><enum>(3)</enum><header>Reports to congress</header> <subparagraph id="H35BFD2E5749A4A9D90EC63CF4EA1006D"><enum>(A)</enum><header>Annual report</header><text>Not later than one year after the commencement of the pilot program, and annually thereafter during the duration of the pilot program, the Secretary shall submit to Congress a report on the pilot program.</text></subparagraph>
<subparagraph id="HB79753EA97E542E1B5CDDC199BC811CF"><enum>(B)</enum><header>Final report</header><text>Not later than 90 days before the conclusion of the pilot program, the Secretary shall submit to Congress a final report on the pilot program that includes—</text> <clause id="H50C1F98AAA8240A29D25E2F4979FC128"><enum>(i)</enum><text>lessons learned during the administration of such pilot program; and</text></clause>
<clause id="H113481E9B9B343468F158515467AFF37"><enum>(ii)</enum><text>specific health outcomes in veteran patient care compared to the Veterans Health Administration system of care in effect as of the date of the enactment of this Act.</text></clause></subparagraph></paragraph></subsection></section> <section id="H7060ED9731F94AD2B0830C19A3B2E3EE" display-inline="no-display-inline" commented="no"><enum>108.</enum><header>Plan on adoption of certain health information standards for Department of Veterans Affairs and certain health care providers</header> <subsection id="H3E65C23F042946D584FA4E6332B0674E" commented="no"><enum>(a)</enum><header>Plan for certain health information standards</header> <paragraph id="H27EBF5009FF74060A6F39DD5F82ADF4D" display-inline="no-display-inline" commented="no"><enum>(1)</enum><header>In general</header><text>The Secretary of Veterans Affairs, in consultation with the Secretary of Health and Human Services, the Administrator of the Centers for Medicare & Medicaid Services, and the National Coordinator for Health Information Technology of the Department of Health and Human Services, shall create and implement a plan to adopt, as rapidly and to the most comprehensive extent feasible, national health information interoperability standards for the Department of Veterans Affairs and community care providers with respect to—</text>
<subparagraph id="HE6EEAE3AF50C4770B3CA856A8028229C" commented="no"><enum>(A)</enum><text>coordination of—</text> <clause id="H5EAC02B35AEF42D6B782DC4D98E58955" commented="no"><enum>(i)</enum><text>care; and</text></clause>
<clause id="H9693D994B9FA4CB89361D6F0A257C192" commented="no"><enum>(ii)</enum><text>benefits;</text></clause></subparagraph> <subparagraph id="H58A31A31D2C7485FAB39A7043582A1E2" commented="no"><enum>(B)</enum><text>patient identity matching;</text></subparagraph>
<subparagraph id="H2D401D75DDAD49D18ED761A4945606FF" commented="no"><enum>(C)</enum><text>measurement and reporting of quality;</text></subparagraph> <subparagraph id="HE36ECE7680EE40BEB38B16DAAEB53F67" commented="no"><enum>(D)</enum><text>population health; and</text></subparagraph>
<subparagraph id="HD0240C4BDB794C3EBD10E7A50E73B1D5" commented="no"><enum>(E)</enum><text>public health.</text></subparagraph></paragraph> <paragraph id="HA86B5DFCFA7A4D898EE6945F20828C53" commented="no"><enum>(2)</enum><header>Consideration</header><text>In developing the plan under paragraph (1), the Secretary of Veterans Affairs shall consider challenges faced by—</text>
<subparagraph id="H2224B20CD3594557A782220258447EB0" commented="no"><enum>(A)</enum><text>small community care providers; and</text></subparagraph> <subparagraph id="HB78B52E86F8A48419FE3CE11CCF74F74" commented="no"><enum>(B)</enum><text>community care providers located in rural areas.</text></subparagraph></paragraph></subsection>
<subsection id="H10BED430DD3E415E8D8DE8DB254CDB7F" commented="no"><enum>(b)</enum><header>Plan on electronic health record exchange</header>
<paragraph id="H1E89533D1B56425CB263985307068D78" commented="no"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a plan to provide, at no cost, to community care providers of the Department, through Third Party Administrators, a capability to facilitate the electronic direct exchange, between such providers and the Department, of—</text> <subparagraph id="H3842414AE44147489F32DFF2742703F3" commented="no"><enum>(A)</enum><text>the health records of veterans; and</text></subparagraph>
<subparagraph id="H273D3E000071403BB247DDC62FAEFC2A" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">documents relating to health care of veterans, clinical notes, and any other information the Secretary determines necessary.</text></subparagraph></paragraph> <paragraph id="H3B45654D1EAC4A0B89DFB9C35CE623DB"><enum>(2)</enum><header>Prioritization</header><text>In developing the plan required under paragraph (1), the Secretary shall prioritize providing the capability described in such paragraph to community care providers that—</text>
<subparagraph id="HC4398358989748CE8EBC0F4CA32CA465"><enum>(A)</enum><text display-inline="yes-display-inline">provide care under the laws administered by the Secretary to—</text> <clause id="H3B8E2BEEF7484D52A68C8A34277888EE"><enum>(i)</enum><text>a lower volume of veterans; and</text></clause>
<clause id="HF16FDB5B3CF647EEA301A49CB9C3371B"><enum>(ii)</enum><text>veterans who are located in rural areas; and</text></clause></subparagraph> <subparagraph id="H4E9EF6D00B63407DB75B16C3BCB938AD"><enum>(B)</enum><text>are unable or unwilling to exchange the records and documents described in subparagraphs (A) and (B) of such paragraph with the Department through standards-based or direct exchange mechanisms in effect as of the date of the enactment of this Act.</text></subparagraph></paragraph></subsection>
<subsection id="H5E2C2B46F86D455E8AF4D226F6DB9CBA" commented="no"><enum>(c)</enum><header>Reports on plan for interoperability standards</header>
<paragraph id="HA0D748F6B60244CE909716EF00893055" commented="no"><enum>(1)</enum><header>Initial report</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives—</text> <subparagraph id="H40A68385181C4677979DE41753829512" commented="no"><enum>(A)</enum><text>the plan required by subsection (a); and</text></subparagraph>
<subparagraph id="HDC4E13C575F143EB99EEEC37090C16DC" commented="no"><enum>(B)</enum><text>a report that includes—</text> <clause id="H4BBE027731AF454FBBB653AEA4BA656E" commented="no"><enum>(i)</enum><text display-inline="yes-display-inline">an analysis of gaps, if any, between the use, by the Department and other agencies, health information exchanges, and technology companies, of national health information interoperability standards and the potential, or optimal, use of such national health information interoperability standards;</text></clause>
<clause id="H7EA20BFEE1614C9A97D54989D7F95307" commented="no"><enum>(ii)</enum><text>an analysis and description of the participation by the Department, community care providers, and other relevant entities in the Trusted Exchange Framework and Common Agreement program of the Department of Health and Human Services as of the date of the enactment of this Act;</text></clause> <clause id="H804E9B15136249258333D4DF5E952465" commented="no"><enum>(iii)</enum><text>recommendations of the Secretary with respect to development of health information interoperability standards;</text></clause>
<clause id="HF63A63F9F2584EFAA8D3DB6DE688FA5E" commented="no"><enum>(iv)</enum><text>timelines or schedules to implement the plan required by subsection (a); and</text></clause> <clause id="H078CEED37C6249D29D48CDAE1D09A83C" commented="no"><enum>(v)</enum><text>an identification of any legislative authorities or resources the Secretary requires to implement such plan.</text></clause></subparagraph></paragraph>
<paragraph id="HCF2F78AB05D74220AD3BDC271B6F4806" commented="no"><enum>(2)</enum><header>Recurring report requirement</header>
<subparagraph id="H5E4763B1C85C4BD3BE489B9FCF48DF16" commented="no"><enum>(A)</enum><header>In general</header><text>Not later than 18 months after the date of the enactment of this Act, and every 180 days thereafter for four years, the Secretary of Veterans Affairs shall submit to Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the status of implementation of the plan required under subsection (a).</text></subparagraph> <subparagraph id="H08F75097CC62414DA4E0B8A90AA97E63" commented="no"><enum>(B)</enum><header>Elements of subsequent reports</header><text>Each report under subparagraph (A) submitted after the date on which the first report required by such subparagraph is submitted shall include a description of any revisions to—</text>
<clause id="H93444DAB7A6949069C2EEC3465A8E1F4" commented="no"><enum>(i)</enum><text>the plan required by subsection (a) made during the period covered by the report; and</text></clause> <clause id="HD9298C62F5374A898180365810985D94" commented="no"><enum>(ii)</enum><text>the analysis, recommendations, timelines, and legislative authorities reported pursuant to paragraph (1).</text></clause></subparagraph></paragraph></subsection>
<subsection id="HDB24FDFB209A481D9885373F1F221178" commented="no"><enum>(d)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HD3C41902980F4BE2AFD6CE19F416D8E5" commented="no"><enum>(1)</enum><text>The term <term>community care provider</term> means a non-Department health care provider providing care (including dental care)—</text>
<subparagraph id="H5215928F258A4CA582DAEFCBF1E62865" commented="no"><enum>(A)</enum><text>under section 1703 of title 38, United States Code;</text></subparagraph> <subparagraph id="HF7E7BDE98DAF4BC9A9743F2D491ABE5D" commented="no"><enum>(B)</enum><text>pursuant to a Veterans Care Agreement under section 1703A of such title; or</text></subparagraph>
<subparagraph id="HAF21890D366D4B7089BF401B85B13666" commented="no"><enum>(C)</enum><text>under any other law administered by the Secretary of Veterans Affairs.</text></subparagraph></paragraph> <paragraph id="HECDCA8648519449180BB2941625F0D54" commented="no"><enum>(2)</enum><text>The term <term>Third Party Administrator</term> means an entity that manages a provider network and performs administrative services related to such network under section 1703 of title 38, United States Code.</text></paragraph></subsection></section>
<section id="HBBF29924611C436BBA4E6C40C92CB6C7"><enum>109.</enum><header>Report on use of value-based reimbursement models under Veterans Community Care Program</header>
<subsection id="H2D8A3D5F2C6A472D8DBA9F9D6618D2C4"><enum>(a)</enum><header>Report on value-based reimbursement models</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Center for Innovation for Care and Payment of the Department of Veterans Affairs under section 1703E of title 38 United States Code, the Office of Integrated Veteran Care of the Department, or successor office, and Third Party Administrators, shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing—</text> <paragraph id="H54A11705783C477BB2549B28F659F9E8"><enum>(1)</enum><text>an assessment of the efforts of the Department pursuant to section 1703(i)(5) of such title, to incorporate value-based reimbursement models under the Veterans Community Care Program to promote the provision of high-quality care to veterans; and</text></paragraph>
<paragraph id="HC77D8416BCF94E4FB3917A40F381FE82"><enum>(2)</enum><text>such recommendations for legislative or administrative action as the Secretary considers appropriate regarding the use of value-based reimbursement models throughout the Veterans Community Care Program under section 1703 of such title.</text></paragraph></subsection> <subsection id="HD9E68AFB654F4B79BFEC092460816461"><enum>(b)</enum><header>Rule of construction</header><text>This section shall not be construed to be a pilot program subject to the requirements of section 1703E of title 38, United States Code.</text></subsection>
<subsection id="HEA272D15890F4B8E959688640835697F"><enum>(c)</enum><header>Third party administrator defined</header><text>In this section, the term <term>Third Party Administrator</term> means an entity that manages a provider network and performs administrative services related to such network under section 1703 of title 38, United States Code.</text></subsection></section> <section id="H5D4F1B5337DC47D5A12FCA9DF04CD77D" commented="no"><enum>110.</enum><header>Inspector General assessment of implementation of Veterans Community Care Program</header> <subsection id="HE10B2953484C4432AFE56C9A41BEB2A9" commented="no"><enum>(a)</enum><header>In general</header><text>Not later than 18 months after the date of the enactment of this Act, and periodically thereafter, the Inspector General shall assess the performance of the Department of Veterans Affairs in—</text>
<paragraph id="HEF5CC16B44D34D3FB125989852E7596D" commented="no"><enum>(1)</enum><text>appropriately identifying veterans eligible for care and services under section 1703 of title 38, United States Code;</text></paragraph> <paragraph id="H6C86A081A37B4EF7BD4E2AC26DEBDFFB" commented="no"><enum>(2)</enum><text>informing veterans of their eligibility for such care and services; and</text></paragraph>
<paragraph id="HDCCE52EF143F42AFA89E611041A927B3" commented="no"><enum>(3)</enum><text>delivering such care and services in a timely manner.</text></paragraph></subsection> <subsection id="H6FFFA65257C4447FA2490435F1E3656B" commented="no"><enum>(b)</enum><header>Briefing on assessments</header><text display-inline="yes-display-inline">Upon the submission of the assessment required by subsection (a), the Inspector General of the Department of Veterans Affairs shall provide to the Committees on Veterans Affairs of the House of Representatives and the Senate a briefing on the results of such assessment.</text></subsection></section>
<section id="HF215AF18D3064C37822AFC22C57B7B2C"><enum>111.</enum><header>Comptroller General report on dentistry under Veterans Community Care Program</header>
<subsection id="HAEB1EB2BB75542E4BD8B8850AC3803A7"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on dental care furnished by the Secretary of Veterans Affairs under the Veterans Community Care Program under section 1703 of title 38, United States Code, that includes a review of—</text> <paragraph id="HA89ADFA91DD6417FA86A62859604EEC5"><enum>(1)</enum><text>the impact current reimbursement rates provided by the Department of Veterans Affairs to dental providers under such program have on—</text>
<subparagraph id="H365E67E35AF4406A8C684C24E0731907"><enum>(A)</enum><text>the availability of dental care for veterans; and</text></subparagraph> <subparagraph id="HDE3DB14B897140B6BEBD09539DBDEBDB"><enum>(B)</enum><text>the ability of Third Party Administrators to meet their contractual obligations for network adequacy;</text></subparagraph></paragraph>
<paragraph id="H56543CA7DF8F489FA198BB79B711D594"><enum>(2)</enum><text>the satisfaction of dental providers providing dental care under such program with the processes of the Department for approving dental care under such program; and</text></paragraph> <paragraph id="H212E94388987487E85A30CFF732827E9" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text>the current processes of the Department for approving emergent dental care under such program.</text></paragraph></subsection>
<subsection id="HB4B45623D1064FB5BBEABA08F214B3CC"><enum>(b)</enum><header>Third party administrator defined</header><text>In this section, the term <term>Third Party Administrator</term> means an entity that manages a provider network and performs administrative services related to such network under section 1703 of title 38, United States Code.</text></subsection></section></subtitle> <subtitle id="H9C6E57BA043142F4A2F585DA8582BEC5"><enum>B</enum><header>Matters Relating to Nursing Home and Other Long Term Care and Family Caregivers</header> <section id="HA9AB45B3460D4D49BF233BA381928F99"><enum>120.</enum><header>Increase of expenditure cap for noninstitutional care alternatives to nursing home care</header> <subsection id="H59F8A84CA02541C683AE1A337B0D30F5"><enum>(a)</enum><header>Increase of expenditure cap</header><text>Section 1720C(d) of title 38, United States Code, is amended—</text>
<paragraph id="HA02FD53754E74D87B50A6ADF047C89B1"><enum>(1)</enum><text>by striking <quote>The total cost</quote> and inserting <quote><header-in-text level="paragraph" style="USC"><enum-in-header>(1)</enum-in-header></header-in-text> Except as provided in paragraph (2), the total cost</quote>;</text></paragraph> <paragraph id="H26CE48B430FB468EBE5AED13ECEAECBC"><enum>(2)</enum><text>by striking <quote>65 percent</quote> and inserting <quote>100 percent</quote>; and</text></paragraph>
<paragraph id="HD00042E73A5C4A52928CE59105B66677"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block style="USC" id="HBD35F95063A5456FB105DF474A2B2D09" display-inline="no-display-inline"> <paragraph id="H54EE908A5ABB4324A5D16B7321C0C1F8" indent="up1"><enum>(2)</enum> <subparagraph id="H8E8661AD218947C29F0833451C124764" display-inline="yes-display-inline"><enum>(A)</enum><text>The total cost of providing services or in-kind assistance in the case of any veteran described in subparagraph (B) for any fiscal year under the program may exceed 100 percent of the cost that would otherwise have been incurred as specified in paragraph (1) if the Secretary determines, based on a consideration of clinical need, geographic market factors, and such other matters as the Secretary may prescribe through regulation, that such higher total cost is in the best interest of the veteran.</text></subparagraph>
<subparagraph id="HF7F2483C95664CC08A8DEBFD4BEDAF8C" indent="up1" commented="no"><enum>(B)</enum><text>A veteran described in this subparagraph is a veteran with amyotrophic lateral sclerosis, a spinal cord injury, or a condition the Secretary determines to be similar to such conditions.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H4591F206004B4E7E83DECD0F63ACC9E2"><enum>(b)</enum><header>Applicability</header><text>The amendments made by subsection (a) shall apply with respect to fiscal years beginning on or after the date of the enactment of this Act. </text></subsection></section>
<section id="H2FA1DC6C2CF04247AAED1B290D591FC0" commented="no"><enum>121.</enum><header>Coordination with Program of All-Inclusive Care for the Elderly</header><text display-inline="no-display-inline">Section 1720C of title 38, United States Code, as amended by <internal-xref idref="H3D156E0F584347899FCC8C50B4647FC6" legis-path="1.">section 120</internal-xref>, is further amended by adding at the end the following new subsection:</text> <quoted-block style="USC" id="H715AE401AB934743969EE519C2E251AF" display-inline="no-display-inline"> <subsection id="H912F2AFAB2A04F7BA4E52FC89CA7AFB6" display-inline="no-display-inline"><enum>(f)</enum><text>In furnishing services to a veteran under the program conducted pursuant to subsection (a), if a medical center of the Department through which such program is administered is located in a geographic area in which services are available to the veteran under a PACE program (as such term is defined in sections 1894(a)(2) and 1934(a)(2) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395eee">42 U.S.C. 1395eee(a)(2)</external-xref>; 1396u–4(a)(2))), the Secretary shall seek to enter into an agreement with the PACE program operating in that area for the furnishing of such services.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="H689E00C906164686948AD712E8E4A6E7"><enum>122.</enum><header>Authority for Secretary of Veterans Affairs to award grants or contracts to entities to improve provision of mental health support to family caregivers of veterans</header><text display-inline="no-display-inline">Subchapter II 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 at the end the following new section (and conforming the table of sections at the beginning of such chapter accordingly):</text> <quoted-block style="USC" display-inline="no-display-inline" id="H579A6FFE0F714180A79CA80D73EE7827"> <section id="H5141058EA9FD439FA0764DC0BB0A12E1"><enum>1720K.</enum><header>Grants or contracts to provide mental health support to family caregivers of veterans</header> <subsection id="HB2BB563972C244259369432FDCFECF2F"><enum>(a)</enum><header>Authority</header><text>The Secretary may award grants to carry out, coordinate, improve, or otherwise enhance mental health counseling, treatment, or support to the family caregivers of veterans participating in the family caregiver program.</text></subsection>
<subsection id="H396025B726C14EA4BE9B902889B7EECD"><enum>(b)</enum><header>Application</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H86110BAA1BF74FE18D2FA966DAA39172"><enum>(1)</enum><text>To be eligible for a grant or contract under this section, an entity shall submit to the Secretary an application therefor at such time, in such manner, and containing such information as the Secretary may require.</text></paragraph> <paragraph id="HFF04D072A25D4CB1AF82E9C11A007C5C" indent="up1"><enum>(2)</enum><text>Each application submitted under paragraph (1) shall include the following:</text>
<subparagraph id="H468D97704849421CA408C78694AE6322"><enum>(A)</enum><text display-inline="yes-display-inline">A detailed plan for the use of the grant or contract.</text></subparagraph> <subparagraph id="H2A0572B4525846A89DA92CB706CFB6B3"><enum>(B)</enum><text>A description of the programs or efforts through which the entity will meet the outcome measures developed by the Secretary under subsection (g).</text></subparagraph>
<subparagraph id="H355A06A3F76E49808BADB8549600DAAA"><enum>(C)</enum><text display-inline="yes-display-inline">A description of how the entity will distribute grant or contract amounts equitably among areas with varying levels of urbanization.</text></subparagraph> <subparagraph id="HC02363437F9A4FA6B842F40CC577C1AE"><enum>(D)</enum><text display-inline="yes-display-inline">A plan for how the grant or contract will be used to meet the unique needs of veterans residing in rural areas, Native American, Native Hawaiian, or Alaska Native veterans, elderly veterans, women veterans, and veterans from other underserved communities.</text></subparagraph></paragraph></subsection>
<subsection id="H61589FD9FC464B1F8C1CE8237DD8FB81"><enum>(c)</enum><header>Distribution</header><text display-inline="yes-display-inline">The Secretary shall seek to ensure that grants and contracts awarded under this section are equitably distributed among entities located in States with varying levels of urbanization.</text></subsection> <subsection id="H85CA0EE13AAC42219E52C49A1420C724"><enum>(d)</enum><header>Priority</header><text display-inline="yes-display-inline">The Secretary shall prioritize awarding grants or contracts under this section that will serve the following areas:</text>
<paragraph id="H5C38AA6796D74520B8FA4A0E04D7B653"><enum>(1)</enum><text>Areas with high rates of veterans enrolled in the family caregiver program.</text></paragraph> <paragraph id="H988FBAB1CA4F4FE5AFE830D3EBB829A4"><enum>(2)</enum><text>Areas with high rates of—</text>
<subparagraph id="H5AA4420E1BE34EBB9C4AA5CD8F1E251B"><enum>(A)</enum><text>suicide among veterans; or</text></subparagraph> <subparagraph id="H2707A0219E0747B6BA712073AAE8C501"><enum>(B)</enum><text>referrals to the Veterans Crisis Line.</text></subparagraph></paragraph></subsection>
<subsection id="H68480AC089034A2F8F7C5D1ABD0BED6E"><enum>(e)</enum><header>Required activities</header><text display-inline="yes-display-inline">Any grant or contract awarded under this section shall be used—</text> <paragraph id="H758FC5B7AD5A4BD6B06012DCBABD1A39"><enum>(1)</enum><text>to expand existing programs, activities, and services;</text></paragraph>
<paragraph id="H35409FB8872142909B89C12DBBE3DC8B"><enum>(2)</enum><text>to establish new or additional programs, activities, and services; or</text></paragraph> <paragraph id="HB9F6A65E78E646239345C420BA8DC7DB"><enum>(3)</enum><text>for travel and transportation to facilitate carrying out paragraph (1) or (2).</text></paragraph></subsection>
<subsection id="H404EEF6E3CFF4D02947A8D3B6462EE45"><enum>(f)</enum><header>Outcome measures</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H99ECC06751914593885363C01CEF8235"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary shall develop and provide to each entity that receives a grant or contract under this section written guidance on the following:</text> <subparagraph id="H7CDABEDBCD6F4DF3A844B267EFBBFDED" indent="up1"><enum>(A)</enum><text>Outcome measures.</text></subparagraph>
<subparagraph id="HCF5252E6A22645BA836F86CEB870CDFA" indent="up1"><enum>(B)</enum><text>Policies of the Department.</text></subparagraph></paragraph> <paragraph id="HE61B23462031455796972C11B0686E8E" indent="up1"><enum>(2)</enum><text>In developing outcome measures under paragraph (1), the Secretary shall consider the following goals:</text>
<subparagraph id="HD2AB0814771542C79487446611077AE2"><enum>(A)</enum><text>Increasing the utilization of mental health services among family caregivers of veterans participating in the family caregiver program.</text></subparagraph> <subparagraph id="HFAB075A8AD00466F8F708DE9716AB5CC"><enum>(B)</enum><text>Reducing barriers to mental health services among family caregivers of veterans participating in such program.</text></subparagraph></paragraph></subsection>
<subsection id="H71321492DDAF4DB8982F42191959DEE5"><enum>(g)</enum><header>Tracking requirements</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H51BA96F5D3CC4779926E740F484DF549"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary shall establish appropriate tracking requirements with respect to the entities receiving a grant or contract under this section.</text></paragraph> <paragraph id="HF60E3D1C54EC432E83D96143E3213C96" indent="up1"><enum>(2)</enum><text>Not less frequently than annually, the Secretary shall submit to Congress a report on such tracking requirements.</text></paragraph></subsection>
<subsection id="HCFA94B04E5CC4D16AB03B1D85FB793DA"><enum>(h)</enum><header>Performance review</header><text>The Secretary shall—</text> <paragraph id="H3B25378C015048AA8EBC47DA6D13DB56" commented="no"><enum>(1)</enum><text display-inline="yes-display-inline">review the performance of each entity that receives a grant or contract under this section; and</text></paragraph>
<paragraph id="HA558BEB8E96749ADABE26193386D86C8" commented="no"><enum>(2)</enum><text>make information regarding such performance publicly available.</text></paragraph></subsection> <subsection id="H29EDE49DC87644C8B6AA88772FD3BA8E"><enum>(i)</enum><header>Remediation plan</header> <paragraph commented="no" display-inline="yes-display-inline" id="H344D79E3270446C598957D6E0D222326"><enum>(1)</enum><text display-inline="yes-display-inline">In the case of an entity that receives a grant or contract under this section and does not meet the outcome measures developed by the Secretary under subsection (g), the Secretary shall require the entity to submit to the Secretary a remediation plan under which the entity shall describe how and when it plans to meet such outcome measures.</text></paragraph>
<paragraph id="H7838A308FBB84E65B9C73891172A3B28" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">The Secretary may not award a subsequent grant or contract under this section to an entity described in paragraph (1) unless the Secretary approves the remediation plan submitted by the entity under such paragraph.</text></paragraph></subsection> <subsection id="H7669AA6D2192408987EA3F502ACFCC18"><enum>(j)</enum><header>Maximum amount</header><text display-inline="yes-display-inline">The amount of a grant or contract awarded under this section may not exceed 10 percent of amounts made available for grants or contracts under this section for the fiscal year in which the grant or contract is awarded.</text></subsection>
<subsection id="HE5A7CB537221487CBDE04B9D1D6D1B9F"><enum>(k)</enum><header>Supplement, not supplant</header><text display-inline="yes-display-inline">Any grant or contract awarded under this section shall be used to supplement and not supplant funding that is otherwise available through the Department to provide mental health support among family caregivers of veterans participating in the family caregiver program.</text></subsection> <subsection id="H65205A83E6DC4D3CAC3C0425139D6747"><enum>(l)</enum><header>Outreach to family caregivers</header><text display-inline="yes-display-inline">The Secretary shall include, in the outreach materials regularly provided to a family caregiver who participates in the family caregiver program, notice of mental health support provided by recipients of grants or contracts under this section that are located in the relevant Veterans Integrated Service Network.</text></subsection>
<subsection id="H98013F5C5F6E4EC5AAA23566BB8E5056"><enum>(m)</enum><header>Funding</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H31057DBEB9D74BFE997978ADD7D5E8DA"><enum>(1)</enum><text>Amounts for the activities of the Department under this section shall be budgeted and appropriated through a separate appropriation account.</text></paragraph> <paragraph id="HAAEF59C371A44FC88EDAA5A92608D724" indent="up1"><enum>(2)</enum><text>In the budget justification materials submitted to Congress in support of the budget of the Department for any fiscal year (as submitted with the budget of the President under section 1105(a) of title 31), the Secretary shall include a separate statement of the amount requested to be appropriated for that fiscal year for the account specified in paragraph (1).</text></paragraph></subsection>
<subsection id="HE505CA909EBD40E7839ECA2F44AF47F3"><enum>(n)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to the Secretary, for each of fiscal years 2025 and 2026, $10,000,000 to carry out this section.</text></subsection> <subsection id="H57A350FBAEF44B57A40CA3D313E753DB"><enum>(o)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H5ED6CF21AF16431BB98C14435367596C"><enum>(1)</enum><text>The terms <term>caregiver</term> and <term>family caregiver</term> have the meanings given those terms in section 1720G of this title.</text></paragraph> <paragraph id="H01D30A2F1F6D4C4EA9AD49B1D381CC80"><enum>(2)</enum><text>The term <term>family caregiver program</term> means the program of comprehensive assistance for family caregivers under section 1720G of this title.</text></paragraph>
<paragraph id="H70BA4BC5E72E42198AC2911BF392F952"><enum>(3)</enum><text>The term <term>Veterans Crisis Line</term> means the toll-free hotline for veterans established under section 1720F of this title.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H4A6FBE288AC741ECA7F4A90BF933C886"><enum>123.</enum><header>Home- and community-based services: programs</header> <subsection id="H641035C3095F42D7B009E27A0150E8FF"><enum>(a)</enum><header>Programs</header><text display-inline="yes-display-inline">Such subchapter is further amended by inserting after section 1720K (as added by section 122) the following new section (and conforming the table of sections at the beginning of such chapter accordingly):</text>
<quoted-block style="USC" id="HB07912F47A174166990BE8C989ED3EAB" display-inline="no-display-inline">
<section id="H55250811BC9247B1A5CA78BA30670F46"><enum>1720L.</enum><header>Home- and community-based services: programs</header>
<subsection id="H3F37199CFDA049009A57188647AE2F94" commented="no"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">In furnishing noninstitutional alternatives to nursing home care pursuant to the authority of section 1720C of this title (or any other authority under this chapter or other provision of law administered by the Secretary of Veterans Affairs), the Secretary shall carry out each of the programs specified in this section in accordance with such relevant authorities except as otherwise provided in this section.</text></subsection> <subsection id="HE2CEDDCC9DD14ED79938B45BF16FAE2A"><enum>(b)</enum><header>Veteran-Directed Care program</header> <paragraph commented="no" display-inline="yes-display-inline" id="HA1C26106AF1D4B4CBFB5DD22AA1556D2"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary of Veterans Affairs, in collaboration with the Secretary of Health and Human Services, shall carry out a program to be known as the <quote>Veteran-Directed Care program</quote>. Under such program, the Secretary of Veterans Affairs may enter into agreements with the providers described in paragraph (2) to provide to eligible veterans funds, to the extent practicable, to obtain such in-home care services and related items that support clinical need and improve quality of life, as may be determined appropriate by the Secretary of Veterans Affairs and selected by the veteran, including through the veteran hiring individuals to provide such services and items or directly purchasing such services and items.</text></paragraph>
<paragraph id="H1F9B4FEE521D4CD9B5BB2FBDCAD29BA1" indent="up1"><enum>(2)</enum><text>The providers described in this paragraph are the following:</text> <subparagraph id="H13EEDC16E955471B9DC56A02334A3EA6" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">An Aging and Disability Resource Center, an area agency on aging, or a State agency.</text></subparagraph>
<subparagraph id="H4F5626A6B5524D4CA4AA5984D5AD2294" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">A center for independent living.</text></subparagraph> <subparagraph id="H1EE5DA0C000640CCABFE67F92A50355E"><enum>(C)</enum><text display-inline="yes-display-inline">An Indian tribe or tribal organization receiving assistance under title VI of the Older Americans Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/42/3057">42 U.S.C. 3057 et seq.</external-xref>).</text></subparagraph>
<subparagraph id="HA8E8A08E812E4F29A66055722895EAD1"><enum>(D)</enum><text>Any other entity that the Secretary, in consultation with the Secretary of Health and Human Services, determines appropriate.</text></subparagraph></paragraph> <paragraph id="HF3FF6FD9E9E84478ABC38EC0505F8966" indent="up1" commented="no"><enum>(3)</enum><text display-inline="yes-display-inline">In carrying out the Veteran-Directed Care program, the Secretary of Veterans Affairs shall—</text>
<subparagraph id="H4E6323FD881D4E5AB97350C0D05027EA" commented="no"><enum>(A)</enum><text>administer such program through each medical center of the Department of Veterans Affairs;</text></subparagraph> <subparagraph id="H7C4C4E0E92AD48A487ECD784AB597BCE" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">seek to ensure the availability of such program in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Commonwealth of Puerto Rico, the Virgin Islands of the United States, and any other territory or possession of the United States, to the extent practicable; and</text></subparagraph>
<subparagraph id="H301AF855CD0A409D829ACE1218B28EAA" commented="no"><enum>(C)</enum><text>seek to ensure the availability of such program for eligible veterans who are Native American veterans receiving care and services furnished by the Indian Health Service, a tribal health program, an Urban Indian organization, or (in the case of a Native Hawaiian veteran) a Native Hawaiian health care system, to the extent practicable.</text></subparagraph></paragraph> <paragraph id="HF8E568940A6C461A85D0320D10B5C119" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">If a veteran participating in the Veteran-Directed Care program is hospitalized, the veteran may continue to use funds under the program during a period of hospitalization in the same manner that the veteran would be authorized to use such funds under the program if the veteran were not hospitalized.</text></paragraph></subsection>
<subsection id="HF99654F31F8F4C188E2F0266D8A0BDC2"><enum>(c)</enum><header>Homemaker and Home Health Aide program</header>
<paragraph commented="no" display-inline="yes-display-inline" id="HE9149F699C3D4C3F93A495AFF88144B2"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary shall carry out a program to be known as the <quote>Homemaker and Home Health Aide program</quote> under which the Secretary may enter into agreements with home health agencies to provide to eligible veterans such home health aide services as may be determined appropriate by the Secretary.</text></paragraph> <paragraph id="H74D93E0071E14912AE0DD6C4E57818EE" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">In carrying out the Homemaker and Home Health Aide program, the Secretary shall—</text>
<subparagraph id="HA495F5FFE9944447AE0397DDE1E7712B"><enum>(A)</enum><text display-inline="yes-display-inline">administer such program in the locations specified in subparagraph (A) of subsection (b)(3);</text></subparagraph> <subparagraph id="HD28BE1CFFFBB4673926D994D204ADB4A"><enum>(B)</enum><text display-inline="yes-display-inline">seek to ensure the availability of such program in the locations specified in subparagraph (B) of subsection (b)(3); and</text></subparagraph>
<subparagraph id="H3C0E320DB1E54A1385DBE526CE5D173B"><enum>(C)</enum><text display-inline="yes-display-inline">seek to ensure the availability of such program for the veteran populations specified in subparagraph (C) of subsection (b)(3).</text></subparagraph></paragraph></subsection> <subsection id="H4F0CB88488CB4BECB4159FC7DCC03B6A"><enum>(d)</enum><header>Home-Based Primary Care program</header><text display-inline="yes-display-inline">The Secretary shall carry out a program to be known as the <quote>Home-Based Primary Care program</quote> under which the Secretary may furnish to eligible veterans in-home health care, the provision of which is overseen by a provider of the Department.</text></subsection>
<subsection id="HF2F5578F3E0A4951B549B9721A0884FE"><enum>(e)</enum><header>Purchased Skilled Home Care program</header><text display-inline="yes-display-inline">The Secretary shall carry out a program to be known as the <quote>Purchased Skilled Home Care program</quote> under which the Secretary may furnish to eligible veterans such in-home care services as may be determined appropriate and selected by the Secretary for the veteran.</text></subsection> <subsection id="HBC8A9436CBD547ABBECCE0975AA0C90C"><enum>(f)</enum><header>Caregiver support</header> <paragraph commented="no" display-inline="yes-display-inline" id="HF398E5460BFA4A87AEABE6A23D5B81B4"><enum>(1)</enum><text display-inline="yes-display-inline">With respect to a resident eligible caregiver of a veteran participating in a program under this section, the Secretary shall—</text>
<subparagraph id="H5CF7D0FF3AAE4E64A7E60FBBB406529F" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">if the veteran meets the requirements of a covered veteran under section 1720G(b) of this title, provide to such caregiver the option of enrolling in the program of general caregiver support services under such section;</text></subparagraph> <subparagraph id="H500925C2A1284D53837C6F2F25920B7A" indent="up1"><enum>(B)</enum><text>provide to such caregiver covered respite care of not less than 30 days annually; and</text></subparagraph>
<subparagraph id="HEDFB22C4F17D4709BB98873495AB1F0D" indent="up1"><enum>(C)</enum><text>conduct on an annual basis (and, to the extent practicable, in connection with in-person services provided under the program in which the veteran is participating), a wellness contact of such caregiver.</text></subparagraph></paragraph> <paragraph id="H8820533AD580479DA0EDA4A7A9FE81BE" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">Covered respite care provided to a resident eligible caregiver of a veteran under paragraph (1) may exceed 30 days annually if such extension is requested by the resident eligible caregiver or veteran and determined medically appropriate by the Secretary.</text></paragraph></subsection>
<subsection id="HB07E7F81EFDC45769EC05920671DE842" commented="no"><enum>(g)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">Nothing in this section shall be construed to limit the authority of the Secretary to carry out programs providing home- and community-based services under any other provision of law.</text></subsection> <subsection id="HD1207FD306904E1BAED21076D1A5D296"><enum>(h)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="HB99470D5859C457E8ADC90A00115245C"><enum>(1)</enum><text display-inline="yes-display-inline">The terms <term>Aging and Disability Resource Center</term>, <term>area agency on aging</term>, and <term>State agency</term> have the meanings given those terms 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>).</text></paragraph> <paragraph id="H18E048E345AD4BDCAB433C4832F4B87A" commented="no"><enum>(2)</enum><text display-inline="yes-display-inline">The terms <term>caregiver</term> and <term>family caregiver</term>, with respect to a veteran, have the meanings given those terms, respectively, under subsection (e) of section 1720G of this title with respect to an eligible veteran under subsection (a) of such section or a covered veteran under subsection (b) of such section, as the case may be.</text></paragraph>
<paragraph id="H639B8F8C24D44AD1BD1829B2A5C0D11C"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>center for independent living</term> has the meaning given that term 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></paragraph> <paragraph id="H322482CC027548AE80242ED91CC556A0"><enum>(4)</enum><text display-inline="yes-display-inline">The term <term>covered respite care</term> has the meaning given such term in section 1720G(d) of this title.</text></paragraph>
<paragraph id="H8DBA62106A4F4673B21F0E92E55F86A1" commented="no"><enum>(5)</enum><text>The term <term>eligible veteran</term> means any veteran—</text> <subparagraph id="HE60CC217037A4F02A5F98C8A37EAE000" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">for whom the Secretary determines participation in a specific program under this section is medically necessary to promote, preserve, or restore the health of the veteran; and</text></subparagraph>
<subparagraph id="H7CB8E4B2610343FE8522F1844638F5F3" commented="no"><enum>(B)</enum><text>who absent such participation would be at increased risk for hospitalization, placement in a nursing home, or emergency room care.</text></subparagraph></paragraph> <paragraph id="H6B8254825EB7497181BBDDC3AB9464D2" commented="no"><enum>(6)</enum><text display-inline="yes-display-inline">The term <term>home health aide</term> means an individual employed by a home health agency to provide in-home care services.</text></paragraph>
<paragraph id="H0976D6BA8D1E4F009C721AAA74FEB812" commented="no"><enum>(7)</enum><text>The term <term>in-home care service</term> means any service, including a personal care service, provided to enable the recipient of such service to live at home.</text></paragraph> <paragraph id="H42477424EC1F48E8967D40A45CFA4ECE"><enum>(8)</enum><text display-inline="yes-display-inline">The terms <term>Indian tribe</term> and <term>tribal organization</term> have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>).</text></paragraph>
<paragraph id="HF007B2FAA50E443C8AFE25488B14D689" commented="no"><enum>(9)</enum><text>The terms <term>Native American</term> and <term>Native American veteran</term> have the meanings given those terms in section 3765 of this title.</text></paragraph> <paragraph id="H0BBF2077F8BF49BA91015DAB8821D4E9" commented="no"><enum>(10)</enum><text display-inline="yes-display-inline">The terms <term>Native Hawaiian</term> and <term>Native Hawaiian health care system</term> have the meanings given those terms in section 12 of the Native Hawaiian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/42/11711">42 U.S.C. 11711</external-xref>).</text></paragraph>
<paragraph id="H1413F7DB5BD54A3CA19D4C17B9827C5A" commented="no"><enum>(11)</enum><text display-inline="yes-display-inline">The terms <term>tribal health programs</term> and <term>Urban Indian organizations</term> have the meanings given those terms in section 4 of the Indian Health Care Improvement Act (<external-xref legal-doc="usc" parsable-cite="usc/25/1603">25 U.S.C. 1603</external-xref>).</text></paragraph> <paragraph id="HD9624011A10B48B0978A04E480CC0856" commented="no"><enum>(12)</enum><text>The term <term>resident eligible caregiver</term> means an individual who—</text>
<subparagraph id="HAF5EA7B26EDE4E98A98CF78BD9E080CB" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">is a caregiver, or a family caregiver, of a veteran and resides with that veteran; and</text></subparagraph> <subparagraph id="H50B87EE2289A440190D766ABB74A0CDA" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">has not entered into a contract, agreement, or other arrangement for such individual to act as a caregiver for that veteran unless such individual is a family member of the veteran or is furnishing caregiver services through a medical foster home.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HC51FB039EF964433BC87BD4267736F82"><enum>(b)</enum><header>Deadline for improved administration</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall ensure that the Veteran-Directed Care program and the Homemaker and Home Health Aide program are administered through each medical center of the Department of Veterans Affairs in accordance with section 1720L of title 38, United States Code (as added by subsection (a)), by not later than two years after the date of the enactment of this Act.</text></subsection> <subsection id="HB92FEA31FB9348E6B1461602F93B5688"><enum>(c)</enum><header>Administration of Veteran-Directed Care program</header> <paragraph id="HF4E2D1C027364977A710D799EC410BD0" commented="no"><enum>(1)</enum><header>Procedures</header> <subparagraph id="HD5DAEF16080640CEAE98D2D9AD166410" commented="no"><enum>(A)</enum><text>The Secretary shall establish procedures to—</text>
<clause id="H25D3EE88246F4641AC24C20823C23AAE" commented="no"><enum>(i)</enum><text>identify the staffing needs for the Veteran-Directed Care program of the Department of Veterans Affairs under such section (as added by subsection (a)); and</text></clause> <clause id="H7FC43A0A632E466BBB0ABEB513053F1F" commented="no"><enum>(ii)</enum><text>define the roles and responsibilities for personnel of the Department responsible for the administration of such program, including such personnel employed at the national, Veterans Integrated Service Network, or medical facility level.</text></clause></subparagraph>
<subparagraph id="HD1FF4F40FDDB4A54BFCCE4B27AED197D" commented="no"><enum>(B)</enum><text>The responsibilities described in clause (ii) of subparagraph (A) shall include responsibilities for engagement with—</text> <clause id="H430AA4B4C26B40439AC1D47803B4990B" commented="no"><enum>(i)</enum><text>veterans participating in such program;</text></clause>
<clause id="H821337AF3C3E463F8014E75ED334F224" commented="no"><enum>(ii)</enum><text>veterans interested in participating in such program; and</text></clause> <clause id="HF3733F07B6E24BB4BCBA0FA27B1159CA" commented="no"><enum>(iii)</enum><text>providers described in section 1720L(b)(2) (as added by subsection (a)).</text></clause></subparagraph></paragraph>
<paragraph id="HA9AFCF85642647989A2A56BB3D50973A" commented="no"><enum>(2)</enum><header>Staffing model; report</header><text display-inline="yes-display-inline">Not later than two years after enactment of this Act, the Secretary of Veterans Affairs shall—</text> <subparagraph id="HDF6503323A2B4FB988290BD78FB1E4F1" commented="no"><enum>(A)</enum><text>establish a staffing model for the administration of such program at each medical facility of the Department of Veterans Affairs; and</text></subparagraph>
<subparagraph id="H08D95ACFC3B24305972A907775A9EBB1" commented="no"><enum>(B)</enum><text>submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing the following:</text> <clause id="H9F903BDAA99E4284A981159DF3F41A88" commented="no"><enum>(i)</enum><text>A description of—</text>
<subclause id="HBF7DCD91F3994479B96345B22C8ACF83" commented="no"><enum>(I)</enum><text>the staffing model described in subparagraph (A); and</text></subclause> <subclause id="H3BB998CFF42C4D0CA9220A88A3D4C8BE" commented="no"><enum>(II)</enum><text>the rationale for such staffing model.</text></subclause></clause>
<clause id="H0A07CB78D1CB43B2B01AAAD49DA70543" commented="no"><enum>(ii)</enum><text>An identification of the ratio of staff required to administer such program to the number of veterans served by such program, disaggregated by each medical facility of the Department of Veterans Affairs.</text></clause> <clause id="H4A14B412367342169C166D1F87470F41" commented="no"><enum>(iii)</enum><text display-inline="yes-display-inline">A description of budgetary resources or other support, if any, required to accommodate an increase in staffing at medical facilities of the Department of Veterans Affairs pursuant to the requirements of the staffing model described in subparagraph (A). </text></clause>
<clause id="HE3F537307D0A41A7906D85E4F956F178" commented="no"><enum>(iv)</enum><text display-inline="yes-display-inline">Such other matters as the Secretary of Veterans Affairs determines appropriate.</text></clause></subparagraph></paragraph></subsection></section> <section id="HB526B3A84487435093151C5CB4162A05" section-type="subsequent-section" display-inline="no-display-inline"><enum>124.</enum><header>Coordination with assistance and support services for caregivers</header> <subsection id="H81E0935F23C34CE7BA28DB4B40253803"><enum>(a)</enum><header>Coordination with Program of Comprehensive Assistance for Family Caregivers</header> <paragraph id="HBC5784B3F2AD478B990E6E6FD2425822"><enum>(1)</enum><header>Coordination</header><text>Section 1720G(a) of title 38, United States Code, is amended by adding at the end the following new paragraph:</text>
<quoted-block style="USC" id="HD80DE2AB464940ADB677867D290A1201" display-inline="no-display-inline">
<paragraph id="H7E0F4FD3CDA54B7596B55BF2219898B6" indent="up1" commented="no"><enum>(14)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="HFED365C863E645C9AF0EDB4F439C8E7C"><enum>(A)</enum><text display-inline="yes-display-inline">In the case of a veteran or caregiver who seeks services under this subsection and is denied such services, or a veteran or the family caregiver of a veteran who is discharged from the program under this subsection, the Secretary shall—</text> <clause id="HA7F13F912A794BB6B17E69AFDBB208FD" indent="up1"><enum>(i)</enum><text display-inline="yes-display-inline">if the veteran meets the requirements of a covered veteran under subsection (b), provide to such caregiver the option of enrolling in the program of general caregiver support services under such subsection;</text></clause>
<clause id="H365FA0FC5C5046A78CE361F85D67E2D1" indent="up1" commented="no"><enum>(ii)</enum><text display-inline="yes-display-inline">assess the veteran or caregiver for participation in any other available program of the Department for home- and community-based services (including the programs specified in section 1720L of this title) for which the veteran or caregiver may be eligible and, with respect to the veteran, store (and make accessible to the veteran) the results of such assessment in the electronic medical record of the veteran; and</text></clause> <clause id="HED150EEE940A4CF1851B52B2CA48E45B" indent="up1" commented="no"><enum>(iii)</enum><text>provide to the veteran or caregiver written information on any such program identified pursuant to the assessment under clause (ii), including information about facilities, eligibility requirements, and relevant contact information for each such program.</text></clause></subparagraph>
<subparagraph id="HDB2F97CAF36C43D0B70515910AE1FE04" indent="up1" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">The Secretary shall, to the extent practicable, provide to a veteran or family caregiver the option of obtaining clinically appropriate services under any other available program of the Department for home- and community-based services (including the programs specified in section 1720L of this title) for which the veteran or family caregiver may be eligible prior to discharging the veteran or family caregiver from the program under this subsection.</text></subparagraph> <subparagraph id="HD933BD2B1215492988F603E558BF7C63" indent="up1"><enum>(C)</enum><text display-inline="yes-display-inline">For each veteran or family caregiver who is discharged from the program under this subsection, a caregiver support coordinator shall provide for a smooth and personalized transition from such program to an appropriate program of the Department for home- and community-based services (including the programs specified in section 1720L of this title), including by integrating caregiver support across programs.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H8E88796B7A2D4D67B047672940260361"><enum>(2)</enum><header>Applicability</header><text display-inline="yes-display-inline">The amendments made by paragraph (1) shall apply with respect to denials and discharges occurring on or after the date that is 180 days after the date of the enactment of this Act.</text></paragraph> <paragraph id="H34BB6A7B1A064BC3ACD8CD8AB0944F2A"><enum>(3)</enum><header>Technical and conforming amendments</header><text>Section 1720G(d) of such title is amended—</text>
<subparagraph id="H120C1EA388D540ACA0F4B69FA889A06A"><enum>(A)</enum><text>by striking <quote>or a covered veteran</quote> each place it appears and inserting <quote>, a veteran denied or discharged as specified in paragraph (14) of such subsection, or a covered veteran</quote>; and</text></subparagraph> <subparagraph id="H6BD1AB07E92E4F8180ED9C95C83F6ED1"><enum>(B)</enum><text>by striking <quote>under subsection (a), means</quote> each place it appears and inserting <quote>under subsection (a) or a veteran denied or discharged as specified in paragraph (14) of such subsection, means</quote>.</text></subparagraph></paragraph></subsection>
<subsection id="H94895A94179F42E08916DEDCBF97DB4D" commented="no"><enum>(b)</enum><header>Conformity of respite care across programs</header><text display-inline="yes-display-inline">Section 1720G of title 38, United States Code, as amended by subsection (a)(3), is further amended—</text> <paragraph id="H016975A517E94D7399F9D86394A30E3C"><enum>(1)</enum><text>in subsection (a)(3)—</text>
<subparagraph id="HDBE7A001C87D428AB2D3F0EA6903A613"><enum>(A)</enum><text>by amending subparagraph (A)(ii)(III) to read as follows:</text> <quoted-block style="USC" id="H5496A0D417EC4CE3BBB408C7B5A4246B" display-inline="no-display-inline"> <subclause id="HA7243C0E93A04B00A03A468439CEEB42" indent="up2"><enum>(III)</enum><text display-inline="yes-display-inline">covered respite care of not less than 30 days annually;</text></subclause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="HDAB1F57D5B0049D082E373CB5577A10B"><enum>(B)</enum><text>by striking subparagraph (B) and redesignating subparagraphs (C) and (D) as subparagraphs (B) through (C), respectively; and</text></subparagraph></paragraph> <paragraph id="H89F945199BD14D4BBBEF6407EB223701"><enum>(2)</enum><text display-inline="yes-display-inline">by amending subsection (b)(3)(A)(iii) to read as follows:</text>
<quoted-block style="USC" id="HDD713D6A81724BE6A9585173E1059AB4" display-inline="no-display-inline">
<clause id="H8A46F14F7E9444179E43DC7566E24350" indent="up2" commented="no"><enum>(iii)</enum><text display-inline="yes-display-inline">Covered respite care of not less than 30 days annually.</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph> <paragraph id="HBD3067E2E11F460DBDE141A90230C349"><enum>(3)</enum><text>in subsection (d)—</text>
<subparagraph id="HCD580DD8A6CA47CD9DD85B8A0CAF98C5"><enum>(A)</enum><text>by redesignating paragraphs (2) through (4) as paragraphs (3) through (5), respectively; and</text></subparagraph> <subparagraph id="H4F6D6378C0B2484FB477EAFEBB26E5D6"><enum>(B)</enum><text>by inserting after paragraph (1) the following new paragraph:</text>
<quoted-block style="USC" id="HFD7319DDE1AA481F9A983D8F82744121" display-inline="no-display-inline">
<paragraph id="H3818E4FF823849F6819D9C819D2C6A23"><enum>(2)</enum><text display-inline="yes-display-inline">The term <term>covered respite care</term> means, with respect to a caregiver of a veteran, respite care under section 1720B of this title that—</text> <subparagraph id="HC2074DEADB5A46538F30E9033D04C517"><enum>(A)</enum><text>is medically and age appropriate for the veteran (including 24-hour per day care of the veteran commensurate with the care provided by the caregiver); and</text></subparagraph>
<subparagraph id="HDF5D2F35BD2945519B01A2147031BEA5"><enum>(B)</enum><text>includes in-home care.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection> <subsection id="H2C4F6EBBF9644924ADF0008CE48B74D7"><enum>(c)</enum><header>Review relating to caregiver contact</header><text display-inline="yes-display-inline">The Secretary shall conduct a review of the capacity of the Department to establish a streamlined system for contacting all caregivers enrolled in the program of general caregiver support services under section 1720G(b) of title 38, United States Code, to provide to such caregivers program updates and alerts relating to emerging services for which such caregivers or the veterans for which they provide care may be eligible.</text></subsection></section>
<section id="H81BCE32D3BC94069931A20A2D8118A48"><enum>125.</enum><header>Improvements to program of comprehensive assistance for family caregivers</header><text display-inline="no-display-inline">Section 1720G(a) of title 38, United States Code, as amended by section 124, is further amended—</text> <paragraph id="HFE0B654E4E054986B9920604C1C1EAFF"><enum>(1)</enum><text>in paragraph (12)—</text>
<subparagraph id="H46BCE267247645DDBE3B6147BF2DF113"><enum>(A)</enum><text>in subparagraph (A), by inserting <quote>, which shall include all criteria used to determine eligibility for such assistance and, in the case of a completed evaluation, how such criteria were used to evaluate information provided in assessments to determine such eligibility</quote> before the period at the end; and</text></subparagraph> <subparagraph id="H1C4CD15FBCE1485082AE44BB5C9740C0"><enum>(B)</enum><text>in subparagraph (C)(i), by striking <quote>who submits</quote> and all that follows through the end of the clause and inserting the following: </text>
<quoted-block style="USC" id="H8E6F53856FD54C4CA87BF7705B4F925A" display-inline="yes-display-inline"><text display-inline="yes-display-inline">who—</text> <subclause id="H0C4E8FBCC9AF4194A336CDE94DFDB42C" indent="up2"><enum>(I)</enum><text display-inline="yes-display-inline">submits an application for the program established under paragraph (1); or</text></subclause>
<subclause id="HD4D46ADF0A274CB48171C7B7453C343D" indent="up2"><enum>(II)</enum><text>is being reassessed for eligibility to continue in such program.</text></subclause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="HDFA514C360294F3887B94AC735FC96FF"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H5986DAB602094AAC82198F2E3290570E">
<paragraph indent="up1" id="H2115A0452F5446949FF8693BB0AEAE2E"><enum>(15)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="H932B6C7E3FA64020884BD3E289FCCC42"><enum>(A)</enum><text>Not less frequently than annually, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a comprehensive report on the program required by paragraph (1) that includes, with respect to one-year period preceding the date of the submission of such report, the following:</text> <clause id="HC7C57A8293EE43848284A5E9D196BE40" indent="up1"><enum>(i)</enum><text>The number of applications received for such program. </text></clause>
<clause id="H4E5115D2BB4D4F4F9A53F7E110D94325" indent="up1"><enum>(ii)</enum><text>The number, disaggregated by race, sex, and era and branch of service in the Armed Forces of the applicant, of—</text> <subclause id="H999FC1CDEA224F038C8A76CB29215B20"><enum>(I)</enum><text>approvals of such applications; and</text></subclause>
<subclause id="H2353DBEFE8EE470290FAD3E0B6FC8A3C"><enum>(II)</enum><text>denials of such applications.</text></subclause></clause> <clause id="H85CF74E8D2E742509C89B25E8BC2F7A0" indent="up1"><enum>(iii)</enum><text>The number of reassessments conducted for such program.</text></clause>
<clause id="HB4028D0C7B0744D9AB38F37548EA34EB" indent="up1"><enum>(iv)</enum><text>An identification of each decision made with respect to a reassessment conducted for such program, disaggregated by decisions resulting in—</text> <subclause id="H51172D1D629A4E6792980E86D6A0F7A9"><enum>(I)</enum><text>disenrollment, including removal, discharge, or voluntary withdrawal;</text></subclause>
<subclause id="HE1E44577BDD54BD98D045AB2337CA61F"><enum>(II)</enum><text>tier reduction; and</text></subclause> <subclause id="HE1ADF2C6CB63418F9A36B6AB5C63FCD8"><enum>(III)</enum><text>tier continuation.</text></subclause></clause>
<clause indent="up1" id="H4B2A79D4B29F4D4DB302313CEA33C435"><enum>(v)</enum><text>The number of appeals of decisions made with respect to such program, disaggregated by type of appeal.</text></clause> <clause indent="up1" id="HF4875D15CE77461CBE25350285D42FA5"><enum>(vi)</enum><text>With respect to each appeal described in clause (v), the decision rendered, if any.</text></clause>
<clause indent="up1" id="HA1822FAFEE4546C89EC3B4BCD526869D"><enum>(vii)</enum><text>A description of all tools used in assessments conducted for such program, including an explanation of how and by whom such tools are administered.</text></clause> <clause indent="up1" id="H75A2FCEFBEC840B58102C96EF4DBDE79"><enum>(viii)</enum><text>A description of procedures used under such program for reviewing and integrating clinical records from health care providers that includes an explanation of how such records are used in determinations of eligibility for such program.</text></clause>
<clause id="H0614ED6FAA424ABFBE4F323C3A681AAE" indent="up1"><enum>(ix)</enum><text>A description of procedures available under such program for health care providers to communicate medical opinions to the teams conducting assessments to determine eligibility for such program, including health care providers in the private sector and health care providers specified in subsection (c) of section 1703 of this title.</text></clause> <clause id="H1AC5EE41A3A24CA1BF951F6456F557F5" indent="up1"><enum>(x)</enum><text>A description of information technology systems and processes used under such program to upload and integrate all clinical records from all non-Department providers, including providers in the private sector and providers under the Veterans Community Care Program established under such section.</text></clause></subparagraph>
<subparagraph indent="up1" id="H4F94A9F927494D5B904677C390F7F672" commented="no"><enum>(B)</enum><text>The Secretary shall ensure that all data included in a report under subparagraph (A)—</text> <clause id="H86842825263446999A5D8C93D45539A1"><enum>(i)</enum><text>relating to a decision made under the program required by paragraph (1), are disaggregated by the specific reason for the decision;</text></clause>
<clause id="H7A251203311F4B959BDCAD1EEB86D19E"><enum>(ii)</enum><text>relating to a veteran, include comprehensive demographic information of the veteran, including the time period of the injuries, if any, of the veteran and the Veterans Integrated Service Network in which the veteran is located; and</text></clause> <clause id="H3C8977F11A534F8F835244238955DE4D"><enum>(iii)</enum><text>with respect to eligibility determinations relating to a serious injury of a veteran, specify—</text>
<subclause id="H429F2D5AC9714A2081ADD45D3FDADA4C"><enum>(I)</enum><text>how many such determinations relate to the ability of the veteran to perform activities of daily living; and</text></subclause> <subclause id="H268FC5FB69B64A0DB983F1EB66CC4F67"><enum>(II)</enum><text>how many such determinations relate to the need of a veteran for supervision and protection.</text></subclause></clause></subparagraph>
<subparagraph id="H4E5A7012D19544A0AD739D56CE806C5D" indent="up1"><enum>(C)</enum><text display-inline="yes-display-inline">The Secretary shall provide the data under paragraph (B) pursuant to Federal laws and in a manner that is wholly consistent with applicable Federal privacy and confidentiality laws, including but the Privacy Act (<external-xref legal-doc="usc" parsable-cite="usc/5/552a">5 U.S.C. 552a</external-xref>), the Health Insurance Portability and Accountability Act (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/42/201">42 U.S.C. 201</external-xref> note) and regulations (title 45, Code of Federal Regulations, parts 160 and 164, or successor regulations), and sections 5701, 5705, and 7332 of this title to ensure that the provided data, or some portion of the data, will not undermine the anonymity of a veteran.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="H68FE406F450C4D6F99A99969DBB0EEFD"><enum>126.</enum><header>Improvements relating to Homemaker and Home Health Aide program</header> <subsection id="H975A0395B53040B1AAEDC8A2EE47CC04"><enum>(a)</enum><header>Pilot program for communities with shortage of home health aides</header> <paragraph id="HF376106D8FFA445F85F11B8983E88125"><enum>(1)</enum><header>Program</header><text display-inline="yes-display-inline">Beginning not later than 18 months after the date of the enactment of this Act, the Secretary shall carry out a three-year pilot program under which the Secretary shall provide homemaker and home health aide services to veterans who reside in communities with a shortage of home health aides.</text></paragraph>
<paragraph id="H2DD8E2FFF36E4DD394ED9118CB3DF027"><enum>(2)</enum><header>Locations</header><text>The Secretary shall select not fewer than five geographic locations in which the Secretary determines there is a shortage of home health aides at which to carry out the pilot program under paragraph (1).</text></paragraph> <paragraph id="H1D32660E06184477B0931EB945E6C0A5"><enum>(3)</enum><header>Nursing assistants</header> <subparagraph id="H8AC8EAB4397245CB8C8F2FBEA8EE848D"><enum>(A)</enum><header>In general</header><text>In carrying out the pilot program under paragraph (1), the Secretary may hire nursing assistants as new employees of the Department of Veterans Affairs, or reassign nursing assistants who are existing employees of the Department, to provide to veterans in-home care services (including basic tasks authorized by the State certification of the nursing assistant) under the pilot program, in lieu of or in addition to the provision of such services through non-Department home health aides.</text></subparagraph>
<subparagraph id="H01D5DB5309ED413CAE799A6E84932BE2"><enum>(B)</enum><header>Relationship to Home-Based Primary Care program</header><text>Nursing assistants hired or reassigned under subparagraph (A) may provide services to a veteran under the pilot program under paragraph (1) while serving as part of a health care team for the veteran under the Home-Based Primary Care program.</text></subparagraph></paragraph> <paragraph id="H89C5B097BF394D8B9C0F81D7D9875E63"><enum>(4)</enum><header>Report to Congress</header><text display-inline="yes-display-inline">Not later than one year before the date of the termination of the pilot program under paragraph (1), the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report that includes—</text>
<subparagraph id="H359438A1239F4428835E94684EDF254B"><enum>(A)</enum><text>a statement of the results of such pilot program; and</text></subparagraph> <subparagraph id="H6026E8D4C2F54642987FB00F7F686ADB"><enum>(B)</enum><text>an assessment of the feasibility and advisability of—</text>
<clause id="H7B08BBE771934F85BB154544273ECA08"><enum>(i)</enum><text>extending such pilot program; or</text></clause> <clause id="HFFE7BC7982024FC788506566F6DD2140"><enum>(ii)</enum><text>making such pilot program a permanent program of the Department of Veterans Affairs.</text></clause></subparagraph></paragraph></subsection>
<subsection id="H744E9F144502462B8059BA6F1D428191"><enum>(b)</enum><header>Report on use of funds</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing, with respect to the period beginning in fiscal year 2012 and ending in fiscal year 2024, the following:</text> <paragraph id="HCBF12908A31D4AC6909C987906C651B9" commented="no"><enum>(1)</enum><text>An identification of the amount of funds that were included in a budget of the Department of Veterans Affairs during such period for the provision of in-home care to veterans under the Homemaker and Home Health Aide program but were not expended for such provision, disaggregated by medical center of the Department for which such unexpended funds were budgeted (if such disaggregation is possible).</text></paragraph>
<paragraph id="H8AF0F44E967D422D945D7C0A3CB6EA25"><enum>(2)</enum><text display-inline="yes-display-inline">To the extent practicable, an identification of the number of veterans for whom, during such period, the hours during which a home health aide was authorized to provide services to the veteran under the Homemaker and Home Health Aide program were reduced for a reason other than a change in the health care needs of the veteran, and a detailed description of the reasons why any such reductions may have occurred.</text></paragraph></subsection> <subsection id="H62055B2DB08245A6B6BFCF01DB59047C"><enum>(c)</enum><header>Updated guidance on program</header><text>Not later than one year after the date of the enactment of this Act, the Secretary shall issue updated guidance for the Homemaker and Home Health Aide program. Such updated guidance shall include the following:</text>
<paragraph id="HCA6C60FC67D74145887D57876D39B08A"><enum>(1)</enum><text display-inline="yes-display-inline">A process for the transition of veterans from the Homemaker and Home Health Aide program to other covered programs.</text></paragraph> <paragraph id="H0C0518CE46644F6685A5CE024B470891"><enum>(2)</enum><text display-inline="yes-display-inline">A requirement for the directors of the medical facilities of the Department to complete such process whenever a veteran with care needs has been denied services from home health agencies under the Homemaker and Home Health Aide program as a result of the clinical needs or behavioral issues of the veteran.</text></paragraph></subsection></section>
<section id="H5ECBA4B6B2774E32A24A47ECA6AB68C1"><enum>127.</enum><header>Pilot program to furnish assisted living services to certain veterans</header>
<subsection id="H1C872C01A2374CB5943DDE1FE683411A"><enum>(a)</enum><header>Establishment</header><text>Beginning not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out a pilot program to assess—</text> <paragraph id="HC1DE072A9D234B6190F10F9C63E75166"><enum>(1)</enum><text>the effectiveness of providing assisted living services to eligible veterans, at the election of such veterans; and</text></paragraph>
<paragraph id="H90F51F3351B2456BA7307081C465749C"><enum>(2)</enum><text>the satisfaction with the pilot program of veterans participating in such pilot program.</text></paragraph></subsection> <subsection id="H3660F9F3C25A4EEE9E18BB9327DAFC00"><enum>(b)</enum><header>Program locations</header> <paragraph id="HE782381C4B884CF4A00FF723605C0437"><enum>(1)</enum><header>Veterans Integrated Service Networks</header><text>The Secretary shall select two Veterans Integrated Service Networks of the Department of Veterans Affairs at which to carry out the pilot program under subsection (a).</text></paragraph>
<paragraph id="H2A5B76BF5BFA4233A160AB971D8BE4ED"><enum>(2)</enum><header>Facilities</header>
<subparagraph id="H7CF2C7264D1243068EA3E88A0619EF05"><enum>(A)</enum><header>In general</header><text>Within the Veterans Integrated Service Networks selected under paragraph (1), the Secretary shall select facilities at which to carry out the pilot program under subsection (a)(1).</text></subparagraph> <subparagraph id="HB2BBDB28B34E4464B6BA13D2D12E516C"><enum>(B)</enum><header>Selection criteria</header><text>In selecting facilities under subparagraph (A) at which to carry out the pilot program under subsection (a)(1), the Secretary shall ensure that—</text>
<clause id="HE9855AA44DEE4960952238911FF0D5DF"><enum>(i)</enum><text>the locations of such facilities are in geographically diverse areas;</text></clause> <clause id="H55F6B10EBD6541408AE0EA7510726CC2"><enum>(ii)</enum><text>not fewer than one such facility serves veterans in rural or highly rural areas (as determined through the use of the Rural-Urban Commuting Areas coding system of the Department of Agriculture);</text></clause>
<clause id="H7077CE7657554CBABCCD4A65492A4264"><enum>(iii)</enum><text>not fewer than one such facility is located in each Veterans Integrated Service Network selected under paragraph (1); and</text></clause> <clause id="H2848306917AC49BC96318CA52EB95F8E"><enum>(iv)</enum><text>not fewer than one such facility is a State home.</text></clause></subparagraph></paragraph></subsection>
<subsection id="H2C9C063F69E04200ACAADF5E1418BFC4"><enum>(c)</enum><header>Program participants</header><text>Not more than 60 eligible veterans may participate in the pilot program under subsection (a)(1) in each Veterans Integrated Service Network selected under subsection (b)(1).</text></subsection> <subsection id="HA31D6C93DD0E4B0E9343C27BFFD9D23C"><enum>(d)</enum><header>Provision of assisted living services</header> <paragraph id="H2B4738743B454805837022C5C0BCECA0"><enum>(1)</enum><header>Agreements</header><text>In carrying out the pilot program under subsection (a)(1), the Secretary may enter into agreements for the provision of assisted living services on behalf of eligible veterans with—</text>
<subparagraph id="HE6C047E86A8D488787C27D176F528236"><enum>(A)</enum><text>a provider participating under a State plan or waiver under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>); or</text></subparagraph> <subparagraph id="HCB4B9918691C40FEBB2D653577BA7412"><enum>(B)</enum><text>a State home recognized and certified under subpart B of part 51 of title 38, Code of Federal Regulations, or successor regulations.</text></subparagraph></paragraph>
<paragraph id="HB6E4B5D402534EA6B33F773276154A13"><enum>(2)</enum><header>Standards</header><text>The Secretary may not place, transfer, or admit a veteran to any facility for assisted living services under the pilot program under subsection (a)(1) unless the Secretary determines that—</text> <subparagraph id="H9FACA36CC2714F4B936AC6F802B23543"><enum>(A)</enum><text>the facility meets the standards for community residential care established under sections 17.61 through 17.72 of title 38, Code of Federal Regulations, or successor regulations, and any additional standards of care as the Secretary may specify; or</text></subparagraph>
<subparagraph id="HA2DD1FA06F99445485C36F8A83B5A5AF"><enum>(B)</enum><text>in the case of a facility that is a State home, the State home meets such standards of care as the Secretary may specify.</text></subparagraph></paragraph> <paragraph id="H762262F674D147188FBAE339F64711D4"><enum>(3)</enum><header>Inspection</header><text>The Secretary shall inspect facilities at which veterans are placed under the pilot program under subsection (a)(1)—</text>
<subparagraph id="HC5EA4B3F07EA4E20B343D7F10AE5270B"><enum>(A)</enum><text>with respect to a facility that is a State home, not less frequently than annually and in the same manner as the Secretary conducts inspection of State homes under section 1742 of title 38, United States Code; and</text></subparagraph> <subparagraph id="HD71346EFE85248F1AB05AE576356E6F5"><enum>(B)</enum><text>with respect to any other facility, not less frequently than annually and in the same manner as the Secretary conducts inspection of facilities under section 1730 of such title.</text></subparagraph></paragraph>
<paragraph id="H9168E226D48E4F38B79A8A299696A160"><enum>(4)</enum><header>Payment to certain facilities</header>
<subparagraph id="HCCD6F84A99A647638B79446A573F334F"><enum>(A)</enum><header>State homes</header><text>In the case of a facility participating in the pilot program under subsection (a)(1) that is a State home, the Secretary shall pay to the State home a per diem for each veteran participating in the pilot program at a rate agreed to by the Secretary and the State home.</text></subparagraph> <subparagraph id="H77EE58256F334DE99D6BF00A07A487BE"><enum>(B)</enum><header>Community assisted living facilities</header><text>In the case of a facility participating in the pilot program under subsection (a)(1) that is a community assisted living facility, the Secretary shall—</text>
<clause id="H5B38500DA0F646B185E017DE22FF74C9"><enum>(i)</enum><text>pay to the facility an amount that is less than the average rate paid by the Department for placement in a community nursing home in the same Veterans Integrated Service Network; and</text></clause> <clause id="HF63717EEC0A74715830D3462E660CE9A"><enum>(ii)</enum><text>re-evaluate payment rates annually to account for current economic conditions and current costs of assisted living services.</text></clause></subparagraph></paragraph></subsection>
<subsection id="HAF69DA399F2A463DA50321BBA729DB2B"><enum>(e)</enum><header>Continuity of care</header><text>Upon the termination of the pilot program under subsection (a)(1), the Secretary shall—</text> <paragraph id="HA8C03C3BF1EB468DA1326F06A849CFFE"><enum>(1)</enum><text>provide to all veterans participating in the pilot program at the time of such termination the option to continue to receive assisted living services at the site they were assigned to under the pilot program, at the expense of the Department; and</text></paragraph>
<paragraph id="H02A5808CC8434EF796BCC7B6F94EAA01"><enum>(2)</enum><text>for such veterans who do not opt to continue to receive such services—</text> <subparagraph id="HAF2AF4FB5EDA448B969818E83486B39C"><enum>(A)</enum><text>ensure such veterans do not experience lapses in care; and</text></subparagraph>
<subparagraph id="H3EE2EEA3DFDB4B8B9F9CEC532C133BD1"><enum>(B)</enum><text>provide such veterans with information on, and furnish such veterans with, other extended care services based on their preferences and best medical interest.</text></subparagraph></paragraph></subsection> <subsection id="H199F03BBC0D6420F8F6039F709C95C8A"><enum>(f)</enum><header>Determination of quality</header><text>The Secretary shall determine a method for assessment of quality of care provided to veterans participating in the pilot program under subsection (a)(1) and shall communicate that method to providers of services under the pilot program.</text></subsection>
<subsection id="HAAEE878B18A04D50A5B0AA7F6274C705"><enum>(g)</enum><header>Annual report</header><text>Not later than one year after the initiation of the pilot program under subsection (a)(1), and annually thereafter for the duration of such pilot program, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the pilot program that includes—</text> <paragraph id="HD85026CC733E49E4869DDF553E65759F"><enum>(1)</enum><text>an identification of Veterans Integrated Services Networks and facilities of the Department participating in the pilot program and assisted living facilities and State homes at which veterans are placed under the pilot program;</text></paragraph>
<paragraph id="H8F75B5CD192A47FEAF9064CB554FDEEE"><enum>(2)</enum><text>the number of participants in the pilot program, disaggregated by facility;</text></paragraph> <paragraph id="HDD2A615B522444BCB5F56046CB426EB6"><enum>(3)</enum><text>general demographic information of participants in the pilot program, including average age, sex, and race or ethnicity;</text></paragraph>
<paragraph id="H0CA3E57B275D402898EF6A2CD7FC3CA2"><enum>(4)</enum><text>disability status of participants in the pilot program;</text></paragraph> <paragraph id="H45A6186FC45C4CB993AE9F68FA48F6DC"><enum>(5)</enum><text>an identification of any barriers or challenges to furnishing care to veterans under the pilot program, conducting oversight of the pilot program, or any other barriers or challenges;</text></paragraph>
<paragraph id="H2ED4F20C0A4A42EA9A75A6638E5DFCC6"><enum>(6)</enum><text>the cost of care at each assisted living facility and State home participating in the pilot program, including an analysis of any cost savings by the Department when comparing that cost to the cost of nursing home care;</text></paragraph> <paragraph id="H3CC9BCCCC4FC44D0BEA2D117F3816877"><enum>(7)</enum><text>aggregated feedback from participants in the pilot program, including from veteran resident surveys and interviews; and</text></paragraph>
<paragraph id="H428987D94A8F40C3980E0540A1D5CD7C"><enum>(8)</enum><text>such other matters the Secretary considers appropriate.</text></paragraph></subsection> <subsection id="H99805D4A8E7545C087DE12E13BCEE05C"><enum>(h)</enum><header>Final report</header><text>Not later than one year after the pilot program terminates under subsection (j), the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the pilot program that—</text>
<paragraph id="HE6EF1E8E96BE4470A30159AE8FF77987"><enum>(1)</enum><text>includes the matters required under paragraphs (1) through (8) of subsection (g);</text></paragraph> <paragraph id="H60CB662DC61C42E2BF8A9EE9AE353384"><enum>(2)</enum><text>includes recommendations on whether the model studied in the pilot program should be continued or adopted throughout the Department; and</text></paragraph>
<paragraph id="H5B9A00244BEB44E08248CCB3C2E58FD2"><enum>(3)</enum><text>indicates whether the Secretary requests action by Congress to make the pilot program permanent.</text></paragraph></subsection> <subsection id="H52B349E7D8154B99A732B542F3AF5B2C"><enum>(i)</enum><header>Inspector General report</header> <paragraph id="H601EB9E904A2497497AD6C9B753124B8"><enum>(1)</enum><header>In general</header><text>Not later than three years after the initiation of the pilot program under subsection (a)(1), the Inspector General of the Department of Veterans Affairs shall submit to the Secretary of Veterans Affairs and the Committees on Veterans’ Affairs of House of Representatives and the Senate a report on the pilot program.</text></paragraph>
<paragraph id="HD1C91A815687482AAAB9B40226BDCDC1"><enum>(2)</enum><header>Elements</header><text>The report required by paragraph (1) shall include an assessment of—</text> <subparagraph id="H4162B36BDF454EDD891B26B1494B49C8"><enum>(A)</enum><text>the quality of care provided to veterans at facilities participating in the pilot program, measured pursuant to the method determined under subsection (f);</text></subparagraph>
<subparagraph id="HCA52E684960D469095FEF2FDC58CD2C5"><enum>(B)</enum><text>the oversight of such facilities, as conducted by the Department, the Centers for Medicare & Medicaid Services, State agencies, and other relevant entities; and</text></subparagraph> <subparagraph id="H2708658F41AA4E2CAA64E76CDB75722C"><enum>(C)</enum><text>such other matters as the Inspector General considers appropriate.</text></subparagraph></paragraph>
<paragraph id="H2E8AC506581246DEA2A6BE9BA083392E"><enum>(3)</enum><header>Plan required</header><text>Not later than 90 days after the submission of the report under paragraph (1), the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a plan to address the deficiencies identified in the report, if any.</text></paragraph></subsection> <subsection id="H9FE96A14746944A58BCD86B6967D8F77"><enum>(j)</enum><header>Termination</header> <paragraph id="HAC466C908D0642E1810E544FC2D095B4"><enum>(1)</enum><header>In general</header><text>Subject to paragraph (2), the pilot program under subsection (a)(1) shall terminate on September 30, 2026.</text></paragraph>
<paragraph id="H1F8C7F3B43834ACEB4E460C59D90665D"><enum>(2)</enum><header>Extension</header><text>The Secretary may extend the duration of the pilot program for an additional two-year period if the Secretary, based on the results of the reports submitted under subsection (g), determines such an extension is appropriate.</text></paragraph></subsection> <subsection id="H612393193C4944658A43284C70553AAD" commented="no"><enum>(k)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H46F187E18A734B6A9E9D8B03ECC1EFE2" commented="no"><enum>(1)</enum><text>The term <term>assisted living services</term> means services of a facility in providing room, board, and personal care for and supervision of residents for their health, safety, and welfare.</text></paragraph> <paragraph id="H863DEA40B84F44FAA7A0745825A4C84D" commented="no"><enum>(2)</enum><text>The term <term>eligible veteran</term> means a veteran who is—</text>
<subparagraph id="H0813FB56B9EA4A4F89E1FE67EF4D0952" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">receiving nursing home care paid for by the Department of Veterans Affairs, eligible to receive such care pursuant to section 1710A of title 38, United States Code, or requires a higher level of care than the domiciliary care provided by the Department of Veterans Affairs, but does not meet the requirements for nursing home level care provided by the Department pursuant to such section; and</text></subparagraph> <subparagraph id="H5D54C69FDAD84D5E99378FBC148E5148" commented="no"><enum>(B)</enum><text>eligible for assisted living services, as determined by the Secretary or meets such additional criteria for eligibility for the pilot program under subsection (a)(1) as the Secretary may establish.</text></subparagraph></paragraph>
<paragraph id="H0FD5D79893EA4C53A71ACF2934701F2E" commented="no"><enum>(3)</enum><text>The term <term>State home</term> has the meaning given that term in section 101 of title 38, United States Code.</text></paragraph></subsection></section> <section id="H26B6CA7BB70C420F972C590C822BD0E4" commented="no"><enum>128.</enum><header>Provision of medicine, equipment, and supplies available to Department of Veterans Affairs to State homes</header> <subsection id="H10856019BA1A44B197DA4E39546EBFCF" commented="no"><enum>(a)</enum><header>Provision authorized</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs may provide to State homes medicine, personal protective equipment, medical supplies, and any other equipment, supplies, and assistance available to the Department of Veterans Affairs.</text></subsection>
<subsection id="HF2FCF9A2BCB84C4390D21D1DE4483F45" commented="no"><enum>(b)</enum><header>Definition</header><text>In this section:</text> <paragraph id="H937F78E7625348449C811077126FD879" commented="no"><enum>(1)</enum><text>The term <term>personal protective equipment</term> means any protective equipment required to prevent the wearer from contracting an infectious disease, including gloves, N–95 respirator masks, gowns, goggles, face shields, or other equipment required for safety.</text></paragraph>
<paragraph id="HB2CA19C2BA3F45778E23B47EFF86F84B" commented="no"><enum>(2)</enum><text>The term <term>State home</term> has the meaning given such term in section 101 of title 38, United States Code.</text></paragraph></subsection></section> <section id="HFE7169543011485387BC7356361935D8"><enum>129.</enum><header>Recognition of organizations and individuals to assist veterans, family members, and caregivers navigating programs and services of Veterans Health Administration</header> <subsection id="H2AB5433492E24DE7BF67A1CC4DCF7753" commented="no" display-inline="no-display-inline"><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 establish a process through which the Department of Veterans Affairs may recognize organizations and individuals to assist a veteran, a family member of a veteran, or a caregiver of a veteran (as defined in section 1720G(d) of title 38, United States Code) in navigating the programs and services of the Veterans Health Administration.</text></subsection>
<subsection id="HA84B342BCBF344589E524E7C6B95F23F" commented="no" display-inline="no-display-inline"><enum>(b)</enum><header>Solicitation of feedback</header><text display-inline="yes-display-inline">The Secretary shall solicit feedback and recommendations in the creation of the process under subsection (a) from such organizations as the Secretary may consider relevant.</text></subsection> <subsection id="H4420BE58952140479F3EC2FA4D25AA40" commented="no" display-inline="no-display-inline"><enum>(c)</enum><header>Limitation</header><text display-inline="yes-display-inline">The Secretary may not recognize an organization or individual pursuant to the process established under subsection (a) unless the organization or individual has certified to the Secretary that no fee or compensation of any nature will be charged to any individual for services rendered in providing assistance pursuant to such subsection. </text></subsection></section>
<section id="H71E4FD3684E24C17B86001FD42E1B2C1"><enum>130.</enum><header>Reviews and other improvements relating to home- and community-based services</header>
<subsection id="HEAB8ABA83FD14E918B26AA2CEF34FE34" commented="no"><enum>(a)</enum><header>Office of Geriatric and Extended Care</header>
<paragraph id="H076F5DE514FB476284F55EAEBC10E4E3"><enum>(1)</enum><header>Review of programs</header><text>The Under Secretary for Health of the Department of Veterans Affairs shall conduct a review of each program administered through the Office of Geriatric and Extended Care of the Department and the Caregiver Support Program Office of the Department, or any successor offices, to—</text> <subparagraph id="H5CCD354E975C424A8E4B76DF6D8AA72F" commented="no"><enum>(A)</enum><text>eliminate service gaps at the medical center level; and</text></subparagraph>
<subparagraph id="HC27DF7B283904A14A2904E39C2259E1A" commented="no"><enum>(B)</enum><text>ensure—</text> <clause id="H4482FED4D9BA434BB5BDFB5C56269E64"><enum>(i)</enum><text>the clinical needs of veterans are met;</text></clause>
<clause id="H13682F70440E44F09A8809781DFA4D74"><enum>(ii)</enum><text>consistency in program management;</text></clause> <clause id="HBFFB77E90CAB48A5BE296A52FC99ED0D" commented="no"><enum>(iii)</enum><text display-inline="yes-display-inline">the availability of, and the access by veterans to, home- and community-based services, including for veterans living in rural areas; and</text></clause>
<clause id="H69573A6AB1034F279870C2327A1D9275"><enum>(iv)</enum><text display-inline="yes-display-inline">proper coordination between covered programs.</text></clause></subparagraph></paragraph> <paragraph id="H711E791AA4E046F0A2D9DC37AE1ADC52"><enum>(2)</enum><header>Assessment of staffing needs</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall conduct an assessment of the staffing needs of the Office of Geriatric and Extended Care of the Department and the Caregiver Support Program Office of the Department, or any successor offices.</text></paragraph>
<paragraph id="HFF2748E748B143E68C562FE7FD758AA7" commented="no"><enum>(3)</enum><header>Goals for geographic alignment of care</header>
<subparagraph id="HA7DBDC51C9CC4ED9832F87F0B930DB76"><enum>(A)</enum><header>Establishment of goals</header><text display-inline="yes-display-inline">The Director of the Office of Geriatric and Extended Care, or successor office, shall establish quantitative goals to enable aging or disabled veterans who are not located near medical centers of the Department to access extended care services (including by improving access to home- and community-based services for such veterans).</text></subparagraph> <subparagraph id="H67953A4307E94F4BAB863740D2470B2C"><enum>(B)</enum><header>Implementation timeline</header><text display-inline="yes-display-inline">Each goal established under subparagraph (A) shall include a timeline for the implementation of the goal at each medical center of the Department.</text></subparagraph></paragraph>
<paragraph id="H0604CB4B83F74544B62B67D14EFD3D2A"><enum>(4)</enum><header>Goals for in-home specialty care</header><text display-inline="yes-display-inline">The Director of the Office of Geriatric and Extended Care, or successor office, shall establish quantitative goals to address the specialty care needs of veterans through in-home care, including by ensuring the education of home health aides and caregivers of veterans in the following areas:</text> <subparagraph id="H08FACFA553A7437294C0137CC0AF5839"><enum>(A)</enum><text>Dementia care.</text></subparagraph>
<subparagraph id="H986B89BA426B415F8BD1A8FC8A8646F7"><enum>(B)</enum><text>Care for spinal cord injuries and diseases.</text></subparagraph> <subparagraph id="H846A67CBF7C64346B235A562E47E6A9B"><enum>(C)</enum><text>Ventilator care.</text></subparagraph>
<subparagraph id="H1F83ED2202D34701A0AA93F57D91E4DC"><enum>(D)</enum><text>Other speciality care areas as determined by the Secretary.</text></subparagraph></paragraph> <paragraph id="H5639D98181AD41E880021E6592911B3C" commented="no"><enum>(5)</enum><header>Input on goals</header><text>To the extent practicable, the head of the Caregiver Support Program Office, or successor office, shall provide to the Director of the Office of Geriatric and Extended Care, or successor office, input with respect to the establishment of the goals under paragraphs (3) and (4).</text></paragraph>
<paragraph id="H23E7D21525F842F9B40A60147044D2B4"><enum>(6)</enum><header>Report to Congress</header><text>Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing the findings of the review under paragraph (1), the results of the assessment under paragraph (2), and the goals established under paragraphs (3) and (4).</text></paragraph></subsection> <subsection id="HADA051AD8B5549D49A0860CF500AFFD6"><enum>(b)</enum><header>Review of incentives and efforts relating to home- and community-based services</header> <paragraph id="H5F4B13DC3E564032990F63523CA5289F"><enum>(1)</enum><header>Review</header><text>The Secretary of Veterans Affairs shall conduct a review of the following:</text>
<subparagraph id="HB8EC87660B5F4CBFACB3D95C9E0E916E"><enum>(A)</enum><text>The financial and organizational incentives or disincentives for the directors of medical centers of the Department to establish or expand covered programs at such medical centers.</text></subparagraph> <subparagraph id="H72C776064F724B23BC879DD18BBC6F83"><enum>(B)</enum><text display-inline="yes-display-inline">Any incentives or disincentives for such directors to provide to veterans home- and community-based services in lieu of institutional care.</text></subparagraph>
<subparagraph id="HC055138EABA14B11BC6E5D04F7B4D4CA" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">The efforts taken by the Secretary to enhance spending of the Department for extended care by balancing spending between institutional care and home- and community-based services consistent with the demand for such services.</text></subparagraph> <subparagraph id="HA889AACDD4B247B48A180E34813BDDF8"><enum>(D)</enum><text display-inline="yes-display-inline">The plan of the Under Secretary for Health of the Department to accelerate efforts to enhance spending as specified in subparagraph (C), to match the progress of similar efforts taken by the Administrator of the Centers for Medicare & Medicaid Services with respect to spending of the Centers for Medicare & Medicaid Services for extended care.</text></subparagraph></paragraph>
<paragraph id="H235F70C94DB3463B92E3C3F4418DE2C6"><enum>(2)</enum><header>Report to Congress</header><text>Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the findings of the review under paragraph (1).</text></paragraph></subsection> <subsection id="H67151D2AA97643F28FE05834BE9602D5"><enum>(c)</enum><header>Review of respite care services</header><text>Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall conduct a review of the use, availability, cost,and effectiveness, of the respite care services furnished by the Secretary under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, including—</text>
<paragraph id="H27153ED94CCB4FECAE68414BCB4CCC57"><enum>(1)</enum><text>the frequency at which the Department of Veterans Affairs is unable to meet demand for such services;</text></paragraph> <paragraph id="HD73D05059B3A4C86AA9D4CF7CC9D74A7"><enum>(2)</enum><text>a detailed description of—</text>
<subparagraph id="HAAF8DF3C41DD4636A961EB429B844AA6"><enum>(A)</enum><text>the reasons the Department of Veterans Affairs is unable to meet the demand for such services; and</text></subparagraph> <subparagraph id="H73FAC6A7C79546A69073ECB583E18237"><enum>(B)</enum><text>any actions, or planned actions, of the Secretary of Veterans Affairs to ensure such demand is met.</text></subparagraph></paragraph></subsection>
<subsection id="H54B466612F1B425193ED5E7DB1963B61"><enum>(d)</enum><header>Collaboration to improve home- and community-based services</header>
<paragraph id="HAC3A75E016764803BCEF678280C00211"><enum>(1)</enum><header>Recommendations</header>
<subparagraph id="HA65ED8DEB04F4C609031759BB1C7E511"><enum>(A)</enum><header>Development</header><text>The Secretary of Veterans Affairs shall develop recommendations as follows:</text> <clause id="HB4C9D6EC34CC4B2C81A08310CED18C70"><enum>(i)</enum><text display-inline="yes-display-inline">With respect to home- and community-based services for veterans, the Secretary of Veterans Affairs shall develop recommendations regarding new services (in addition to those furnished as of the date of enactment of this Act) in collaboration with the Secretary of Health and Human Services.</text></clause>
<clause id="H48424D80C5214072B1B2DA9FFFBE8AC9"><enum>(ii)</enum><text display-inline="yes-display-inline">With respect to the national shortage of home health aides, the Secretary of Veterans Affairs shall develop recommendations regarding methods to address such shortage in collaboration with the Secretary of Health and Human Services and the Secretary of Labor.</text></clause></subparagraph> <subparagraph id="HC1E726F7102C40B68A03FDF617E80F0E"><enum>(B)</enum><header>Submission to Congress</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report containing the recommendations developed under subparagraph (A) and an identification of any changes in existing law or new statutory authority necessary to implement the recommendations, as determined by the Secretary.</text></subparagraph>
<subparagraph id="H74ABCC920D6F4A9190A9853CBDADC545"><enum>(C)</enum><header>Consultation with Secretary of Labor</header><text>In carrying out this paragraph, the Secretary of Veterans Affairs shall consult with the Secretary of Labor.</text></subparagraph></paragraph> <paragraph id="HBE780A4183274C6E88D87D7CE71D9477" commented="no"><enum>(2)</enum><header>Feedback and recommendations on caregiver support</header> <subparagraph id="HF190E3B06E514E008CF27CFE572522A6" commented="no"><enum>(A)</enum><header>Feedback and recommendations</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall solicit from the entities described in subparagraph (B) feedback and recommendations regarding opportunities for the Secretary to enhance home- and community-based services for veterans and the caregivers of veterans, including through the potential provision by the entity of care and respite services to veterans and caregivers who may not be eligible for any program under section 1720G of title 38, United States Code, or section 1720L of such title (as added by <internal-xref idref="H4A6FBE288AC741ECA7F4A90BF933C886" legis-path="4.">section 124</internal-xref>), but have a need for assistance.</text></subparagraph>
<subparagraph id="HF1FB85AF392D48DFAA27D59BD373AEB8" commented="no"><enum>(B)</enum><header>Covered entities</header><text display-inline="yes-display-inline">The entities described in this subparagraph are veterans service organizations and nonprofit organizations with a focus on caregiver support or long term care (as determined by the Secretary).</text></subparagraph></paragraph> <paragraph id="HE7216882DE984189BF0B5FC267170234"><enum>(3)</enum><header>Collaboration for certain veterans</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall collaborate with the Director of the Indian Health Service and representatives from tribal health programs and Urban Indian organizations to ensure the availability of home- and community-based services for—</text>
<subparagraph id="H5159A17A143F4368A027470025F17448"><enum>(A)</enum><text>Native American veterans, including Native American veterans receiving health care and medical services under multiple health care systems; and</text></subparagraph> <subparagraph id="H527C11586E8246019B8EC5E027783410"><enum>(B)</enum><text>Native Hawaiian veterans, including Native Hawaiian veterans receiving health care and medical services under the Native Hawaiian health care system.</text></subparagraph></paragraph></subsection></section>
<section id="H8AC9CF4F87B745FCB2C4FA8EB14DCDA7"><enum>131.</enum><header>GAO report on mental health support for caregivers</header>
<subsection id="HEC1B64E75BE445379A1E59E13C9562B7"><enum>(a)</enum><header>Report required</header><text>Not later than one year 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 provision of mental health support to caregivers of veterans.</text></subsection> <subsection id="H830BDCE8BF1C420F8BD63EA476202155"><enum>(b)</enum><header>Contents</header><text>The report submitted under subsection (a) shall include the following:</text>
<paragraph id="H30369BCEFDE84C6F894B8F11F2911E8D"><enum>(1)</enum><text>An assessment of the need for mental health support among caregivers participating in the caregiver programs.</text></paragraph> <paragraph id="H55BC62DEEB014FF588CFE054E6C3602A"><enum>(2)</enum><text>An assessment of options for mental health support in facilities of the Department of Veterans Affairs and in the community for caregivers participating in the caregiver programs.</text></paragraph>
<paragraph id="HEBAAFF538DF54E45BFB5FE68BCA681CF"><enum>(3)</enum><text>An assessment of the availability and accessibility of mental health support in facilities of the Department and in the community for caregivers participating in the caregiver programs.</text></paragraph> <paragraph id="HE07BB124AC934AC8B5B6522075943477"><enum>(4)</enum><text>An assessment of the awareness among caregivers of the availability of mental health support in facilities of the Department and in the community for caregivers participating in the caregiver programs.</text></paragraph>
<paragraph id="HDC4C15B977314BFD9F7EB90D42FB06C7"><enum>(5)</enum><text>An assessment of barriers to mental health support in facilities of the Department and in the community for caregivers participating in the caregiver programs.</text></paragraph></subsection> <subsection id="H2217E7B2E1DB42A181700387DCDA12B3"><enum>(c)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H836E160EA9C74FF8A71FB06002FBD5BF"><enum>(1)</enum><text>The term <term>caregiver</term> has the meaning given that term in section 1720G of title 38, United States Code. </text></paragraph> <paragraph id="H22089A1C2AC04AA089580EE2B2F87845"><enum>(2)</enum><text>The term <term>caregiver programs</term> means—</text>
<subparagraph id="H5228C6043DD54985A6299E263D75E8AB"><enum>(A)</enum><text>the program of comprehensive assistance for family caregivers under subsection (a) of section 1720G of title 38, United States Code; and</text></subparagraph> <subparagraph id="HF21EC70C57464C4F8E1331AB70380C8F"><enum>(B)</enum><text>the program of support services for caregivers under subsection (b) of such section.</text></subparagraph></paragraph></subsection></section>
<section id="H758DCA0EBD2D429AA84E0395C0C9043C" commented="no"><enum>132.</enum><header>Development of centralized website for program information</header>
<subsection id="H477FFDB3EE6D402389D3B8CC82F55EBE" commented="no"><enum>(a)</enum><header>Centralized website</header><text>The Secretary shall develop and maintain a centralized and publically accessible internet website of the Department as a clearinghouse for information and resources relating to covered programs.</text></subsection> <subsection id="HCF0ECB98DDA944B7825E42AB0F98454E" commented="no"><enum>(b)</enum><header>Contents</header><text>The website under subsection (a) shall contain the following:</text>
<paragraph id="HA036DEA7BD9246B2A5012E1367C84712" commented="no"><enum>(1)</enum><text>A description of each covered program.</text></paragraph> <paragraph id="HA721BB404A2042B8ABAB8278C52A134D" commented="no"><enum>(2)</enum><text display-inline="yes-display-inline">An informational assessment tool that—</text>
<subparagraph id="HE9947D209D664D9DB94333E5C6D72912" commented="no"><enum>(A)</enum><text>explains the administrative eligibility, if applicable, of a veteran, or a caregiver of a veteran, for any covered program; and</text></subparagraph> <subparagraph id="H2EFA5CF2DF624DCD8A3F417355493FA9" commented="no"><enum>(B)</enum><text>provides information, as a result of such explanation, on any covered program for which the veteran or caregiver (as the case may be) may be eligible.</text></subparagraph></paragraph>
<paragraph id="HCE418C0CCEBB4DB9BAA21047994FF8C3" commented="no"><enum>(3)</enum><text display-inline="yes-display-inline">A list of required procedures for the directors of the medical facilities of the Department to follow in determining the eligibility and suitability of veterans for participation in a covered program, including procedures applicable to instances in which the resource constraints of a facility (or of a community in which a facility is located) may result in the inability to address the health needs of a veteran under a covered program in a timely manner.</text></paragraph></subsection> <subsection id="H15F3CBCFB41E4BE29FFBE4D4EE380E78" commented="no"><enum>(c)</enum><header>Updates</header><text>The Secretary shall ensure the website under subsection (a) is updated on a periodic basis.</text></subsection></section>
<section id="H9A67C144423A4E09A5864FD7F393D566"><enum>133.</enum><header>Definitions</header><text display-inline="no-display-inline">In this title:</text> <paragraph id="H8548B0AC0AEB4F45B9EDBF97C33E59D0" commented="no"><enum>(1)</enum><text>The terms <term>caregiver</term> and <term>family caregiver</term> have the meanings given those terms under section 1720L(h) of title 38, United States Code (as added by <internal-xref idref="HB526B3A84487435093151C5CB4162A05" legis-path="5.">section 123</internal-xref>).</text></paragraph>
<paragraph id="H9CBE10201CD04C47BD3F790C6ACF6D0D"><enum>(2)</enum><text>The term <term>covered program</term>—</text> <subparagraph id="H43B8CB63E3BE472B96D70AB6932E34F0"><enum>(A)</enum><text display-inline="yes-display-inline">means any program of the Department of Veterans Affairs for home- and community-based services; and</text></subparagraph>
<subparagraph id="H142F6F9DB36C4DCBBF2419AE64BAC346"><enum>(B)</enum><text display-inline="yes-display-inline">includes the programs specified in section 1720L of title 38, United States Code (as added by <internal-xref idref="H4A6FBE288AC741ECA7F4A90BF933C886" legis-path="4.">section 123</internal-xref>).</text></subparagraph></paragraph> <paragraph id="H665D9C94F3D94419AC6FF9A9826A8EAE"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>home- and community-based services</term>—</text>
<subparagraph id="HE4ABBFA0D43B4338A4F6643936B34FBA"><enum>(A)</enum><text>means the services referred to in section 1701(6)(E) of title 38, United States Code; and</text></subparagraph> <subparagraph id="HDCA62202135445F6898AB7B9C4819620"><enum>(B)</enum><text>includes services furnished under a program specified in section 1720L of such title (as added by <internal-xref idref="H4A6FBE288AC741ECA7F4A90BF933C886" legis-path="4.">section 123</internal-xref>).</text></subparagraph></paragraph>
<paragraph id="H8C86F1D688D240F1A9B2F55072DAB37D"><enum>(4)</enum><text display-inline="yes-display-inline">The terms <term>Home-Based Primary Care program</term>, <term>Homemaker and Home Health Aide program</term>, and <term>Veteran-Directed Care program</term> mean the programs of the Department of Veterans Affairs specified in subsection (d), (c), and (b) of such section 1720L, respectively.</text></paragraph> <paragraph id="H5328A4A6A9E74D2CB87855943A977BD7"><enum>(5)</enum><text display-inline="yes-display-inline">The terms <term>home health aide</term>, <term>Native American</term>, <term>Native American veteran</term>, <term>tribal health programs</term>, and <term>Urban Indian organizations</term> have the meanings given those terms in subsection (h) of such section 1720L.</text></paragraph>
<paragraph id="H27CE2066E0944CE983F8DF14AF4DAE45"><enum>(6)</enum><text display-inline="yes-display-inline">The term <term>Vet Center</term> has the meaning given that term in section 1712A(h) of title 38, United States Code.</text></paragraph> <paragraph id="HA9FC2A600948455595C43A26CA017A7A"><enum>(7)</enum><text display-inline="yes-display-inline">The term <term>veterans service organization</term> means any organization recognized by the Secretary under section 5902 of such title.</text></paragraph></section></subtitle>
<subtitle id="H62B56195A3744D43A94D9E1CA3528D07"><enum>C</enum><header>Medical Treatment and Other Matters</header>
<section id="H6A608300315F470ABF100808EDE82CF6" display-inline="no-display-inline" commented="no"><enum>140.</enum><header>Quarterly report on referrals for non-Department of Veterans Affairs health care</header><text display-inline="no-display-inline">Subchapter I 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 adding at the end the following new section (and amending the table of sections at the beginning of such chapter accordingly):</text> <quoted-block style="USC" id="HA4729036F01F4A42B9D6F22DF3F14549" display-inline="no-display-inline"> <section id="HD34C938C93B74822B15CFC11BCB72B39"><enum>534.</enum><header>Quarterly report on referrals for non-Department health care</header><text display-inline="no-display-inline">Not later than 180 days after the date of the enactment of this section, and not less frequently than quarterly thereafter, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report containing, with respect to referrals for non-Department health care originating from a medical facility of the Department during the quarter preceding the date of the submission of the report, a measurement of, for each such medical facility—</text>
<paragraph id="H13DBBF0512714163B34031CC08456E82" commented="no"><enum>(1)</enum><text>the period of time between—</text> <subparagraph id="H193CC95C2B3041A09AFF862BC8540077" commented="no"><enum>(A)</enum><text>the date on which a clinician employed by the Department determines that a veteran requires care, or a veteran presents to the Department requesting care, and the date on which the referral for care is sent to a non-Department health care provider;</text></subparagraph>
<subparagraph id="H7BB6425783FC4328903B26508A729A89" commented="no"><enum>(B)</enum><text>the date on which such referral is sent to a non-Department health care provider and the date on which such non-Department health care provider accepts such referral;</text></subparagraph> <subparagraph id="H12E163A3DF66454CB5AC3CCFDFF26EC1" commented="no"><enum>(C)</enum><text>the date on which such non-Department health care provider accepts such referral and the date on which such referral is completed;</text></subparagraph>
<subparagraph id="H4331DA1F644848208ADFF38DF28B5B37" commented="no"><enum>(D)</enum><text>the date on which such referral is completed and the date on which an appointment with a non-Department health care provider is made; and</text></subparagraph> <subparagraph id="HF20F465311584B5398EDA7360E632C1B" commented="no"><enum>(E)</enum><text>the date on which such an appointment is made and the date on which such appointment occurs; and</text></subparagraph></paragraph>
<paragraph id="H5307B7BB91B34593BEB8A5FCC9EA8E18" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text>any other period of time that the Secretary determines necessary.</text></paragraph></section><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="H3DDAC0A668AF45278CB630FF51116C53"><enum>141.</enum><header>Elimination of certain requirements for certain Department of Veterans Affairs Assistant Under Secretaries</header><text display-inline="no-display-inline">Section 7306 of title 38, United States Code, is amended—</text>
<paragraph id="HBBDF057D2FAE47A08EEB8ABB5536194B"><enum>(1)</enum><text>by striking subsection (b);</text></paragraph> <paragraph id="H7576C6D1F12545F5B2B7B98076303FF8"><enum>(2)</enum><text>by redesignating subsections (c) through (g) as subsections (b) through (f), respectively; and</text></paragraph>
<paragraph id="H0F1DB4CCCA3B40648EC7BD7C88D95B93"><enum>(3)</enum><text>in subsection (c) (as so redesignated), by striking <quote>subsection (e)</quote> and inserting <quote>subsection (f)</quote>.</text></paragraph></section> <section id="HA1B92282492A4BDD8423543B78386C5A" display-inline="no-display-inline"><enum>142.</enum><header>Modification of pay limitation for physicians, podiatrists, optometrists, and dentists of Department of Veterans Affairs</header> <subsection id="HC940B20967594F2D89206B5912A13CA0"><enum>(a)</enum><header>Pay</header> <paragraph id="H030788E1420849E2989581C060344337"><enum>(1)</enum><header>In general</header><text>Section 7431 of title 38, United States Code, is amended—</text>
<subparagraph id="HF1C406B4E2374C219CBB56094D9DE13B"><enum>(A)</enum><text>by inserting <quote>optometrists,</quote> after <quote>podiatrists,</quote> each place it appears;</text></subparagraph> <subparagraph id="H6AF155BF25394BA1ABE57EFE19613034"><enum>(B)</enum><text>by inserting <quote>optometrist</quote> after <quote>podiatrist,</quote> each place it appears;</text></subparagraph>
<subparagraph id="H304ED1EAD2584CCC8DBCEBF2F06B191F"><enum>(C)</enum><text>in subsection (c)—</text> <clause id="HEA2A988A2B6E4BF4BFB4351C82ADF4B9"><enum>(i)</enum><text>in paragraph (5), by adding at the end the following new sentence: <quote>Such a notice shall include a statement of whether the market pay will increase, decrease, or remain unchanged following such evaluation.</quote>; and</text></clause>
<clause id="H6E6A31946CE3475B90FC7480FA0DE41A"><enum>(ii)</enum><text>by adding at the end the following new paragraphs:</text> <quoted-block style="USC" id="H9A90228851C04B49BA3B99354EA90A49" display-inline="no-display-inline"> <paragraph id="HF4A86E3E230C49BBB604CA86071595A3"><enum>(7)</enum><text display-inline="yes-display-inline">The Secretary shall ensure that each physician, podiatrist, optometrist, and dentist in the Veterans Health Administration is—</text>
<subparagraph id="H5F69056D673F42E2881A8D561AACA8AA"><enum>(A)</enum><text>advised, on an annual basis, of the criteria described in subparagraph (F) of paragraph (4);</text></subparagraph> <subparagraph id="H251835C7EDC441D6B96EF3FCC57DDDF5"><enum>(B)</enum><text>evaluated in accordance with such criteria; and</text></subparagraph>
<subparagraph id="H98565FEB0B0E4F7596B18F5C87313990"><enum>(C)</enum><text>compensated in accordance with—</text> <clause id="H1F5B901387DF4A4EA647755F7DF793C7"><enum>(i)</enum><text>applicable assignment and pay levels, subject to relevant pay limitations; and</text></clause>
<clause id="H7DE38C2D9D2544BCB55A117A9F89E9FC"><enum>(ii)</enum><text>the extent to which such criteria is met.</text></clause></subparagraph></paragraph> <paragraph id="H75AE6D48F40A49E9A8757DE9B1C31727"><enum>(8)</enum><text display-inline="yes-display-inline">Not later than 120 days after the end of each fiscal year, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes the following:</text>
<subparagraph id="HE2CC4E4D6013493FABF3FEC3082285B8" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">A list of each facility and specialty that conducted an evaluation of pay during the period covered by the report.</text></subparagraph> <subparagraph id="H4B20189B78C44F04B3EB6B22E939418C"><enum>(B)</enum><text>For each evaluation described in subparagraph (A)—</text>
<clause id="H67F0258DE0774926B6E7AE6F454DD11A"><enum>(i)</enum><text>a list of occupations for which pay was evaluated, disaggregated by medical specialty, number of authorized full-time employees, and onsite full-time employees as of the date of the evaluation;</text></clause> <clause id="HCB8C1C7273504FCD9BE2F36BA4C56209"><enum>(ii)</enum><text>the date such evaluation was completed;</text></clause>
<clause id="H519E69AEDF7C432BB086A310845A19E5"><enum>(iii)</enum><text display-inline="yes-display-inline">whether a market pay adjustment was made following the evaluation per each occupation and specialty evaluated;</text></clause> <clause id="H451783FB9B874B6E977CA88647CE4E74"><enum>(iv)</enum><text>whether applicable employees were notified of such evaluation;</text></clause>
<clause id="H54DA748885B84B94852B0C753438C361"><enum>(v)</enum><text>whether local labor partners were notified of such evaluation; and</text></clause> <clause id="HE46AD28AED974E6CA5BEC14742736D06"><enum>(vi)</enum><text>in the case of an evaluation that resulted in an adjustment of pay—</text>
<subclause id="H8FE994F5BA364FEDB201CFBE1656B9F0"><enum>(I)</enum><text display-inline="yes-display-inline">the date such adjustment—</text> <item id="H6982FE50154840F9A0BB22A27BA69EB1"><enum>(aa)</enum><text>was implemented; and</text></item>
<item id="HBDA90DF0852442D7A452311215FECA8C"><enum>(bb)</enum><text>became effective; and</text></item></subclause> <subclause id="H145CC8669B7B40CCBB3967AFE5A12EBF"><enum>(II)</enum><text>the percentage of employees of each occupation and specialty for which pay was adjusted pursuant to such evaluation.</text></subclause></clause></subparagraph>
<subparagraph id="HD579D06375814755BE35669196AAAE1C"><enum>(C)</enum><text display-inline="yes-display-inline">A list of facilities of the Department that have not conducted an evaluation of market pay, pursuant to paragraph (5), during the 18-month-period that precedes the date of the submission of such report.</text></subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="HE728C589973E4AA09F99A47944A4B8F5"><enum>(D)</enum><text>in subsection (e)—</text>
<clause id="H29D64257289C491FB9D0C6EB1E79544B"><enum>(i)</enum><text display-inline="yes-display-inline">in paragraph (1)(A), by inserting <quote>optometrists,</quote> after <quote>podiatrists,</quote>; and</text></clause> <clause id="H21BE744DC6BE46B2AACF7C1DEF2693DA"><enum>(ii)</enum><text>by adding at the end the following new paragraphs:</text>
<quoted-block style="USC" id="HB2F97E5EE357442E9EB77E0F40C2A561" display-inline="no-display-inline">
<paragraph id="H8758A3ACA4DE4E08B27DB7D67FBF2BB4"><enum>(5)</enum><text>Notwithstanding any compensation or pay limitations under this title or title 5, the Secretary may authorize the Under Secretary for Health to pay physicians, podiatrists, optometrists and dentists—</text> <subparagraph id="HBF7AD7D022DB489E9BCE0971CEDA98D3"><enum>(A)</enum><text>awards authorized under this title;</text></subparagraph>
<subparagraph id="HBEE25DBE6B664B269EC957E7D3E087CD"><enum>(B)</enum><text>advance payments, recruitment or relocation bonuses, and retention allowances authorized under section 7410(a) of this title or as otherwise provided by law;</text></subparagraph> <subparagraph id="H798CF4B09E7D458B8B894740599417E0"><enum>(C)</enum><text>incentives or bonuses under section 706 of this title or as otherwise provided by law; and</text></subparagraph>
<subparagraph id="HF0FD552FB71643FF8DDF534640506D78"><enum>(D)</enum><text>earnings from fee-basis appointments under section 7405(a)(2) of this title.</text></subparagraph></paragraph> <paragraph id="H1CCF416F70114024AB5B33B926FABF0E"><enum>(6)</enum> <subparagraph id="H9EDBCF5738EF49D4A48121D24EBC4E9B" display-inline="yes-display-inline"><enum>(A)</enum><text>The Secretary may waive any pay limitation described in this section (including tier limitations) that the Secretary determines necessary for the recruitment or retention of critical health care personnel whom the Secretary determines would provide direct patient care.</text></subparagraph>
<subparagraph id="HA1288ADFFDB745B980B3EE13C73E1CA1" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">Priority for such waivers shall be given for positions, locations, and care provided through contracts at a high cost to the Department.</text></subparagraph> <subparagraph id="H1843A0835ED44A5192C937609FA69EEA" indent="up1"><enum>(C)</enum><text display-inline="yes-display-inline">The Chief Human Capital Officer of the Department, the Chief Financial Officer of the Department, and the Office of the General Counsel of the Department shall review any waiver issued under subparagraph (A).</text></subparagraph>
<subparagraph id="H8C32AC87D5EA4F6D9BF5934DE3AAB934" indent="up1"><enum>(D)</enum><text>During the period the authority under subparagraph (A) is effective, the Secretary may not issue more than 300 waivers under such subparagraph. </text></subparagraph> <subparagraph id="H8C6786AE9E01480DAF3C7D1C8CC91CB5" indent="up1"><enum>(E)</enum><text>The Secretary may prescribe requirements, limitations, and other considerations for waivers under such subparagraph.</text></subparagraph>
<subparagraph id="HDE45B19E3FCB4662A109E1F51DABAAF2" indent="up1"><enum>(F)</enum><text>Not later than 180 days after the date of the enactment of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act, and annually thereafter, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes—</text> <clause id="H3BDE255FD62C4835A778CD4273441BC5"><enum>(i)</enum><text>any updates to the requirements, limitations, and considerations prescribed under subparagraph (B) during the period covered by the report;</text></clause>
<clause id="H64B96F4026E84AB39B0539648327A6C9"><enum>(ii)</enum><text>a description of the findings of each review, if any, conducted pursuant to subparagraph (C);</text></clause> <clause id="H9CBCA72B9BD44D9F90F8E2F3F36E07D0"><enum>(iii)</enum><text>a description of each waiver under subparagraph (A) in effect as of the date of the submission of the report, including the—</text>
<subclause id="HFA635ECD85BE4D43A28691390E7F78F4"><enum>(I)</enum><text>duty location, position, specialty, market and performance considerations for the waiver; and</text></subclause> <subclause id="HD17CA9F0C7634BE5B4094A7748C8D6F5"><enum>(II)</enum><text>impact, if any, of the waiver on contracted care purchased by the Department for the region; and</text></subclause></clause>
<clause id="HFA37A4E08DC547D49EABB2F505165A83"><enum>(iv)</enum><text>a list of any separation actions during the period covered by the report with respect to a position for which a waiver under subparagraph (A) is in effect.</text></clause></subparagraph> <subparagraph id="HAC380B4BC71F4AB7976D998F9323ABC1" indent="up1" commented="no"><enum>(G)</enum><text display-inline="yes-display-inline">The authority of the Secretary under subparagraph (A) shall terminate on the last day of the third full fiscal year following the date of the enactment of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph></paragraph>
<paragraph id="HD00C768B0EA14CADB7B6655974BB6CD6"><enum>(2)</enum><header>Report on waiver authority</header><text>Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report that includes a description of the requirements, limitations, and other considerations prescribed under section 7431(b)(6)(D) of title 38, United States Code, as added by paragraph (1).</text></paragraph> <paragraph id="HF04DEAAA10EF4D3FAAC0C30AED1205BA"><enum>(3)</enum><header>Conforming amendments</header> <subparagraph id="HDB37278F909F4EB79116AC43471C07AF"><enum>(A)</enum><header>Pay of Under Secretary for Health</header><text>Section 7432(b)(1) of such title is amended by inserting <quote>, podiatrist, optometrist,</quote> after <quote>physician</quote>.</text></subparagraph>
<subparagraph id="H2F45A9227D6942DD8FA0080CD19F4A1F"><enum>(B)</enum><header>Administrative matters</header><text>Section 7433 of such title is amended by inserting <quote>optometrists,</quote> after <quote>physicians,</quote> each place it appears.</text></subparagraph> <subparagraph id="H0C8ABF8529E34EF8817DEA1263CA73E4"><enum>(C)</enum><header>Competitive pay</header><text>Section 7451(a)(2)(C) of such title is amended by inserting <quote>optometrist,</quote> after <quote>physician,</quote>.</text></subparagraph></paragraph>
<paragraph id="H1835BF01EC2C4190A01919F713C79412"><enum>(4)</enum><header>Clerical amendments</header>
<subparagraph id="H836F2B9F4F0C408CB10C8B29E7141394" commented="no"><enum>(A)</enum><header>Subchapter heading</header><text display-inline="yes-display-inline">Subchapter III of chapter 74 of such title is amended in the heading by inserting <quote><header-in-text level="subchapter" style="OLC">Optometrists,</header-in-text></quote> after <quote><header-in-text level="subchapter" style="USC">Podiatrists,</header-in-text></quote>.</text></subparagraph> <subparagraph id="HB337AE75D77049C3A318273201966E43" commented="no"><enum>(B)</enum><header>Table of sections</header><text display-inline="yes-display-inline">The table of sections for such chapter is amended by striking the item relating to subchapter III and inserting the following: </text>
<quoted-block style="USC" id="H6B40F8306B514F80BBF0583803323339" display-inline="no-display-inline">
<toc regeneration="no-regeneration">
<toc-entry level="subchapter">Subchapter III—Pay for Physicians and Other Health-Care Personnel</toc-entry></toc><after-quoted-block>. </after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H6F69A511AFDD4137BD29BE6B9918E4FA"><enum>(5)</enum><header>Applicability dates</header><text>The amendments made by this subsection shall apply to any pay period of the Department of Veterans Affairs beginning on or after the date that is 180 days after the date of the enactment of this Act.</text></paragraph></subsection> <subsection id="H59EA9FA1F0EB431BB7E321CA9A4E9493"><enum>(b)</enum><header>Modification and clarification of pay grade for optometrists</header><text>Section 7404 of title 38, United States Code, is amended—</text>
<paragraph id="H27AC992C47434CA49BDD9DE1B5653830"><enum>(1)</enum><text>in subsection (a)(2)(A), by striking <quote>podiatrists, and dentists</quote> and inserting <quote>podiatrists, optometrists, and dentists</quote>; and</text></paragraph> <paragraph id="H036D341BA7F54474A846A5BEAB953570"><enum>(2)</enum><text>in subsection (b)—</text>
<subparagraph id="H32F804DA955944598CB037A071E96813"><enum>(A)</enum><text>by striking <quote>podiatrist (dpm), and dentist</quote> and inserting <quote>podiatrist (dpm), optometrist (od), and dentist</quote>;</text></subparagraph> <subparagraph id="HD132A3BCE8614F94B006E9B17D66DB6F"><enum>(B)</enum><text>by striking <quote>clinical chiropractor and optometrist schedule,</quote> and inserting <quote>clinical chiropractor schedule</quote>; and</text></subparagraph>
<subparagraph id="H3002CF4B0C2A4DCFA95E6C4350A8CCBE"><enum>(C)</enum><text>by inserting <quote>optometrist grade</quote> after <quote>Podiatrist grade</quote>.</text></subparagraph></paragraph></subsection> <subsection id="H456CDC81FEF048DB94873DDC1B8ABC43"><enum>(c)</enum><header>Retroactive authority for compensation</header> <paragraph id="H8DDCA8029F5F4B098709D91AABCA4213"><enum>(1)</enum><header>In general</header><text>The Secretary of Veterans Affairs may pay retroactive compensation to a covered employee in an amount that equals the amount of compensation that was authorized to be paid to such covered employee during the period specified in paragraph (2), but was deferred and paid to such employee in the calendar year following the calender year in which such compensation was authorized because the payment such compensation would have exceeded an applicable cap on annual compensation.</text></paragraph>
<paragraph id="H51DF021F2C854FB1979CC1CB39FD2F77"><enum>(2)</enum><header>Period specified</header><text>The period specified in this paragraph is the period beginning on January 8, 2006, and ending on December 31, 2017.</text></paragraph> <paragraph id="H79467A7C3F424A73B0FDB4EA0F7ED068"><enum>(3)</enum><header>Exclusion</header><text>Compensation authorized under this subsection shall not be included in the calculation of any aggregate limit on compensation for a covered employee for the year in which it is paid.</text></paragraph>
<paragraph id="H4AD180B19EF44E868947DA90B01C2E78"><enum>(4)</enum><header>Charging of compensation</header><text>Compensation authorized under this subsection shall be charged to the appropriate medical care appropriation account of the Department of Veterans Affairs for the fiscal year in which the work was performed except as follows:</text> <subparagraph id="H8535B0B8327149078D67A1FBE0357DD0"><enum>(A)</enum><text>In the case of an account that has closed pursuant to section 1552 of title 31, United States Code, the compensation shall be charged to a current appropriation account in accordance with section 1553 of such title.</text></subparagraph>
<subparagraph id="H9E94C34E72974455B6174876AADC7CE0"><enum>(B)</enum><text>In the case of an expired account that has not closed, if charging the compensation to the expired account would cause such account to have a negative unliquidated or unexpended balance, the compensation may be charged to a current appropriation account available for the same purpose.</text></subparagraph></paragraph> <paragraph id="H103D4029E19D4F838C2F25165997F9D2"><enum>(5)</enum><header>Definitions</header><text>In this subsection:</text>
<subparagraph id="H1E2FF6C28B4E4291B6B892AA88349245"><enum>(A)</enum><text>The term <term>compensation</term> means any pay, including salary, awards, and incentives.</text></subparagraph> <subparagraph id="HBAF46476CEE043F084D95E49AD05611E"><enum>(B)</enum><text>The term <term>covered employee</term> means a physician, podiatrist, or dentist subject to market pay under section 7431 of title 38, United States Code.</text></subparagraph></paragraph></subsection></section>
<section id="H2EF31016C9624FC1B5983CD95D2C3FE0" display-inline="no-display-inline" section-type="subsequent-section"><enum>143.</enum><header>Reimbursement of ambulance cost for care for certain rural veterans</header>
<subsection commented="no" display-inline="no-display-inline" id="H0CB0C06BFD944C8F8555CA6D70CF966C"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall pay, or reimburse a covered veteran for, the cost of transporting the veteran by ambulance, including air ambulance, from a covered location to a provider of the Department of Veterans Affairs, a non-Department provider, or the nearest hospital that can meet the needs of the veteran (including a hospital that compacts with the Indian Health Service) for covered care.</text></subsection> <subsection id="H9C89919C480D4AECAF08F89B58D66508"><enum>(b)</enum><header>Amount covered</header><text>The maximum cumulative amount covered under this section for a covered veteran is $46,000.</text></subsection>
<subsection id="HA9AD5A8B2964409B94203D6351B7F525"><enum>(c)</enum><header>Sunset</header><text>This section shall cease to be effective on September 30, 2026.</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="HC2EDBFBA0312481D9767A5AB903305D9"><enum>(d)</enum><header>Definitions</header><text>In this section:</text>
<paragraph commented="no" display-inline="no-display-inline" id="H1B15841E0D4D47308A2FB0C83E533FB5"><enum>(1)</enum><text>The term <term>covered care</term> means care for a veteran eligible for care provided by the Department of Veterans Affairs under title 38, United States Code, or any other law administered by the Secretary of Veterans Affairs, even if the care associated with the transport described in subsection (a) is not authorized by the Department. </text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HB2F9DB6B79764C5083730FC7D95F0E88"><enum>(2)</enum><text>The term <term>covered location</term> means a location that is—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HA16F2170F112491CB87BF115812E17CE"><enum>(A)</enum><text display-inline="yes-display-inline">in a State that is 100 miles or more from the nearest medical center of the Department of Veterans Affairs; and</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H52F7DE4BC30041479669D1FFDD3745C9"><enum>(B)</enum><text>in an area rated as a 10 or higher under the rural-urban commuting areas coding system of the Department of Agriculture.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HF4DFCF432F654E4D885B111C59661976"><enum>(3)</enum><text>The term <term>covered veteran</term> means a veteran who—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H5D76F0BA4AF041F386C96D6F1B224058"><enum>(A)</enum><text display-inline="yes-display-inline">has a service-connected disability rated by the Secretary as between 0 and 30 percent disabling;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HA95ED1EF451143D3862C5C0AF2551816"><enum>(B)</enum><text display-inline="yes-display-inline">is not eligible for payments or reimbursements for beneficiary travel or other transportation under the laws administered by the Secretary of Veterans Affairs, other than under this section; and</text></subparagraph> <subparagraph id="H0C4EF6B711FD4F168DD70B9A7DDF8AE0"><enum>(C)</enum><text>is not entitled to care or services under a non-Department of Veterans Affairs health-plan contract.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H1E29D44601854BB8AAF09F372D8C5052"><enum>(4)</enum><text>The term <term>health-plan contract</term> has the meaning given that term in section 1725 of title 38, United States Code.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H8187F38B5D654518AA3CBD7A262A972E"><enum>(5)</enum><text>The term <term>service-connected</term> has the meaning given that term in section 101 of such title.</text></paragraph></subsection></section>
<section id="H1016AA339FF04E1DBB40851F9C78C6C5"><enum>144.</enum><header>Pilot program to furnish dental care from the Department of Veterans Affairs to certain veterans diagnosed with ischemic heart disease</header>
<subsection id="HC478CEA973F243E6B46607EFA07B1602"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Beginning not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall carry out a two-year pilot program (in this section referred to as the <quote>pilot program</quote>) under which the Secretary shall furnish covered care to covered veterans through means that include the use of community care.</text></subsection> <subsection id="HEFBD334DF7324C2AB562DE1254724B66"><enum>(b)</enum><header>Locations</header> <paragraph id="H5F5272ED7D3046C39B586D2671E32660"><enum>(1)</enum><header>In general</header><text>The Secretary shall select not more than four States in which to carry out the pilot program.</text></paragraph>
<paragraph id="HCF8296C38F384679B48A062A3865E07C"><enum>(2)</enum><header>Selection criteria</header><text>In selecting States under paragraph (1), the Secretary shall prioritize States in which—</text> <subparagraph id="H8C07579F8F254FCCA2B267C0D9B51BD8"><enum>(A)</enum><text>the Department of Veterans Affairs serves a high proportion, as determined by the Secretary, of veterans residing in rural or highly rural areas (as determined through the use of the Rural-Urban Commuting Areas coding system of the Department of Agriculture);</text></subparagraph>
<subparagraph id="H1B01B0A97C464A09ADE379B79077FCC9"><enum>(B)</enum><text>dental clinics operated by the Department of Veterans Affairs currently utilize teledentistry;</text></subparagraph> <subparagraph id="HC32D13EC3D1D4982880BCD0A014ABD34"><enum>(C)</enum><text>the Department of Veterans Affairs does not currently operate a dental clinic; or</text></subparagraph>
<subparagraph id="H1A04971B1D9E48D5B2530F78EB522B4C"><enum>(D)</enum><text>the Secretary determines a large percentage of veterans enrolled in the system of annual patient enrollment of the Department of Veterans Affairs established and operated under paragraphs (1) or (2) of section 1705(a) of title 38, United States Code, visit emergency rooms for dental emergencies at high rates.</text></subparagraph></paragraph></subsection> <subsection id="HA11FAFC1601D4ADC9F5E5008891CC432" commented="no"><enum>(c)</enum><header>Participation limitation</header><text display-inline="yes-display-inline">Participation in a pilot program established pursuant to this section shall be limited to a covered veteran who receives health care in a facility of the Department located in a State selected under subsection (b).</text></subsection>
<subsection id="H6B353DE128CA4DCAA112FE550418B1CD"><enum>(d)</enum><header>Use of certain methods to provide care</header>
<paragraph id="H89AD5C2AE96D4D2B87141A577DA3CCB3"><enum>(1)</enum><header>Mobile dental clinics</header><text>In carrying out the pilot program, the Secretary shall test the efficacy of mobile dental clinics to service rural areas that do not have a population base to warrant a full-time clinic but where there are covered veterans in need of dental care.</text></paragraph> <paragraph id="H014F92FD1ECC46438B9497254741A5B6"><enum>(2)</enum><header>Home-based dental care</header><text>In carrying out the pilot program, the Secretary shall test the efficacy of portable dental care units to service rural veterans in their homes, as the Secretary considers medically appropriate.</text></paragraph></subsection>
<subsection id="HB420183A023F44DDA5602F59172C3156"><enum>(e)</enum><header>Administration</header>
<paragraph id="HC4AB1C9C094142A1BC252EA0C497AAF0"><enum>(1)</enum><header>Community care network review</header>
<subparagraph id="HF5B7BA4C3DFC431CB2743B3F6047AFBF"><enum>(A)</enum><header>In general</header><text>Before commencing the pilot program, the Secretary shall work with third party administrators to conduct a review of dental providers who are part of the community care network of the Department in each State selected under subsection (b)(1) to ensure—</text> <clause id="HBBD10C18ABD7487199F113443AB87BB9"><enum>(i)</enum><text>dental providers who are no longer accepting patients from the Department—</text>
<subclause id="HDD55FB8EBED34D1DB2D58023CC1CA309"><enum>(I)</enum><text>are not still listed as providers accepting referrals from the Department; and</text></subclause> <subclause id="HA93085D5F2544BEA808F3D7B35646335"><enum>(II)</enum><text>are not sent referrals from the Department; and</text></subclause></clause>
<clause id="H766B536464B0468A8CBBF8D6820DE194"><enum>(ii)</enum><text>dental providers participating in each such network are capable of receiving an influx of patients from the Department under the pilot program.</text></clause></subparagraph> <subparagraph id="H87391008233F4A81B43FB368A93BBA56" commented="no"><enum>(B)</enum><header>Expansion of network</header><text>If, pursuant to a review under subparagraph (A), the Secretary determines the community care network in a State selected under subsection (b)(1) is not capable of receiving an influx of patients under the pilot program, the Secretary shall coordinate with the Third Party Administrator for such State to ensure the dental provider network of such community care network is sufficiently expanded before the initiation of the pilot program.</text></subparagraph></paragraph>
<paragraph id="H7C6637A028E042B0B11FCCB7051FEF06"><enum>(2)</enum><header>Notice to covered veterans</header><text>In carrying out the pilot program, the Secretary shall inform all covered veterans in States selected under subsection (b)(1) of the covered care available under the pilot program.</text></paragraph> <paragraph id="H097E9A151CB44BE7A086C46316B9AF53"><enum>(3)</enum><header>Loss of eligibility</header><text display-inline="yes-display-inline">Any veteran participating in the pilot program who ceases to be a covered veteran shall be removed from the pilot program on the date that is 90 days after the Secretary determines the participant is no longer a covered veteran.</text></paragraph>
<paragraph id="HE2789468B8EA4F798D30161D3E000D26"><enum>(4)</enum><header>Continuity of care</header>
<subparagraph id="HBC120407E67948D1A320B6748EE14E26"><enum>(A)</enum><header>In general</header><text>Upon the termination of the pilot program, the Secretary shall provide to all veterans participating in the pilot program at the time of such termination—</text> <clause id="H012CFDE595574F42B080FB6803E3751B"><enum>(i)</enum><text>information on how to enroll in the dental insurance plan of the Department of Veterans Affairs under section 1712C of title 38, United States Code;</text></clause>
<clause id="HCE72C3FA5E0C47BBA6FD32EFBB1FBDD9"><enum>(ii)</enum><text>if appropriate, information on the VETSmile program of the Department of Veterans Affairs, or any successor program; or</text></clause> <clause id="HC8D73F2F7AFE43FAA6E2C6E1DC1FB429"><enum>(iii)</enum><text>contact information for dental providers in the surrounding community who provide low- or no-cost dental care and whom the Secretary has confirmed are available to take on new patients.</text></clause></subparagraph>
<subparagraph id="HECE94118DDEE4899AD5E20F1FB631F26"><enum>(B)</enum><header>Continuation of treatment plan</header><text>Any veteran participating in the pilot program may continue to receive services under the pilot program after the termination of the pilot program to complete a treatment plan commenced under the pilot program, as determined necessary by the Secretary.</text></subparagraph></paragraph></subsection> <subsection id="H6EF3CB5EFE2B47828C809B623BA5C81E"><enum>(f)</enum><header>Reports</header> <paragraph id="H57425B19B06D4F739D800D69F1A66CB4"><enum>(1)</enum><header>Annual report</header><text>Not later than one year after the commencement of the pilot program, and annually thereafter for the duration of the pilot program, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the pilot program that includes—</text>
<subparagraph id="H9345FC4CCF41485387075995855743AD"><enum>(A)</enum><text>an identification of the States participating in the pilot program;</text></subparagraph> <subparagraph id="H1177DA09617C40AE8088B45F24010214"><enum>(B)</enum><text>a description of the implementation and operation of the pilot program;</text></subparagraph>
<subparagraph id="HAEC16AFE6F4348F487D120069A1D3366"><enum>(C)</enum><text>the number of participants in the pilot program, disaggregated by—</text> <clause id="HDDE327D5B0DD45FE8CA6D9922A4CDE94"><enum>(i)</enum><text>State; and</text></clause>
<clause id="H1779B030A5C64861A03A8CFB6E6CBE29"><enum>(ii)</enum><text>disability rating;</text></clause></subparagraph> <subparagraph id="HD9BA2B09CE8541C5B24860AD3AE111EB"><enum>(D)</enum><text>an identification of any barriers or challenges to implementing the pilot program;</text></subparagraph>
<subparagraph id="H6FE6D16814A64BB88348F67150B7DB79"><enum>(E)</enum><text>aggregated feedback from participants in the pilot program, including from interviews and surveys;</text></subparagraph> <subparagraph id="HE65AE1FD810D4AA38942B2D1735EC180"><enum>(F)</enum><text>the average annual cost of providing covered care to a participant in the pilot program, disaggregated by—</text>
<clause id="HD37FF2A429BF489E8442831A6E485F63"><enum>(i)</enum><text>State;</text></clause> <clause id="HD60620AF6E234291BEBB5D69472A43E4"><enum>(ii)</enum><text>disability rating; and</text></clause>
<clause id="H57D239F53CEA44B69A4EC002E592442A"><enum>(iii)</enum><text>whether the care was provided through the community care network or through a provider of the Department;</text></clause></subparagraph> <subparagraph id="H992371824A934A5D984A2947B1963414"><enum>(G)</enum><text>an analysis of the communication and collaboration of the Department with Third Party Administrators and community care dental providers, disaggregated by State;</text></subparagraph>
<subparagraph id="H9555EDF036784400BADD92863BDA7ECA"><enum>(H)</enum><text display-inline="yes-display-inline">an analysis of any cost savings by the Department with respect to the treatment of ischemic heart disease;</text></subparagraph> <subparagraph id="H5680E076EDFF418FB69A334BDE1FD387"><enum>(I)</enum><text display-inline="yes-display-inline">an assessment of the impact of the pilot program on appointments for care, prescriptions, hospitalizations, emergency room visits, wellness, employability, satisfaction, and perceived quality of life of covered veterans related to their diagnosis of ischemic heart disease;</text></subparagraph>
<subparagraph id="HBAEFF3B5E77742E884E6DB815DD98BB1"><enum>(J)</enum><text>an analysis and assessment of the efficacy of mobile clinics and portable dental care units, to the extent such modalities are used, to service the needs of covered veterans under the pilot program;</text></subparagraph> <subparagraph id="HD1BEC05297BC49B390C2F081EBB7675A"><enum>(K)</enum><text>an analysis and assessment of the usage of teledentistry to service the needs of covered veterans under the pilot program, to include a cost benefit analysis of such services; and</text></subparagraph>
<subparagraph id="H90AC403CA87747B6A549595A5F0F23D4"><enum>(L)</enum><text>such other matters as the Secretary considers appropriate.</text></subparagraph></paragraph> <paragraph id="H4673CED75767466AA801969DBF965221"><enum>(2)</enum><header>Final report</header><text>Not later than 90 days before the completion of the pilot program, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the pilot program that—</text>
<subparagraph id="H65BE179430C647BD8D567C5C1BEA5BC1"><enum>(A)</enum><text>includes the matters required under paragraph (1);</text></subparagraph> <subparagraph id="HB9CBFFD43D3945C4A6B929A9DB9F9893"><enum>(B)</enum><text>includes recommendations on whether the pilot program should be continued, expanded, or adopted throughout the Department; and</text></subparagraph>
<subparagraph id="HDD068C53503D45A5B40046F5FDA17C8C"><enum>(C)</enum><text>indicates whether the Secretary requests action by Congress to make the pilot program permanent.</text></subparagraph></paragraph></subsection> <subsection id="HDE89EBD05A1340B59A007990E6AFAA17"><enum>(g)</enum><header>Impact on community care</header><text display-inline="yes-display-inline">Participants in the pilot program shall be able to access covered care in the community under section 1703 of title 38, United States Code.</text></subsection>
<subsection id="HCCEA6253DAB845F28DEEC45C55A1EB58"><enum>(h)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H9D5A69AE6C464F4CB67753994F041231"><enum>(1)</enum><text>The term <term>covered care</term> means dental care that is consistent with the dental services and treatment furnished by the Secretary of Veterans Affairs to veterans pursuant to section 1712(a)(1)(G) of title 38, United States Code.</text></paragraph>
<paragraph id="H77064F42C27A4E23AE97AD117DE7215B"><enum>(2)</enum><text>The term <term>covered veteran</term> means a veteran who—</text> <subparagraph id="H581CCCED903443E69FCB6308C5EC4E8D"><enum>(A)</enum><text>is enrolled in the system of annual patient enrollment of the Department established and operated under paragraphs (1) or (2) of section 1705(a) of title 38, United States Code;</text></subparagraph>
<subparagraph id="H61C156CB6F2B434BBA964AFFA40B0211"><enum>(B)</enum><text>is not eligible for dental services and treatment and related dental appliances under the laws administered by the Secretary as of the date of the enactment of this Act; and</text></subparagraph> <subparagraph id="H4D5215ED397044BC8FE609810229A424"><enum>(C)</enum><text display-inline="yes-display-inline">has a diagnosis of ischemic heart disease.</text></subparagraph></paragraph>
<paragraph id="H33D683BCD8D24708A52B96B83EE9284B"><enum>(3)</enum><text>The term <term>Third Party Administrator</term> has the meaning given such term in section 1703F of such title.</text></paragraph></subsection></section> <section id="HFD46E30E7CF54974A2F1E4C65BAAE342" commented="no"><enum>145.</enum><header>Documentation of preferences of veterans for scheduling of appointments for health care under laws administered by Secretary of Veterans Affairs</header> <subsection id="H1FC12CFA9BF146C38FDB69DA85FB5058" commented="no"><enum>(a)</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 shall develop a mechanism to solicit information regarding the preference of veterans enrolled in the system of annual patient enrollment of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code, for scheduling of appointments for health care and related services under the laws administered by the Secretary, including through non-Department providers.</text></subsection>
<subsection id="H4DFD8FDDE99744BDB832793FC369A1B0" commented="no"><enum>(b)</enum><header>Documentation of preference</header><text>Preferences provided voluntarily by a veteran pursuant to subsection (a) shall be documented on My HealtheVet or another system designated by the Secretary that allows the veteran to view and change such preferences at any time.</text></subsection> <subsection id="H3FAD3E9F3A9548B888E489EB46A6076F" commented="no"><enum>(c)</enum><header>Inclusion in preference</header><text>Preferences solicited under subsection (a) shall include the following:</text>
<paragraph id="H241E7191D5254F258310AFA09AE77122" commented="no"><enum>(1)</enum><text>How and when the veteran prefers to be contacted about an appointment for health care.</text></paragraph> <paragraph id="H94E9E4E242C145EBBCF7C8676C0BEB80" commented="no"><enum>(2)</enum><text>Whether the veteran prefers to schedule appointments without the assistance of the Department, if able.</text></paragraph>
<paragraph id="HFDA7A3F4EBFA4FB28912CE7F01A5F09B" commented="no"><enum>(3)</enum><text>Whether the veteran prefers to select a provider without the assistance of the Department, if able.</text></paragraph> <paragraph id="H4C11F653B8894537BE85EB8AD3803681" commented="no"><enum>(4)</enum><text>Whether the veteran prefers appointments to be scheduled during certain days or times.</text></paragraph></subsection>
<subsection id="HA30DD42D7E9D4B91B66D5B11351C08D1" commented="no"><enum>(d)</enum><header>Use of preference</header><text>The Secretary shall make the preferences provided under subsection (a) easily accessible to medical support assistants and other staff of the Department, or non-Department staff, as the Secretary determines appropriate, who assist in the appointment scheduling process.</text></subsection> <subsection id="H3DEDE25309274BDFBF12C5E3AA7B29AC" commented="no"><enum>(e)</enum><header>Deployment of mechanism</header> <paragraph id="HE0C6D3EEE055429FBC9EC35ABE19D691" commented="no"><enum>(1)</enum><header>In general</header><text>Beginning after the date on which the Secretary develops the mechanism required under subsection (a), the Secretary shall—</text>
<subparagraph id="H1C17ACC88F854952A01FE8DE4DF7C213" commented="no"><enum>(A)</enum><text>test the mechanism in not fewer than three geographically diverse Veterans Integrated Service Networks; and</text></subparagraph> <subparagraph id="HE6FCDA5E3EE14555BC08E8CA6488DAC1" commented="no"><enum>(B)</enum><text>gather feedback about the effectiveness of such mechanism from veterans, medical support assistants, staff and other stakeholders as the Secretary determines appropriate.</text></subparagraph></paragraph>
<paragraph id="H4E897E57FB614DE2B81148F9A2835CF9" commented="no"><enum>(2)</enum><header>Limitation</header><text>The Secretary may not implement such mechanism across the Veterans Health Administration of the Department before the Secretary addresses the feedback described in paragraph (1)(B).</text></paragraph></subsection></section> <section id="H765BF4D0980B4219B50898A41EE4E47C"><enum>146.</enum><header>Staffing model and performance metrics for certain employees of the Department of Veterans Affairs</header> <subsection id="HFDAB71C574B84CC6919392A5869D5C52"><enum>(a)</enum><header>Staffing model</header> <paragraph id="H47DD95FF99C149BF94F0BC152781CB7A"><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 shall—</text>
<subparagraph id="HDC29082E25AB4D5F8BFC6C0F73086235"><enum>(A)</enum><text>develop, validate, and implement a staffing model for the Office of Integrated Veteran Care of the Department of Veterans Affairs, or successor office, Veterans Integrated Services Networks, and medical centers of the Department that includes appropriate target staffing levels nationally, regionally, and locally to ensure timely access to care and effectively oversee the provision of care by the Department, whether at a facility of the Department or through a non-Department provider; and</text></subparagraph> <subparagraph id="HF053FBF38C95499B98F544CC8BB4303F"><enum>(B)</enum><text>provide to Congress a briefing on such staffing model, which shall include—</text>
<clause id="HF9D10C7632A941A09EEA8FDE10143446"><enum>(i)</enum><text>the metrics and measures used by the Secretary in developing such staffing model;</text></clause> <clause id="H94E8D1655B7D4AABB7EBB777B01644BC"><enum>(ii)</enum><text>an analysis of how such staffing model compares to the staffing models of other relevant Government-owned and private sector health care systems; and</text></clause>
<clause id="H4BC45450CEE04C029883CADAD78602B8"><enum>(iii)</enum><text>an estimate of the portion of the roles in such staffing model that will be filled by contracted staff at any given time.</text></clause></subparagraph></paragraph> <paragraph id="H9B6F0875D165404C988FF56E4D97BB3C"><enum>(2)</enum><header>Report on implementation of staffing model</header><text>Not later than one year after the date on which the Secretary implements the staffing model required under paragraph (1), the Secretary shall submit to Congress and the Comptroller General of the United States a report containing—</text>
<subparagraph id="H7B579B0766244F29BEB112CA06B4B867"><enum>(A)</enum><text>an update on such implementation; and</text></subparagraph> <subparagraph id="H5540DD94853043B0878695D6E87EDD80"><enum>(B)</enum><text>information on the outcomes yielded by such staffing model in terms of improved access to care for veterans and improved compliance with relevant laws, regulations, policy directives, and guidance governing access to care.</text></subparagraph></paragraph></subsection>
<subsection id="H61E2E40C03774F6DB77E179B8613FE22"><enum>(b)</enum><header>Performance metrics</header>
<paragraph id="H764297FDBB0649CC8C6864C99AC81EC3"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary shall develop and implement a plan, with an appropriate tracking system, to incorporate appropriate standardized performance metrics and oversight measures within the performance appraisal systems for employees of the Department specified in paragraph (2).</text></paragraph> <paragraph id="H1BBA3D60B4B64AF4B1DFE7F24F954162"><enum>(2)</enum><header>Employees of the Department specified</header><text>Employees of the Department specified in this paragraph are employees who are responsible for ensuring timely access to care from the Department, compliance with relevant statutes and regulations relating to the provision of care, including section 1703 of title 38, United States Code, and overseeing the provision of care, whether at a facility of the Department or through a non-Department provider, including employees within the Office of Integrated Veteran Care of the Department, or successor office, employees of a Veterans Integrated Service Network, and employees of a medical center of the Department. </text></paragraph>
<paragraph id="H73050925BDF047AE9159F4192DD8D229"><enum>(3)</enum><header>Report on implementation of performance metrics</header><text>Not later than one year after implementing the performance metrics required under paragraph (1), the Secretary shall submit to Congress and the Comptroller General of the United States a report containing—</text> <subparagraph id="H3C703EB6789C4FD1BBAA02311A0C6735"><enum>(A)</enum><text>an update on such implementation; and</text></subparagraph>
<subparagraph id="H341F94E5C18C4E9B842EC4E7E938D7F2"><enum>(B)</enum><text>information on the outcomes yielded by such performance metrics in terms of improved access to care for veterans and improved compliance with relevant laws, policy directives, and guidance governing access to care.</text></subparagraph></paragraph></subsection> <subsection id="H1E0BD736B3B54D388D556586D1241CF1"><enum>(c)</enum><header>GAO report</header><text>Not later than two years after the later of the date on which the Comptroller General receives the report under subsection (a)(2) or the report under subsection (b)(3), the Comptroller General shall submit to Congress a report that includes—</text>
<paragraph id="H17D8577E0F444EF49A3C4E0E3F8AD3FE"><enum>(1)</enum><text>an assessment of the performance of the Office of Integrated Veteran Care of the Department, or successor office, in improving access to care for veterans in facilities of the Department and pursuant to section 1703 of title 38, United States Code; and</text></paragraph> <paragraph id="H16A690D1774845C9B3AF7BF9921D2683"><enum>(2)</enum><text>such recommendations as the Comptroller General considers appropriate with respect to improving access to the care described in paragraph (1) for veterans.</text></paragraph></subsection></section>
<section id="H6FCE907734A64673BCB8B73AA2AEAD85"><enum>147.</enum><header>Online health education portal for veterans enrolled in patient enrollment system of Department of Veterans Affairs</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 establish, on an Internet website of the Department, a health education portal that includes interactive educational modules to ensure veterans enrolled in the patient enrollment system of the Department of Veterans Affairs established and operated under section 1705(a) of title 38, United States Code, understand the basic health care eligibilities and entitlements of veterans under the laws administered by the Secretary, including under the Veterans Community Care Program under section 1703 of such title.</text></section> <section id="H48CADE8E924D46A7AD4DAD5D6293BA97"><enum>148.</enum><header>Limitation on detail of directors of medical centers of Department of Veterans Affairs to different positions</header> <subsection id="HD047F0932E4F49E69C467461ECBAD26F"><enum>(a)</enum><header>Notification</header> <paragraph id="HFD771630701D499EB46EEDD785A92420"><enum>(1)</enum><header>In general</header><text>Not later than 90 days after detailing a director of a medical center of the Department of Veterans Affairs to a different position within the Department, the Secretary of Veterans Affairs shall notify the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives of such detail.</text></paragraph>
<paragraph id="H6234733CEFBC4A91AA4720413DE6995B"><enum>(2)</enum><header>Matters to be included</header><text>The notification required by paragraph (1) shall include, with respect to a director of a medical center who is detailed to a different position within the Department, the following information:</text> <subparagraph id="HBA3D7F97BF9A4FEBA2218A1504443217"><enum>(A)</enum><text>The location at which the director is detailed.</text></subparagraph>
<subparagraph id="H0B4B867D9E564A279E36206C8EF76331"><enum>(B)</enum><text>The position title of the detail.</text></subparagraph> <subparagraph id="HD423F317D8B9437EA8EB4954E742731B"><enum>(C)</enum><text>The estimated time the director is expected to be absent from their duties at the medical center.</text></subparagraph>
<subparagraph id="HA90EA91AB0764456838CFEE6D98F1CC7"><enum>(D)</enum><text>Such other information as the Secretary may determine appropriate.</text></subparagraph></paragraph></subsection> <subsection id="H611C66D401D6442EA0E406464117E849"><enum>(b)</enum><header>Appointment of acting director</header><text>Not later than 120 days after detailing a director of a medical center of the Department to a different position within the Department, the Secretary shall appoint an individual as acting director of such medical center with all of the authority and responsibilities of the detailed director.</text></subsection>
<subsection id="H4CAED0A888AA4C069D9A69AAF19F30FF"><enum>(c)</enum><header>Update on detail</header><text>Not later than 120 days after detailing a director of a medical center of the Department to a different position within the Department, and not less frequently than every 30 days thereafter while the detail is in effect or while the director position at the medical center is vacant, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives an update regarding the status of the detail.</text></subsection> <subsection id="HB23A55EB06C24C06BCACA835E8375B94"><enum>(d)</enum><header>Return to position or reassignment</header> <paragraph id="HFAA8F857D83247AABA9BA4F11853C7BA"><enum>(1)</enum><header>In general</header><text>Except as provided in paragraph (2), not later than 180 days after detailing a director of a medical center of the Department to a different position within the Department, for a reason other than an ongoing investigation or administrative action with respect to the director, the Secretary shall—</text>
<subparagraph id="H61356B770C7B40BEA1EA3337579FDFD1"><enum>(A)</enum><text>return the individual to the position as director of the medical center; or</text></subparagraph> <subparagraph id="H80C0AD8B44F64144992F70A5D71B6C4C"><enum>(B)</enum><text>reassign the individual from the position as director of the medical center and begin the process of hiring a new director for such position.</text></subparagraph></paragraph>
<paragraph id="H18B33A2C4CA34A56B32B1916A886E5AF"><enum>(2)</enum><header>Waiver</header>
<subparagraph id="H384E7A4905D047F68528B45849B6F716"><enum>(A)</enum><header>In general</header><text>The Secretary may waive the requirement under paragraph (1) with respect to an individual for successive 90-day increments for a total period of not more than 540 days from the original date the individual was detailed away from their position as director of a medical center.</text></subparagraph> <subparagraph id="H30638BE84BD44CF78FD70F18B164B4D0"><enum>(B)</enum><header>Notification</header><text>Not later than 30 days after exercising a waiver under subparagraph (A), the Secretary shall notify Congress of the waiver and provide to Congress information as to why the waiver is necessary.</text></subparagraph></paragraph></subsection></section>
<section id="H743CD7D022984224B8758B1A8205BE5B" display-inline="no-display-inline" section-type="subsequent-section"><enum>149.</enum><header>National Veteran Suicide Prevention Annual Report</header>
<subsection id="H68C77153EAE0469BB4E36FBBA5EB0CBA"><enum>(a)</enum><header>National Veteran Suicide Prevention Annual Report</header>
<paragraph id="H59449EC881964D9F898E5F47B0826FCF"><enum>(1)</enum><header>In general</header><text>Not later than 18 months after the date of the enactment of this Act, and not later than September 30 of each year thereafter, the Secretary of Veterans Affairs shall submit to the appropriate congressional committees and publish on a publicly available website of the Department of Veterans Affairs a report to be known as the <quote>National Veteran Suicide Prevention Annual Report</quote>.</text></paragraph> <paragraph id="HEE3469747073498F84FA984EC63DF3B1"><enum>(2)</enum><header>Extension</header> <subparagraph id="HD35EC5A48BBA4BD2A87D46B9B1A0AF50"><enum>(A)</enum><header>In general</header><text>If the Secretary requires an extension of the deadline for a report under subsection (a), the Secretary shall submit to the appropriate congressional committees a written request for such an extension.</text></subparagraph>
<subparagraph id="H81BDCF674354466DA1F231E6B43CD163"><enum>(B)</enum><header>Elements</header><text>Each written request under paragraph (1) for an extension for a report shall include the following:</text> <clause id="H232362CE182041DDA60065697C7EC814"><enum>(i)</enum><text>The rationale for the delay in the submission of the report.</text></clause>
<clause id="HD487E1966BF94ACF989C5EDC13EE1CCB"><enum>(ii)</enum><text>An explanation of the need for an extension.</text></clause> <clause id="H7FE0166340544110AC1E9210CEE7EB60"><enum>(iii)</enum><text>A proposed amended date for the submission and publication of the report. </text></clause></subparagraph></paragraph>
<paragraph id="H8EB387AFCA044F839621F11FEA192A23" commented="no"><enum>(3)</enum><header>Briefing</header><text>With respect to each report required under paragraph (1), the Secretary shall, before the date on which the Secretary submits such report, provide to the appropriate congressional committees a briefing on such report. </text></paragraph> <paragraph id="H58767CCBBD6C4C6C90A7A178AF024963"><enum>(4)</enum><header>Elements</header> <subparagraph id="HB5A82BC7F6E1466CAFEE5353B15891A5"><enum>(A)</enum><header>In general</header><text>Each report required under paragraph (1) shall include—</text>
<clause id="H90C0A16995214DCC810C368960285C4B"><enum>(i)</enum><text>the findings of the national analysis of veteran suicide rates for the latest year for which data is available;</text></clause> <clause id="HFBF992C150A44BD99C00630DBF0F7B9B"><enum>(ii)</enum><text>an identification of trends, if any, demonstrated by such data; and</text></clause>
<clause id="H165698771BA643E99C9B2B514F0E0423"><enum>(iii)</enum><text>a comparison of such data to data on veteran suicide rates during preceding years.</text></clause></subparagraph> <subparagraph id="HF0146C65F7AB4ABCA477B9DF96C6F429"><enum>(B)</enum><header>Additional elements</header><text>Each report under paragraph (1) shall include, for the year covered by the report, the following:</text>
<clause id="H3252B6DAAB3244A0A5DCA0EB758E4702"><enum>(i)</enum><text>Suicide rates of veterans disaggregated by age, gender, and race or ethnicity.</text></clause> <clause id="H44F03622991E412DA8177FDBCA8A3B17"><enum>(ii)</enum><text>Trends in suicide rates of veterans compared to engagement of those veterans with health care from the Veterans Health Administration, including an examination of trends in suicide rates or deaths among— </text>
<subclause id="HA64BD6BD5799427FB853AC2F51FCE8C3"><enum>(I)</enum><text>veterans who have recently received health care from the Veterans Health Administration as compared to veterans who have never received health care from the Veterans Health Administration;</text></subclause> <subclause id="H7C0FAF9181024B8AB81E10E9739763C1"><enum>(II)</enum><text>veterans who are enrolled in the patient enrollment system of the Department of Veterans Affairs under section 1705(a) of title 38, United States Code, as compared to veterans who have never enrolled in such system;</text></subclause>
<subclause id="H88CED7ACC21448889168754C4E9F7709"><enum>(III)</enum><text>veterans who have recently used services from a Vet Center as compared to veterans who have never used such services; </text></subclause> <subclause id="H6B63CA575FE541EFB1DA3BD80D170603" commented="no" display-inline="no-display-inline"><enum>(IV)</enum><text display-inline="yes-display-inline">to the extent practicable, veterans who have a diagnosis of substance use disorder; and</text></subclause>
<subclause id="H57AE52FAEF2041558D1B2CEC914F3DD9"><enum>(V)</enum><text>other groups of veterans relating to engagement with health care from the Veterans Health Administration, as the Secretary considers practicable.</text></subclause></clause> <clause id="H1631B55FAFF04FD5BA3FA32647D09263"><enum>(iii)</enum><text>To the extent practicable, trends in suicide rates of veterans compared to engagement of those veterans with benefits from the Veterans Benefits Administration, including an examination of trends in suicide rates or deaths among—</text>
<subclause id="H0746F856B255410598C2412C7077BEB8" commented="no"><enum>(I)</enum><text>veterans who are currently using, have previously used, or have never used educational assistance under the laws administered by the Secretary;</text></subclause> <subclause id="H5ABBA804879B4C909D9B0DE54096407A" commented="no"><enum>(II)</enum><text>veterans who are currently receiving, have previously received, or have never received services or assistance under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/31">chapter 31</external-xref> of title 38, United States Code;</text></subclause>
<subclause id="HFD7C6CFB0E4845F0B4ADED1A03DCFF86"><enum>(III)</enum><text>with respect to compensation under chapter 11 of such title—</text> <item id="H712AC848B28744489E6AE74E8318D985"><enum>(aa)</enum><text>veterans who were recipients of such compensation as compared to veterans who never applied for such compensation prior to death;</text></item>
<item id="HFB54FA345BBC442FBFF8D7A09A538C24"><enum>(bb)</enum><text>veterans who had a claim denied for such compensation prior to death;</text></item> <item id="H894CBBC72427446EA05D654DA5785AF2"><enum>(cc)</enum><text>veterans who had a pending claim for such compensation at time of death; and</text></item>
<item id="H3AC6938214934109A59C964264E18940"><enum>(dd)</enum><text>veterans who had an entitlement for such compensation reduced prior to death;</text></item></subclause> <subclause id="HD74813B86FD1477E9C8CD29F284ABF3A"><enum>(IV)</enum><text>veterans who are currently receiving or have never received pension under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/15">chapter 15</external-xref> of title 38, United States Code;</text></subclause>
<subclause id="HEFF44639134C4A04ACBE346359942CEC"><enum>(V)</enum><text>veterans who are currently using, have recently used, or have never used programs or services provided by the Homeless Programs Office of the Department, including an examination of trends in suicide rates or deaths among veterans who made contact with such office but were denied or deemed ineligible for any such program or service;</text></subclause> <subclause id="HF6273FDEC772460FA35184671EEFB579"><enum>(VI)</enum><text>with respect to housing loans guaranteed by the Secretary under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/37">chapter 37</external-xref> of title 38, United States Code, veterans who are current recipients of, were recent recipients of, or have never received such a loan;</text></subclause>
<subclause id="H0CB77EA92AFB41DEAA66781F49A8B2CA"><enum>(VII)</enum><text>veterans owing debts to the Department;</text></subclause> <subclause id="HA2FE506CD0CB454A84948B1871E49998"><enum>(VIII)</enum><text>veterans who were involved in a veterans treatment court program, whether they graduated successfully or not; and</text></subclause>
<subclause id="HCEDA8DA317EE4283B5273BBF15212160"><enum>(IX)</enum><text>veterans who were successfully contacted, unsuccessfully contacted, or never contacted by the Department through the Solid Start program under section 6320 of title 38, United States Code. </text></subclause></clause></subparagraph> <subparagraph id="HA779C054327740FE8D7CE39A35DE13E5" commented="no" display-inline="no-display-inline"><enum>(C)</enum><header display-inline="yes-display-inline">Strategy and recommendations</header> <clause id="H6CE6B333272F4876849FBA1C9799243E" commented="no" display-inline="no-display-inline"><enum>(i)</enum><header>Initial report</header><text display-inline="yes-display-inline">The initial report under paragraph (1) shall include a strategy and recommendations developed by the Secretary of Veterans Affairs, in collaboration with the Director of the Centers for Disease Control and Prevention, for—</text>
<subclause id="HEBF64834CE564C148B92D12F481FDE42"><enum>(I)</enum><text>improving data collection at the State and local levels to accurately capture suicide deaths of veterans;</text></subclause> <subclause id="H01CDF190D6074373A16B193976DC50EA"><enum>(II)</enum><text>improving the timeliness, efficacy, and standardization of data reporting on suicide deaths of veterans at the Federal level, including by the Centers for Disease Control and Prevention and the Department of Veterans Affairs;</text></subclause>
<subclause id="HC67EBBFB23C84AA2BF39E3014C55A149"><enum>(III)</enum><text>improving the timeliness of identification and analysis of suicide deaths of veterans by Federal agencies, including the Centers for Disease Control and Prevention, and the Department of Veterans Affairs; and</text></subclause> <subclause id="H0B0A40C51D2243878397B9345E8A6E63" commented="no" display-inline="no-display-inline"><enum>(IV)</enum><text>any other necessary process improvements for improving the timeliness, efficacy, and standardization of reporting of data relating to suicide deaths of veterans, particularly with respect to the annual report under this section.</text></subclause></clause>
<clause id="H5CF99B9A8454412691496C7085719714" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><header>Subsequent reports</header><text display-inline="yes-display-inline">Each report after the initial report under paragraph (1) shall include updates on actions taken to meet the strategy and recommendations developed under subparagraph (A).</text></clause></subparagraph></paragraph> <paragraph id="H26464EE8DC37448B919CD3B9CEB204DD"><enum>(5)</enum><header>Definitions</header><text>In this subsection:</text>
<subparagraph id="H2DA57D8FEA1D4660BE9B64DBFC080EE1"><enum>(A)</enum><text>The term <term>appropriate congressional committees</term> means the Committees on Veterans’ Affairs of the Senate and the House of Representatives.</text></subparagraph> <subparagraph id="H8C340081486B49439E2C71380BCCDC29" commented="no"><enum>(B)</enum><text>The term <term>Vet Center</term> means a center for readjustment counseling and related mental health services for veterans under section 1712A of title 38, United States Code.</text></subparagraph></paragraph></subsection>
<subsection id="HBCA96FD6BA74405AAD0F2A5100760DC8"><enum>(b)</enum><header>Independent assessment of National Veteran Suicide Prevention Annual Report</header>
<paragraph id="H858C6D497E6849438B87CFEA435155EE"><enum>(1)</enum><header>In general</header><text>Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall enter into one or more contracts with a private sector entity described in paragraph (5) to conduct an independent assessment of the National Veteran Suicide Prevention Annual Report required under subsection (a).</text></paragraph> <paragraph id="H97D43D3550EF421A989941C7FE42829F"><enum>(2)</enum><header>Frequency</header><text>The private sector entity or entities carrying out the assessment required under paragraph (1) shall complete such assessment not later than 240 days after entering into the contract described in such subsection and not less frequently than every five years thereafter.</text></paragraph>
<paragraph id="H2AA54EC0FC094FE3BEB0F9C5B5284BDA"><enum>(3)</enum><header>Elements</header><text>Each assessment required under paragraph (1) shall analyze the following:</text> <subparagraph id="H929F4178341F407CAFF12939226DFC3A"><enum>(A)</enum><text>The methodology used by the Department to track, analyze, categorize, and report suicide deaths and suicide rates among veterans.</text></subparagraph>
<subparagraph id="HC69D3AD55FA644149C285D57CA767C6F"><enum>(B)</enum><text>Whether data sources used by the Department to compile data on suicide deaths and suicide rates among veterans are accurately reflecting such data.</text></subparagraph> <subparagraph id="H5208C391978F475FAC37F2A739FE3C38"><enum>(C)</enum><text>Vulnerabilities in the methodology used by the Department that could lead to inaccurate counting of suicide deaths and suicide rates among veterans.</text></subparagraph>
<subparagraph id="HD600FED5E38B4C1BA03983C410E84B41"><enum>(D)</enum><text>The ability of the Department to cross reference suicide deaths and suicide rates among veterans with trends in usage of programs of the Veterans Health Administration or the Veterans Benefits Administration or other programs that could serve as widespread protective factors against suicide.</text></subparagraph> <subparagraph id="HF9B9D65D857142E887697FA1B7C04FA6" commented="no" display-inline="no-display-inline"><enum>(E)</enum><text>Improvements that could be made to ensure the National Veteran Suicide Prevention Annual Report required under subsection (a) is accurate and comprehensive and provides insights for making improvements to the suicide prevention efforts of the Department. </text></subparagraph></paragraph>
<paragraph id="H0FAC9A9493484F8B99701E0DB6A8D792"><enum>(4)</enum><header>Report on assessment</header>
<subparagraph id="H2D436E2D0C694C7A9D651E73F07FAE0C"><enum>(A)</enum><header>Report on findings and recommendations</header><text>Not later than 60 days after completing an assessment required by paragraph (1), the private sector entity or entities carrying out the assessment shall submit to the Secretary of Veterans Affairs and the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the findings and recommendations of the private sector entity or entities with respect to such assessment.</text></subparagraph> <subparagraph id="H57840C1AEA8146D1962BEF33730A65B6"><enum>(B)</enum><header>Report on planned improvements</header><text>Not later than 60 days after receiving a report under paragraph (1) with respect to an assessment required by paragraph (1), the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on how the Department plans to improve the National Veteran Suicide Prevention Annual Report required under subsection (a) based on such assessment.</text></subparagraph></paragraph>
<paragraph id="H2A1212C450534193898F3AA9E35756DD"><enum>(5)</enum><header>Private sector entity described</header><text>A private sector entity described in this paragraph is a private entity that—</text> <subparagraph id="HBE53EE3FB0CE4DB18796D289474197F0"><enum>(A)</enum><text>specializes in analyzing large-scale organizational data collection and analysis efforts, especially with respect to the health care sector; and</text></subparagraph>
<subparagraph id="H271D9AD1ED9E4FBCA7420842B819B681"><enum>(B)</enum><text>has experience and proven outcomes in optimizing the accuracy and comprehensiveness of data collection and analysis related to suicide.</text></subparagraph></paragraph></subsection> <subsection id="H4B3DCC83A7F54704B0E86AD1AA325270"><enum>(c)</enum><header>Report on additional benefits and services from Department of Veterans Affairs to prevent veteran suicide</header> <paragraph id="H0392905C90F54D7E84FC4DED9DEAC25A"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than three years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives and publish on a publicly available website of the Department of Veterans Affairs a report that analyzes which benefits and services under the laws administered by such Secretary, including such benefits and services furnished by the Veterans Benefits Administration, have the greatest impact on the prevention of suicide among veterans, including recommendations for potential expansion of services and benefits to reduce the number of veteran suicides.</text></paragraph>
<paragraph id="H8D82C8B463324A4DB6FD88E0DCA7B440"><enum>(2)</enum><header>Assessment of Solid Start program</header><text>The report required by paragraph (1) shall include an analysis of the effectiveness of the Solid Start program under section 6320 of title 38, United States Code, on prevention of suicide among veterans. </text></paragraph></subsection> <subsection id="H8A1E76EED4D54CBC8646A9A6471C4091"><enum>(d)</enum><header>Toolkit for State and local coroners and medical examiners on best practices for identifying and reporting on suicide deaths of veterans</header> <paragraph id="HDE2268D2C08A47A9B76FA9D53AE2164A" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text>The Secretary of Veterans Affairs, in collaboration with the Director of the Centers for Disease Control and Prevention, shall develop a toolkit for State and local coroners and medical examiners that contains best practices for—</text>
<subparagraph id="H1BA10071DECE4A1B8C60B3E36B811043" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text display-inline="yes-display-inline">accurately identifying and reporting suicide deaths of veterans, including how to identify veteran status; and</text></subparagraph> <subparagraph id="H67FCF45E3B85419F90EBCF2084BF903F" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">reporting such deaths to the Centers for Disease Control and Prevention and other applicable entities.</text></subparagraph></paragraph>
<paragraph id="H0F19CB8447964E66A182C1EA3BD5E65B"><enum>(2)</enum><header>Availability</header><text>Not later than two years after the date of the enactment of this Act, the Secretary shall make the toolkit developed under paragraph (1) available on a publicly available website of the Department of Veterans Affairs.</text></paragraph> <paragraph id="HC718E7A76BEC4B9684D5AB66B6922943"><enum>(3)</enum><header>Outreach</header><text>The Secretary, in collaboration with the Director of the Centers for Disease Control and Prevention, shall conduct outreach to appropriate State and local agencies to promote the availability and use of the toolkit developed under paragraph (1).</text></paragraph></subsection></section>
<section id="HE65712A4A4FD4849A3888149FE813C49" commented="no"><enum>150.</enum><header>Report on physical infrastructure required by medical facilities of Department of Veterans Affairs to provide dental care services</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 Committees on Veterans’ Affairs of the Senate and the House of Representatives a report, for each medical center or other relevant health care facility of the Department of Veterans Affairs, that includes—</text> <paragraph id="HA40173F5A684416BA54A337CF056291E" commented="no"><enum>(1)</enum><text>an identification of the physical infrastructure, including new facilities, renovations, remodels, leases, or other infrastructure, such medical center or health care facility requires to provide dental care services to veterans eligible for such services under the laws administered by the Secretary; and</text></paragraph>
<paragraph id="HA20BD570CE3C42C586E3B7A392198761" commented="no"><enum>(2)</enum><text>an analysis of the physical infrastructure such medical center or health care facility would require if a greater number of veterans became eligible for such dental care services pursuant to a modification of the laws administered by the Secretary.</text></paragraph></section> <section id="HD477DAE970644C0B9324CE8A49EBE295" commented="no"><enum>151.</enum><header>Comptroller General report on certain oral health care programs under laws administered by Secretary of Veterans Affairs</header> <subsection id="H5B7611BBAF694CD2A7C41036AA111732"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report on the status of the oral health care programs of the Department of Veterans Affairs, that includes an assessment of—</text>
<paragraph id="HB1A1AA9821FB4975B01A8385CC2396D2" commented="no"><enum>(1)</enum><text>any issues with information technology programs, including Dental Record Manager Plus, that affect dental care staff of the Department;</text></paragraph> <paragraph id="H6229908BFECB438888E39BB30786733B" commented="no"><enum>(2)</enum><text>the implementation of the dental insurance plan of the Department under section 1712C of title 38, United States Code;</text></paragraph>
<paragraph id="H81B8D80B8F5846F4B2BE20A77B4D1151" commented="no"><enum>(3)</enum><text>the implementation and expansion of the VETSmile program of the Department;</text></paragraph> <paragraph id="H1FD22A2BDF1A42DF8F09FED56886A222" commented="no"><enum>(4)</enum><text>barriers preventing the Department from expanding dental care eligibility to all veterans with ischemic heart disease, including such barriers relating to physical infrastructure, workforce, and cost of such dental care;</text></paragraph>
<paragraph id="H4694145BBBE941229D6C0C9A38B4E5DE" commented="no"><enum>(5)</enum><text>barriers preventing dental clinics of the Department, if any, from adopting teledentistry;</text></paragraph> <paragraph id="HB4A1D6BB182C4A5BABFE14ECFD1070EF" commented="no"><enum>(6)</enum><text>the demographic makeup of veterans eligible for dental care paid for by the Department as of the commencement of the pilot program under section 145 of this Act, including information on—</text>
<subparagraph id="H9A6F48AB178541FB8B422A85E0D25E57" commented="no"><enum>(A)</enum><text>age;</text></subparagraph> <subparagraph id="H3E01A6A60780493AAD2CF1CD793979D1" commented="no"><enum>(B)</enum><text>gender;</text></subparagraph>
<subparagraph id="H34A8CE9EAD684586A1FAB1A5F85AFEAE" commented="no"><enum>(C)</enum><text>race or ethnicity, disaggregated by—</text> <clause id="H6E5EA2DDA43348D88808F7B059ECC977" commented="no"><enum>(i)</enum><text>membership in an Indian Tribe; and</text></clause>
<clause id="H127274FCFC16449C9E1A59F4658CD579"><enum>(ii)</enum><text>the major race groups used in the decennial census;</text></clause></subparagraph> <subparagraph id="H636360448F3141B78A2FA4A9B9BD0FAE" commented="no"><enum>(D)</enum><text>employment status; and</text></subparagraph>
<subparagraph id="H4F56507C836B4D158E279D99EEB9CFA5" commented="no"><enum>(E)</enum><text>location of residence, disaggregated by rural, highly rural, and urban locations; and</text></subparagraph></paragraph> <paragraph id="H0739CD1066BD4EC48F66F6B334EB71F6" display-inline="no-display-inline" commented="no"><enum>(7)</enum><text>changes to such demographic makeup if any, that would result from an expansion of eligibility for dental care under the laws administered by the Secretary to all veterans with ischemic heart disease including changes to demographics specified in paragraph (6).</text></paragraph></subsection>
<subsection id="H200FBCE0A85F4ACFA52125A96620A663"><enum>(b)</enum><header>Third Party Administrator defined</header><text display-inline="yes-display-inline">In this section, the term <quote>Third Party Administrator</quote> means an entity that manages a provider network and performs administrative services related to such network under section 1703 of title 38, United States Code.</text></subsection></section> <section changed="not-changed" id="HAE444BAC1FAD4E7AA9658979BF544E4E"><enum>152.</enum><header>Review of workflows associated with processing referrals between facilities of the Veterans Health Administration</header> <subsection changed="not-changed" id="HE4EFEAF74A22466B8ED462E91D53DB78"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall conduct a review of the workflows directly associated with processing referrals of patients between facilities of the Veterans Health Administration of the Department of Veterans Affairs to identify specific delays or bottlenecks in such referrals.</text></subsection>
<subsection changed="not-changed" id="HA8EDBABF5A5349819B4BDD7C04E84105"><enum>(b)</enum><header>Elements of review</header><text display-inline="yes-display-inline">The review required under subsection (a) shall include a review of—</text> <paragraph changed="not-changed" id="HA627D0308F4B45B5B225E497369C7A49"><enum>(1)</enum><text display-inline="yes-display-inline">the interfacility consult management guidance of the Veterans Health Administration that assists facilities described in subsection (a) in constructing a workflow for consults between such facilities; and</text></paragraph>
<paragraph changed="not-changed" id="H1B743E11C671477DA2B1D673503406DE"><enum>(2)</enum><text display-inline="yes-display-inline">the roles and responsibilities of the individuals involved in the consult management process in managing such consults, including the role of the referral coordination team.</text></paragraph></subsection> <subsection changed="not-changed" id="HA1A41AF4745D4308B7D98C1653E7C285"><enum>(c)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to Congress a report on the results of the review required under subsection (a).</text></subsection></section>
<section id="H500AE6F12A384B75A6847B3A0BB67F17"><enum>153.</enum><header>Plan for timely scheduling of appointments at medical facilities of Department of Veterans Affairs</header>
<subsection id="H4E30AB69699B408BB70AFDA042BD446C"><enum>(a)</enum><header>Plan required</header><text>To improve responsiveness in the provision of hospital care and medical services at medical facilities of the Department of Veterans Affairs, the Secretary of Veterans Affairs shall develop a plan to—</text> <paragraph id="HD0B353FC6F3E4E56AA297C64BB50689D"><enum>(1)</enum><text>ensure that whenever a covered veteran contacts the Department by telephone to request the scheduling of an appointment for care or services for the covered veteran at such a facility, the scheduling for the appointment occurs during that telephone call (regardless of the prospective date of the appointment being scheduled); and</text></paragraph>
<paragraph id="HB9FD4183BDC949B3A90BEBE3ECC1D3F4"><enum>(2)</enum><text>provide timely and, where applicable, same-day scheduling for an appointment described in paragraph (1).</text></paragraph></subsection> <subsection id="H0313A860AF2D40209D3B9AFB6346E539"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report on the plan under subsection (a).</text></subsection>
<subsection id="H3A1A55A0C3184E6983263825E0C83D9B"><enum>(c)</enum><header>Covered veteran defined</header><text>In this section, the term <term>covered veteran</term> means a veteran who is enrolled in the system of patient enrollment of the Department under section 1705(a) of title 38, United States Code.</text></subsection></section> <section id="H6F706EA16177432B9D5DDE630A985831"><enum>154.</enum><header>Authorization of appropriations to support initiatives for mobile mammography services for veterans</header><text display-inline="no-display-inline">There is authorized to be appropriated to the Secretary of Veterans Affairs $5,000,000 for fiscal year 2025 for the Office of Women’s Health of the Department of Veterans Affairs under section 7310 of title 38, United States Code, to be used by the Secretary to expand access of women veterans to—</text>
<paragraph id="H4BBB04FB129F4DF893D2898225776E54"><enum>(1)</enum><text>mobile mammography initiatives;</text></paragraph> <paragraph id="H7381F943B98C4A38BB6BF6BFBA001713"><enum>(2)</enum><text>advanced mammography equipment; and</text></paragraph>
<paragraph id="H71CAD11DE88A4CD0BA46A38E66D04FAE"><enum>(3)</enum><text>outreach activities to publicize those initiatives and equipment.</text></paragraph></section></subtitle> <enum>II</enum><header>Economic Opportunity Matters</header> <subtitle id="HDB817516294245D3A60B81D1D3351137"><enum>A</enum><header>Educational Assistance</header> <section section-type="subsequent-section" id="H52C9F9B9087E4C59948BD3A102E386B7" display-inline="no-display-inline"><enum>201.</enum><header>Temporary expansion of eligibility for Marine Gunnery Sergeant John David Fry Scholarship</header> <subsection id="H7CC92977916145E88C8BABDF3528E232"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall treat an individual described in subsection (b) as a covered individual described in section 3311(b) of title 38, United States Code.</text></subsection>
<subsection id="H1BBBB6084A1C4C3DA6F4ADEFF541247E"><enum>(b)</enum><header>Covered individual described</header><text display-inline="yes-display-inline">An individual described in this subsection is an individual who is the child or spouse of a person—</text> <paragraph id="H22098E7F25214AB29CD685F16AB53E7A"><enum>(1)</enum><text>who dies from a service-connected disability during the 120-day period immediately following the day on which the person was discharged or released from duty as a member of the Armed Forces (without regard to whether such duty was active duty); and</text></paragraph>
<paragraph id="HC6685AC37E6E46729B124492D2DE25A3"><enum>(2)</enum>
<subparagraph id="HBD337D5798434BA0B201D118A28E7497" display-inline="yes-display-inline"><enum>(A)</enum><text>who received an honorable discharge; or</text></subparagraph> <subparagraph id="H5BC629EB052A42CFBBC32659939D3A0D" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">whose service in the Armed Forces is characterized by the Secretary concerned as honorable service.</text></subparagraph></paragraph></subsection>
<subsection id="H6F297734E8454684AC9419633934780C"><enum>(c)</enum><header>Applicability</header><text>This section shall apply with respect to—</text> <paragraph id="HE083BB32FC6E4422A52F9F989091E5B5"><enum>(1)</enum><text>deaths that occur before, on, or after the date of the enactment of this Act; and</text></paragraph>
<paragraph id="HC8A654348DE84DCE85D520B373738A6A"><enum>(2)</enum><text display-inline="yes-display-inline">a quarter, semester, or term, as applicable, commencing—</text> <subparagraph id="H44AA8ADD82E0403FA93888F2146522A3"><enum>(A)</enum><text>on or after August 1, 2025; and</text></subparagraph>
<subparagraph id="H661D1F85EAB349B2A463B7BF17BCA94A"><enum>(B)</enum><text>before October 1, 2027.</text></subparagraph></paragraph></subsection></section> <section id="H30CEC303A68F4FA08A3403B494A22C5B"><enum>202.</enum><header>Removal of expiration on entitlement to Marine Gunnery Sergeant John David Fry Scholarship for surviving spouses</header><text display-inline="no-display-inline">Section 3311(f) of title 38, United States Code, is amended—</text>
<paragraph id="H2610168A5BE24E8EBFB90DABA5468E0E"><enum>(1)</enum><text display-inline="yes-display-inline">by striking paragraph (2);</text></paragraph> <paragraph id="H011D2EC2C0BA4938801D8FC6C58836B8"><enum>(2)</enum><text>by redesignating paragraphs (3) through (5) as paragraphs (2) through (4), respectively;</text></paragraph>
<paragraph id="HF03F45418EB1446F85CD51828BC7488A"><enum>(3)</enum><text>in paragraph (2), as redesignated by paragraph (2) of this section, by striking <quote>in paragraph (4)</quote> and inserting <quote>in paragraph (3)</quote>; and</text></paragraph> <paragraph id="HB4FACCD506C646E9846BCA663A926089"><enum>(4)</enum><text>in paragraph (3)(A), as redesignated by paragraph (2) of this section, by striking <quote>under paragraph (3)</quote> and inserting <quote>under paragraph (2)</quote>.</text></paragraph></section>
<section id="H7093C3A13E574E2087DBB1CBC4BFC20E" section-type="subsequent-section"><enum>203.</enum><header>Sole liability for transferred educational assistance by an individual who fails to complete a service agreement</header><text display-inline="no-display-inline">Subsection (i) of section 3319 of title 38, United States Code, is amended—</text> <paragraph id="H4A8750A03C2845B4839D08EAF2689364"><enum>(1)</enum><text display-inline="yes-display-inline">in paragraph (1)—</text>
<subparagraph id="H872131697B4A4B8CA44340BD219C18FC"><enum>(A)</enum><text>by striking <quote>In the event</quote> and inserting <quote>Subject to paragraph (2), in the event</quote>; and</text></subparagraph> <subparagraph id="HEB4F7E1ABD274ACBB387408D2F81E511"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting <quote>of this title</quote> after <quote>section 3685</quote>;</text></subparagraph></paragraph>
<paragraph id="HB8A2B9E80F934E94BBC6584BA96BB32F"><enum>(2)</enum><text display-inline="yes-display-inline">in subparagraph (A) of paragraph (2)—</text> <subparagraph id="HDA2D399600BB4E5DB024FE237C8BFF4C"><enum>(A)</enum><text display-inline="yes-display-inline">in the heading, by striking <quote><header-in-text level="subparagraph" style="USC">In general</header-in-text></quote> and inserting <quote><header-in-text level="subparagraph" style="USC">Sole liability</header-in-text></quote>; and</text></subparagraph>
<subparagraph id="H5E78A4B5934547FCA46A7DEABC583713"><enum>(B)</enum><text>by striking <quote>under paragraph (1)</quote> and inserting <quote>for which the individual shall be solely liable to the United States for the amount of the overpayment for purposes of section 3685 of this title</quote>; and</text></subparagraph></paragraph> <paragraph id="H4F8EC6899D4747FB8EEBE99058E4F5BD"><enum>(3)</enum><text display-inline="yes-display-inline">in subparagraph (B) of paragraph (2)—</text>
<subparagraph id="HCA5DFD51F7644D468BDEB8D829764524"><enum>(A)</enum><text>in the matter preceding clause (i), by striking <quote>Subparagraph (A) shall not apply</quote> and inserting <quote>Neither the individual nor the dependent shall be liable to the United States for the amount of the overpayment for purposes of section 3685 of this title</quote>; and</text></subparagraph> <subparagraph id="H4FD3E56D3C014CB4AED4FFBED29773D8"><enum>(B)</enum><text display-inline="yes-display-inline">in clause (ii), by inserting <quote>of this title</quote> after <quote>section 3311(c)(4)</quote>.</text></subparagraph></paragraph></section>
<section id="H8073CB92901E494886DC015C8DB96AE9"><enum>204.</enum><header>Notice to educational institutions of risk-based surveys</header><text display-inline="no-display-inline">Section 3673A(d) of title 38, United States Code, is amended by striking <quote>one business day</quote> and inserting <quote>two business days</quote>.</text></section> <section id="H65CBA533FF044C80B22197E0D48EA75F" commented="no"><enum>205.</enum><header>Relationship of participation by an educational institution in certain Federal student financial aid programs to approval of such institution for purposes of Department of Veterans Affairs educational assistance programs</header><text display-inline="no-display-inline">Paragraph (4) of section 3675(b) of title 38, United States Code, is amended to read as follows:</text>
<quoted-block style="USC" id="H4DC585D6E57D4256A662F56EA0796F86" display-inline="no-display-inline">
<paragraph id="H528CC4720B7C44D5A1DB1590C8DC13A5" commented="no"><enum>(4)</enum><text display-inline="yes-display-inline">The educational institution—</text> <subparagraph id="H868B00DA8EDD4A83950643E9654F5181" commented="no"><enum>(A)</enum><text>is approved and participates in a program under title IV of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1070">20 U.S.C. 1070 et seq.</external-xref>); or</text></subparagraph>
<subparagraph id="HF667FDFFC757401091B9FF918B7AE8F0" commented="no"><enum>(B)</enum><text>does not participate in such a program and the Secretary has waived the requirement under this paragraph with respect to the educational institution, and submits to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives notice of such waiver, because the Secretary determines that the educational institution—</text> <clause id="H9B6E708C81A141DDA7CB06B87375CC10" commented="no"><enum>(i)</enum><text display-inline="yes-display-inline">elects not to participate in such a program;</text></clause>
<clause id="H5D311E4FD5824691BCB7D696F17C0B84" commented="no"><enum>(ii)</enum><text>cannot participate in such a program; or</text></clause> <clause id="HEC74A7C8E82040EBA2E77EC52842CA62" commented="no"><enum>(iii)</enum><text>is in the process of making a good-faith effort to submit an initial application for approval to participate in such a program, except that a waiver under this clause may not be provided for a period of longer than 36 months.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="H44A6227E39F54D5AB8E2629B0434275E"><enum>206.</enum><header>Expansion of Department of Veterans Affairs oversight of certain educational institutions</header>
<subsection id="HE3D7F31420D14EADAA60C1C623B8F775"><enum>(a)</enum><header>Additional requirement for approval</header><text display-inline="yes-display-inline">Section 3675(b) of title 38, United States Code, as amended by section 205, is further amended by adding at the end the following new paragraph: </text> <quoted-block style="USC" id="H7BF97DAFAB6145AABDDEA3DF2F381614" display-inline="no-display-inline"> <paragraph id="HC268847F33E843C0887F0F7B5345DA6F"><enum>(5)</enum><text display-inline="yes-display-inline">The educational institution agrees to, not later than 30 days after any date on which such educational institution becomes subject to an action or event described in section 3673(e)(3) of this title, submit to the State approving agency, or the Secretary when acting in the role of a State approving agency, a notification of such action or event in such form and containing such information as the Secretary determines appropriate.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HF2F71188D8684D1DA9507989CBF0D411"><enum>(b)</enum><header>Additional requirement for approval of nonaccredited courses</header>
<paragraph id="H3C35160CAE8644ACA479E4FAAF85D436"><enum>(1)</enum><header>In general</header><text>Section 3676(c) of such title is amended—</text> <subparagraph id="HF6714F9A5A8240178B883020706EF92B"><enum>(A)</enum><text>by redesignating paragraphs (14) through (16) as paragraphs (15) through (17), respectively; and</text></subparagraph>
<subparagraph id="H9433F0B6B8C3402B807F58E4A44AF061"><enum>(B)</enum><text>by inserting after paragraph (13) the following new paragraph:</text> <quoted-block style="USC" id="H58ADA5128F424985A46FD161AB78444C" display-inline="no-display-inline"> <paragraph id="HE7D3E8410A954A8CBA0B59EAA5A07A32"><enum>(14)</enum><text display-inline="yes-display-inline">The institution agrees to, not later than 30 days after any date on which such institution becomes subject to an action or event described in section 3673(e)(3) of this title, submit to the State approving agency, or the Secretary when acting in the role of a State approving agency, a notification of such action or event in such form and containing such information as the Secretary determines appropriate.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="HA3560A449E42410D90A0CCB6CCBAA3AE"><enum>(2)</enum><header>Conforming amendments</header><text display-inline="yes-display-inline">Such title is further amended—</text> <subparagraph id="HA86A5ED03CEC48E189F36BCB3C3E8B3F"><enum>(A)</enum><text>in section 3672(b)(2)(C), by striking <quote>paragraph (14) or (15)</quote> and inserting <quote>paragraph (15) or (16)</quote>;</text></subparagraph>
<subparagraph id="H6399987316034F4C9A55EA84C0D7D132"><enum>(B)</enum><text>in section 3675(b)(3), by striking <quote>(14), (15), and (16)</quote> and inserting <quote>(15), (16), and (17)</quote>;</text></subparagraph> <subparagraph id="HFD0B09045EE044F38B190B8722A217B5"><enum>(C)</enum><text>in section 3679(d), by striking <quote>described in paragraph (14) or (15)</quote> and inserting <quote>described in paragraph (15) or (16)</quote>; and</text></subparagraph>
<subparagraph id="H619D2581747743D3B7024E4194E97B80"><enum>(D)</enum><text>in section 3680A(a)(4)(C)(iii), by striking <quote>section 3676(c)(14) and (15)</quote> and inserting <quote>section 3676(c)(15) and (16)</quote>.</text></subparagraph></paragraph></subsection> <subsection id="H67035DD4781544D9BDF5688BD9E33ECC"><enum>(c)</enum><header>Additional grounds for suspension of approval</header><text>Section 3679(f)(1) of such title is amended by adding at the end the following new subparagraph:</text>
<quoted-block style="USC" id="HB911BF707C5547358CFD74C2C7425311" display-inline="no-display-inline">
<subparagraph id="H0F4EBEB8587042DB8402DCD87555AC01" indent="up1"><enum>(I)</enum><text display-inline="yes-display-inline">Comply with the notification requirements under sections 3675(b)(5) and 3676(c)(14) of this title, when applicable.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H24CE7CE90B3E4E58874112EFBA6FD159"><enum>(d)</enum><header>Deadline for risk-based surveys database</header><text>The Secretary of Veterans Affairs shall establish the database required under section 3673A(c) of title 38, United States Code, by not later than 180 days after the date of the enactment of this Act. </text></subsection></section>
<section id="HF241DE8FE9B54F6E8F06805BD0473982" section-type="subsequent-section"><enum>207.</enum><header>Requirement that educational institutions approved for purposes of Department of Veterans Affairs educational assistance programs provide digital official transcripts</header>
<subsection id="H9695EB8867104BF5AB178CD6E7A316ED"><enum>(a)</enum><header>Requirement</header><text display-inline="yes-display-inline">Section 3675(b) of title 38, United States Code, as amended by sections 205 and 206, is further amended by adding at the end the following new paragraph:</text> <quoted-block style="USC" id="HC62B8D767C144A2B8C318F5E5658BD1A" display-inline="no-display-inline"> <paragraph id="H2D43987801B74F44A0DFA1FD7EA8D2F6"><enum>(6)</enum><text display-inline="yes-display-inline">The educational institution makes available to each eligible person or veteran a copy of the person or veteran’s official transcript in a digital format.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H76346A790CCA4627B3093951C7FE9A9E"><enum>(b)</enum><header>Conforming amendments</header>
<paragraph id="H9DA9BF6A58EF46A3B3E4E31CE2A25F0E"><enum>(1)</enum><header>Approval of courses</header><text>Section 3672(b)(2)(A) of such title is amended by striking <quote>(b)(1) and (b)(2)</quote> and inserting <quote>paragraphs (1), (2), and (6) of section 3675(b)</quote>.</text></paragraph> <paragraph id="H4F00F7BEFB96411AAFAD702E7077552B" commented="no"><enum>(2)</enum><header>Approval of nonaccredited courses</header><text>Section 3676(c) of such title is amended—</text>
<subparagraph id="HDB128FA4B020405F83EFD3F02A1B4CD9" commented="no"><enum>(A)</enum><text>by redesignating paragraph (17) as paragraph (18); and</text></subparagraph> <subparagraph id="H130A4D5D44184073ABDA560143E1D147" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">by inserting after paragraph (16) the following new paragraph (17):</text>
<quoted-block style="USC" id="HCBCCE101513F4A2291383BD8705991A3" display-inline="no-display-inline">
<paragraph id="H7F6E0019CBB641538EBB79C9D832DBDA" commented="no"><enum>(17)</enum><text display-inline="yes-display-inline">In the case of a course that leads to a standard college degree, the educational institution satisfies the requirements of section 3675(b)(6) of this title.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H1144E3161B434096B745B2723CEC1387"><enum>(3)</enum><header>Conforming amendments</header><text>Section 3675(b)(3) of such title is amended by striking <quote>(15), (16), and (17)</quote> and inserting <quote>(15), (16), and (18)</quote>.</text></paragraph></subsection>
<subsection id="HE4CF941004B1432DA094D196BBFCC330" commented="no"><enum>(c)</enum><header>Effective date</header><text display-inline="yes-display-inline">The amendments made by this section shall take effect on August 1, 2025, and apply with respect to a quarter, semester, or term, as applicable, commencing on or after such date.</text></subsection></section> <section id="H290FC4CCCB94496EA9BC6CD0D5E9E7C6" section-type="subsequent-section"><enum>208.</enum><header>Payment of full monthly housing stipend for veterans enrolled in final semester using educational assistance under Post-9/11 Educational Assistance Program</header> <subsection id="HA4730E9B8DE1400C9C28F6E55A9CF0CB"><enum>(a)</enum><header>Housing allowance</header><text display-inline="yes-display-inline">Section 3680(a)(3) of title 38, United States Code, is amended—</text>
<paragraph id="H23070386D7A84F429E5105CBC1BC24A5"><enum>(1)</enum><text display-inline="yes-display-inline">by redesignating subparagraphs (A) and (B) as clauses (i) and (ii), respectively (and by redesignating each subordinate provision and the margins thereof accordingly);</text></paragraph> <paragraph id="H18602967E02143DDBD0922D5F91679CF"><enum>(2)</enum><text>by striking <quote>Notwithstanding paragraph (1)</quote> and inserting <quote>(A) Notwithstanding paragraph (1)</quote>;</text></paragraph>
<paragraph id="H68C6788395F6494A94A0CE350666F20C"><enum>(3)</enum><text>by striking <quote>, including a monthly housing stipend described in section 3313(c) of this title,</quote>; and</text></paragraph> <paragraph id="H384F7A9107D34168AFE13EE1B87985D2"><enum>(4)</enum><text>by adding at the end the following new subparagraph (B):</text>
<quoted-block style="USC" id="H628FCFA2CBA0455481BA95B757E55449" display-inline="no-display-inline">
<subparagraph id="H6C803AB94AC14B11BF8C80F1088BCB71" indent="up2"><enum>(B)</enum><text display-inline="yes-display-inline">For purposes of providing a monthly housing stipend described in section 3313(c) to an eligible veteran or eligible person for whom the Secretary is providing educational assistance under chapter 33 of this title during a period that is the last semester, term, or academic period pursuant to subparagraph (A), the Secretary shall treat the veteran or person as pursuing a program of education on a full-time basis.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H9486A5DB89704A2B95CF3E483521EB3D" commented="no"><enum>(b)</enum><header>Application</header><text display-inline="yes-display-inline">The amendments made by subsection (a) shall take effect on the date of the enactment of this Act and apply with respect to a quarter, semester, or term, as applicable, commencing on or after January 1, 2025.</text></subsection></section>
<section section-type="subsequent-section" id="H6AF8EB0EABD144CEBFB08CD73EB8F17B" display-inline="no-display-inline"><enum>209.</enum><header>Modification of rules for approval of commercial driver education programs for purposes of educational assistance programs of the Department of Veterans Affairs</header>
<subsection id="H4F7D4898261043598766EA2FC62FF823"><enum>(a)</enum><header>In general</header><text>Section 3680A(e) of title 38, United States Code, is amended—</text> <paragraph id="HE209C749394A419E8393950D0CC80B00"><enum>(1)</enum><text>by redesignating paragraphs (1) through (3) as subparagraphs (A) though (C), respectively;</text></paragraph>
<paragraph id="H98491514A402461E961A55C5A33CECD0"><enum>(2)</enum><text>in the matter before subparagraph (A), as redesignated by paragraph (1), by inserting <quote><header-in-text level="paragraph" style="USC"><enum-in-header>(1)</enum-in-header></header-in-text></quote> before <quote>The Secretary</quote>;</text></paragraph> <paragraph id="H7682D42CE2DB433A9521EF5571683433"><enum>(3)</enum><text>in paragraph (1)(B), as redesignated by paragraph (1), by inserting <quote>except as provided in paragraph (2),</quote> before <quote>the course</quote>; and</text></paragraph>
<paragraph id="HA60AF61D80AA4210B29A8D19A0803DCC"><enum>(4)</enum><text>by adding at the end the following new paragraph (2):</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H7B63936D4FE048C2B2A56BFE79D0EF4C"> <paragraph id="HAF725D6E0C60473A9079DB7DD2BAE759" indent="up1"><enum>(2)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="H960B6ADCF35842E79A4506309B3FB57F"><enum>(A)</enum><text>Subject to this paragraph, a commercial driver education program is exempt from paragraph (1)(B) for a branch of an educational institution if the commercial driver education program offered at the branch by the educational institution—</text>
<clause id="HE67B252AD2854EC59352D12F3854DBEE" indent="up1"><enum>(i)</enum><text>is appropriately licensed; and</text></clause> <clause id="HD03296D2BAA8465C9CD764463012AE70" indent="up1" commented="no" display-inline="no-display-inline"><enum>(ii)</enum> <subclause id="H9854ED3D3A924B08813EF4FED3A49BF9" commented="no" display-inline="yes-display-inline"><enum>(I)</enum><text>the branch is located in a State in which the same commercial driver education program is offered by the same educational institution at another branch of that educational institution in the same State that is approved for purposes of this chapter by a State approving agency or the Secretary when acting in the role of a State approving agency; or</text></subclause>
<subclause id="H0C7EE949450141D9AA866810B9BB016D" indent="up1" commented="no" display-inline="no-display-inline"><enum>(II)</enum>
<item id="HC0A6BACE80B54967ABFF54635E7977D6" commented="no" display-inline="yes-display-inline"><enum>(aa)</enum><text>the branch is located in a State in which the same commercial driver education program is not offered at another branch of the same educational institution in the same State; and</text></item> <item id="HB17E1B55CDF04192B2169156F84D1222" indent="up1" commented="no" display-inline="no-display-inline"><enum>(bb)</enum><text>the branch has been operating for a period of at least one year using the same curriculum as a commercial driver education program offered by the educational institution at another location that is approved for purposes of this chapter by a State approving agency or the Secretary when acting in the role of a State approving agency.</text></item></subclause></clause></subparagraph>
<subparagraph indent="up1" id="H1AC828AE7F4945FAB44780D532E38E77"><enum>(B)</enum>
<clause commented="no" display-inline="yes-display-inline" id="H035730BEAFC44086A52A9EACCEF2D431"><enum>(i)</enum><text>In order for a commercial driver education program of an educational institution offered at a branch described in paragraph (1)(B) to be exempt under subparagraph (A) of this paragraph, the educational institution shall submit to the Secretary each year that paragraph (1)(B) would otherwise apply a report that demonstrates that the curriculum at the new branch is the same as the curriculum at the primary location.</text></clause> <clause indent="up1" id="HAEBE7062E94F4D60A1C83B127556526A"><enum>(ii)</enum><text>Reporting under clause (i) shall be submitted in accordance with such requirements as the Secretary shall establish in consultation with the State approving agencies.</text></clause></subparagraph>
<subparagraph indent="up1" id="H99E6A83BCAE74C89A6180DD10F6BDFFC"><enum>(C)</enum>
<clause commented="no" display-inline="yes-display-inline" id="HA4D8F469496C43B5BF7DA82ECCAA2D2E"><enum>(i)</enum><text>The Secretary may withhold an exemption under subparagraph (A) for any educational institution or branch of an educational institution as the Secretary considers appropriate.</text></clause> <clause id="HA2B248A4ECB6465BBFDF177E97CC395B" indent="up1"><enum>(ii)</enum><text>In making any determination under clause (i), the Secretary may consult with the Secretary of Transportation on the performance of a provider of a commercial driver program, including the status of the provider within the Training Provider Registry of the Federal Motor Carrier Safety Administration when appropriate.</text></clause></subparagraph>
<subparagraph id="HC56951B72A4741B7BDE1A2BC4F758189" indent="up1"><enum>(D)</enum><text>The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a notification not later than 30 days after the Secretary grants an exemption under this paragraph. Such notification shall identify the educational institution and branch of such educational institution granted such exemption.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H8923CFB8154946DC89416ADEFC38908E"><enum>(b)</enum><header>Implementation</header> <paragraph id="HE03C2DED74A64C67B5F74B86C6C46952"><enum>(1)</enum><header>Establishment of requirements</header><text>Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish requirements under section 3680A(e)(2)(B)(ii) of such title, as added by subsection (a).</text></paragraph>
<paragraph id="H8FCC5DB26BDA4F08B5EA4CDAD8C95C0C" display-inline="no-display-inline"><enum>(2)</enum><header>Rulemaking</header><text>In promulgating any rules to carry out paragraph (2) of section 3680A(e) of title 38, United States Code, as added by subsection (a), the Secretary of Veterans Affairs shall consult with State approving agencies.</text></paragraph> <paragraph id="HE16067F3719E4CA894F4C0B733280730"><enum>(3)</enum><header>Applicability</header><text>The amendments made by subsection (a) shall apply to commercial driver education programs on and after the day that is 365 days after the date on which the Secretary establishes the requirements under paragraph (1) of this subsection.</text></paragraph></subsection>
<subsection id="HED54A226F5E241A4A99B873FD1687F63"><enum>(c)</enum><header>Comptroller General of the United States Study</header><text display-inline="yes-display-inline">Not later than 365 days after the date of the enactment of this Act, the Comptroller General of the United States shall—</text> <paragraph id="HFDFCAD1C3AE24873BDD2BF5B5021EDD4"><enum>(1)</enum><text display-inline="yes-display-inline">conduct a study to—</text>
<subparagraph id="H83C414A0B1FF41AFA08FFB945B014A09"><enum>(A)</enum><text>ascertain the effects of the amendments made by subsection (a); and</text></subparagraph> <subparagraph id="HD9C4E687AE1E4B98BABEDA0D232232F9"><enum>(B)</enum><text display-inline="yes-display-inline">the feasibility and advisability of similarly amending the rules for approval of programs of education for other vocational programs of education; and</text></subparagraph></paragraph>
<paragraph id="H4C4597CF7F9B4BF8825530278FEC4BEF"><enum>(2)</enum><text display-inline="yes-display-inline">submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the findings of the Comptroller General with respect to such study.</text></paragraph></subsection></section> <section id="H28BDEE7001D346A69BAA75AB8A3BCCF4"><enum>210.</enum><header>Provision of certificates of eligibility and award letters using electronic means</header> <subsection id="H38AD8E9413AD4BCBB30430421EAC54B7"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/36">Chapter 36</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/3698">section 3698</external-xref> the following new section (and conforming the table of sections at the beginning of such chapter accordingly):</text>
<quoted-block id="HD2A5D4A45DC54ACBBEAD9CAFC680B09F" style="USC">
<section id="H244A6F9E71194EED94F352D9F336D01D"><enum>3698A.</enum><header>Provision of certificates of eligibility and award letters using electronic means</header>
<subsection id="H3B2C18A9898843DB8D69D0FC830ADA3F"><enum>(a)</enum><header>Requirement</header><text>Except as provided by subsection (b), the Secretary shall provide to an individual the following documents using electronic means:</text> <paragraph id="HA80CC86C60A34085856FEB8C3975ECA8"><enum>(1)</enum><text>A certificate of eligibility for the entitlement of the individual to covered educational assistance.</text></paragraph>
<paragraph id="H2C81C9DE67FE47F88D953CCBF8C83212"><enum>(2)</enum><text>An award letter regarding the authorization of the individual to receive covered educational assistance.</text></paragraph></subsection> <subsection id="HDCDFB65F950C4B36A606E3D83FBCAD8C"><enum>(b)</enum><header>Election to opt out</header><text>An individual may elect to receive the documents specified in subsection (a) by mail rather than through electronic means under subsection (a). An individual may revoke such an election at any time, by means prescribed by the Secretary.</text></subsection>
<subsection id="H5711E88C9341403FA53BEF7769D4832B"><enum>(c)</enum><header>Covered educational assistance</header><text display-inline="yes-display-inline">In this section, the term <quote>covered educational assistance</quote> means educational assistance under chapter 30, 33, or 35 of this title, or section 3699C of this title.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HB766E12402054D9DA342EC291952AE79"><enum>(b)</enum><header>Clerical amendment</header><text display-inline="yes-display-inline">The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 3698 the following new item:</text>
<quoted-block style="USC" id="H2DE4ED4B60C048FD9CDEB696BB722971" display-inline="no-display-inline">
<toc regeneration="no-regeneration">
<toc-entry level="section">3698A. Provision of certificates of eligibility and award letters using electronic means.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="HAAC6A912FFC747D5AE7569B71362BEFC"><enum>211.</enum><header>Retroactive effective date of law regarding charge to entitlement to educational assistance for individuals who do not transfer credits from certain closed or disapproved programs of education</header><text display-inline="no-display-inline">Section 3699(c)(2) of title 38, United States Code, is amended by striking subparagraph (C) and inserting the following new subparagraph (C):</text> <quoted-block style="USC" id="HF8D2BFEEF36149968CC8DD00E557F29D" display-inline="no-display-inline"> <subparagraph id="H788DD9B4D8D04055936506848CE9F274" indent="up2"><enum>(C)</enum><text display-inline="yes-display-inline">This paragraph, including clauses (ii) and (iii) of subparagraph (A), shall apply with respect to the closure or discontinuation of a course or program of education, as described in subsection (b)(1), that occurs during the period beginning on August 1, 2021, and ending on September 30, 2025.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="H8A51E5FA5A624E11AD23301C083275D4"><enum>212.</enum><header>Department of Veterans Affairs high technology program</header>
<subsection id="H6EEE8D81AAB34F7F86472593FFB1C09C"><enum>(a)</enum><header>High technology program</header>
<paragraph id="H7F524C87BE6C46AEAA406CF5E00A7E96"><enum>(1)</enum><header>In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/36">Chapter 36</external-xref> of title 38, United States Code, as amended by section 210, is amended by adding at the end the following new section:</text> <quoted-block style="USC" id="H5A2B0A9223B84C84B513758D9FB2685C" display-inline="no-display-inline"> <section id="H5BE851F3D1014376A73E8A94F23BAF9E"><enum>3699C.</enum><header>High technology program </header> <subsection id="HD7AA1368D7A345A786BE50E02AC37825"><enum>(a)</enum><header>Establishment</header> <paragraph commented="no" display-inline="yes-display-inline" id="H4561A831EF754ED5922F995FCEDF6AAC"><enum>(1)</enum><text>The Secretary shall carry out a program under which the Secretary provides covered individuals with the opportunity to enroll in high technology programs of education that the Secretary determines provide training or skills sought by employers in a relevant field or industry.</text></paragraph>
<paragraph id="HDB3E0ECE45A040CA9799531D400928CE" indent="up1"><enum>(2)</enum><text>Not more than 4,000 covered individuals may participate in the program under this section in any fiscal year.</text></paragraph></subsection> <subsection id="H0EA91903C16948B78EA8BE3886E98E05"><enum>(b)</enum><header>Amount of assistance</header> <paragraph commented="no" display-inline="yes-display-inline" id="H4094C91E99AB4D9EB753CEE68F66C96A"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary shall provide, to each covered individual who pursues a high technology program of education under this section, educational assistance in amounts equal to the amounts provided under section 3313(c)(1) of this title, including, except as provided in paragraph (3), with respect to the housing stipend described in that section and in accordance with the treatment of programs that are distance learning and programs that are less than half-time. </text></paragraph>
<paragraph id="H109CC140D2DF4E8CB7E8285B0869E559" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">Under paragraph (1), the Secretary shall provide such amounts of educational assistance to a covered individual for each of the following:</text> <subparagraph id="H816725CEDBB04D3DA5DBD2CA1943AF15"><enum>(A)</enum><text>A high technology program of education.</text></subparagraph>
<subparagraph id="H6C4E2DB6264841BEA5B9D3FD76F971AB"><enum>(B)</enum><text>A second such program if—</text> <clause id="HB98AAE3B1F324060BB3BF9223F8FC3EF"><enum>(i)</enum><text>the second such program begins at least 18 months after the covered individual graduates from the first such program; and</text></clause>
<clause id="HFB1BF10F0B0641EFB464AE93F59E243E"><enum>(ii)</enum><text display-inline="yes-display-inline">the covered individual uses educational assistance under chapter 33 of this title to pursue the second such program.</text></clause></subparagraph></paragraph> <paragraph id="H886037856DE9404597AD236564B0E31A" indent="up1"><enum>(3)</enum><text>No covered individual may receive a housing stipend under this subsection for any month if such individual is in receipt of a housing stipend under chapter 33 of this title for that month.</text></paragraph></subsection>
<subsection id="H1AA4F34A76D84D1FA93AEF760C72F167"><enum>(c)</enum><header>Contracts</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H91473001E73F47779DFA3291C4432A85"><enum>(1)</enum><text display-inline="yes-display-inline">For purposes of carrying out subsection (a), the Secretary shall seek to enter into contracts with any number of qualified providers of high technology programs of education for the provision of such programs to covered individuals. Each such contract shall provide for the conditions under which the Secretary may terminate the contract with the provider and the procedures for providing for the graduation of students who were enrolled in a program provided by such provider in the case of such a termination.</text></paragraph> <paragraph id="HABF5F1468371477E99B0257224989E58" indent="up1"><enum>(2)</enum><text>A contract under this subsection shall provide that the Secretary shall pay to a provider—</text>
<subparagraph id="HFB7CC624F4054A2A8CB4DA1297ABD8DF"><enum>(A)</enum><text>upon the enrollment of a covered individual in the program, 25 percent of the cost of the tuition and other fees for the program of education for the individual;</text></subparagraph> <subparagraph id="H936B7BB0F4D64D56A77EC7C88E23A506"><enum>(B)</enum><text>upon graduation of the individual from the program, 25 percent of such cost; and</text></subparagraph>
<subparagraph id="HA166B3CDBF5F4591BABA66CAC56F4756"><enum>(C)</enum><text>50 percent of such cost upon—</text> <clause id="H558654E422904B87A1C4639AA7948059"><enum>(i)</enum><text display-inline="yes-display-inline">the successful employment of the covered individual for a period—</text>
<subclause id="H3E0524610CFD4DA2B890FB4500544E69"><enum>(I)</enum><text>of 180 days in the field of study of the program; and</text></subclause> <subclause id="H9278F25B64BD4C57BBEDDF0185347B64"><enum>(II)</enum><text display-inline="yes-display-inline">that begins not later than 180 days following graduation of the covered individual from the program;</text></subclause></clause>
<clause id="H03085BB465924D25BD3CC4694F61A219"><enum>(ii)</enum><text>the employment of the individual by the provider for a period of one year; or</text></clause> <clause id="H87A8EF0E0DAB4B508C0F1FF7EB58EAA5"><enum>(iii)</enum><text display-inline="yes-display-inline">the enrollment of the individual in a program of education to continue education in such field of study.</text></clause></subparagraph></paragraph>
<paragraph id="HC495BD48DFC14DC19BF845A933A176FF" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">For purposes of this section, a provider of a high technology program of education is qualified if—</text> <subparagraph id="H3D20BF3A257E447692A3CA3F0B3814D9"><enum>(A)</enum><text>the provider employs instructors whom the Secretary determines are experts in their respective fields in accordance with paragraph (5);</text></subparagraph>
<subparagraph id="H478B3FEC8A8945F8A2385EB1EAFCF88D"><enum>(B)</enum><text>the provider has successfully provided the high technology program for at least one year;</text></subparagraph> <subparagraph id="H272380B49753466685F083C623DA6401" commented="no"><enum>(C)</enum><text>the provider does not charge tuition and fees to a covered individual who receives assistance under this section to pursue such program that are higher than the tuition and fees charged by such provider to another individual; and</text></subparagraph>
<subparagraph id="H00BAE68C20E84247A97F6A55D8D57090"><enum>(D)</enum><text>the provider meets the approval criteria developed by the Secretary under paragraph (4).</text></subparagraph></paragraph> <paragraph id="HD7266E675F7E4ABDB7D82151483D767B" indent="up1"><enum>(4)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="H6AC1CBCE1C5B452B997789A5479EC6E6"><enum>(A)</enum><text>The Secretary shall prescribe criteria for approving providers of a high technology program of education under this section.</text></subparagraph>
<subparagraph id="HBA8D789B86464EF19510AF40B6EBC3DD" indent="up1"><enum>(B)</enum><text>In developing such criteria, the Secretary may consult with State approving agencies.</text></subparagraph> <subparagraph id="H22216B5FFF884FC5A3800E6F399308F1" indent="up1"><enum>(C)</enum><text>Such criteria are not required to meet the requirements of section 3672 of this title.</text></subparagraph>
<subparagraph id="HCB2C2D25A2944CAC9497D00B37321657" indent="up1"><enum>(D)</enum><text display-inline="yes-display-inline">Such criteria shall include the job placement rate, in the field of study of a program of education, of covered individuals who complete such program of education.</text></subparagraph></paragraph> <paragraph id="HDC0D7795F04E4EC8B07081CB8E870B31" indent="up1"><enum>(5)</enum><text>The Secretary shall determine whether instructors are experts under paragraph (3)(A) based on evidence furnished to the Secretary by the provider regarding the ability of the instructors to—</text>
<subparagraph id="HC0E0D5AAC79344329EE55DBBC2FBA8F0"><enum>(A)</enum><text>identify professions in need of new employees to hire, tailor the programs to meet market needs, and identify the employers likely to hire graduates;</text></subparagraph> <subparagraph id="HAB9FE565010D42DB9568E6753221F5AE"><enum>(B)</enum><text>effectively teach the skills offered to covered individuals;</text></subparagraph>
<subparagraph id="HEB52EA27AA7243A7A878EC12C213DE56"><enum>(C)</enum><text display-inline="yes-display-inline">provide relevant industry experience in the fields of programs offered to incoming covered individuals; and</text></subparagraph> <subparagraph id="HC11AFF2EFA7943938BB796639DE2E16F"><enum>(D)</enum><text>demonstrate relevant industry experience in such fields of programs.</text></subparagraph></paragraph>
<paragraph id="HFABD73FD6185466EAB4E92E625EFC650" indent="up1"><enum>(6)</enum><text display-inline="yes-display-inline">In entering into contracts under this subsection, the Secretary shall give preference to a provider of a high technology program of education—</text> <subparagraph id="H58817A88B7A844AB917C1135451BC663"><enum>(A)</enum><text display-inline="yes-display-inline">from which at least 70 percent of graduates find full-time employment in the field of study of the program during the 180-day period beginning on the date the student graduates from the program; or</text></subparagraph>
<subparagraph id="H57115334A2C84FDAB1A2F382261F7A5B"><enum>(B)</enum><text>that offers tuition reimbursement for any student who graduates from such a program and does not find employment described in subparagraph (A).</text></subparagraph></paragraph></subsection> <subsection id="HDDFB6687696D4919B8405C49ACD9EA08" commented="no"><enum>(d)</enum><header>Effect on other entitlement</header> <paragraph commented="no" display-inline="yes-display-inline" id="H57A56C52B1AA49F98E7C67D550C9323F"><enum>(1)</enum><text display-inline="yes-display-inline">If a covered individual enrolled in a high technology program of education under this section has remaining entitlement to educational assistance under chapter 30, 32, 33, 34, or 35 of this title, such entitlement shall be charged at the rate of one month of such entitlement for each month of educational assistance provided under this section.</text></paragraph>
<paragraph id="H6D92E07101854E3DA5C26B90F56F22B0" indent="up1"><enum>(2)</enum><text>If a covered individual enrolled in a high technology program of education under this section does not have remaining entitlement to educational assistance under chapter 30, 32, 33, 34, or 35 of this title, any educational assistance provided to such individual under this section shall be provided in addition to the entitlement that the individual has used.</text></paragraph> <paragraph id="HB9F8FDB2D1A04A4C9C44B8E61998EB77" indent="up1" commented="no"><enum>(3)</enum><text>The Secretary may not consider enrollment in a high technology program of education under this section to be assistance under a provision of law referred to in section 3695 of this title.</text></paragraph>
<paragraph id="H2A9C05BB6B594AAB9EB6672DA19EC712" indent="up1"><enum>(4)</enum>
<subparagraph id="H32CEDEC0C57B4F419BD0EB0070F7DF32" display-inline="yes-display-inline"><enum>(A)</enum><text>An application for enrollment in a high technology program of education under this section shall include notice of the requirements relating to use of entitlement under paragraphs (1) and (2), including—</text> <clause id="H6ECEACB65BCA43879117738092C0825A" indent="up1"><enum>(i)</enum><text display-inline="yes-display-inline">in the case of the enrollment of an individual referred to under paragraph (1), the amount of entitlement that is typically charged for such enrollment;</text></clause>
<clause id="H43794A87E22247EAAFFF7BC8C4BFB9F7" indent="up1"><enum>(ii)</enum><text>an identification of any methods that may be available for minimizing the amount of entitlement required for such enrollment; and</text></clause> <clause id="H998B2DAEFA1B49CA8EC84CAEAA1E930F" indent="up1"><enum>(iii)</enum><text display-inline="yes-display-inline">an element requiring applicants to acknowledge receipt of the notice under this subparagraph.</text></clause></subparagraph>
<subparagraph id="H2B6703FAE17D4F618B037CF2CCC089B9" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">If the Secretary approves the enrollment of a covered individual in a high technology program of education under this section, the Secretary shall deliver electronically to the individual an award letter that provides notice of such approval and includes specific information describing how paragraphs (1) and (2) will be applied to the individual if the individual chooses to enroll in the program.</text></subparagraph></paragraph></subsection> <subsection id="HF1C293E7F0224C988742C2F8CA574007"><enum>(e)</enum><header>Requirements for educational institutions</header> <paragraph commented="no" display-inline="yes-display-inline" id="H5F8D7FB7CE6C4122A4A97F576B369838"><enum>(1)</enum><text display-inline="yes-display-inline">The Secretary shall not approve the enrollment of any covered individual, not already enrolled, in any high technology programs of education under this section for any period during which the Secretary finds that more than 85 percent of the students enrolled in the program are having all or part of their tuition, fees, or other charges paid to or for them by the educational institution or by the Department of Veterans Affairs under this title or under chapter 1606 or 1607 of title 10, except with respect to tuition, fees, or other charges that are paid under a payment plan at an educational institution that the Secretary determines has a history of offering payment plans that are completed not later than 180 days after the end of the applicable term, quarter, or semester.</text></paragraph>
<paragraph id="H592945CD886B42759B05F5B266587615" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">The Secretary may waive a requirement of paragraph (1) if the Secretary determines, pursuant to regulations which the Secretary shall prescribe, such waiver to be in the interest of the covered individual and the Federal Government. Not later than 30 days after the Secretary waives such a requirement, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report regarding such waiver. </text></paragraph> <paragraph id="H3AD29133093F4A1496111D3A601C56BE" indent="up1"><enum>(3)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="H228C0122D70E4007B6FE9E6005056367"><enum>(A)</enum> <clause commented="no" display-inline="yes-display-inline" id="H6DB718D47F174378BAB39954F3E5FF4E"><enum>(i)</enum><text>The Secretary shall establish and maintain a process by which an educational institution may request a review of a determination that the educational institution does not meet the requirements of paragraph (1). </text></clause>
<clause id="HCAF8682D1070455AAD0572809A8F0AE5" indent="up2"><enum>(ii)</enum><text>The Secretary may consult with a State approving agency regarding such process or such a review.</text></clause> <clause id="HF518D8ACAB2F4CAB9678A1547E9EC3DC" indent="up2"><enum>(iii)</enum><text display-inline="yes-display-inline">Not later than 180 days after the Secretary establishes or revises a process under this subparagraph, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report regarding such process.</text></clause></subparagraph>
<subparagraph id="H8C754D4598B343C385447A54303BFC0E" indent="up1"><enum>(B)</enum><text>An educational institution that requests a review under subparagraph (A)—</text> <clause id="H85380324F0D74714B6362D6D5B58AA2F"><enum>(i)</enum><text>shall request the review not later than 30 days after the start of the term, quarter, or semester for which the determination described in subparagraph (A) applies; and</text></clause>
<clause id="HF8F8D01D78044640A63FD56282FED595"><enum>(ii)</enum><text>may include any information that the educational institution believes the Department should have taken into account when making the determination, including with respect to any mitigating circumstances.</text></clause></subparagraph></paragraph></subsection> <subsection id="HC4666160828B4983A4AB93A78A0312D3"><enum>(f)</enum><header>Annual reports</header><text>Not later than one year after the date of the enactment of this section, and annually thereafter until the termination date specified in subsection (i), the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on the operation of program under this section during the year covered by the report. Each such report shall include each of the following:</text>
<paragraph id="HFA0A790A53A94169B59AD0E3B67BA398"><enum>(1)</enum><text display-inline="yes-display-inline">The number of covered individuals enrolled in the program, disaggregated by type of educational institution, during the year covered by the report.</text></paragraph> <paragraph id="H13E1896BB1EC494BBA078155D97C5465"><enum>(2)</enum><text>The number of covered individuals who completed a high technology program of education under the program during the year covered by the report.</text></paragraph>
<paragraph id="HB099F073748449AEB3C65884BC86511C"><enum>(3)</enum><text>The average employment rate of covered individuals who completed such a program of education during such year, as of 180 days after the date of completion.</text></paragraph> <paragraph id="H10455C053E76400F8D6FBE7BCB867209"><enum>(4)</enum><text>The average length of time between the completion of such a program of education and employment.</text></paragraph>
<paragraph id="H8CEE062152114EDB92398FC1554464CC"><enum>(5)</enum><text>The total number of covered individuals who completed a program of education under the program and who, as of the date of the submission of the report, are employed in a position related to technology.</text></paragraph> <paragraph id="H03F5875065BC4212BB695C313F60F9FF"><enum>(6)</enum><text>The average salary of a covered individual who completed a program of education under the program and who is employed in a position related to technology, in various geographic areas determined by the Secretary.</text></paragraph>
<paragraph id="H444337A676EC4DF5BBD09F0ED30A2172"><enum>(7)</enum><text display-inline="yes-display-inline">The average salary of all individuals employed in positions related to technology in the geographic areas determined under subparagraph (F), and the difference, if any, between such average salary and the average salary of a covered individual who completed a program of education under the program and who is employed in a position related to technology.</text></paragraph> <paragraph id="HDC166DA1C41C403C93C35AF038BC7A10"><enum>(8)</enum><text display-inline="yes-display-inline">The number of covered individuals who completed a program of education under the program and who subsequently enrolled in a second program of education under the program.</text></paragraph></subsection>
<subsection id="H53D994D0724442DBABCACEB9ECD829DC"><enum>(g)</enum><header>Collection of information; consultation</header>
<paragraph commented="no" display-inline="yes-display-inline" id="HAFDE5A6F451745DCB154B64412F90F58"><enum>(1)</enum><text>The Secretary shall develop practices to use to collect information about covered individuals and providers of high technology programs of education.</text></paragraph> <paragraph id="HC07F9736439C42068A8451E51B1615E5" indent="up1"><enum>(2)</enum><text>For the purpose of carrying out program under this section, the Secretary may consult with providers of high technology programs of education and may establish an advisory group made up of representatives of such providers, private employers in the technology field, and other relevant groups or entities, as the Secretary determines necessary.</text></paragraph></subsection>
<subsection id="HBEA2625309C24E2F83859862AAD2D19B"><enum>(h)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H8773A6B2576F43AA9E7A828411BD6A70"><enum>(1)</enum><text>The term <term>covered individual</term> means any of the following:</text>
<subparagraph id="H9E2DC433A984429D93B6514710141447"><enum>(A)</enum><text>A veteran whom the Secretary determines—</text> <clause id="HF0B963DAF8884ECFABD766464BAAB8F0"><enum>(i)</enum><text display-inline="yes-display-inline">served an aggregate of at least 36 months on active duty in the Armed Forces (including service on active duty in entry level and skill training) and was discharged or released therefrom under conditions other than dishonorable; and</text></clause>
<clause id="H39922CB7AED74CA99BE639A7E0F29053"><enum>(ii)</enum><text>has not attained the age of 62.</text></clause></subparagraph> <subparagraph id="H9CC4647B008946F2B5FE016296EBAC64"><enum>(B)</enum><text display-inline="yes-display-inline">A member of the Armed Forces that the Secretary determines will become a veteran described in subparagraph (A) fewer than 180 days after the date of such determination.</text></subparagraph></paragraph>
<paragraph id="HEE2597F121204AC3B1FC47FC14B49480"><enum>(2)</enum><text>The term <term>high technology program of education</term> means a program of education—</text> <subparagraph id="H1268904DC9C2424E94844713387C7678" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">offered by a public or private educational institution;</text></subparagraph>
<subparagraph id="HBBB55E88F08446C99380FE52A94ADFAA"><enum>(B)</enum><text display-inline="yes-display-inline">if offered by an institution of higher learning, that is provided directly by such institution rather than by an entity other than such institution under a contract or other agreement;</text></subparagraph> <subparagraph id="H38217792A3AD4C469459FE372CFC6504"><enum>(C)</enum><text>that does not lead to a degree;</text></subparagraph>
<subparagraph id="HFF4B029BB42F43CA9BA4AAFDC07D2BEE"><enum>(D)</enum><text>that has a term of not less than six and not more than 28 weeks; and</text></subparagraph> <subparagraph id="HA5E269B3E0B3467782B49FBCDA40D11F"><enum>(E)</enum><text>that provides instruction in computer programming, computer software, media application, data processing, or information sciences.</text></subparagraph></paragraph></subsection>
<subsection id="HDB55D519681142F1992532D6BF962EB8"><enum>(i)</enum><header>Termination</header><text display-inline="yes-display-inline">The Secretary may not provide educational assistance under this section for a high technology program of education that begins after September 30, 2027.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> <paragraph id="HF7C30F37C56E44A7BD1DB8FCBCCE2DB9"><enum>(2)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 3699B the following new item:</text>
<quoted-block style="USC" id="HA1F2D44E70164AEB825366B6F3E55CD1" display-inline="no-display-inline">
<toc regeneration="no-regeneration">
<toc-entry level="section">3699C. High technology program.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HD7D01F457B444544B6186F7D7453B856"><enum>(b)</enum><header>Effect on high technology pilot program</header><text display-inline="yes-display-inline">Section 116 of the Harry W. Colmery Veterans Educational Assistance Act of 2017 (<external-xref legal-doc="public-law" parsable-cite="pl/115/48">Public Law 115–48</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/3001">38 U.S.C. 3001</external-xref> note) is amended—</text> <paragraph id="HCDDF8218B17B41FBA4E7449980ED2FB4"><enum>(1)</enum><text>by amending subsection (d) to read as follows:</text>
<quoted-block style="OLC" id="H04D9A64F69FF4F5A80667F2EDDA7D1AE" display-inline="no-display-inline">
<subsection id="HD38666CFA11542A986D193B4B70F7704"><enum>(d)</enum><header>Housing stipend</header>
<paragraph id="H30B984D85F1846B2A6ADB11FA1EF0B5F"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Except as provided under paragraph (2), the Secretary shall pay to each eligible veteran (not including an individual described in the second sentence of subsection (b)) who is enrolled in a high technology program of education under the pilot program on a full-time or part-time basis a monthly housing stipend equal to the product—</text> <subparagraph id="HF08664E113CD4249951CCFEB8168FF80"><enum>(A)</enum><text>of—</text>
<clause id="HA4FA641909124897AEAD31018548547C"><enum>(i)</enum><text>in the case of a veteran pursuing resident training, the monthly amount of the basic allowance for housing payable under section 403 of title 37, United States Code, for a member with dependents in pay grade E–5 residing in the military housing area that encompasses all or the majority portion of the ZIP code area in which is located the campus of the institution where the individual physically participates in a majority of classes; or</text></clause> <clause id="H51C5AE39D4B548A7A364F91F3841EA84"><enum>(ii)</enum><text>in the case of a veteran pursuing a program of education through distance learning, a monthly amount equal to 50 percent of the national average of the monthly amount of the basic allowance for housing payable under section 403 of title 37, United States Code, for a member with dependents in pay grade E–5, multiplied by</text></clause></subparagraph>
<subparagraph id="H4942FC5A38734B84B78E0813BA139DAA"><enum>(B)</enum><text>the lesser of—</text> <clause id="H1EC871C1125F411AB169ED4C300D1F13"><enum>(i)</enum><text>1.0; or</text></clause>
<clause id="H3E4263F0638245B0A1C8D8AFF065E934"><enum>(ii)</enum><text>the number of course hours borne by the individual in pursuit of the program of education involved, divided by the minimum number of course hours required for full-time pursuit of such program of education, rounded to the nearest multiple of 10.</text></clause></subparagraph></paragraph> <paragraph id="HB115726EE90A4C3CBCAE2DFA0BA62987"><enum>(2)</enum><header>Bar to dual eligibility</header><text display-inline="yes-display-inline">No covered individual may receive a housing stipend under this subsection for any month if such individual is in receipt of a housing stipend under chapter 33 ot title 38, United States Code, for that month.</text></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph>
<paragraph id="H0D618103032F473FB2F4EC7ECE797035"><enum>(2)</enum><text>in subsection (g), by striking paragraph (6); and</text></paragraph> <paragraph id="H46554CCC4DC74D7CAE56AFBCCFCF93DF"><enum>(3)</enum><text>by striking subsection (h) and inserting the following new subsection (h):</text>
<quoted-block style="OLC" id="H497B6E65AAD94F6790779C626544D112" display-inline="no-display-inline">
<subsection id="H4E4767709612493485341807A3ACF2F1"><enum>(h)</enum><header>Termination</header><text display-inline="yes-display-inline">The Secretary may not, under this section, pay a provider for a high technology program of education that begins after September 30, 2024.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H50A034BC878E433598366C22B09A6A6D"><enum>(c)</enum><header>Approval of certain high technology programs</header><text>Section 3680A of title 38, United States Code, is amended—</text>
<paragraph id="H85599E9D19974C21B08E4E6914321959"><enum>(1)</enum><text>in subsection (a), by striking paragraph (4) and inserting the following:</text> <quoted-block style="USC" id="H09C66E130436418C9E2194330B5AF7E0" display-inline="no-display-inline"> <paragraph id="H5FCEF68BFD924B5B9931388AB13D4E05"><enum>(4)</enum><text display-inline="yes-display-inline">Any independent study program except—</text>
<subparagraph id="H5CC873C8858B4B5E9DAC103B39C982B7"><enum>(A)</enum><text>an independent study program (including such a program taken over open circuit television) that—</text> <clause id="HFFC2685668DC4334BDA209FE035A01C7"><enum>(i)</enum><text>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></clause>
<clause id="HCAFF885FE6A948B898A137C86FFF8323"><enum>(ii)</enum><text>leads to—</text> <subclause id="H1A91BEBFE7FC4E248D3ED624CB6B3F3B"><enum>(I)</enum><text>a standard college degree;</text></subclause>
<subclause id="HF199AF3005814558A848B8F9AC3D0334"><enum>(II)</enum><text>a certificate that reflects educational attainment offered by an institution of higher learning; or</text></subclause> <subclause id="H55A414E2FA1D41A1886050AECD3166B5"><enum>(III)</enum><text>a certificate that reflects graduation from a course of study offered by—</text>
<item id="HB5C3D39949364364BBF6670C3BFA495C"><enum>(aa)</enum><text>an area career and technical education school (as defined in subparagraphs (C) and (D) of section 3(3) of the Carl D. Perkins Career and Technical Education Act of 2006 (<external-xref legal-doc="usc" parsable-cite="usc/20/2302">20 U.S.C. 2302(3)</external-xref>)) that provides education at the postsecondary level; or</text></item> <item id="H7837EFC872DE413CB69575C395EFA0F3"><enum>(bb)</enum><text>a postsecondary vocational institution (as defined in section 102(c) of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1002">20 U.S.C. 1002(c)</external-xref>)) that provides education at the postsecondary level; and</text></item></subclause></clause>
<clause id="HAA9C72B2316847CA99E9DCFA0D46CD5D"><enum>(iii)</enum><text>in the case of a program described in clause (ii)(III)—</text> <subclause id="HF5B7F7072B594A2295D90319739C4751"><enum>(I)</enum><text>provides training aligned with the requirements of employers in the State or local area where the program is located, which may include in-demand industry sectors or occupations;</text></subclause>
<subclause id="HAA63ECCC5A4E41F2A0DCDBC4409CAE48"><enum>(II)</enum><text>provides a student, upon graduation from the program, with a recognized postsecondary credential that is recognized by employers in the relevant industry, which may include a credential recognized by industry or sector partnerships in the State or local area where the industry is located; and</text></subclause> <subclause id="H7105FFAF5EEF4C959BF53357B75E36EE"><enum>(III)</enum><text>meets such content and instructional standards as may be required to comply with the criteria under section 3676(c)(14) and (15) of this title; or</text></subclause></clause></subparagraph>
<subparagraph id="HD153696A712740E2B741192B3FAC571B" commented="no"><enum>(B)</enum><text>an online high technology program of education (as defined in subsection (h)(2) of section 3699C of this title)—</text> <clause id="H0807E869A97D4FA2982268AF0D7B80C6" commented="no"><enum>(i)</enum><text>the provider of which has entered into a contract with the Secretary under subsection (c) of such section;</text></clause>
<clause id="HB6FE8991CD47488B9505F6D6658ACE4F" commented="no"><enum>(ii)</enum><text>that has been provided to covered individuals (as defined in subsection (h)(1) of such section) under such contract for a period of at least five years;</text></clause> <clause id="H4CF2F3992DD74DE0AA1CC4ABB85B8004" commented="no"><enum>(iii)</enum><text>regarding which the Secretary has determined that the average employment rate of covered individuals who graduated from such program of education is 65 percent or higher for the year preceding such determination; and</text></clause>
<clause id="HD40C48F75AD7443C81404955B48A1E26" commented="no"><enum>(iv)</enum><text>that satisfies the requirements of subsection (e) of such section.</text></clause></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph> <paragraph id="HBDDD274A71AD4E19A723D9DAF1F3D406"><enum>(2)</enum><text>in subsection (d), by adding at the end the following:</text>
<quoted-block style="USC" id="HB8A2B02BBAC74E529A287B403B26BE50" display-inline="no-display-inline">
<paragraph id="H15B6E9226F094C72A2738F40610186D6" display-inline="no-display-inline" indent="up1"><enum>(8)</enum><text display-inline="yes-display-inline">Paragraph (1) shall not apply to the enrollment of a veteran in an online high technology program described in subsection (a)(4)(B).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section> <section id="H05A224BF7B4241838B3D8A67DC22AEFF" section-type="subsequent-section"><enum>213.</enum><header>Notice of changes to Department of Veterans Affairs policies and guidance affecting the educational assistance programs of the Department</header> <subsection id="H848D6BE7A58B4CDBBE66CF0139B3F8F2"><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/38/36">chapter 36</external-xref> of title 38, United States Code, as amended by sections 210 and 212, is further amended by adding at the end the following new section:</text>
<quoted-block style="USC" id="HDCD0F744B5EB4BD498822F2A40586412" display-inline="no-display-inline">
<section id="H8121604F241E4DE9ADDF4685FDB08528"><enum>3699D.</enum><header>Notice of changes to policies and guidance relating to educational assistance programs</header><text display-inline="no-display-inline">In the case of any change to any policy or guidance provided by the Secretary that relates to any educational assistance program of the Department, the Secretary may not implement the change before the date that is 90 days after the date on which the Secretary makes available to students, educational institutions, and the Committees on Veterans’ Affairs of the Senate and House of Representatives notice of, and justification for, the change.</text></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HF6955F79EB0F4FA4A40FD1BF2CCA5CC5"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 3699B the following new item:</text>
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<toc regeneration="no-regeneration">
<toc-entry level="section">3699D. Notice of changes to policies and guidance relating to educational assistance programs.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section section-type="subsequent-section" id="H84585CDF96614E3BA8073765FC3502C4"><enum>214.</enum><header>Payment of VA educational assistance via electronic fund transfer to a foreign institution of higher education</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 update the payment system of the Department of Veterans Affairs to allow for electronic fund transfer of educational assistance, administered by the Secretary, to a foreign institution of higher education that—</text> <paragraph id="H27499A60210549DC855B6999B937E1AB"><enum>(1)</enum><text>provides an approved course of education to an eligible recipient of such assistance; and</text></paragraph>
<paragraph id="H20CBAF7A64CE49EF8901DAB4D5F913B8"><enum>(2)</enum><text>does not have—</text> <subparagraph id="H231C0AC4ADEF489796074313CC1AB74C"><enum>(A)</enum><text>an employer identification number; or</text></subparagraph>
<subparagraph id="H4C90735ADBF846289DF3933CE18158C1"><enum>(B)</enum><text>an account with a domestic bank.</text></subparagraph></paragraph></section> <section id="HFBD6EF82A634472D92C5821FE1C3DCB4"><enum>215.</enum><header>Improving transparency and accountability of educational institutions for purposes of veterans educational assistance</header> <subsection id="H3DFE56D5D0204D8695DF1B5DFCF95A33"><enum>(a)</enum><header>Requirement relating to G.I. Bill comparison tool</header> <paragraph id="H6A44FDC9BCDF41CCBA748FB10B60C6E5"><enum>(1)</enum><header>Requirement to maintain tool</header><text>The Secretary of Veterans Affairs shall maintain the G.I. Bill Comparison Tool that was established pursuant to Executive Order 13607 (77 Fed. Reg. 25861; relating to establishing principles of excellence for educational institutions serving service members, veterans, spouses, and other family members) and in effect on the day before the date of enactment of this Act, or a successor tool, to provide relevant and timely information about programs of education approved under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/36">chapter 36</external-xref> of title 38, United States Code, and the educational institutions that offer such programs.</text></paragraph>
<paragraph id="H71A4704AD7E24F11AF71F96560CDD36A"><enum>(2)</enum><header>Data retention</header><text>The Secretary shall ensure that historical data that is reported via the tool maintained under paragraph (1) remains easily and prominently accessible on the benefits.va.gov website, or a successor website, for a period of not less than six years from the date of initial publication.</text></paragraph></subsection> <subsection id="HDF6D0FFF81FC40BCAA0D7565025C8281"><enum>(b)</enum><header>Providing timely and relevant education information to veterans, members of the Armed Forces, and other individuals</header> <paragraph id="H602F2B07402C4A7FB33A3B69FBE56F67"><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, in consultation with the Secretary of Education, the Secretary of the Treasury, and the heads of other relevant Federal agencies, shall make such changes to the tool maintained under subsection (a) as the Secretary of Veterans Affairs determines appropriate to ensure that such tool is an effective and efficient method for providing information pursuant to section 3698(b)(5) of title 38, United States Code.</text></paragraph>
<paragraph id="HFED1F55AA4244D4BAB86BFE860AE0C3C"><enum>(2)</enum><header>Memorandum of understanding required</header><text>Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall seek to enter into a memorandum of understanding with the Secretary of Education and the heads other relevant Federal agencies, as the Secretary of Veterans Affairs determines appropriate, to obtain information on outcomes with respect to individuals who are entitled to educational assistance under the laws administered by the Secretary of Veterans Affairs and who are attending educational institutions. Such memorandum of understanding may include data sharing or computer matching agreements.</text></paragraph> <paragraph id="HAD3B2F2A833B47DE8D6D73D965CC4EF0"><enum>(3)</enum><header>Modification of scope of comprehensive policy on providing education information</header><text>Section 3698 of title 38, United States Code, is amended—</text>
<subparagraph id="HA0EFFD601A734B0AAD39D9AE86F60FAA"><enum>(A)</enum><text>in subsection (a), by striking <quote>veterans and members of the Armed Forces</quote> and inserting <quote>individuals entitled to educational assistance under laws administered by the Secretary of Veterans Affairs</quote>; and</text></subparagraph> <subparagraph id="H7A2002A298C0443593D3243AE1928A2E"><enum>(B)</enum><text>in subsection (b)(5)—</text>
<clause id="H4F896DE1848C44DC86528FC4E1B4A97B"><enum>(i)</enum><text>by striking <quote>veterans and members of the Armed Forces</quote> and inserting <quote>individuals described in subsection (a)</quote>; and</text></clause> <clause id="H362AD47E55D14AB19AD7C7AC6F858494"><enum>(ii)</enum><text>by striking <quote>the veteran or member</quote> and inserting <quote>the individual</quote>.</text></clause></subparagraph></paragraph>
<paragraph id="HF7AB602B20C144369397B3ECD71DD21C"><enum>(4)</enum><header>G.I. Bill comparison tool required disclosures</header><text>Paragraph (1) of subsection (c) of such section is amended—</text> <subparagraph id="H71707C5E4A84468F869CC3C4473DF2F8"><enum>(A)</enum><text>by striking subparagraph (B) and inserting the following:</text>
<quoted-block id="H304D52BAD1594B8A92E24A40D5B17853" style="OLC">
<subparagraph id="H0B57FB89DF0B421189865B01F96ADF1D" indent="up1"><enum>(B)</enum><text>for each individual described in subsection (a) seeking information provided under subsection (b)(5), the name of each Federal student aid program, and a description of each such program, from which the individual may receive educational assistance; and</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph> <subparagraph id="HBD856DAAD25E46D2BEB1F9073448D1CF"><enum>(B)</enum><text>in subparagraph (C)—</text>
<clause id="HBBC2594304CA41FB94013DF5D0055F95"><enum>(i)</enum><text>in clause (i), by inserting <quote>and a definition of each type of institution</quote> before the semicolon;</text></clause> <clause id="H585FC8628CA34CE5B165705CFC86FDD6"><enum>(ii)</enum><text>in clause (iv), by inserting <quote>and if so, which programs</quote> before the semicolon;</text></clause>
<clause id="H4F282DEFAC1C43BB9890CDD0A1E4D218"><enum>(iii)</enum><text>by striking clause (v) and inserting the following:</text> <quoted-block id="HF4870060F0334DDAB85315ECFC32A291" style="OLC"> <clause id="H1838A7BC1F1F4FAFA9A8090A97C3469F" indent="up1"><enum>(v)</enum><text>the average annual cost and the total cost to earn an associate’s degree and a bachelor’s degree, with available cost information on any other degree or credential the institution awards;</text></clause><after-quoted-block>;</after-quoted-block></quoted-block></clause>
<clause id="HB3AB1CE8127F408BA68AB50E3DA4481D"><enum>(iv)</enum><text display-inline="yes-display-inline">in clause (vi), by inserting before the semicolon the following:</text> <quoted-block style="OLC" id="H7DB34C9EC6654E71A29EC3FA5B61B0E2" display-inline="yes-display-inline"><text display-inline="yes-display-inline">disaggregated by—</text>
<subclause id="H6063F1682F394DC4A82E7297D6B80F94" indent="up1"><enum>(I)</enum><text>the type of beneficiary of educational assistance;</text></subclause> <subclause id="HDA790487FF0F4BA0B4ED6B9BC95B34B8" indent="up1"><enum>(II)</enum><text>individuals who received a credential and individuals who did not; and</text></subclause>
<subclause id="HFA3968C756374E6D9CF48700DDAA48CE" indent="up1"><enum>(II)</enum><text>individuals using educational assistance under laws administered by the Secretary and individuals who are not;</text></subclause><after-quoted-block>;</after-quoted-block></quoted-block></clause> <clause id="H278E917D8F8B450CB5C1E3DEF0FC26A3"><enum>(v)</enum><text>in clause (xiv), by striking <quote>and</quote> at the end; </text></clause>
<clause id="H924B1E17603D46469DCC586B34AE1B84"><enum>(vi)</enum><text>in clause (xv), by striking the period at the end and inserting a semicolon; and</text></clause> <clause id="H8CADA13ABF894C41AC3D2F9035AB9D8E"><enum>(vii)</enum><text>by adding at the end the following new clauses:</text>
<quoted-block id="HAAD90EBFD9824DBB9CE9728441480E7B" style="OLC">
<clause id="H8E759E17D07E492891B9B66E405BA7D8" indent="up1"><enum>(xvi)</enum><text>the number of veterans or members who completed covered education at the institution leading to—</text> <subclause id="HAAB7129207774345BAE452CBE7C635D1"><enum>(I)</enum><text>a degree, disaggregated by type of program, including—</text>
<item id="H515B8357EA77414489A14284986F7493"><enum>(aa)</enum><text>an associate degree;</text></item> <item id="HCEA3C4FD4DD9456FA64EB252C26EFFA1"><enum>(bb)</enum><text>a bachelor’s degree; and</text></item>
<item id="H538B7C654CF747B5A0BDC3BA6E88D8E3"><enum>(cc)</enum><text>a postbaccalaureate degree; and</text></item></subclause> <subclause id="H3C1A98A5D77A4E559C67A4EE0E4178B1"><enum>(II)</enum><text>a certificate or professional license, disaggregated by type of certificate or professional license;</text></subclause></clause>
<clause id="H6D1550782A2C46088CD2417643CB95CF" indent="up1"><enum>(xvii)</enum><text>programs available and the average time for completion of each program;</text></clause> <clause id="HC5E16D625D6A4A79A01F3CF66CA87664" indent="up1"><enum>(xviii)</enum><text>employment rate and median income of graduates of the institution in general two and five years after graduation, disaggregated by—</text>
<subclause id="H3A8C8B63374F472494875A115483F2F2"><enum>(I)</enum><text>specific program; and</text></subclause> <subclause id="H68FD783F616D4BB783C250D39483DAD6"><enum>(II)</enum><text>individuals using educational assistance under laws administered by the Secretary and individuals who are not; and</text></subclause></clause>
<clause id="HEBFAFB14CECD40608D64F34F87B28A69" indent="up1"><enum>(xix)</enum><text>the number of individuals using educational assistance under laws administered by the Secretary who are enrolled in the both the institution and specific program per year.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph></paragraph> <paragraph id="H077C7C2A9D4749D385A23CBFA557C1FA"><enum>(5)</enum><header>Clarity and anonymity of information provided</header><text>Paragraph (2) of such subsection is amended—</text>
<subparagraph id="H95DEE9A48B044E6092F037BB85038A41"><enum>(A)</enum><text>by inserting <quote>(A)</quote> before <quote>To the extent</quote>; and</text></subparagraph> <subparagraph id="H080D311309DA4C3ABA1443C691D84D50"><enum>(B)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block id="HC6B15C831E834412839786822D76B1B5" style="OLC">
<subparagraph id="H1BA43B9EAECC45D2A38FD0D954048AC1" indent="up2"><enum>(B)</enum><text>The Secretary shall ensure that information provided pursuant to subsection (b)(5) is provided in a manner that is easy for, and accessible to, individuals described in subsection (a).</text></subparagraph> <subparagraph id="HA096A8A8A2134BD68AFD06659ECD6DE5" indent="up2"><enum>(C)</enum><text>In providing information pursuant to subsection (b)(5), the Secretary shall maintain the anonymity of individuals described in subsection (a) and, to the extent that a portion of any data would undermine such anonymity, ensure that such data is not made available pursuant to such subsection.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection>
<subsection id="HA998988000BA42C29ED3D3FDB2DFA2E4"><enum>(c)</enum><header>Improvements for student feedback</header>
<paragraph id="HF0A2CA5C531A4BFCBBBADBED363194D3"><enum>(1)</enum><header>In general</header><text>Subsection (b)(2) of such section is amended—</text> <subparagraph id="H4F549BDC0EE9475AA160E1C1C101CA50"><enum>(A)</enum><text>by amending subparagraph (A) to read as follows:</text>
<quoted-block id="HCAEC8EC372C74C44AF9A62AE69E7AC86" style="OLC">
<subparagraph id="HCCB2F3829A7047FF8DFBAF4876D83269"><enum>(A)</enum><text display-inline="yes-display-inline">provides institutions of higher learning—</text> <clause id="H68942151421D423792AFFAB689D5E951" display-inline="no-display-inline"><enum>(i)</enum><text>up to 30 days to review and respond to feedback from individuals described in subsection (a) and address issues regarding the feedback before the feedback is published; and</text></clause>
<clause id="HF6D900F67FF041CF8851B9D9EA6ED62E" display-inline="no-display-inline"><enum>(ii)</enum><text>if an institution of higher learning contests the accuracy of the feedback, the opportunity to challenge the inclusion of such data with an official appointed by the Secretary;</text></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph> <subparagraph id="HA1CAD31F1CAF479895EBCD05B9C5A073"><enum>(B)</enum><text>in subparagraph (B), by striking <quote>and</quote> at the end;</text></subparagraph>
<subparagraph id="H8AFD767597AE486DAF34A3DE77B2CE73"><enum>(C)</enum><text>in subparagraph (C), by striking <quote>that conforms with criteria for relevancy that the Secretary shall determine.</quote> and inserting <quote>, and responses from institutions of higher learning to such feedback, that conform with criteria for relevancy that the Secretary shall determine;</quote>; and</text></subparagraph> <subparagraph id="HAA468F1A67024C06A1CB4343A83BC765"><enum>(D)</enum><text>by adding at the end the following new subparagraphs:</text>
<quoted-block id="HB0642FA3BF7E43C498212001DCF3C5D2" style="OLC">
<subparagraph id="H06CBFC3DEE8D4C3A98DCF3317AB44C57"><enum>(D)</enum><text>for each institution of higher learning that is approved under this chapter, retains, maintains, and publishes all of such feedback for not less than six years; and</text></subparagraph> <subparagraph id="H6711F20C20054D0B8C28A82300629689"><enum>(E)</enum><text>is easily accessible to individuals described in subsection (a) and to the general public.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H2D58CA413879481AA40F585EB8D47875"><enum>(2)</enum><header>Accessibility from G.I. Bill comparison tool</header><text>The Secretary shall ensure that—</text> <subparagraph id="HBEE07EFD2F2946698821BDADCA2035D1"><enum>(A)</enum><text>the feedback tracked and published under subsection (b)(2) of such section, as amended by paragraph (1), is prominently displayed in the tool maintained under subsection (a) of this section; and</text></subparagraph>
<subparagraph id="H49B1B1BD46174EC699BBAF59A5697C7D"><enum>(B)</enum><text>when such tool displays information for an institution of higher learning, the applicable feedback is also displayed for such institution of higher learning.</text></subparagraph></paragraph></subsection> <subsection id="HC69A50C9F56043D9AB4A2C328CD7296E"><enum>(d)</enum><header>Training for provision of education counseling services</header> <paragraph id="HEE38FEA753F948D7BA58D047EC390806"><enum>(1)</enum><header>In general</header><text>Not less than one year after the date of the enactment of this Act, the Secretary shall ensure that personnel employed by the Department of Veteran Affairs, or a contractor of the Department, to provide education benefits counseling, vocational or transition assistance, or similar functions, including employees or contractors of the Department who provide such counseling or assistance as part of the Transition Assistance Program, are trained on how—</text>
<subparagraph id="H2064D7438ED947369A0FB27A2AA04E22"><enum>(A)</enum><text>to use properly the tool maintained under subsection (a); and</text></subparagraph> <subparagraph id="HC27321617BC64E8FBA6280E844333BF9"><enum>(B)</enum><text>to provide appropriate educational counseling services to individuals described in section 3698(a) of such title, as amended by subsection (b)(3)(A).</text></subparagraph></paragraph>
<paragraph id="HD9B6352024534758ACB87C15A250EF13"><enum>(2)</enum><header>Transition assistance program defined</header><text>In this subsection, the term <term>Transition Assistance Program</term> means the program of counseling, information, and services under section 1142 of title 10, United States Code.</text></paragraph></subsection></section></subtitle> <subtitle id="H5B3D5660B0B44E28A6ED1D6B49BBF983"><enum>B</enum><header>Employment and Training</header> <section id="H1047FBB9D3A84DFEBFBE11B6B8DD9E0D"><enum>221.</enum><header>Improvements to reemployment rights of members of the Armed Forces</header> <subsection id="HD5C523B7F0FE4C959A47796C5280AE90"><enum>(a)</enum><header>USERRA purposes</header><text>Section 4301(a)(1) of title 38, United States Code, is amended by striking <quote>encourage noncareer service in the uniformed services</quote> and inserting <quote>encourage service in the uniformed services</quote>.</text></subsection>
<subsection id="HCE1697A023F54F5CAB076449A5FBA8B2"><enum>(b)</enum><header>Prohibition of retaliation</header><text>Subsection (b) of section 4311 of title 38, United States Code, is amended by inserting <quote>or other retaliatory action</quote> after <quote>employment action</quote>.</text></subsection> <subsection id="H643560FF04D440FDBCF45D98C0D42233"><enum>(c)</enum><header>Expansion of injunctive relief</header><text display-inline="yes-display-inline">Subsection (e) of section 4323 of such title is amended—</text>
<paragraph id="HAF81C8C184B3406A98685F060C399612"><enum>(1)</enum><text>by striking <quote>The court shall use</quote> and inserting <quote>(1) The court shall use</quote>; and</text></paragraph> <paragraph id="HE0F98ADEA0314FD7ADDE7C6BCC13C2E3"><enum>(2)</enum><text>by adding at the end the following new paragraphs:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="HD177124A082847789759FD9D3561148E">
<paragraph id="HF1800D70B6724996A740DE13E41853CA" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">A person bringing an action to enforce a provision of this chapter pursuant to subsection (a) shall be entitled to an injunction under paragraph (1) if such person demonstrates—</text> <subparagraph id="H152EACAF64404173B66B8D6CDBCE7F08"><enum>(A)</enum><text>a violation—</text>
<clause id="H0872A8A84C8A4E52AFC83367052933CD"><enum>(i)</enum><text>of the provisions of this chapter; or</text></clause> <clause id="H3717BD1EF3104247899963FD3FD582EF"><enum>(ii)</enum><text>of the provisions of this chapter is threatened or is imminent;</text></clause></subparagraph>
<subparagraph id="HF29CF3DE79FB408CAE7A54398FDA43E2"><enum>(B)</enum><text display-inline="yes-display-inline">the harm to the person outweighs the injury to the employer;</text></subparagraph> <subparagraph id="H0CC716BE40014E9DB6F2D516D92D0CE6"><enum>(C)</enum><text>a likelihood of success on the merits of such action; and</text></subparagraph>
<subparagraph id="HB8E59D6847A94394B87715F71671B4CA"><enum>(D)</enum><text display-inline="yes-display-inline">awarding such relief is in the public interest.</text></subparagraph></paragraph> <paragraph id="H3730BD6089834E16AD6D2F7EE25CA5FE" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">The court may not deny a motion for injunctive relief on the basis that a party bringing an action to enforce a provision of this chapter may be awarded wages unearned due to an unlawful termination or denial of employment at the conclusion of such action.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H0792CB24DDDB4993B20E11701407D989"><enum>(d)</enum><header>Damages against a State or private employer</header><text display-inline="yes-display-inline">Section 4323 of such title is further amended, in paragraph (1) of subsection (d), by striking subparagraph (C) and inserting the following new subparagraphs:</text> <quoted-block style="USC" id="HB90D971B1FD64032ADE04A7917CCE99D" display-inline="no-display-inline"> <subparagraph id="H620F4E588F1D4384AF9CA11E10D77608" indent="up1"><enum>(C)</enum><text display-inline="yes-display-inline">The court may require the employer to pay the person the amount referred to in subparagraph (B) and interest on such amount, calculated at a rate of 3 percent per year.</text></subparagraph>
<subparagraph id="H83EC9D9B5B3B402B9E34F61853E781EF" indent="up1"><enum>(D)</enum><text>The court may require the employer to pay the person the greater of $50,000 or the amount equal to the amounts referred to in subparagraphs (B) and (C) as liquidated damages, if the court determines that the employer knowingly failed to comply with the provisions of this chapter.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HAED5A5F6010144B083F8C43261827295"><enum>(e)</enum><header>Mandatory attorney fees award in successful actions for reemployment</header> <paragraph id="H6E2AC47FCC0A4908A93621CB198DFDBB"><enum>(1)</enum><header>MSPB actions</header><text display-inline="yes-display-inline">Paragraph (4) of subsection (c) of section 4324 of such title is amended—</text>
<subparagraph id="HCCAE615F4C6F4770813909B2638B9AD4"><enum>(A)</enum><text>by striking <quote>may, in its discretion,</quote> and inserting <quote>shall</quote>; and</text></subparagraph> <subparagraph id="HD5F8FB96150348DEB57DAF01D80E7FAE"><enum>(B)</enum><text>by adding at the end the following new sentence: <quote>The Board may, in its discretion, award reasonable attorney fees in a case settled before the issuance of an order if the person can demonstrate that significant attorney fees were incurred and that justice requires such an award.</quote>.</text></subparagraph></paragraph>
<paragraph id="H333CDC8A34B540B6BC563A338E445EFF"><enum>(2)</enum><header>Federal Circuit actions</header><text display-inline="yes-display-inline">Subsection (d) of such section is amended by adding at the end the following new paragraph:</text> <quoted-block style="USC" id="H2E3842D97C8B419DB45EDA4F52FF2EE8" display-inline="no-display-inline"> <paragraph id="H673C858AB61D4EE487E9A000B07FD6F0" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">In such Federal Circuit proceeding, the court shall award such person reasonable attorney fees, expert witness fees, and other litigation expenses if such person—</text>
<subparagraph id="H95B9C6BAFA1B4EBCAEC3A743B10271C9"><enum>(A)</enum><text>prevails in such Federal Circuit proceeding; and</text></subparagraph> <subparagraph id="H3EF6280634DC4E9E841334E0D94EF6DC"><enum>(B)</enum><text>is not represented by the Special Counsel in such Federal Circuit proceeding.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H7C716DD16DBB406EA2056ED596B041BB"><enum>(3)</enum><header>Actions against a State or private employer</header><text>Paragraph (2) of section 4323(h) of such title is amended—</text> <subparagraph id="H607A1E3991BD4969BF69010EE8CE1899"><enum>(A)</enum><text>by striking <quote>subsection (a)(2)</quote> and inserting <quote>subsection (a)(3)</quote>; and</text></subparagraph>
<subparagraph id="H883BCAB8908C4761AEC84FCE472CEB2A"><enum>(B)</enum><text>by striking <quote>the court may award any such person who prevails in such action or proceeding reasonable attorney fees</quote> and inserting <quote>the court shall award any such person who prevails in such action or proceeding reasonable attorney fees</quote>.</text></subparagraph></paragraph></subsection> <subsection id="HD24F74D87DFD4FA8892973A3E93D8397" commented="no"><enum>(f)</enum><header>GAO review and report on USERRA</header> <paragraph id="H11E0F48F8D9C4583B07E2CE10A12FC62" commented="no"><enum>(1)</enum><header>Review</header><text display-inline="yes-display-inline">The Comptroller General of the United States shall review the methods through which the Secretary of Labor, acting through the Veterans’ Employment and Training Service, processes actions for relief under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/43">chapter 43</external-xref> of title 38, United States Code.</text></paragraph>
<paragraph id="H1CAE909DEBA1442F89FD4F8AEF38098D" commented="no"><enum>(2)</enum><header>Elements</header><text>Not later than one year after the date of the enactment of this Act, the Comptroller General shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report that includes—</text> <subparagraph id="H2673D689321242DAA01F9B8B2C65589E"><enum>(A)</enum><text>the findings of the review required under paragraph (1);</text></subparagraph>
<subparagraph id="HCEA02408EF7C4CA7A154C957C713C45F"><enum>(B)</enum><text>an identification of the number of actions for relief under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/43">chapter 43</external-xref> of title 38, United States Code, initiated during the period covered by the report, disaggregated by size of employer and geographic region;</text></subparagraph> <subparagraph id="H041E09A6B3714FC4AA94236AE8010CF9" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">an identification of the number of such actions for relief that were erroneously dismissed, as determined by the Comptroller General;</text></subparagraph>
<subparagraph id="HCCD9B1663046428B9FD18272DADECD9E"><enum>(D)</enum><text display-inline="yes-display-inline">an identification of the number of such actions for relief that were referred to the Department of Justice; and</text></subparagraph> <subparagraph id="H9A0D818E4DB949119A8AA7F748D84767"><enum>(E)</enum><text>an assessment of trends, if any, in such actions for relief initiated during such period.</text></subparagraph></paragraph></subsection>
<subsection id="H2B656A8BCBDF495BB0A28E346C095CB6"><enum>(g)</enum><header>GAO review of protections for members of the uniformed services by Federal intelligence agencies</header>
<paragraph id="H11BB053516B74869B35FABF4B32BF515"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the appropriate congressional committees a report on the processes and procedures adopted and used by the intelligence community to provide the protections for members of the uniformed services otherwise established under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/43">chapter 43</external-xref> of title 38, United States Code.</text></paragraph> <paragraph id="H501EFDC26EB3429798BD00141B906128"><enum>(2)</enum><header>Definitions</header><text>In this subsection:</text>
<subparagraph id="H58A101572F11437E854C38AE817A63F1"><enum>(A)</enum><text display-inline="yes-display-inline">The term <term>appropriate congressional committees</term> means the Committees on Veterans’ Affairs of the House of Representatives and Senate, the Permanent Select Committee on Intelligence of the House of Representatives, and the Select Committee on Intelligence of the Senate.</text></subparagraph> <subparagraph id="HA5DF43A7A40044D19AB4620E917DEA86"><enum>(B)</enum><text display-inline="yes-display-inline">The term <term>intelligence community</term> has the meaning given such term in section 3(4) of the National Security Act of 1947 (<external-xref legal-doc="usc" parsable-cite="usc/50/3003">50 U.S.C. 3003(4)</external-xref>).</text></subparagraph></paragraph></subsection></section>
<section id="H1B7F40B19CC44244B239114243126764"><enum>222.</enum><header>Review of investigations manual of Veterans’ Employment and Training Service</header>
<subsection id="H670BD8D8300E43CF86A9D6F5BE93F4FB"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, and once every two years thereafter for the period of five years beginning on such date, the Secretary of Labor, shall review the manual of the Department of Labor titled <quote>Veterans’ Employment and Training Service Investigations Manual: USERRA, VEOA, and VP</quote> (or a successor manual) and make such revisions to such manual as the Secretary determines appropriate. </text></subsection> <subsection id="H28C3D1E7D3FA436199B26F62FA717166"><enum>(b)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than 90 days after any date on which the Secretary completes a review required under subsection (a), the Secretary shall submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate—</text>
<paragraph id="H74785376B1F941149DBC13F52DE0CA4E"><enum>(1)</enum><text>a report that includes a description of any revision to such manual made pursuant to such review; and </text></paragraph> <paragraph id="HC2F0DBD2D98C4073BF9565C2A29DA8E3"><enum>(2)</enum><text display-inline="yes-display-inline">a copy of the entire such manual which—</text>
<subparagraph id="H40DFCC7794D84081AB11909994BB550E"><enum>(A)</enum><text>shall be provided to the Chairman and Ranking Member of each such committee; and</text></subparagraph> <subparagraph id="H2C0AEF06B93D42069F861DD1D9BCAAA2"><enum>(B)</enum><text>may contain a separate addendum for portions of the manual that contain law enforcement sensitive materials.</text></subparagraph></paragraph></subsection></section>
<section id="HDB3BB60CC87B4C66A657494A29EE6BE8"><enum>223.</enum><header>Warrior Training Advancement Course</header>
<subsection id="H1BE5D5F7F4844BE2AF8D5273A042E126"><enum>(a)</enum><header>Reporting on the Warrior Training Advancement Course</header>
<paragraph id="HBCBDA70039244286B64E2DC79879F4DC"><enum>(1)</enum><header>Reports required</header>
<subparagraph id="H3F5C6C9D44824C8DA90176139354DF70"><enum>(A)</enum><header>Initial report</header><text>Not later than six months after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report on WARTAC.</text></subparagraph> <subparagraph id="H07F40BD55B6D4A85B6813DD796E8A4F3"><enum>(B)</enum><header>Annual report</header><text>One year after the submission of the report required under paragraph subparagraph (A) and annually thereafter, the Secretary shall submit to such Committees a report that contains the elements under subparagraphs (A) and (C) of paragraph (2) with regards to the preceding year.</text></subparagraph></paragraph>
<paragraph id="HD3A6F52C77704D40A379110B9A73B4A7"><enum>(2)</enum><header>Elements</header><text>Except as provided in paragraph (1)(B), the reports under this subsection shall include the following elements:</text> <subparagraph id="H1850A42539F1409D9FBF7212089F6084"><enum>(A)</enum><header>Best practices</header><text>With regards to best practices of WARTAC—</text>
<clause id="H79970FD0A58B41B8AD02C225E906D8AA"><enum>(i)</enum><text>how many covered members have applied to participate in WARTAC;</text></clause> <clause id="HC763A9878E5C4EE7B9BA5060EB29B264"><enum>(ii)</enum><text display-inline="yes-display-inline">how many covered members have participated in WARTAC;</text></clause>
<clause id="H6DCE4C66A4244C819FD967CC74CCC681"><enum>(iii)</enum><text>how the Secretary provides training to covered members during TAP;</text></clause> <clause id="H70C86C1C020E4DD6900199586C00B948"><enum>(iv)</enum><text display-inline="yes-display-inline">how many covered members have completed WARTAC; and</text></clause>
<clause id="HFFC33E8B9FCE4D43BA2179F9FC67C2CF"><enum>(v)</enum><text>any other information the Secretary determines appropriate.</text></clause></subparagraph> <subparagraph id="H7D981BF15E4C45AFB520CCFAAE11D18C"><enum>(B)</enum><header>Cost savings</header><text display-inline="yes-display-inline">With regards to cost savings of WARTAC—</text>
<clause id="HA0531DD1B0A3470CBDDB1E521AC67AC2"><enum>(i)</enum><text>how much money the Secretary determines WARTAC saves the United States each fiscal year;</text></clause> <clause id="HFFF3F0214BBB45088A1A66FB78004F78"><enum>(ii)</enum><text display-inline="yes-display-inline">how much money the Secretary determines WARTAC has saved the United States since its establishment; and</text></clause>
<clause id="H68958B9DC0AF40DB8C140617D8DF5512"><enum>(iii)</enum><text>the determination of the Secretary whether other Federal agencies may save money by establishing a program similar to WARTAC.</text></clause></subparagraph> <subparagraph id="H12BBAE34F82247D0A0F5AFEC9764D7A6"><enum>(C)</enum><header>Hiring</header><text>With regards to hiring covered members who complete WARTAC—</text>
<clause id="HD6CC1872F767455C8EA0115546D9F550"><enum>(i)</enum><text display-inline="yes-display-inline">how the Secretary identifies positions in the Department of Veterans Affairs for which such covered members may qualify;</text></clause> <clause id="HCEBD3F4FD58045168AB73F2691B2A10B"><enum>(ii)</enum><text>the grades of such positions on the General Schedule under section 5332 of title 5, United States Code; and</text></clause>
<clause id="HE5174FF0B17D42F993807F1F9EE5AD21"><enum>(iii)</enum><text>how many such covered members the Secretary has hired to such positions.</text></clause></subparagraph></paragraph> <paragraph id="H1542A543AE71434CA1488A68ECE68B43"><enum>(3)</enum><header>Distribution</header><text>Not later than 30 days after submitting the report under paragraph (1)(A), the Secretary of Veterans Affairs shall transmit a copy of the report under this section to the head of each Federal agency.</text></paragraph>
<paragraph id="H1EC8DCAF4E1444EC8934B552EAC69ABC"><enum>(4)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this subsection:</text> <subparagraph id="H46B53BFC089942EA8F1BB3102CA12F0E"><enum>(A)</enum><text display-inline="yes-display-inline">The term <quote>covered member</quote> means members of the Armed Forces participating in TAP.</text></subparagraph>
<subparagraph id="HA6BA741C018E4E12B21B0829DC0A1119"><enum>(B)</enum><text>The term <quote>TAP</quote> means the Transition Assistance Program under sections 1142 and 1144 of title 10, United States Code.</text></subparagraph> <subparagraph id="HAD32C61EA13747E3895894B939C44735"><enum>(C)</enum><text>The term <quote>WARTAC</quote> means the Warrior Training Advancement Course of the Veterans Benefit Administration, in which the Secretary provides training to covered members so such covered members may qualify for certain employment in the Veterans Benefit Administration.</text></subparagraph></paragraph></subsection>
<subsection id="H590D1218EA4244D6AE4AA259568FC1D9"><enum>(b)</enum><header>Pilot program to employ veterans in positions relating to conservation and resource management activities</header>
<paragraph id="H1525F5107A394715890170F5AC721656"><enum>(1)</enum><header>Best practices for other departments</header><text>The Assistant Secretary of Labor for Veterans’ Employment and Training, in consultation with the Secretary of Veterans Affairs, shall establish guidelines containing best practices for departments and agencies of the Federal Government that carry out programs to employ veterans who are transitioning from service in the Armed Forces. Such guidelines shall include the findings of the initial report required under subsection (a)(1).</text></paragraph> <paragraph id="H9AF6F8E0F3F542ABA0268A04F8E9FDCA"><enum>(2)</enum><header>Pilot program</header> <subparagraph id="HD28FF4A058604345A55B85151B3C4852"><enum>(A)</enum><header>Establishment</header><text>The Secretary of the Interior, in consultation with the Assistant Secretary of Labor for Veterans’ Employment and Training and the Secretary of Veterans Affairs, shall establish a pilot program under which veterans are employed by the Federal Government in positions that relate to the conservation and resource management activities of the Department of the Interior.</text></subparagraph>
<subparagraph id="HA8ED892EDA2743159532D133F4A07D8A"><enum>(B)</enum><header>Positions</header><text display-inline="yes-display-inline">The Secretary of the Interior shall—</text> <clause id="HE087BEB16F90486FBCFA1CF74F10444F"><enum>(i)</enum><text>identify vacant positions in the Department of the Interior that are appropriate to fill using the pilot program; and</text></clause>
<clause id="HEE2FF838DF6D484289F8196B2BED30F1"><enum>(ii)</enum><text display-inline="yes-display-inline">to the extent practicable, fill such positions using the pilot program.</text></clause></subparagraph> <subparagraph id="HC81B9CA74417436587AEE0E386D6D60F"><enum>(C)</enum><header>Application of civil service laws</header><text>A veteran employed under the pilot program shall be treated as an employee as defined by section 2105 of title 5, United States Code.</text></subparagraph>
<subparagraph id="H06679EC43C1B4103B7E5BA60BD7419FE"><enum>(D)</enum><header>Briefings and report</header>
<clause id="HFA441664F38640F7962613C4DB03CF89" commented="no"><enum>(i)</enum><header>Initial briefing</header><text display-inline="yes-display-inline">Not later than 60 days after the date of the submission of the report required under subsection (a)(1)(A), the Secretary of the Interior and the Assistant Secretary of Labor for Veterans’ Employment and Training shall jointly provide to the appropriate congressional committees a briefing on the pilot program under this subsection, which shall include a description of how the pilot program will be carried out in a manner to reduce the unemployment of veterans and any recommendations for legislative actions to improve the pilot program.</text></clause> <clause id="H24C5BFC4257E4905BEC19F6942240018"><enum>(ii)</enum><header>Implementation briefing</header><text display-inline="yes-display-inline">Not later than one year after the date on which the pilot program under this paragraph commences, the Secretary of the Interior and the Assistant Secretary of Labor for Veterans’ Employment and Training shall jointly provide to the appropriate congressional committees a briefing on the implementation of the pilot program.</text></clause>
<clause id="HCB4474E4E1784831967F9F15130759B6" commented="no"><enum>(iii)</enum><header>Final report</header><text display-inline="yes-display-inline">Not later than 30 days after the date on which the pilot program under this paragraph is completed, the Secretary of the Interior and the Assistant Secretary of Labor for Veterans’ Employment and Training shall jointly submit to the appropriate congressional committees a report on the pilot program that includes the following:</text> <subclause id="HD6F237B12FC248E79CCB89DC60F21CB3" commented="no"><enum>(I)</enum><text>The number of veterans who applied to participate in the pilot program.</text></subclause>
<subclause id="HA07F6686745740478A2A279A4BE4D623" commented="no"><enum>(II)</enum><text>The number of such veterans employed under the pilot program.</text></subclause> <subclause id="HA319B6F3E96A493FA174C59B6DCC2E5D" commented="no"><enum>(III)</enum><text display-inline="yes-display-inline">The number of veterans identified in subclause (II) who transitioned to full-time positions with the Federal Government after participating in the pilot program.</text></subclause>
<subclause id="H63CF93B10CF74EF88C6EBE78116FD1CD" commented="no"><enum>(IV)</enum><text>Any other information the Secretary and the Assistant Secretary determine appropriate with respect to measuring the effectiveness of the pilot program.</text></subclause></clause></subparagraph> <subparagraph id="H704A2487006E408280D09D7C44B94D07"><enum>(E)</enum><header>Duration</header><text>The authority to carry out the pilot program under this paragraph shall terminate on the date that is two years after the date on which the pilot program commences.</text></subparagraph></paragraph>
<paragraph id="H9ADA35872AC34BD8955ECC3D2E3D6027"><enum>(3)</enum><header>Outdoor recreation program attendance</header><text display-inline="yes-display-inline">The Secretary of each of the military department is encouraged to allow members of the Armed Forces serving on active duty to participate in programs related to environmental stewardship or guided outdoor recreation.</text></paragraph> <paragraph id="HFA3D996C40114827932550BC201C7EB4"><enum>(4)</enum><header>Appropriate congressional committees defined</header><text>In this subsection, the term <term>appropriate congressional committees</term> means—</text>
<subparagraph id="H3D1E38A90B5C48B9B064FE7F9FEF9379"><enum>(A)</enum><text>the Committee on Veterans’ Affairs and the Committee on Natural Resources of the House of Representatives; and</text></subparagraph> <subparagraph id="H626A9D3D21034AED9C06D65714B927CC"><enum>(B)</enum><text display-inline="yes-display-inline">the Committee on Veterans’ Affairs and the Committee on Energy and Natural Resources of the Senate.</text></subparagraph></paragraph></subsection></section></subtitle>
<subtitle id="H60958FDB01F743C38E76B75352ABC342"><enum>C</enum><header>Home Loans</header>
<section id="H42C155E176EC4ABAB822EC0393142C0E"><enum>231.</enum><header>Improvements to program for direct housing loans made to Native American veterans by the Secretary of Veterans Affairs</header>
<subsection id="H2BE70DBAE2BA481789616DE54FA48CBB"><enum>(a)</enum><header>General authorities and requirements</header>
<paragraph id="HEFA53130674B40AFAD2D12A93F1B14FF"><enum>(1)</enum><header>Direct housing loans to Native American veterans</header><text>Section 3762(a) of title 38, United States Code, is amended to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HE37EAEADB4D946ED8232F83BAD4D2DCE"> <subsection id="HF1CCE16256EE4565BE1F18DD7918593D"><enum>(a)</enum><text>The Secretary may make a direct housing loan to a Native American veteran under this subchapter if the Secretary ensures the following:</text>
<paragraph id="H86269D8F696B4A64901DEDE95802450B"><enum>(1)</enum><text>That each Native American veteran to whom the Secretary makes a direct housing loan under this subchapter—</text> <subparagraph id="HACC6F91EF3CD45A59C32366CF92958CE"><enum>(A)</enum><text>holds, possesses, or purchases using the proceeds of the loan a meaningful interest in a lot or dwelling (or both) that is located on trust land; and</text></subparagraph>
<subparagraph id="H100D98FDD39645768F6A3BB5693619BB"><enum>(B)</enum><text>will purchase, construct, or improve (as the case may be) a dwelling on the lot using the proceeds of the loan.</text></subparagraph></paragraph> <paragraph id="HC982A3E80FC64033B8D07350D4CE3789"><enum>(2)</enum><text>That each such Native American veteran will convey to the Secretary by an appropriate instrument the interest referred to in paragraph (1)(A) as security for a direct housing loan under this subchapter.</text></paragraph>
<paragraph id="HC552395E05484DDFB26BCA8D0BA7C9BC"><enum>(3)</enum><text>That the Secretary, including the Secretary’s employees or agents, may enter upon the trust land for the purposes of carrying out such actions as the Secretary determines are necessary, including—</text> <subparagraph id="HC0F9131D8A574FFCACE181B558896B7B"><enum>(A)</enum><text>to evaluate the advisability of the loan;</text></subparagraph>
<subparagraph id="H984B49CC3A4F44EAA38184349A2D3882"><enum>(B)</enum><text>to monitor any purchase, construction, or improvements carried out using the proceeds of the loan; and</text></subparagraph> <subparagraph id="H133190A418B94B2DA479AF43A5CF1EB8"><enum>(C)</enum><text>to manage any servicing or post-foreclosure activities, including acquisition, property inspections, and property management.</text></subparagraph></paragraph>
<paragraph id="HC204616696144A3C8411DEB214829348"><enum>(4)</enum><text>That there are established standards and procedures that apply to the foreclosure of the interest conveyed by a Native American veteran pursuant to paragraph (2), including—</text> <subparagraph id="H80F940C3ED79447EA80CB107523AD8A4"><enum>(A)</enum><text>procedures for foreclosing the interest; and</text></subparagraph>
<subparagraph id="HE2FBD79563EC4D769372D909F64183CF"><enum>(B)</enum><text>procedures for the resale of the lot or dwelling (or both) purchased, constructed, or improved using the proceeds of the loan.</text></subparagraph></paragraph> <paragraph id="H4BA2AE2F8B874DBD9C556D84D4E5FE50"><enum>(5)</enum><text>That the loan is made in a responsible and prudent manner, subject to standards and procedures as are necessary for the reasonable protection of the financial interests of the United States.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H8C68F20CF3164532B02A5F8283FA6B4A"><enum>(2)</enum><header>Memorandums of understanding, agreements, and determinations</header><text>Section 3762(b) of such title is amended to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H37FC27145CEE408792A9CCCE55E03158"> <subsection id="HEB6A28180AC249518FDE41096844A842"><enum>(b)</enum> <paragraph commented="no" display-inline="yes-display-inline" id="HE298BAEEC7AF4E7BB1819E658F11E9DF"><enum>(1)</enum><text>To carry out the purpose of subsection (a), the Secretary may—</text>
<subparagraph id="H32F646B4157F419CA4D24DE23E5278DD" indent="up1"><enum>(A)</enum><text>enter into a memorandum of understanding with a tribal organization, other entity, or individual;</text></subparagraph> <subparagraph id="H4968707995D743DE969A3984510BFB50" indent="up1"><enum>(B)</enum><text>rely on agreements or determinations of other Federal agencies to guarantee, insure, or make loans on trust land; and</text></subparagraph>
<subparagraph id="H5B0B946858894F6D9D8CFA67BE5CB78D" indent="up1"><enum>(C)</enum><text>enter into other agreements or take such other actions as the Secretary determines necessary.</text></subparagraph></paragraph> <paragraph id="H907B058290B54852B07A5AD1B0D1C489" indent="up1"><enum>(2)</enum><text>If the Secretary determines that the requirements under subsection (a) are not being enforced by a tribal organization, other entity, or individual that is a party to any memorandum of understanding, agreement, or determination described in paragraph (1), the Secretary may cease making new direct housing loans to Native American veterans under this subchapter within the area of the authority of the tribal organization, other entity, or individual (as the case may be).</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H087F831E790C4074A250EE8A2CC8FFD8"><enum>(b)</enum><header>Direct loans to Native American veterans To refinance existing mortgage loans</header><text>Section 3762(h) of such title is amended to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H0D404D89EF6D4910A22E449EFE4B069F"> <subsection id="HA1EAA2308C454E4898ADD01F05A9DF1E"><enum>(h)</enum><text>The Secretary may make direct loans to Native American veterans in order to enable such veterans to refinance existing mortgage loans for any of the following purposes:</text>
<paragraph id="H4250186B2E284A62A3D42C3813862A99"><enum>(1)</enum><text>To refinance an existing loan made under this section, if the loan—</text> <subparagraph id="H4C288D9702E84EBFA6B4C395128C7E63"><enum>(A)</enum><text>meets the requirements set forth in subparagraphs (B), (C), and (E) of paragraph (1) of section 3710(e) of this title;</text></subparagraph>
<subparagraph id="HE7A45237578B4142B0399A05228FE8E1"><enum>(B)</enum><text>will bear an interest rate at least one percentage point less than the interest rate borne by the loan being refinanced; and</text></subparagraph> <subparagraph id="H67564A04400F4A52BACE113E485823F0"><enum>(C)</enum><text>complies with paragraphs (2) and (3) of section 3710(e) of this title, except that for the purposes of this subsection the reference to subsection (a)(8) of section 3710 of this title in such paragraphs (2) and (3) shall be deemed to be a reference to this subsection.</text></subparagraph></paragraph>
<paragraph id="H2B13B68E9586474AA9098F5BEAC587F4"><enum>(2)</enum><text>To refinance an existing mortgage loan not made under this section on a dwelling owned and occupied by the veteran as the veteran’s home, if all of the following requirements are met:</text> <subparagraph id="H1D13821291074E1AB9C4DA17F597D672"><enum>(A)</enum><text>The loan will be secured by the same dwelling as was the loan being refinanced.</text></subparagraph>
<subparagraph id="HCA158EB5141947BDACAC03C315B0AD96" commented="no"><enum>(B)</enum><text>The loan will provide the veteran with a net tangible benefit.</text></subparagraph> <subparagraph id="HBB63C817582240268C9CA0960A6C801D"><enum>(C)</enum><text>The nature and condition of the property is such as to be suitable for dwelling purposes.</text></subparagraph>
<subparagraph id="H1406912CBF1A4CD3BFDCE2DA6FC6D117"><enum>(D)</enum><text>The amount of the loan does not exceed either of the following:</text> <clause id="H739A1423D248422B8BAE60DCD328EB7E"><enum>(i)</enum><text>100 percent of the reasonable value of the dwelling, with such reasonable value determined under the procedures established by the Secretary under subsection (d)(2).</text></clause>
<clause id="H5901520AF7AB44EA888B5DCD2BFA994F"><enum>(ii)</enum><text>An amount equal to the sum of the balance of the loan being refinanced and such closing costs (including any discount points) as may be authorized by the Secretary to be included in the loan.</text></clause></subparagraph> <subparagraph id="H310AB040F7F44632BCA64C5F2B1CA9EB"><enum>(E)</enum><text>Notwithstanding subparagraph (D), if a loan is made for both the purpose of this paragraph and to make energy efficiency improvements, the loan must not exceed either of the following:</text>
<clause id="H3EB8A2BD2377422CBCCC3F713B853073"><enum>(i)</enum><text>100 percent of the reasonable value of the dwelling as improved for energy efficiency, with such reasonable value determined under the procedures established by the Secretary under subsection (d)(2).</text></clause> <clause id="HFBA5D66AF02B453CB9AFDDE7E46A7C74"><enum>(ii)</enum><text>The amount referred to under subparagraph (D)(ii), plus the applicable amount specified under section 3710(d)(2) of this title.</text></clause></subparagraph>
<subparagraph id="HBE73F6C7B66647C6BA6AD84BC0951374"><enum>(F)</enum><text>The loan meets all other requirements the Secretary may establish under this subchapter.</text></subparagraph> <subparagraph id="H7416DBAFCB254E2FA6AD08FFF854F503"><enum>(G)</enum><text>The existing mortgage being refinanced is a first lien on the property and secured of record.</text></subparagraph></paragraph>
<paragraph id="HDFF17ACCA29A48E8AE783AF9106AE50E"><enum>(3)</enum><text>To refinance an existing mortgage loan to repair, alter, or improve a dwelling owned by the veteran and occupied by the veteran as the veteran’s home, if all of the following requirements are met:</text> <subparagraph id="H08A1D0406DBA4C6CA08ADC81B695A33B"><enum>(A)</enum><text>The loan will be secured by the same dwelling as was the loan being refinanced.</text></subparagraph>
<subparagraph id="H498A40DCEBFB491088E0561FCCFCEB0B"><enum>(B)</enum><text>The nature and condition of the property is such as to be suitable for dwelling purposes, and the repair, alteration, or improvement substantially protects or improves the basic livability or utility of such property.</text></subparagraph> <subparagraph id="HB45BB6F862564AEE8657195A76E946BD"><enum>(C)</enum><text>The amount of the loan, including the costs of repairs, alterations, and improvements, does not exceed either of the following:</text>
<clause id="H964B5718095E4E9D947BC113CA69CC73"><enum>(i)</enum><text>100 percent of the reasonable value of the dwelling as repaired, altered, or improved, with such reasonable value determined under the procedures established by the Secretary under subsection (d)(2).</text></clause> <clause id="H794DF777810C49DDB7EF7CC8156F1DC1"><enum>(ii)</enum><text>An amount equal to the sum of—</text>
<subclause id="HD683DCE7BAE24A158044C67EC57E9836"><enum>(I)</enum><text>the balance of the loan being refinanced;</text></subclause> <subclause id="HAABFC58CC0AA451383E0C594FB0CC12A"><enum>(II)</enum><text>the actual cost of repairs, alterations, or improvements; and</text></subclause>
<subclause id="HFEE1D4F45327412A8D80B48E54FDBC75"><enum>(III)</enum><text>such closing costs (including any discount points) as may be authorized by the Secretary to be included in the loan.</text></subclause></clause></subparagraph> <subparagraph id="H6753D50DEAB0491FBFB622AB9F79C086"><enum>(D)</enum><text>The loan meets all other requirements the Secretary may establish under this subchapter.</text></subparagraph>
<subparagraph id="H856AD75FF33948478D45CB020709BF04"><enum>(E)</enum><text>The existing mortgage loan being refinanced is a first lien on the property and secured of record.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H278FCE491AC7431D857DBD4A8A36B8D8"><enum>(c)</enum><header>Expansion of outreach program on availability of direct housing loans for Native American veterans</header><text>Section 3762(i)(2) of such title is amended by adding at the end the following new subparagraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H3F4DDC9E5160446E91DCCE7CB559D49A">
<subparagraph id="H32CE125802004F539411812D4D6DE09C" indent="up1"><enum>(G)</enum><text>Pursuant to subsection (g)(4), assisting Native American veterans in qualifying for mortgage financing by—</text> <clause id="HCAE84E27A424424AB7C2CEA0EDB1B299"><enum>(i)</enum><text>partnering with local service providers, such as tribal organizations, tribally designated housing entities, Native community development financial institutions, and nonprofit organizations, for conducting outreach, homebuyer education, housing counseling, and post-purchase education; and </text></clause>
<clause id="HC0B21013D7BA4D9C8CAB2FED9B77C50A"><enum>(ii)</enum><text>providing other technical assistance as needed. </text></clause></subparagraph> <subparagraph id="HB99C888D6AC845DEA6EB483A5A37794C" indent="up1"><enum>(H)</enum><text>Attending conferences and conventions conducted by the network of Native community development financial institutions and other Native American homeownership organizations to provide information and training to Native community development financial institutions about the availability of the relending program under section 3762A of this title.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H605CF7185DAF4194B1819B23E728D22B"><enum>(d)</enum><header>Adequate personnel</header><text>Section 3762 of such title is amended by adding at the end the following new subsection:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H77C64930136A45A8977F5C334253C840"> <subsection id="HD0A5F8C6589F4913BD281A107B7E831F"><enum>(k)</enum><text>The Secretary shall assign a sufficient number of personnel of the Department dedicated to carrying out the authority of the Secretary under this subchapter, including construction and valuation specialists to assist with issues unique to new construction and renovations on trust land.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HE896786CA5364FCA92BB3EEAA531B969"><enum>(e)</enum><header>Definitions</header><text>Section 3765 of such title is amended—</text> <paragraph id="H551A57A49F2143D28E7B594709E0291F"><enum>(1)</enum><text>in paragraph (1)—</text>
<subparagraph id="H9B5AB821C5274828BDFE977ADAD2606B"><enum>(A)</enum><text>by amending subparagraph (C) to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H8274E20D9D6F41E8872CA9C0064E8C3D"> <subparagraph id="H95B442DD05974F6BBB302A9356D54320"><enum>(C)</enum><text>is located in the State of Alaska within a region established under section 7(a) of the Alaska Native Claims Settlement Act (<external-xref legal-doc="usc" parsable-cite="usc/43/1606">43 U.S.C. 1606(a)</external-xref>);</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="H6B3E764B2DA74852B5CE53BCDD504178"><enum>(B)</enum><text>in subparagraph (D), by striking the period at the end and inserting a semicolon; and</text></subparagraph> <subparagraph id="HDD29EDB78DC4402DAD58FBE0BF277635"><enum>(C)</enum><text>by adding at the end the following new subparagraphs:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HFC039F9E659341809BCCB6D706352193">
<subparagraph id="HFE728820367E402CBA0D7E850895B0DC" commented="no"><enum>(E)</enum><text>is defined by the Secretary of the Interior and recognized by the United States as land over which an Indian Tribe has governmental dominion; or</text></subparagraph> <subparagraph commented="no" id="HCEDF3908BC6C4B4086E714E9BC3E9AB3"><enum>(F)</enum><text>is on any land that the Secretary determines is provided to Native American veterans because of their status as Native Americans.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="HE738CD13B5354444AE62B905B85D3802"><enum>(2)</enum><text>by adding at the end the following new paragraphs:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H18A0A0AEDCA44D7DABD595A0708035B8"> <paragraph id="HCC3D5A4B8C6F4A32AA907C2186DED6FE"><enum>(6)</enum><text>The term <term>community development financial institution</term> has the meaning given that term in section 103 of the Community Development Banking and Financial Institutions Act of 1994 (<external-xref legal-doc="usc" parsable-cite="usc/12/4702">12 U.S.C. 4702</external-xref>).</text></paragraph>
<paragraph id="H55F36838F8144CC9BF4D153592754526"><enum>(7)</enum><text>The term <term>Indian Tribe</term> means any Indian tribe, band, nation, or other organized group or community, including any Alaska Native village or regional or village corporation as defined in or established pursuant to the Alaska Native Claims Settlement Act (<external-xref legal-doc="usc" parsable-cite="usc/43/1601">43 U.S.C. 1601 et seq.</external-xref>), which is recognized as eligible for the special programs and services provided by the United States to Indians because of their status as Indians. </text></paragraph> <paragraph id="H478C38D9FC22491D8AAFAA9BD4F558AF"><enum>(8)</enum><text>The term <term>Native community development financial institution</term> means any entity—</text>
<subparagraph id="H359066A1ED7E4DC7BD4E7A699565E66C"><enum>(A)</enum><text>that has been certified as a community development financial institution by the Secretary of the Treasury;</text></subparagraph> <subparagraph id="HF3448EB880F442D9B51731AD2AB61D65"><enum>(B)</enum><text>that is not less than 51 percent owned or controlled by Native Americans; and</text></subparagraph>
<subparagraph id="HC3A3D53B18354987A4A8CF2B59104769"><enum>(C)</enum><text>for which not less than 51 percent of the activities of the entity serve Native Americans.</text></subparagraph></paragraph> <paragraph id="H8E1D2E52C5EE4875A45B75D7E6405C79"><enum>(9)</enum><text>The term <term>net tangible benefit</term> shall have such meaning as the Secretary determines appropriate, but shall include the refinance of an interim construction loan.</text></paragraph>
<paragraph id="H2CE952AF93F741868C00C71461EDBF1E"><enum>(10)</enum><text>The term <term>other technical assistance</term> means services to assist a Native American veteran to navigate the steps necessary for securing a mortgage loan on trust land, including pre-development activities related to utilities, identifying appropriate residential construction services, and obtaining lease clearances and title status reports from the applicable tribal organization or the Bureau of Indian Affairs.</text></paragraph> <paragraph id="H3AE7ECD94F4D491487A8A31ACAFD3F35"><enum>(11)</enum><text>The term <term>tribally designated housing entity</term> has the meaning given that term in section 4 of the Native American Housing Assistance and Self-Determination Act of 1996 (<external-xref legal-doc="usc" parsable-cite="usc/25/4103">25 U.S.C. 4103</external-xref>).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HEF19461CD31B43F7831505B60DE1288D"><enum>(f)</enum><header>Interest rate reduction financing loan</header><text>Section 3729(b)(4)(F) of such title is amended by striking <quote>3762(h)</quote> and inserting <quote>3762(h)(1)</quote>.</text></subsection> <subsection id="H4255FE2F0A704D70B5CB37BD2960BF3F"><enum>(g)</enum><header>Regulations</header><text>Section 3761 of such title is amended by adding at the end the following new subsection:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HEDAF3A0009ED418F86AE99D6F74B5965">
<subsection id="H00FF32CCCBCD48A3899E98B525B86137"><enum>(c)</enum><text>The Secretary shall prescribe such regulations as may be necessary to carry out this subchapter.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> <section id="HFC358F6CDE724DB195BD1AA2D9D0A2AD"><enum>232.</enum><header>Native community development financial institution relending program</header> <subsection id="HA075D6879FAB4C6893747D18A702A696"><enum>(a)</enum><header>In general</header><text>Subchapter V of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/37">chapter 37</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/3762">section 3762</external-xref> the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="HCC1EAA4C4CA84C39B925E20878152662">
<section id="H39BFEBC084E04DAD8434CFEE87662E91"><enum>3762A.</enum><header>Native community development financial institution relending program</header>
<subsection id="HFE5B70C997AA42EDA84E309BAF12436F"><enum>(a)</enum><header>Purpose</header><text>The Secretary may make a loan to a Native community development financial institution for the purpose of allowing the institution to relend loan amounts to qualified Native American veterans, subject to the requirements of this section.</text></subsection> <subsection id="H5EE5D2E99ABB4BFC9A7B79EBC534E659"><enum>(b)</enum><header>Standards</header> <paragraph id="H41FB7625C4264CEE91F50F5AD583AA22" display-inline="yes-display-inline"><enum>(1)</enum><text>The Secretary shall establish standards to be used in evaluating whether to make a loan to a Native community development financial institution under this section.</text></paragraph>
<paragraph id="H6B5ABAFDAFA94CBE9883AB15CF361DA9" indent="up1"><enum>(2)</enum><text>In establishing standards under paragraph (1), the Secretary shall ensure that a Native community development financial institution—</text> <subparagraph id="HB14B28936E16473E8055A8D04FA744A1"><enum>(A)</enum><text>is able to originate and service loans for single-family homes;</text></subparagraph>
<subparagraph id="H8CC50C593ACA4A7F82CD1DC67FA86412"><enum>(B)</enum><text>is able to operate the relending program in a manner consistent with the mission of the Department to serve veterans; and</text></subparagraph> <subparagraph id="H6F0C2EEB256A4BC182F055AFA72EAC6F"><enum>(C)</enum><text>uses loan amounts received under this section only for the purpose of relending, as described in subsection (c), to Native American veterans.</text></subparagraph></paragraph></subsection>
<subsection id="H167FAE000AD34885B3631FA3EA2AEED3"><enum>(c)</enum><header>Relending requirements</header>
<paragraph id="H6851592196C64080BB5800D281CD0462" display-inline="yes-display-inline"><enum>(1)</enum><text>A Native community development financial institution that receives a loan under this section shall use the loan amounts to make loans to Native American veterans residing on trust land.</text></paragraph> <paragraph id="HD959476D40F74E80A7724511CF1F52AE" indent="up1"><enum>(2)</enum><text>A loan to a Native American veteran made by a Native community development financial institution under paragraph (1) shall—</text>
<subparagraph id="HABB3BDDA9F3343AAB763111D1C8E76A3"><enum>(A)</enum><text>be limited either to the purpose of purchase, construction, or improvement of a dwelling located on trust land or to the refinance of an existing mortgage loan for a dwelling on trust land, consistent with the requirements of section 3762(h) of this title; and</text></subparagraph> <subparagraph id="H9FFA2C38C30C497FAD02CB199ED57C41"><enum>(B)</enum><text>comply with such terms and conditions as the Secretary determines are necessary to protect against predatory lending, including the interest rate charged on a loan to a Native American veteran.</text></subparagraph></paragraph></subsection>
<subsection id="HCF82946EA273497B8B883FE73DD227A2"><enum>(d)</enum><header>Repayment</header><text>A loan made to a Native community development financial institution under this section shall—</text> <paragraph id="H8D931CA674504DE593FCC02F6DECAC60"><enum>(1)</enum><text>be payable to the Secretary upon such terms and conditions as are prescribed in regulations pursuant to this subchapter; and</text></paragraph>
<paragraph id="H451E3B8361C14F058A3AD5CC31BCD163"><enum>(2)</enum><text>bear interest at a rate of one percent.</text></paragraph></subsection> <subsection id="HE98E566D6D7848DE944B709DBCC4D7B9"><enum>(e)</enum><header>Oversight</header><text>Subject to notice and opportunity for a hearing, whenever the Secretary finds with respect to loans made under subsection (a) or (c) that any Native community development financial institution has failed to maintain adequate loan accounting records, to demonstrate proper ability to service loans adequately, or to exercise proper credit judgment, or that such Native community development financial institution has willfully or negligently engaged in practices otherwise detrimental to the interest of veterans or of the Government, the Secretary may take such actions as the Secretary determines necessary to protect veterans or the Government, such as requiring immediate repayment of any loans made under subsection (a) and the assignment to the Secretary of loans made under subsection (c).</text></subsection>
<subsection id="HCD26FF90C0FB49E686742991006539DC"><enum>(f)</enum><header>Sunset</header><text>The Secretary may not make a loan under this section after September 30, 2027.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H02A11261360B42A5B4EDF5FD4048D98F"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 37 of such title is amended by inserting after the item relating to section 3762 the following new item:</text></subsection>
<subsection id="HFD10543CB4FD4A3B809AE99EFF4D119C"><enum></enum>
<toc>
<toc-entry level="section" bold="off"><quote>3762A. Native community development financial institution relending program.</quote>.</toc-entry></toc></subsection>
<subsection id="H4695B38322A24ED28FE86E90047ADD9F"><enum>(c)</enum><header>Native American veteran housing loan program account</header><text>Section 3763 of such title is amended by adding at the end the following new subsection:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H1BF4BDBE5D084314B45E02158719197C"> <subsection id="H877BDA7B510144ABB95553FC0F304F63"><enum>(c)</enum><text>Of amounts available in the Account, the Secretary may use for loans made under section 3762A of this title—</text>
<paragraph id="HB0F77144736F44DAA9CEDED88C359A14"><enum>(1)</enum><text>in fiscal year 2025, not more than $5,000,000; and</text></paragraph> <paragraph id="H9178DDA92B2D49E0A7B834EF43AD934A"><enum>(2)</enum><text>in any fiscal year after fiscal year 2025, an amount determined necessary by the Secretary to meet the demand for such loans.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section></subtitle>
<enum>III</enum><header>Disability and Memorial Affairs Matters</header>
<section id="H96DED4DE452A4F1D8AD918F5E9A292A4" section-type="subsequent-section"><enum>301.</enum><header>Burial allowance for certain veterans who die at home while in receipt of hospice care furnished by Department of Veterans Affairs</header>
<subsection id="H9C2A4AEF90B9471BB0EE61DD7103333A"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall treat a veteran described in subsection (b) as a veteran described in subparagraph (A) of section 2303(a)(2) of title 38, United States Code.</text></subsection> <subsection id="HA99EEEB6D9C941F5B71003BFF11FAD69"><enum>(b)</enum><header>Veteran described</header><text display-inline="yes-display-inline">A veteran described in this subsection is a veteran who dies in a home or other setting at which the deceased veteran was, at the time of death, receiving hospice care pursuant to section 1717(a) of such title if such care was directly preceded by the Secretary furnishing to the veteran hospital care or nursing home care described in clause (ii) of such subparagraph.</text></subsection>
<subsection id="H8AB2099C2B944BF8BABF623AB31B9842" commented="no"><enum>(c)</enum><header>Effective date; applicability</header><text display-inline="yes-display-inline">This section shall apply with respect to deaths that occur—</text> <paragraph id="H6B923CA56ACC476FB37BB64396A75FEA"><enum>(1)</enum><text>on or after the date that is 180 days after the date of the enactment of this Act; and</text></paragraph>
<paragraph id="HC4CCD89FF3D14DCFBFC152E2C1C3593A"><enum>(2)</enum><text>before October 1, 2026.</text></paragraph></subsection></section> <section id="H9E636EB0DBE84D6E94AD27BCA6E33BC8"><enum>302.</enum><header>Authority for Secretary of Veterans Affairs to award grants to States and Indian Tribes to improve outreach to veterans</header> <subsection id="H499104DFB8674BC799E0FF0956A29B54"><enum>(a)</enum><header>In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/63">Chapter 63</external-xref> of title 38, United States Code, is amended—</text>
<paragraph id="HA60A10F698B74771A2FCC950BE04144D"><enum>(1)</enum><text>by redesignating sections 6307 and 6308 as sections 6308 and 6309, respectively; and</text></paragraph> <paragraph id="H1A4DAAE80E2F42A1983A29B26342C038"><enum>(2)</enum><text>by inserting after section 6306 the following new section 6307:</text>
<quoted-block id="HF4CF8DD412A74813B19BEC9C5D106264" style="USC">
<section id="H176FB1966D414C7DA2C59C09E88CC99D"><enum>6307.</enum><header>Grants to States and Indian Tribes to improve outreach to veterans</header>
<subsection id="H43D453FA89B443C2A4978EE5D1A9CEA2"><enum>(a)</enum><header>Purpose</header><text>It is the purpose of this section to provide for assistance by the Secretary to States and Indian Tribes to carry out programs that improve covered outreach and assistance to veterans and the spouses, children, and parents of veterans, to ensure that such individuals are fully informed about, and assisted in applying for, any veterans and veterans-related benefits and programs (including veterans programs of a State or Indian Tribe) for which they may be eligible and facilitate opportunities for such individuals to receive competent, qualified services in the preparation, presentation and prosecution of veterans benefits claims.</text></subsection> <subsection id="H477017690CB64BFCAB88F79765EE1302"><enum>(b)</enum><header>Authority</header><text>The Secretary may award grants to States and Indian Tribes—</text>
<paragraph id="H788B4760CB26410B943CEEB34123F028"><enum>(1)</enum><text>to carry out, coordinate, improve, or otherwise enhance—</text> <subparagraph id="H9E252F8CE6594149B6DCB0254EBB3573"><enum>(A)</enum><text>covered outreach activities; or</text></subparagraph>
<subparagraph id="HCD2292899EAB42658BF4B289B6A3A7F8"><enum>(B)</enum><text>activities to assist in the development and submittal of claims for veterans and veterans-related benefits; or</text></subparagraph></paragraph> <paragraph id="H3E8AB686FFF84338808328D0515D5D34"><enum>(2)</enum><text>to increase the number of county or Tribal veterans service officers serving in the State by hiring new, additional such officers.</text></paragraph></subsection>
<subsection id="H83E21835C0254D388D4C319107896062"><enum>(c)</enum><header>Application</header>
<paragraph id="HE821C3C163624FBDA83C86998AA33264" display-inline="yes-display-inline"><enum>(1)</enum><text>To be eligible for a grant under this section, a State or Indian Tribe shall submit to the Secretary an application therefor at such time, in such manner, and containing such information as the Secretary may require.</text></paragraph> <paragraph id="HA3E531F7D54642E9B6C9E7C2D76F7D3C" indent="up1"><enum>(2)</enum><text>Each application submitted under paragraph (1) shall include the following:</text>
<subparagraph id="HD367B04DE24D40A5AF35A3CB7EB59E3C"><enum>(A)</enum><text>A detailed plan for the use of the grant.</text></subparagraph> <subparagraph id="H5D8C0DEE945D4E71B77C12B6464CDA65"><enum>(B)</enum><text>A description of the programs through which the State or Indian Tribe will meet the outcome measures developed by the Secretary under subsection (j).</text></subparagraph>
<subparagraph id="HE127B561BCC04A00970C7B3633D86052"><enum>(C)</enum><text>A description of how the State or Indian Tribe will distribute grant amounts equitably among counties or Tribal lands with varying levels of urbanization.</text></subparagraph> <subparagraph id="HEDADFB585C4E4C4BA767798573BC346E"><enum>(D)</enum><text>A plan for how the grant will be used to meet the unique needs of American Indian veterans, Alaska Native veterans, or Native Hawaiian veterans, elderly veterans, and veterans from other underserved communities.</text></subparagraph></paragraph></subsection>
<subsection id="HC3AFBD7B427E452A89C6F5103422C460"><enum>(d)</enum><header>Distribution</header><text>The Secretary shall seek to ensure that grants awarded under this section are equitably distributed among States and Indian Tribes with varying levels of urbanization.</text></subsection> <subsection id="HEACF462600B349F28879A85F307DDC76"><enum>(e)</enum><header>Set-aside</header><text>Of the amounts authorized to be appropriated or otherwise made available for grants under this section for any fiscal year, the Secretary shall ensure that not less than five percent is used to make grants to Indian Tribes.</text></subsection>
<subsection id="H2C10F6C6D00D444C94B1BFF9B024D216"><enum>(f)</enum><header>Priority</header><text>The Secretary shall prioritize awarding grants under this section that will serve the following areas:</text> <paragraph id="HACBF51303B5E4424A7E6F2811BD60582"><enum>(1)</enum><text>Areas with a critical shortage of county or Tribal veterans service officers.</text></paragraph>
<paragraph id="H797D05B7646D4A60BB9A4F0D72EFE3FC"><enum>(2)</enum><text>Areas with high rates of—</text> <subparagraph id="HAA8A7CB6E01B49A38FBCF5C5EF95AD9D"><enum>(A)</enum><text>suicide among veterans; or</text></subparagraph>
<subparagraph id="HC22D12B09A6545ACA6F20703E3B6CD6C"><enum>(B)</enum><text>referrals to the Veterans Crisis Line.</text></subparagraph></paragraph></subsection> <subsection id="H5B2B0D88681748C4A4EEC12058CA87F8"><enum>(g)</enum><header>Use of county or Tribal veterans service officers</header><text>A State or Indian Tribe that receives a grant under this section to carry out an activity described in subsection (b)(1) shall carry out the activity through—</text>
<paragraph id="H79D038F327704D2EA7BC3109A7FC781A"><enum>(1)</enum><text>a county or Tribal veterans service officer of the State; or</text></paragraph> <paragraph id="H121A1BCC62774080B43BA73199969247"><enum>(2)</enum><text>if the State or Indian Tribe does not have a county or Tribal veterans service officer, or if the county or Tribal veterans service officers of the State or Indian Tribe cover only a portion of that State or Indian Tribe, an appropriate entity of a State, local, or Tribal government, as determined by the Secretary.</text></paragraph></subsection>
<subsection id="H5B08A9342AF048CB8488FC321868E10E"><enum>(h)</enum><header>Required activities</header><text>Any grant awarded under this section shall be used—</text> <paragraph id="H99645D36F01242A5B1F8D3BED084F50B"><enum>(1)</enum><text>to expand existing programs, activities, and services;</text></paragraph>
<paragraph id="H7E8B86F14CA64A059A2D22E5D538321F"><enum>(2)</enum><text>to hire new, additional county or Tribal veterans service officers; or</text></paragraph> <paragraph id="H06BA0C544B2F4B51A28F529E331007BC"><enum>(3)</enum><text>for travel and transportation to facilitate carrying out paragraph (1) or (2).</text></paragraph></subsection>
<subsection id="H012A2F36AFCD470F921E63B8B73D483D"><enum>(i)</enum><header>Authorized activities</header><text>A grant under this section may be used to provide education and training, including on-the-job training, for State, county, local, and Tribal government employees who provide (or when trained will provide) covered outreach services in order for those employees to obtain accreditation in accordance with procedures approved by the Secretary.</text></subsection> <subsection id="H0F9BF25344374C949C50A1CE2C7AD996"><enum>(j)</enum><header>Outcome measures</header> <paragraph id="H914FBF4DB53843A89DC46BBAFC61F8C6" display-inline="yes-display-inline"><enum>(1)</enum><text>The Secretary shall develop and provide to each State or Indian Tribe that receives a grant under this section written guidance on the following:</text>
<subparagraph id="HA73F7FF7DB5A444A9F859C5695B2838A" indent="up1"><enum>(A)</enum><text>Outcome measures.</text></subparagraph> <subparagraph id="H58A1EDD8E1A24481A7619EFD3E3A2641" indent="up1"><enum>(B)</enum><text>Policies of the Department.</text></subparagraph></paragraph>
<paragraph id="HCA159B32B51A46DDB15D514EF3A1C190" indent="up1"><enum>(2)</enum><text>In developing outcome measures under paragraph (1), the Secretary shall consider the following goals:</text> <subparagraph id="H377BC01D1D0B491D8BE915ADF796FC93"><enum>(A)</enum><text>Increasing the use of veterans and veterans-related benefits, particularly among vulnerable populations.</text></subparagraph>
<subparagraph id="H58B0280D6E4E4720B07D273FCF97AA74"><enum>(B)</enum><text>Increasing the number of county and Tribal veterans service officers recognized by the Secretary for the representation of veterans under chapter 59 of this title.</text></subparagraph></paragraph></subsection> <subsection id="HC224DA49A29B4CEE983BB31D71ABAB29"><enum>(k)</enum><header>Tracking requirements</header> <paragraph id="H23E39B5F261445DAB89FBE1181C2FC79" display-inline="yes-display-inline"><enum>(1)</enum><text>With respect to each grant awarded under this section, the Secretary shall track the use of veterans and veterans-related benefits among the population served by the grant, including the average period of time between the date on which a veteran applies for such a benefit and the date on which the veteran receives the benefit, disaggregated by type of benefit.</text></paragraph>
<paragraph id="HD3708FEECD7E44A3AE88B56AB6607E67" indent="up1"><enum>(2)</enum><text>Not less frequently than annually during the life of the grant program established under this section, the Secretary shall submit to Congress a report on—</text> <subparagraph id="H68D321A1CC9244F0B25117DDD4387202"><enum>(A)</enum><text>the information tracked under paragraph (1);</text></subparagraph>
<subparagraph id="H55C34435E0DD4A1185BB372849158A95"><enum>(B)</enum><text>how the grants awarded under this section serve the unique needs of American Indian veterans, Alaska Native veterans, or Native Hawaiian veterans, elderly veterans, and veterans from other underserved communities; and</text></subparagraph> <subparagraph id="HCA8E86849EA14946B2291D11B66E8962"><enum>(C)</enum><text>other information provided by States and Indian Tribes pursuant to the grant reporting requirements.</text></subparagraph></paragraph></subsection>
<subsection id="HA8DF7CBF57FE43F99328CEF851845856" display-inline="no-display-inline"><enum>(l)</enum><header>Performance review</header><text display-inline="yes-display-inline">The Secretary shall—</text> <paragraph id="H3546B68F96A945F49EC875493282C4D7"><enum>(1)</enum><text>review the performance of each State or Indian Tribe that receives a grant under this section; and</text></paragraph>
<paragraph id="H165879DF17FB4BC4951728933091864B"><enum>(2)</enum><text>make information regarding such performance publicly available.</text></paragraph></subsection> <subsection id="H4F877B7F99354C7A880BEE0B3E6EEDFA"><enum>(m)</enum><header>Remediation plan</header> <paragraph id="H233EEEA4AFC145D1A46BB45AD72A8F98" display-inline="yes-display-inline"><enum>(1)</enum><text>In the case of a State or Indian Tribe that receives a grant under this section and does not meet the outcome measures developed by the Secretary under subsection (j), the Secretary shall require the State or Indian Tribe to submit a remediation plan under which the State shall describe how and when it plans to meet such outcome measures.</text></paragraph>
<paragraph id="H22905055520F4574B46C38C73BAEE1CB" indent="up1"><enum>(2)</enum><text>The Secretary may not award a subsequent grant under this section to a State or Indian Tribe described in paragraph (1) unless the Secretary approves the remediation plan submitted by the State or Indian Tribe.</text></paragraph></subsection> <subsection id="H317CC9EB0EBC49A7A8DAE6B6FAC0C712"><enum>(n)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H4881B1A50C074D66BD79F853CCB0C58C"><enum>(1)</enum><text>The term <term>county or Tribal veterans service officer</term> includes a local equivalent veterans service officer.</text></paragraph> <paragraph id="H3C8F739D826942DEA9EC505C2FE72CFB"><enum>(2)</enum><text>The term <term>covered outreach</term> means outreach with respect to—</text>
<subparagraph id="HD03C4637891F4DD4A960EA875948E396"><enum>(A)</enum><text>benefits administered by the Under Secretary for Benefits; or</text></subparagraph> <subparagraph id="H52B74B5B52A142DC946B6A69DC7A744E"><enum>(B)</enum><text>similar benefits administered by a State or Indian Tribe.</text></subparagraph></paragraph>
<paragraph id="H6DD9B4C19FA9495996E92EABC5AC22F5"><enum>(3)</enum><text>The term <term>Indian Tribe</term> has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>).</text></paragraph> <paragraph id="HBCFB9CFDD762461BB193835644ED26DF"><enum>(4)</enum><text>The term <term>State</term> includes the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, and any territory or possession of the United States.</text></paragraph>
<paragraph id="H397121E7F9C747789179C3F0754DA5ED"><enum>(5)</enum><text>The term <term>Veterans Crisis Line</term> means the toll-free hotline for veterans established under section 1720F(h) of this title.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H0E99CC4AD22A4A5A8A1CAB220AB67E33"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 63 of such title is amended by striking the items relating to sections 6307 and 6308 and inserting the following new items:</text>
<quoted-block id="H84E38717BCE84906B94F5E81B4EB597A" style="USC">
<toc regeneration="no-regeneration">
<toc-entry level="section">6307. Grants to States and Indian Tribes to improve outreach to veterans</toc-entry>
<toc-entry level="section">6308. Outreach for eligible dependents</toc-entry>
<toc-entry level="section">6309. Biennial report to Congress</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HBF8494814BE542D7A3FB19D88CD91220"><enum>(c)</enum><header>Authorization of appropriations</header><text>There is authorized to be appropriated to the Secretary of Veterans Affairs for each of fiscal years 2026 and 2027, $10,000,000 to carry out section 6307 of title 28, United States Code, as added by subsection (a).</text></subsection></section> <section id="H2DD0616437224A1D83686968B5F1A1B2"><enum>303.</enum><header>Definition of surviving spouse</header><text display-inline="no-display-inline">Paragraph (3) of section 101 of title 38, United States Code, is amended to read as follows:</text>
<quoted-block style="USC" id="HADA60797BAA9423D8F9C05A43C9F66C7" display-inline="no-display-inline">
<subsection id="H2FF3B6917248449CA433F57E6766C4E1"><enum>(3)</enum><text display-inline="yes-display-inline">The term <term>surviving spouse</term> means (except for purposes of chapter 19 of this title) a person who was the spouse of a veteran at the time of the veteran’s death, and who lived with the veteran continuously from the date of marriage to the date of the veteran’s death (except where there was a separation which was due to the misconduct of, or procured by, the veteran without the fault of the spouse) and who has not remarried.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section> <section section-type="subsequent-section" id="H5F08B4BF66A3467F875B62202910E01F" display-inline="no-display-inline"><enum>304.</enum><header>Ensuring only licensed health care professionals perform medical disability examinations under certain Department of Veterans Affairs pilot program</header> <subsection id="H06C6BC139A57479BBC7254C7AF452366"><enum>(a)</enum><header>Prohibition on use of certain health care professionals</header><text>Section 504(c)(1) of the Veterans’ Benefits Improvements Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note) is amended by inserting <quote>only</quote> before <quote>a health care professional</quote>. </text></subsection>
<subsection id="HBF8DF26416204DDBB834119363F0D2BA"><enum>(b)</enum><header>Remedies</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall take such actions as the Secretary considers appropriate to ensure compliance with section 504(c) of the Veterans’ Benefits Improvements Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note), as amended by subsection (a).</text></subsection> <subsection id="H7FDAA7EF726B4DD285366962AE5768D5"><enum>(c)</enum><header>Annual report</header><text>Not later than one year after the date of the enactment of this Act and not less frequently than once each year thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on—</text>
<paragraph id="HFB7758FD72F743319B795B31D4D73768"><enum>(1)</enum><text>the conduct of the pilot program established under section 504 of the Veterans’ Benefits Improvements Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note); and</text></paragraph> <paragraph id="H50557C8DCD804CE38850518B6A765182"><enum>(2)</enum><text>the actions of the Secretary under subsection (b).</text></paragraph></subsection>
<subsection id="HC99A3752B9594FD6A11CF71078959AE9"><enum>(d)</enum><header>Technical corrections</header><text>Section 504 of the Veterans’ Benefits Improvements Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note) is amended, in the section heading, by striking <quote><header-in-text level="section" style="OLC">physicians</header-in-text></quote> and inserting <quote><header-in-text level="section" style="OLC">health care professionals</header-in-text></quote>.</text></subsection></section> <section id="HEF4C47373C9F418393D0B919FE5056DA"><enum>305.</enum><header>Provision of information regarding an agent or attorney to a licensed health care professional who performs a medical disability examination under certain Department of Veterans Affairs pilot program</header> <subsection id="H50920066CB804995BED73D50C4B060E9"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 504 of the Veterans’ Benefits Improvements Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note), as amended by section 304, is further amended by adding at the end the following new subsection:</text>
<quoted-block style="OLC" id="HE70C608134B84E15B87B0B9390502723" display-inline="no-display-inline">
<subsection id="HD6268C257E7A4ED9833CC56520954B45"><enum>(f)</enum><header>Certain information provided to health care professional</header><text display-inline="yes-display-inline">The Secretary shall provide to a health care professional who performs an examination under subsection (a), or a contractor performing a contract under such subsection, the contact information of any agent or attorney recognized by the Secretary under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/59">chapter 59</external-xref> of title 38, United States Code, with regards to a claim for benefits that gives rise to such examination.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H997288B1367F4E86BE88A495524841BC"><enum>(b)</enum><header>Applicability</header><text display-inline="yes-display-inline">The amendment made by this section shall apply to an examination described in subsection (a) of such section that is performed on or after the date of the enactment of this Act.</text></subsection></section>
<section id="H3D0618F0A0F24EA7B0C16B2B665A15E6" display-inline="no-display-inline" section-type="subsequent-section"><enum>306.</enum><header>Modernization of Department of Veterans Affairs disability benefit questionnaires</header>
<subsection id="H5163E557DBFC414B83AB78DC1710B5A4"><enum>(a)</enum><header>Requirement for transmission of certain information in machine-readable format</header>
<paragraph id="H8F5993D7D7AD401AAACE0D7E5F4905C2"><enum>(1)</enum><header>Requirement</header><text display-inline="yes-display-inline">Not later than 180 days after enactment of this Act, the Secretary of Veterans Affairs shall require all disability benefit questionnaire data collected in the course of medical disability examinations made by covered non-Department providers to be transmitted to the Department in a machine-readable format.</text></paragraph> <paragraph id="HAB686CF4E10342F48AAD7BCC852DD4CF"><enum>(2)</enum><header>Issuance of standards</header><text display-inline="yes-display-inline">Not later than 90 days after the date of the enactment of this Act, the Secretary shall issue standards for the transmission of disability benefit questionnaire data in a machine-readable format as required under paragraph (1).</text></paragraph>
<paragraph id="HA5FFC3CC0B9C44CAB832FF6293376987"><enum>(3)</enum><header>Updates</header><text display-inline="yes-display-inline">In making updates to disability benefit questionnaires after the date specified in paragraph (1), the Secretary shall—</text> <subparagraph id="H3392A15D2EB241CABC1B58EC98EB2F23"><enum>(A)</enum><text display-inline="yes-display-inline">ensure that the updates are made in a manner that allows for the data collected under the questionnaires to be in a machine-readable format as of the date on which the update goes into effect; and</text></subparagraph>
<subparagraph id="H2F5EAA292C104C49AC6B33A37B6371D2"><enum>(B)</enum><text display-inline="yes-display-inline">not later than 30 days before an update goes into effect, notify the covered non-Department providers (or the contractor performing a contract under section 504 of the Veterans Benefits Improvement Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note)) described in such paragraph of such updates.</text></subparagraph></paragraph></subsection> <subsection id="H3C1656D96F494C91A75108020E6EB717"><enum>(b)</enum><header>Plan for information technology system modification</header><text display-inline="yes-display-inline">Not later than 180 days after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a plan to modify the information technology systems and processes of the Department to enable a non-Department health care professional, assigned to or selected by a claimant, to transmit to the Department, in a machine-readable format, disability benefit questionnaire data, including complete disability benefit questionnaires rather than partial questionnaires or elements of medical evidence.</text></subsection>
<subsection id="H0185407843714F51A0D39B6F0865CF49"><enum>(c)</enum><header>Public availability of information</header><text>The Secretary shall make publicly available on the internet website of the Department referred to in section 5101(d) of title 38, United States Code—</text> <paragraph id="HC2C0B1A4E99244FABF19D92374DA2B24"><enum>(1)</enum><text>a description of the standards issued under subsection (a)(2); and</text></paragraph>
<paragraph id="HCD6A77D416704C998D129181847D306E"><enum>(2)</enum><text>the plan required under subsection (b).</text></paragraph></subsection> <subsection id="H332CA010ABD9417BBD9DC16B1C683E0F"><enum>(d)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H41A161E16261468BB83843AF88D1B3B4"><enum>(1)</enum><text>The term <term>claimant</term> has the meaning given such term in section 5100 of title 38, United States Code.</text></paragraph> <paragraph id="H53A7F307D815412B82307D2CF8E4C787"><enum>(2)</enum><text display-inline="yes-display-inline">The term <term>covered non-Department provider</term> means a health care provider who—</text>
<subparagraph id="HE3F36ADFD7CF4FE699FC179769BA1134"><enum>(A)</enum><text>is not an employee of the Department of Veterans Affairs; and</text></subparagraph> <subparagraph id="H39DDBA3094A04FDDA7F4334F7B44BDA7"><enum>(B)</enum><text display-inline="yes-display-inline">pursuant to a contract under section 504 of the Veterans Benefits Improvement Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note), as amended by sections 304 and 305, examines a claimant for a medical disability.</text></subparagraph></paragraph></subsection></section>
<section id="HC6314D6CE7DA485286F7A57D04A59AAE" display-inline="no-display-inline" section-type="subsequent-section"><enum>307.</enum><header>Department of Veterans Affairs automatic processing of certain claims for temporary disability ratings</header>
<subsection id="H6C7195B179944C74BA755356274642C8"><enum>(a)</enum><header>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 modify the information technology systems of the Department of Veterans Affairs to use automation technology for claims for temporary disability ratings for veterans described in section 1156(a)(1)(C) of title 38, United States Code.</text></subsection> <subsection id="H47C7441626A74004A82D40B5FDF9B16B"><enum>(b)</enum><header>Additional requirements</header><text>In providing for the automatic processing of claims as required under subsection (a), the Secretary shall ensure that—</text>
<paragraph id="H51F66201E06B496080E15AB9736AD0F9"><enum>(1)</enum><text display-inline="yes-display-inline">medical evidence is obtained from the corporate data warehouse of the Department or other sources of data, the Secretary determines appropriate;</text></paragraph> <paragraph id="H94D4B53957F0448EB05D03E3345D3D57"><enum>(2)</enum><text>employees of the Department continue to determine whether a veteran is entitled to a temporary disability rating under section 1156(a)(1)(C) of title 38, United States Code; and</text></paragraph>
<paragraph id="H121AD5CCF8C44CD8B296EEA896AAB684"><enum>(3)</enum><text>claims may be processed manually if the evidence of record is not sufficient to decide the claim or if the medical evidence is provided in a format that is not compatible with the system developed under subsection (a).</text></paragraph></subsection></section> <enum>IV</enum><header>Homelessness Matters</header> <section id="HE37A76DBD43F4337B1D0E0D276A5E251" section-type="subsequent-section"><enum>401.</enum><header>Short title</header><text display-inline="no-display-inline">This title may be cited as the <quote><short-title>Housing our Military Veterans Effectively Act of 2024</short-title></quote> or the <quote>HOME Act of 2024</quote>.</text></section>
<section id="H4E83B0E6CFB548C6991597F9F47DDC6F"><enum>402.</enum><header>Per diem payments provided by the Secretary of Veterans Affairs for services furnished to homeless veterans</header>
<subsection id="HDE60CCFA05A247E39FE42A98641B7E0A"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2012 of title 38, United States Code, is amended—</text> <paragraph id="H15D2C33706024640AD323D059F0DC1EB"><enum>(1)</enum><text>in subsection (a)—</text>
<subparagraph id="H7BD7E7B51B6D41DAB4D05E7905C30004"><enum>(A)</enum><text>in paragraph (2)(B)—</text> <clause id="H6CC62EEC36DD494FA90C509EA7F1F0F5"><enum>(i)</enum><text>in clause (i)(II)(aa)(BB), by striking <quote>115 percent</quote> and inserting <quote>115 percent (or, during the period beginning on the date of the enactment of the <short-title>the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act</short-title> and ending on September 30, 2027, 133 percent)</quote>; and</text></clause>
<clause id="H390B72B291A2425CB44B54F7E5919E1C"><enum>(ii)</enum><text>by adding at the end the following:</text> <quoted-block id="HB94FE45700A144DEB6CD2F982141EBD9" style="OLC"> <clause id="HE0C4A5EC703449BFB152CA9F3E095D47" indent="up3"><enum>(iii)</enum><text display-inline="yes-display-inline">For each of fiscal years 2025 through 2027, the Secretary may waive the maximum rate for per diem payments under clause (i)(II)(aa)(BB) or (ii) and, subject to the availability of appropriations, provide such payments at a rate that does not exceed 200 percent of 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, if the Secretary notifies Congress of such waiver.</text></clause>
<clause id="H238B462A4D844055A74B29009F0E1605" indent="up3"><enum>(iv)</enum><text display-inline="yes-display-inline">The Secretary may not, pursuant to clause (iii), waive the maximum rate described in such clause for more than 50 percent of all grant recipients and eligible entities for a fiscal year.</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="H7E306F06D2434138AB1D0702EE424A1C"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block style="USC" id="HC0831015AA774FA393CA49D42D83B2D0" display-inline="no-display-inline">
<paragraph id="H2653F05F8D964C63860BAC82F1644539" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">The Secretary may not provide more than 12,000 per diem payments under this section for a fiscal year.</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H7CC5135C67C948B6AFD4DE59B469BE14"><enum>(2)</enum><text>by adding at the end the following new subsection:</text>
<quoted-block id="H07229F1BC5D44354980D3BC299FDF862" style="OLC">
<subsection id="HDC9C6ACF82444FEDB0701117A3B14C9D"><enum>(f)</enum><header>Reports required</header><text>Not later than 90 days after the date of the enactment of the HOME Act of 2024, and not less frequently than twice each year thereafter, the Secretary shall submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report on the rate for per diem payments under this section that includes, for each Veterans Integrated Service Network of the Department, the following data:</text> <paragraph id="HF3AB193EA7D746B981202BA7D11D863E"><enum>(1)</enum><text>The average rate for such a payment.</text></paragraph>
<paragraph id="H3B8029038A494967AF138AEB5178CC71"><enum>(2)</enum><text>A list of locations where the rate for such a payment is within 10 percent of the maximum rate for such a payment authorized under this section.</text></paragraph> <paragraph id="H51C9C0F9BF784199872BD364355BE033"><enum>(3)</enum><text>The average length of stay by a veteran participating in a program described in section 2012(a) of this title.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HFB5EFA5BF2B84284AAFC82C076B79BCB"><enum>(b)</enum><header>Regulatory authority</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs may carry out the amendments made by subsection (a) through interim guidance in advance of the issuance of regulations for such purpose.</text></subsection> <subsection id="H2A4F691F9A164435BFB1AF725FE67441"><enum>(c)</enum><header>Strategic plan</header> <paragraph id="H721B021ADB0A41B79BC823725BA77ED3"><enum>(1)</enum><header>In general</header><text>Not later than September 30, 2025, 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 strategic plan for the provision of grants and per diem payments for services furnished to homeless veterans under sections 2011 and 2012 of title 38, United States Code.</text></paragraph>
<paragraph id="H9B0D98AB51E245DA8B11BB38B822343C"><enum>(2)</enum><header>Elements</header><text>The plan required by paragraph (1) shall include the following:</text> <subparagraph id="H3F82725223924A9BA43579584D7AFF19"><enum>(A)</enum><text>A method for administering grant funding equitably without using the rate authorized for State homes for domiciliary care under subsection (a)(1)(A) of section 1741 of title 38, United States Code, as the Secretary may increase from time to time under subsection (c) of that section, that takes into account—</text>
<clause id="H5DAB174220EA4C3F83DE17598B596FFD"><enum>(i)</enum><text>the wide variety of services furnished by grant recipients and eligible entities under sections 2011 and 2012 of title 38, United States Code;</text></clause> <clause id="H9DA1584881EF44089FF0F43BF8DDB796"><enum>(ii)</enum><text>varying costs of living across different geographic locations;</text></clause>
<clause id="HE890791FB6494172AB6FC155A6063C9D"><enum>(iii)</enum><text>varying availability of affordable housing in different geographic locations;</text></clause> <clause id="H1CC48E5A92E04893A8F732B57E1C0836"><enum>(iv)</enum><text>circumstances of housing insecurity in rural and Tribal communities;</text></clause>
<clause id="H00620A466F2F43E5A3B9DDEE0B365618"><enum>(v)</enum><text>veterans with significant medical care needs; and</text></clause> <clause id="HAC7BDEB06B3645BA82E26BE4D63A0F4B"><enum>(vi)</enum><text>the changing dynamic of the veteran population nationwide.</text></clause></subparagraph>
<subparagraph id="H8890783F14DB4FF485E3428AE032C325"><enum>(B)</enum><text>A plan and timeline for implementation of the method included under subparagraph (A).</text></subparagraph> <subparagraph id="H188FBC5167CB474F97D6F5DE91BE5D78"><enum>(C)</enum><text>An estimate of increased costs or savings per year under the plan.</text></subparagraph>
<subparagraph id="HFD2A9223F0A04CB289AF952CD2BDB077"><enum>(D)</enum><text>An overview of the different grants that will be available once the plan is implemented.</text></subparagraph></paragraph></subsection></section> <section id="H3B1E5AD0B6C0442C8247212F6474EAA5"><enum>403.</enum><header>Authorization for Secretary of Veterans Affairs to use of certain funds for improved flexibility in assistance to homeless veterans</header> <subsection id="HA4E373CE78604E0AB23B2DA34F3FF27C"><enum>(a)</enum><header>Use of funds</header><text display-inline="yes-display-inline">During the period beginning on the date of the enactment of this Act and ending on the termination date specified in subsection (d), the Secretary of Veterans Affairs may provide to a covered veteran, as the Secretary determines necessary—</text>
<paragraph id="H8E91D1CF503647718522043A6D2B78C9"><enum>(1)</enum><text>food, shelter, clothing, blankets, and hygiene items required for the safety and survival of the veteran;</text></paragraph> <paragraph id="HEEF33C8D6266475E84719D2696F56369"><enum>(2)</enum><text>transportation required to support the stability and health of the veteran for appointments with service providers, the conduct of housing and employment searches, and the obtainment of food and supplies; and</text></paragraph>
<paragraph id="H8F79B40E3F1749E2B2BFCCFE8D0F49D4"><enum>(3)</enum><text>tablets, smartphones, disposable phones and other technology, and related service plans required to support the stability and health of the veteran through the maintenance of contact with service providers, prospective landlords, and family members.</text></paragraph></subsection> <subsection id="H44BBCB606CB74B8D95FC2A93D5805C36"><enum>(b)</enum><header>Homeless veterans on Department of Veterans Affairs land</header> <paragraph id="HDD674E256617412E8DDFD09B4F784957" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary may collaborate, to the extent practicable, with one or more organizations to manage the use of land of the Department of Veterans Affairs for homeless veterans for living and sleeping.</text></paragraph>
<paragraph id="HAEE500C2C7A142D693FAF1E13696B778"><enum>(2)</enum><header>Forms of collaboration</header><text display-inline="yes-display-inline">Collaboration under paragraph (1) may include the provision by either the Secretary or the head of the organization concerned of food services and security for property, buildings, and other facilities owned or controlled by the Department of Veterans Affairs.</text></paragraph></subsection> <subsection id="H20693C3831FB429389A0EE71BE4F29BC"><enum>(c)</enum><header>Report required</header><text>Not later than six months after the date of the enactment of this Act, and annually thereafter until the date specified in subsection (d), the Secretary shall submit to Congress a report that includes, with respect to the period covered by such report—</text>
<paragraph id="HB2F9ED9AC1EA442EBA6DD532FEBFD0B6"><enum>(1)</enum><text>a statement, disaggregated by each medical center of the Department of Veterans Affairs, of the amount of funds under this section—</text> <subparagraph id="H899D18A91D2747868E3D886E2769BE93"><enum>(A)</enum><text>each such medical center requested from the Secretary; and</text></subparagraph>
<subparagraph id="H073A81BAFBC44F09807549410F2C0100"><enum>(B)</enum><text>to which the Secretary provided each such medical center;</text></subparagraph></paragraph> <paragraph id="HC2A76623517149EA98AADFF65FABA422"><enum>(2)</enum><text>data, disaggregated by each such medical center, relating to how each such medical center used amounts provided by the Secretary under this section;</text></paragraph>
<paragraph id="H0B72843D50284146A48CC79458F8E648"><enum>(3)</enum><text>the number of covered veterans to which the Secretary provided assistance under this section;</text></paragraph> <paragraph id="H05AC029DC57046E19C4B98E4E023F6B7"><enum>(4)</enum><text display-inline="yes-display-inline">the total amount of assistance the Secretary provided to covered veterans pursuant to subsection (a)(3) for communications equipment, broken down by the type of equipment provided;</text></paragraph>
<paragraph id="H13DF2922939849009A5DAA1FB8B04294"><enum>(5)</enum><text>the total amount of assistance the Secretary provided covered veterans pursuant to subsection (a)(2) for ridesharing;</text></paragraph> <paragraph id="H2E37CBAD06F54B63918996B07A0699E4"><enum>(6)</enum><text>the number of covered veterans who received such assistance; and</text></paragraph>
<paragraph id="H770F7D2C2CBF4532AF78B9216EF959BD"><enum>(7)</enum><text>a description, for each rideshare used by a covered veteran with such assistance, of the reasons such covered veteran used such rideshare.</text></paragraph> <paragraph id="HB82366779BE04CF29773288152A72592"><enum>(8)</enum><text display-inline="yes-display-inline">the number of covered veterans who lived or slept on Department land;</text></paragraph>
<paragraph id="H6B1887E6AF454A3FA77EDEE56740A180"><enum>(9)</enum><text>the amount of funds used to make available Department land for covered veterans to live and sleep;</text></paragraph> <paragraph id="HE9EFDDE2772C48A181F9EF0F09903D64"><enum>(10)</enum><text>the number of Department employees whose primary responsibilities involved providing services for covered veterans living or sleeping on Department land;</text></paragraph>
<paragraph id="HAFE6FD23239941AA86B0D346998AE6A2"><enum>(11)</enum><text>the average length of time a covered veteran lived or slept on Department land, and</text></paragraph> <paragraph id="HA044817F436143BFADC4F3CC1608E934"><enum>(12)</enum><text>the period of time the Secretary expects Department land will be made available for covered veterans to live and sleep.</text></paragraph></subsection>
<subsection id="HEF7C4A44865E41D89C4A0E3D4C1376A1"><enum>(d)</enum><header>Termination date</header><text>The termination date specified in this subsection is September 30, 2027.</text></subsection> <subsection id="H6306138772594AE8B074D1EB3F93D77F"><enum>(e)</enum><header>Definitions</header><text>In this section, the term <term>covered veteran</term> means—</text>
<paragraph id="H98225F4B354B4AC893A7524B658B6B0C"><enum>(1)</enum><text display-inline="yes-display-inline">a homeless veteran, as such term is defined in section 2002 of title 38, United States Code; and</text></paragraph> <paragraph id="HC8F036B7D0854C00A5AE7F80795BED03"><enum>(2)</enum><text display-inline="yes-display-inline">a veteran participating in the program carried out under 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></subsection></section>
<section id="H4BA30B77C03B44EA81C7C99E0EC3D8DA"><enum>404.</enum><header>Access to Department of Veterans Affairs telehealth services</header>
<subsection id="H19180C66462341C0AB72AA236B8C7900"><enum>(a)</enum><header>In general</header><text>Subtitle 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 id="H970204FB83A1479C8BB5210BFF439B9B" style="USC"> <section id="HCBDFFC63B93F46ABBBA7A70AE6B2B9A5"><enum>2069.</enum><header>Access to telehealth services</header><text display-inline="no-display-inline">To the extent practicable, the Secretary shall ensure that veterans participating in or receiving services from a program under this chapter have access to telehealth services to which such veterans are eligible under the laws administered by the Secretary, including by ensuring that telehealth capabilities are available to—</text>
<paragraph id="H4D15477403564D0A83D0D0017AC1C761"><enum>(1)</enum><text>such veterans;</text></paragraph> <paragraph id="HD7AE815E2FD14B31B3DC657884CF4664"><enum>(2)</enum><text>case managers of the Department of programs for homeless veterans authorized under this chapter; and</text></paragraph>
<paragraph id="H17FBBF131DB54F799173DE75410A7AFE"><enum>(3)</enum><text>community-based service providers for homeless veterans receiving funds from the Department through grants or contracts.</text></paragraph></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H78ABB8E15B8A4DDAA9ACE645656B2AB8"><enum>(b)</enum><header>Clerical amendment</header><text display-inline="yes-display-inline">The table of sections at the beginning 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 item:</text>
<quoted-block id="H6F7CC72CB1B3456C90C183E8EE935C87" style="OLC">
<toc regeneration="no-regeneration">
<toc-entry level="section">2069. Access to telehealth services.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<enum>V</enum><header>Oversight and Investigations Matters</header>
<section id="HAEF157011058486781BF03AEB3259836" commented="no" display-inline="no-display-inline" section-type="subsequent-section"><enum>501.</enum><header display-inline="yes-display-inline">Department of Veterans Affairs employee training regarding Office of Inspector General</header>
<subsection id="HED4DDDF39D554BABB04B44411A3A2D31" commented="no" display-inline="no-display-inline"><enum>(a)</enum><header display-inline="yes-display-inline">Training</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall require each employee of the Department of Veterans Affairs who begins employment with the Department on or after the date of the enactment of this Act to receive training that the Inspector General of the Department shall develop on the reporting of wrongdoing to, responding to requests from, and the duty of cooperating with the Office of Inspector General of the Department.</text></subsection> <subsection id="H8CF8C35EA8CD49E199A8F150708194C0" commented="no" display-inline="no-display-inline"><enum>(b)</enum><header display-inline="yes-display-inline">Timing of training</header><text display-inline="yes-display-inline">In carrying out subsection (a), the Secretary shall require each employee of the Department covered under such subsection to undergo the training required by such subsection not later than one year after the date on which the employee begins employment with the Department.</text></subsection>
<subsection id="H22C53710A94D48D5A6867E1294B72734" commented="no" display-inline="no-display-inline"><enum>(c)</enum><header display-inline="yes-display-inline">Elements</header><text display-inline="yes-display-inline">Training developed and required under subsection (a) shall include the following:</text> <paragraph id="H914C43A5303B4F299D0AC82695FC173E" commented="no" display-inline="no-display-inline"><enum>(1)</enum><text display-inline="yes-display-inline">Definition of the role, responsibilities, and legal authority of the Inspector General of the Department and the duties of employees of the Department for engaging with the Office of Inspector General.</text></paragraph>
<paragraph id="HDDEBEB648F5A44A89FA741B465F5ED8B" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text display-inline="yes-display-inline">Identification of Federal whistleblower protection rights, including the right to report fraud, waste, abuse, and other wrongdoing to Congress.</text></paragraph> <paragraph id="HFD4520978CC9479095DA127C2EB907DF" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text display-inline="yes-display-inline">Identification of the circumstances and mechanisms for reporting fraud, waste, abuse, and other wrongdoing to the Inspector General, including making confidential complaints to the Inspector General.</text></paragraph>
<paragraph id="H762D2C9EF414447F9CD8E2D5EA9C7828" commented="no" display-inline="no-display-inline"><enum>(4)</enum><text display-inline="yes-display-inline">Identification of the prohibitions and remedies that help to protect employees of the Department from retaliation when reporting wrongdoing to the Inspector General.</text></paragraph> <paragraph id="H2795398E50EE434C8451649910DFC4C6" commented="no" display-inline="no-display-inline"><enum>(5)</enum><text display-inline="yes-display-inline">Recognition of opportunities to engage with staff of the Office of Inspector General to improve programs, operations, and services of the Department.</text></paragraph>
<paragraph id="H6A3FB4D27F8F4CDCAE3A6F02626E5D35" commented="no" display-inline="no-display-inline"><enum>(6)</enum><text display-inline="yes-display-inline">Notification of the authority of the Inspector General to subpoena the attendance and testimony of witnesses, including former employees of the Department, as necessary to carry out the duties of the Office of Inspector General under section 312 of title 38, United States Code.</text></paragraph></subsection> <subsection id="HEDD7214F279E4B65800273963C4F9206" commented="no" display-inline="no-display-inline"><enum>(d)</enum><header display-inline="yes-display-inline">Design and update</header><text display-inline="yes-display-inline">The Inspector General of the Department shall design, and update as the Inspector General considers appropriate, the training developed and required by subsection (a).</text></subsection>
<subsection id="H0093BB4BCFBE4343911E5FAAC6372079" commented="no" display-inline="no-display-inline"><enum>(e)</enum><header display-inline="yes-display-inline">System</header><text display-inline="yes-display-inline">The Secretary shall provide, via the talent management system of the Department, or successor system, the training developed and required under subsection (a).</text></subsection> <subsection id="HC8C502F17B8C4B73B4DB87795B7C1038" commented="no" display-inline="no-display-inline"><enum>(f)</enum><header display-inline="yes-display-inline">Relation to certain training</header><text display-inline="yes-display-inline">The Secretary shall ensure that training developed and required under subsection (a) is separate and distinct from training provided under section 733 of title 38, United States Code.</text></subsection>
<subsection id="H222BBD120F18426590C2B0D7702F0AFF" commented="no" display-inline="no-display-inline"><enum>(g)</enum><header display-inline="yes-display-inline">Notice to employees</header><text display-inline="yes-display-inline">The Secretary shall ensure that the Inspector General is afforded the opportunity, not less frequently than twice each year and more frequently if the Inspector General considers appropriate under extraordinary circumstances, to use the electronic mail system of the Department to notify all authorized users of such system of the following:</text> <paragraph id="H2769C5941F38423FA0CEEA54BE0FCD65" commented="no" display-inline="no-display-inline"><enum>(1)</enum><text display-inline="yes-display-inline">The roles and responsibilities of the employees of the Department when engaging with the Office of Inspector General.</text></paragraph>
<paragraph id="H3446E6FE7CD94C05A24EA4E17F69B0CE" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text display-inline="yes-display-inline">The availability of training provided under subsection (a).</text></paragraph> <paragraph id="HEB070A2B286447D6A49E871AB03C3F94" commented="no" display-inline="no-display-inline"><enum>(3)</enum><text display-inline="yes-display-inline">How to access training provided under subsection (a).</text></paragraph>
<paragraph id="HDA6D254D50954E0AB48FD0B45EA5B786" commented="no" display-inline="no-display-inline"><enum>(4)</enum><text display-inline="yes-display-inline">Information about how to contact the Office of Inspector General, including a link to any website-based reporting form of the Office. </text></paragraph></subsection></section> <section id="H79F7598E0D7E4F12BFE6A42E28265E29"><enum>502.</enum><header>Annual review of security at covered facilities of the Department of Veterans Affairs</header> <subsection id="H763C760A4F014EB181D4641ADA741289"><enum>(a)</enum><header>Annual survey</header><text>Not later than one year after the date of the enactment of this Act, and annually thereafter for each of the following five fiscal years, the Secretary of Veterans Affairs, in coordination with the Director of the Office of Security and Law Enforcement of the Department of Veterans Affairs, shall conduct a survey of the covered employees at each covered facility to collect information regarding security. Each annual survey shall include questions about—</text>
<paragraph id="HE73A78BE72534560A446AF770A190A13"><enum>(1)</enum><text>the type and frequency of criminal activity experienced at the covered facility during the fiscal year which most recently concluded including whether or not the criminal activity was related to residents at the facility or campus such as those in a residential rehabilitation treatment program or enhanced-use lease facility;</text></paragraph> <paragraph id="HC3B479F8C5BD4DC291DE6F5C3F7EFFBB"><enum>(2)</enum><text>the number of vacancies and number of days vacant for Department police officers at the covered facility at the time of the survey delineated by recruitment status and stage;</text></paragraph>
<paragraph id="H9B02C4A809D1424DB6A67D6F669A5EED"><enum>(3)</enum><text>the availability and adequacy of covered equipment;</text></paragraph> <paragraph id="HBC6DB3E596A94A30B5412B22AFCB72D0"><enum>(4)</enum><text>the availability and adequacy of resources, classes, or other time set aside for training Department police officers who work at each covered facility about any skill or tactic related to law enforcement, including the proper use of force, firearms qualifications and training, procedures for responding to an active threat, and any other training required for Department police officers;</text></paragraph>
<paragraph id="HD6F6CFDBB60B47298D779D9110F2720D"><enum>(5)</enum><text>any security weakness at covered facilities;</text></paragraph> <paragraph id="HEF14CB58D245469996161E279C32D2A2"><enum>(6)</enum><text>the relationship between the covered facility (including the Department police officers who work at the covered facility) and local, state, and federal law enforcement agencies including what agreements or memorandums of understanding exist between each covered facility and external law enforcement agencies;</text></paragraph>
<paragraph id="H6CFE150E778B4AFC9730782A056FE4F8"><enum>(7)</enum><text>efforts by the personnel of the covered facility to address and reduce criminal activity at, or in close proximity to, the covered facility; and</text></paragraph> <paragraph id="HF5E5B58DBA01451CA2B885591AB79143"><enum>(8)</enum><text>recommendations for the Secretary to better address and reduce criminal activity at, or in close proximity to, covered facilities so as to improve the safety of veterans, employees, visitors, other authorized personnel, and the surrounding community.</text></paragraph></subsection>
<subsection id="H623BDCF4753C480EAABA90B22E9E8490"><enum>(b)</enum><header>Report</header><text>Not later than 30 days after the end of the next full Fiscal Year after the enactment of this Act and for each of the following five fiscal years, the Secretary shall submit to each of the Committees on Veterans’ Affairs of the Senate and the House of Representatives a report regarding the results of the surveys conducted under subsection (a) during the previous fiscal year. The report shall include—</text> <paragraph id="H0B307F37449C482F93B45B9DD0D2C0A5"><enum>(1)</enum><text>the results of the annual survey described under subsection (a) for the year covered by the report;</text></paragraph>
<paragraph id="H7DAF8904B2904FDAB1D8BA241CD875AE"><enum>(2)</enum><text>an analysis, made in coordination with the Director of the Office of Security and Law Enforcement of such Department, each director and police chief of a Veterans Integrated Service Network, and the directors and police chiefs of the medical centers within the Veterans Integrated Service Network of the results of the triannual security inspections conducted in prior fiscal year, to include a plan of action that describes how the Secretary plans to address any security weakness identified in the results of the triannual security inspections and includes clearly-stated goals with measurable benchmarks for each goal and deadlines for each benchmark; and</text></paragraph> <paragraph id="H571C32433EDF42E2AEB4B75A9F5D9E10"><enum>(3)</enum><text>a list of all vacant positions for police chief or deputy police chief at each covered facility during the prior fiscal year, the number of individuals who filled those positions over the two years prior to the date of the survey, the number of days the positions were vacant without someone serving in an acting capacity, and the number of days the positions were filled by individuals serving in an acting capacity.</text></paragraph></subsection>
<subsection id="H6D5D724F6E3949999B31B145C9496E9D"><enum>(c)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H1065C0C4D9F94385B954FC7249D84CA1"><enum>(1)</enum><text>The term <quote>covered equipment</quote> means any item issued by the Secretary of Veterans Affairs to a Department police officer (including firearms, weapons detecting technology, ballistic vests, body-worn cameras, and radios) for use in the provision of services under section 902 of title 38, United States Code.</text></paragraph>
<paragraph id="H6ACD9A9F0FCF4EF0827D726FEDA1509F"><enum>(2)</enum><text>The term <quote>covered employee</quote> means an employee of the Department of Veterans Affairs who is employed and responsible for security operations at a covered facility including a covered facility’s police chief, facility emergency management leader, facility director, or person carrying out the responsibilities of one of these positions in an acting capacity.</text></paragraph> <paragraph id="H856F8442A5E7405081241F96A7633352"><enum>(3)</enum><text>The term <quote>covered facility</quote> means any facility of the Department of Veterans Affairs where Department police officers have jurisdiction.</text></paragraph>
<paragraph id="H1C2039559A1E4B329926D4118A930F16"><enum>(4)</enum><text>The term <quote>Department police officer</quote> is used as such term as used in section 902 of title 38, United States Code.</text></paragraph> <paragraph id="H8271A8D5A2304700A03A02D8A192C297"><enum>(5)</enum><text>The term <quote>security weakness</quote> means a deficiency in the facilities, staffing, or covered equipment at a covered facility that a covered employee of the covered facility determines presents a risk to the safety of visitors or staff, including an unsecured door, inoperable security camera, unsecured police operations room, a lack of security presence at an entrance to the covered facility, and a lack of security presence in an area of the covered facility or the grounds of the covered facility that the director of the covered facility determines requires an increased security presence.</text></paragraph></subsection></section>
<section id="H32640ED6C1B84C4BAFA4CC600BC85161" display-inline="no-display-inline" section-type="subsequent-section"><enum>503.</enum><header>Modification of certain housing loan fees</header><text display-inline="no-display-inline">The loan fee table in section 3729(b)(2) of title 38, United States Code, is amended by striking <quote>November 29, 2031</quote> each place it appears and inserting <quote>June 9, 2034</quote>.</text></section> Passed the House of Representatives November 18, 2024.Kevin F. McCumber,Clerk.