[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 785 Introduced in Senate (IS)]

<DOC>






116th CONGRESS
  1st Session
                                 S. 785

 To improve mental health care provided by the Department of Veterans 
                    Affairs, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 13, 2019

  Mr. Tester (for himself, Mr. Moran, Ms. Baldwin, Ms. Stabenow, Mr. 
 Kaine, Mr. Markey, Ms. Sinema, Ms. Hirono, Mr. Durbin, Mr. Casey, Ms. 
Harris, Mr. Udall, Mr. Blumenthal, Mr. Murphy, Mr. Warner, Mrs. Murray, 
 Mrs. Feinstein, Mr. Menendez, Mr. Booker, Ms. Smith, Mr. Manchin, Ms. 
  Klobuchar, Mr. Sanders, and Ms. Duckworth) introduced the following 
 bill; which was read twice and referred to the Committee on Veterans' 
                                Affairs

_______________________________________________________________________

                                 A BILL


 
 To improve mental health care provided by the Department of Veterans 
                    Affairs, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Commander John 
Scott Hannon Veterans Mental Health Care Improvement Act of 2019''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title; table of contents.
  TITLE I--IMPROVEMENT OF TRANSITION OF INDIVIDUALS TO SERVICES FROM 
                     DEPARTMENT OF VETERANS AFFAIRS

Sec. 101. Expansion of health care coverage for veterans.
Sec. 102. Grants for provision of transition assistance to former 
                            members of the Armed Forces transitioning 
                            to civilian life.
Sec. 103. Study of community-based transition assistance programs for 
                            former members of the Armed Forces.
Sec. 104. Modification of eligibility for care from Department of 
                            Veterans Affairs for former members of the 
                            Armed Forces with other than honorable 
                            discharges and report on such care.
                      TITLE II--SUICIDE PREVENTION

Sec. 201. Grants for organizations providing mental health wellness 
                            services to veterans.
Sec. 202. Designation of buddy check week by Department of Veterans 
                            Affairs.
Sec. 203. Post-traumatic growth partnerships.
Sec. 204. Progress of Department of Veterans Affairs in meeting goals 
                            and objectives of National Strategy for 
                            Preventing Veteran Suicide.
Sec. 205. Study on feasibility and advisability of providing certain 
                            complementary and integrative health 
                            services.
Sec. 206. Program to provide veterans access to complementary and 
                            integrative health services through animal 
                            therapy, agri-therapy, and outdoor sports 
                            therapy.
Sec. 207. Comptroller General report on management by Department of 
                            Veterans Affairs of veterans at high risk 
                            for suicide.
     TITLE III--PROGRAMS, STUDIES, AND GUIDELINES ON MENTAL HEALTH

Sec. 301. Program to provide veterans access to computerized cognitive 
                            behavioral therapy.
Sec. 302. Study on connection between living at high altitude and 
                            suicide risk factors among veterans.
Sec. 303. Establishment by Department of Veterans Affairs and 
                            Department of Defense of clinical practice 
                            guidelines for comorbid mental health 
                            conditions.
Sec. 304. Update of clinical practice guidelines for assessment and 
                            management of patients at risk for suicide.
Sec. 305. Precision medicine initiative of Department of Veterans 
                            Affairs to identify and validate brain and 
                            mental health biomarkers.
Sec. 306. Preventative and complex data analysis by Department of 
                            Veterans Affairs.
     TITLE IV--OVERSIGHT OF MENTAL HEALTH CARE AND RELATED SERVICES

Sec. 401. Study on effectiveness of suicide prevention and mental 
                            health outreach programs of Department of 
                            Veterans Affairs.
Sec. 402. Oversight of mental health and suicide prevention media 
                            outreach conducted by Department of 
                            Veterans Affairs.
Sec. 403. Annual report on progress of Department of Veterans Affairs 
                            in meeting goals and objectives of 
                            Executive Order 13822.
Sec. 404. Comptroller General management review of mental health and 
                            suicide prevention services of Department 
                            of Veterans Affairs.
Sec. 405. Comptroller General report on efforts of Department of 
                            Veterans Affairs to integrate mental health 
                            care into primary care clinics.
Sec. 406. Joint mental health programs by Department of Veterans 
                            Affairs and Department of Defense.
                       TITLE V--MEDICAL WORKFORCE

       Subtitle A--Improvement of Mental Health Medical Workforce

Sec. 501. Treatment of psychologists.
Sec. 502. Staffing improvement plan for psychiatrists and psychologists 
                            of Department of Veterans Affairs.
Sec. 503. Occupational series and staffing improvement plan for 
                            licensed professional mental health 
                            counselors and marriage and family 
                            therapists of Department of Veterans 
                            Affairs.
Sec. 504. Staffing improvement plan for peer specialists of Department 
                            of Veterans Affairs who are women.
Sec. 505. Establishment of Department of Veterans Affairs Readjustment 
                            Counseling Service Scholarship Program.
Sec. 506. Comptroller General report on Readjustment Counseling Service 
                            of Department of Veterans Affairs.
Sec. 507. Expansion of reporting requirements on Readjustment 
                            Counseling Service of Department of 
                            Veterans Affairs.
Sec. 508. Studies on alternative work schedules for employees of 
                            Veterans Health Administration.
Sec. 509. Suicide prevention coordinators.
Subtitle B--Direct Hiring Authorities for Certain Health Care Positions

Sec. 521. Direct hiring authorities for certain health care positions.
              TITLE VI--IMPROVEMENT OF TELEHEALTH SERVICES

Sec. 601. Expanded telehealth from Department of Veterans Affairs.
Sec. 602. Implementation of national protocol for telehealth security 
                            and interfacing instructions.

  TITLE I--IMPROVEMENT OF TRANSITION OF INDIVIDUALS TO SERVICES FROM 
                     DEPARTMENT OF VETERANS AFFAIRS

SEC. 101. EXPANSION OF HEALTH CARE COVERAGE FOR VETERANS.

    (a) In General.--Section 1710(a)(1) of title 38, United States 
Code, is amended--
            (1) in subparagraph (A), by striking ``and'' at the end;
            (2) by redesignating subparagraph (B) as subparagraph (C); 
        and
            (3) by inserting after subparagraph (A) the following new 
        subparagraph (B):
            ``(B) to any veteran during the one-year period following 
        the discharge or release of the veteran from active military, 
        naval, or air service; and''.
    (b) Patient Enrollment System.--Section 1705(c) of such title is 
amended by adding at the end the following new paragraph:
    ``(3) Nothing in this section shall be construed to prevent the 
Secretary from providing hospital care and medical services to a 
veteran under section 1710(a)(1)(B) of this title during the period 
specified in such section notwithstanding the failure of the veteran to 
enroll in the system of patient enrollment established by the Secretary 
under subsection (a).''.
    (c) Promotion of Expanded Eligibility.--
            (1) Transition assistance program.--
                    (A) In general.--The Secretary of Labor, in 
                consultation with the Secretary of Defense and the 
                Secretary of Veterans Affairs, shall promote to members 
                of the Armed Forces transitioning from service in the 
                Armed Forces to civilian life through the Transition 
                Assistance Program the expanded eligibility of veterans 
                for health care under the laws administered by the 
                Secretary of Veterans Affairs pursuant to the 
                amendments made by this section.
                    (B) Transition assistance program defined.--In this 
                paragraph, the term ``Transition Assistance Program'' 
                means the Transition Assistance Program under sections 
                1142 and 1144 of title 10, United States Code.
            (2) Publication by department of veterans affairs.--Not 
        later than 30 days after the date of the enactment of this Act, 
        the Secretary of Veterans Affairs shall publish on a website of 
        the Department of Veterans Affairs notification of the expanded 
        eligibility of veterans for health care under the laws 
        administered by the Secretary pursuant to the amendments made 
        by this section.

SEC. 102. GRANTS FOR PROVISION OF TRANSITION ASSISTANCE TO FORMER 
              MEMBERS OF THE ARMED FORCES TRANSITIONING TO CIVILIAN 
              LIFE.

    (a) Program Required.--Commencing not later than 180 days after the 
date of the enactment of this Act, the Secretary of Labor shall, in 
coordination with the Secretary of Veterans Affairs, carry out a 
program on the provision of assistance to former members of the Armed 
Forces, and spouses of such members, transitioning from service in the 
Armed Forces to civilian life.
    (b) Duration of Program.--The Secretary of Labor shall carry out 
the program during the five-year period beginning on the date of the 
commencement of the program.
    (c) Grants.--
            (1) In general.--The Secretary shall carry out the program 
        through the award of grants to eligible organizations for the 
        provision of assistance described in subsection (a).
            (2) Matching funds required.--A grant under this section 
        shall be in an amount that does not exceed 50 percent of the 
        amount required by the organization to provide the services 
        described in subsection (f).
    (d) Eligible Organizations.--For purposes of this section, an 
eligible organization is any nonprofit organization that the Secretary 
of Labor determines, in consultation with the Secretary of Veterans 
Affairs and State entities that serve veterans, is suitable for receipt 
of a grant under the program pursuant to receipt by the Secretary of 
Labor of an application submitted under subsection (e)(1).
    (e) Selection of Grant Recipients.--
            (1) Applications.--An organization seeking a grant under 
        the program shall submit to the Secretary of Labor an 
        application therefor at such time, in such manner, and 
        containing such information and assurances as the Secretary, in 
        consultation with the Secretary of Veterans Affairs and State 
        entities that serve veterans, may require.
            (2) Priority for hubs of services.--In awarding grants 
        under the program, the Secretary of Labor shall give priority 
        to an organization that provides multiple forms of services 
        described in subsection (f).
    (f) Use of Grant Funds.--Each organization receiving a grant under 
the program shall use the grant to provide to former members of the 
Armed Forces and spouses described in subsection (a) the following:
            (1) Resume assistance.
            (2) Interview training.
            (3) Job recruitment training.
            (4) Entrepreneurship training.
            (5) Financial services.
            (6) Legal assistance.
            (7) Educational supportive services.
            (8) Assistance with accessing benefits provided under laws 
        administered by the Secretary of Veterans Affairs, including 
        home loan benefits, education benefits, adaptive housing 
        grants, and all other benefits.
            (9) Nonclinical case management.
            (10) Other related services leading directly to successful 
        transition, as determined by the Secretary of Labor in 
        consultation with the Secretary of Veterans Affairs.
    (g) Annual Reports.--
            (1) In general.--Not later than one year after the date of 
        the commencement of the program and not less frequently than 
        once each year thereafter until the termination of the program, 
        the Secretary of Labor shall, in consultation with the 
        Secretary of Veterans Affairs, submit to the appropriate 
        committees of Congress a report on the program carried out 
        under this section.
            (2) Contents.--Each report submitted under paragraph (1) 
        shall include the following:
                    (A) A list of the organizations that have received 
                grants under the program, including the geographic 
                location of the organization and the types of services 
                outlined in subsection (f) that each organization 
                provides.
                    (B) The number of veterans served by each 
                organization.
                    (C) An assessment of the effectiveness of the 
                services provided under the program at improving the 
                transition process for former members of the Armed 
                Forces and spouses described in subsection (a), based 
                on metrics determined by the Secretary of Labor in 
                consultation with the Secretary of Veterans Affairs.
                    (D) The amount of each grant awarded to each 
                organization under the program.
                    (E) Such other matters as the Secretary of Labor, 
                in consultation with the Secretary of Veterans Affairs, 
                considers appropriate.
            (3) Appropriate committees of congress.--In this 
        subsection, the term ``appropriate committees of Congress'' 
        means--
                    (A) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the Senate; and
                    (B) the Committee on Veterans' Affairs and the 
                Committee on Appropriations of the House of 
                Representatives.
    (h) Authorization of Appropriations.--There is authorized to be 
appropriated $10,000,000 to carry out this section.

SEC. 103. STUDY OF COMMUNITY-BASED TRANSITION ASSISTANCE PROGRAMS FOR 
              FORMER MEMBERS OF THE ARMED FORCES.

    (a) Study.--
            (1) In general.--The Secretary of Veterans Affairs shall, 
        in consultation with the Secretary of Labor and State entities 
        that serve former members of the Armed Forces, enter into an 
        agreement with a Federal or non-Federal entity to develop or 
        access a comprehensive list of community-based programs that--
                    (A) provide transition assistance to such former 
                members that lead directly to successful transition to 
                civilian life, such as--
                            (i) resume assistance;
                            (ii) interview training;
                            (iii) job recruitment training;
                            (iv) entrepreneurship training;
                            (v) financial services;
                            (vi) legal assistance;
                            (vii) educational supportive services;
                            (viii) assistance with accessing benefits 
                        provided under laws administered by the 
                        Secretary of Veterans Affairs, including home 
                        loan benefits, education benefits, adaptive 
                        housing grants, and other benefits; and
                            (ix) nonclinical case management; and
                    (B) are operated by nonprofit organizations.
            (2) Updates.--
                    (A) Periodic.--Not less frequently than once every 
                five years, the Secretary shall update the list created 
                under paragraph (1).
                    (B) Upon request.--In addition to periodic updates 
                under subparagraph (A), the Secretary shall update the 
                list created under paragraph (1) upon request of an 
                organization with a program included in the list.
                    (C) Verification.--The Secretary shall, in 
                consultation with State entities that serve former 
                members of the Armed Forces and to the degree 
                practicable, verify changes to the list made under this 
                paragraph.
    (b) Transmission to Members.--The Secretary shall transmit the list 
created, and revised as the case may be, under subsection (a) to the 
Secretary of Labor and the Secretary of Defense so the Secretaries of 
the military departments may provide information in the list to members 
of the Armed Forces who participate in the Transition Assistance 
Program under sections 1142 and 1144 of title 10, United States Code.
    (c) Online Publication.--The Secretary of Veterans Affairs shall 
publish the list created, and revised as the case may be, under 
subsection (a) on a public website of the Department of Veterans 
Affairs.

SEC. 104. MODIFICATION OF ELIGIBILITY FOR CARE FROM DEPARTMENT OF 
              VETERANS AFFAIRS FOR FORMER MEMBERS OF THE ARMED FORCES 
              WITH OTHER THAN HONORABLE DISCHARGES AND REPORT ON SUCH 
              CARE.

    (a) Eligibility.--Subsection (b)(2)(B) of section 1720I of title 
38, United States Code, is amended by striking ``a discharge by court 
martial'' and inserting ``a dismissal''.
    (b) Information.--Subsection (e) of such section is amended--
            (1) in paragraph (3)--
                    (A) in subparagraph (B), by striking ``and'' at the 
                end;
                    (B) in subparagraph (C), by striking ``and'' at the 
                end;
                    (C) by redesignating subparagraph (C) as 
                subparagraph (D); and
                    (D) by inserting after subparagraph (B) the 
                following new subparagraph (C):
                    ``(C) is displayed prominently on a website of the 
                Department; and'';
            (2) by redesignating paragraph (4) as paragraph (5); and
            (3) by inserting after paragraph (3) the following new 
        paragraph (4):
            ``(4) shall include outreach on Internet search engines; 
        and''.
    (c) Annual Report.--Subsection (f) of such section is amended--
            (1) in paragraph (1), by striking ``Not less frequently 
        than once'' and inserting ``Not later than February 15''; and
            (2) in paragraph (2)--
                    (A) by redesignating subparagraph (C) as 
                subparagraph (F); and
                    (B) by inserting after subsection (B) the following 
                new subparagraphs:
                    ``(C) The types of mental or behavioral health care 
                needs treated under this section.
                    ``(D) The demographics of individuals being treated 
                under this section, including--
                            ``(i) age;
                            ``(ii) era of service in the Armed Forces;
                            ``(iii) branch of service in the Armed 
                        Forces; and
                            ``(iv) geographic location.
                    ``(E) The average number of visits for an 
                individual for mental or behavioral health care under 
                this section.''.

                      TITLE II--SUICIDE PREVENTION

SEC. 201. GRANTS FOR ORGANIZATIONS PROVIDING MENTAL HEALTH WELLNESS 
              SERVICES TO VETERANS.

    (a) Purpose.--The purpose of this section is to facilitate the 
provision of mental health services for veterans with mental health 
conditions who are receiving care outside of the Department of Veterans 
Affairs.
    (b) Grants.--
            (1) In general.--Subchapter II of chapter 17 of title 38, 
        United States Code, is amended by adding at the end the 
        following new section:
``Sec. 1720J. Financial assistance for mental health supportive 
              services for veterans seeking mental health treatment
    ``(a) Distribution of Financial Assistance.--(1) The Secretary 
shall provide financial assistance to eligible entities approved under 
this section to provide or coordinate the provision of mental health 
supportive services described in subsection (b) for a veteran with a 
mental health condition who is seeking mental health treatment.
    ``(2) Financial assistance under paragraph (1) shall consist of the 
award of a grant to an approved eligible entity for each veteran 
described in paragraph (1) for which the approved eligible entity is 
providing or coordinating the provision of mental health supportive 
services.
    ``(3)(A) The Secretary shall award grants under this section to 
each approved eligible entity that is providing or coordinating the 
provision of mental health supportive services under this section.
    ``(B) The Secretary may establish intervals of payment for the 
administration of grants under this section and establish a maximum 
amount to be awarded, in accordance with the services being provided 
and the duration of such services.
    ``(4) In providing financial assistance under paragraph (1), the 
Secretary shall give preference to entities providing or coordinating 
the provision of supportive mental health services for veterans with 
mental health conditions who face barriers in accessing mental health 
care services from the Department.
    ``(5) The Secretary shall ensure that, to the extent practicable, 
financial assistance under this subsection is equitably distributed 
across geographic regions, including rural communities and tribal 
lands.
    ``(6) Each entity receiving financial assistance under this section 
to provide mental health supportive services to a veteran with a mental 
health condition shall notify that veteran that such services are being 
paid for, in whole or in part, by the Department.
    ``(7) The Secretary shall require entities receiving financial 
assistance under this section to submit a report to the Secretary that 
describes the services provided or coordinated with such financial 
assistance.
    ``(b) Mental Health Supportive Services.--The mental health 
supportive services described in this subsection are services provided 
by an eligible entity or a subcontractor of an eligible entity that 
address the needs of veterans with mental health conditions, 
including--
            ``(1) outreach services;
            ``(2) case management services;
            ``(3) assistance in obtaining any benefits from the 
        Department that the veteran may be eligible to receive, 
        including health care services, vocational and rehabilitation 
        counseling, employment and training services, and educational 
        assistance; and
            ``(4) assistance in obtaining and coordinating the 
        provision of other public benefits provided by any Federal, 
        State, or local agency, or any other eligible entity, 
        including--
                    ``(A) health care services (including obtaining 
                health insurance);
                    ``(B) daily living services;
                    ``(C) personal financial planning services;
                    ``(D) transportation services;
                    ``(E) income support services;
                    ``(F) fiduciary and representative payee services;
                    ``(G) legal services to assist the veteran with 
                issues that interfere with the ability of the veteran 
                to find and retain meaningful employment, housing, or 
                benefits to which the veteran may be entitled;
                    ``(H) child care services;
                    ``(I) housing counseling; and
                    ``(J) other services necessary for maintaining 
                independent living.
    ``(c) Application for Financial Assistance.--(1) An eligible entity 
seeking financial assistance under subsection (a) shall submit to the 
Secretary an application therefor in such form, in such manner, and 
containing such commitments and information as the Secretary determines 
to be necessary to carry out this section.
    ``(2) Each application submitted by an eligible entity under 
paragraph (1) shall contain--
            ``(A) a description of the mental health supportive 
        services described in subsection (b) proposed to be provided by 
        the eligible entity under this section and the identified needs 
        for those services;
            ``(B) a description of the types of veterans with a mental 
        health condition proposed to be provided such services;
            ``(C) an estimate of the number of veterans with a mental 
        health condition proposed to be provided such services;
            ``(D) evidence of the experience of the eligible entity in 
        providing mental health supportive services to veterans with a 
        mental health condition; and
            ``(E) a description of the managerial capacity of the 
        eligible entity--
                    ``(i) to coordinate the provision of mental health 
                supportive services with the provision of mental health 
                services by the eligible entity or another 
                organization;
                    ``(ii) to assess continually the needs of veterans 
                with a mental health condition for mental health 
                supportive services;
                    ``(iii) to coordinate the provision of mental 
                health supportive services with the services of the 
                Department; and
                    ``(iv) to tailor supportive mental health services 
                to the needs of veterans with a mental health 
                condition.
    ``(3)(A) The Secretary shall establish criteria for the selection 
of eligible entities to be provided financial assistance under this 
section.
    ``(B) Criteria established under subparagraph (A) with respect to 
an eligible entity shall include the following:
            ``(i) Relevant accreditation as may be required by each 
        State in which the eligible entity operates.
            ``(ii) Experience coordinating care or providing treatment 
        for veterans or members of the Armed Forces.
    ``(d) Technical Assistance.--(1) The Secretary shall provide 
training and technical assistance to eligible entities provided 
financial assistance under this section regarding the planning, 
development, and provision of mental health supportive services under 
this section.
    ``(2) The Secretary may provide the training described in paragraph 
(1) directly or through grants or contracts with appropriate public or 
nonprofit private entities, including through grants awarded under 
section 2064 of this title.
    ``(e) Collection of Information.--To the extent practicable, the 
Secretary may collect information from an eligibility entity awarded a 
grant under this section relating to a mental health condition of a 
veteran for inclusion in the electronic health record of the Department 
for such veteran for the sole purpose of improving care provided to 
such veteran.
    ``(f) Funding.--From amounts appropriated to the Department for 
medical services, there shall be available to carry out subsections 
(a), (b), and (c) the following:
            ``(1) $5,000,000 for fiscal year 2021.
            ``(2) $10,000,000 for fiscal year 2022.
            ``(3) $15,000,000 for fiscal year 2023.
    ``(g) Definitions.--In this section:
            ``(1) The term `eligible entity' means any of the 
        following:
                    ``(A) An incorporated private institution or 
                foundation--
                            ``(i) no part of the net earnings of which 
                        inures to the benefit of any member, founder, 
                        contributor, or individual;
                            ``(ii) that has a governing board that is 
                        responsible for the operation of the mental 
                        health supportive services provided under this 
                        section; and
                            ``(iii) that is approved by the Secretary 
                        with respect to financial responsibility.
                    ``(B) A for-profit limited partnership, the sole 
                general partner of which is an organization meeting the 
                requirements of clauses (i), (ii), and (iii) of 
                subparagraph (A).
                    ``(C) A corporation wholly owned and controlled by 
                an organization meeting the requirements of clauses 
                (i), (ii), and (iii) of subparagraph (A).
                    ``(D) A tribally designated housing entity (as 
                defined in section 4 of the Native American Housing 
                Assistance and Self-Determination Act of 1996 (25 
                U.S.C. 4103)).
            ``(2) The term `veteran with a mental health condition' 
        means a veteran who has been diagnosed with, or who is seeking 
        treatment for, one or more mental health conditions, as 
        determined by the Secretary.''.
            (2) Clerical amendment.--The table of sections at the 
        beginning of chapter 17 is amended by inserting after the item 
        relating to section 1720I the following new item:

``1720J. Financial assistance for mental health supportive services for 
                            veterans seeking mental health 
                            treatment.''.
    (c) Study on Effectiveness of Program.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        conduct a study on the effectiveness of the program of 
        financial assistance under section 1720J of title 38, United 
        States Code, as added by subsection (b), in meeting the needs 
        of veterans with a mental health condition, as that term is 
        defined in that section.
            (2) Comparison.--In conducting the study required by 
        paragraph (1), the Secretary shall compare the results of the 
        program described in that paragraph with other programs of the 
        Department of Veterans Affairs dedicated to the delivery of 
        mental health services to veterans.
            (3) Criteria.--In making the comparison required by 
        paragraph (2), the Secretary shall examine the following:
                    (A) The satisfaction of veterans targeted by the 
                programs described in paragraph (2).
                    (B) The health status of such veterans.
                    (C) The mental wellness of such veterans.
                    (D) The degree to which such veterans are 
                encouraged to engage in productive activity by such 
                programs.
                    (E) The number of veterans using such programs, 
                disaggregated by--
                            (i) veterans who have received care from 
                        the Department in the previous two years; and
                            (ii) veterans who have not received care 
                        from the Department in the previous two years.
                    (F) The number of veterans who die by suicide while 
                receiving services from an entity in receipt of a grant 
                under the program of financial assistance under section 
                1720J of title 38, United States Code, as added by 
                subsection (b), or who die by suicide during the 180-
                day period after receiving such services.
            (4) Report.--Not later than December 31, 2021, and annually 
        thereafter, the Secretary shall submit to the Committee on 
        Veterans' Affairs of the Senate and the Committee on Veterans' 
        Affairs of the House of Representatives a report on the results 
        of the study required by paragraph (1).
    (d) Effective Date.--The Secretary shall begin providing financial 
assistance under section 1720J of title 38, United States Code, as 
added by subsection (b), not later than one year after the date of the 
enactment of this Act.

SEC. 202. DESIGNATION OF BUDDY CHECK WEEK BY DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall designate 
one week per year to organize outreach events and educate veterans on 
how to conduct peer wellness checks, which shall be known as ``Buddy 
Check Week''.
    (b) Events and Education.--
            (1) In general.--During Buddy Check Week, the Secretary, in 
        consultation with organizations that represent veterans, non-
        profits that serve veterans, mental health experts, members of 
        the Armed Forces, and such other entities and individuals as 
        the Secretary considers appropriate, shall collaborate with 
        organizations that represent veterans to provide educational 
        opportunities for veterans to learn how to conduct peer 
        wellness checks.
            (2) Training matters.--As part of the educational 
        opportunities provided under paragraph (1), the Secretary shall 
        provide the following:
                    (A) A script for veterans to use to conduct peer 
                wellness checks that includes information on 
                appropriate referrals to resources veterans might need.
                    (B) Online and in-person training, as appropriate, 
                on how to conduct a peer wellness check.
                    (C) Opportunities for members of organizations that 
                represent veterans to learn how to train individuals to 
                conduct peer wellness checks.
                    (D) Training for veterans participating in Buddy 
                Check Week on how to transfer a phone call directly to 
                the Veterans Crisis Line.
                    (E) Resiliency training for veterans participating 
                in Buddy Check Week on handling a veteran in crisis.
            (3) Online materials.--All training materials provided 
        under the educational opportunities under paragraph (1) shall 
        be made available on a website of the Department.
    (c) Outreach.--The Secretary, in collaboration with organizations 
that represent veterans, may conduct outreach regarding educational 
opportunities under subsection (b) at--
            (1) public events where many veterans are expected to 
        congregate;
            (2) meetings of organizations that represent veterans;
            (3) facilities of the Department of Veterans Affairs; and
            (4) such other locations as the Secretary, in collaboration 
        with organizations that represent veterans, considers 
        appropriate.
    (d) Veterans Crisis Line Plan.--
            (1) In general.--The Secretary shall ensure that the 
        Veterans Crisis Line has a plan for handling the potential 
        increase of calls that may occur during Buddy Check Week.
            (2) Submittal of plan.--The head of the Veterans Crisis 
        Line shall submit to the Secretary a plan for how to handle 
        excess calls during Buddy Check Week, which may include the 
        following:
                    (A) Additional hours for staff.
                    (B) The use of a backup call center.
                    (C) Any other plan to ensure that calls from 
                veterans in crisis are being answered in a timely 
                manner by an individual trained at the same level as a 
                Veterans Crisis Line responder.
    (e) Veterans Crisis Line Defined.--In this section, the term 
``Veterans Crisis Line'' means the toll-free hotline for veterans 
established under section 1720F(h) of title 38, United States Code.

SEC. 203. POST-TRAUMATIC GROWTH PARTNERSHIPS.

    (a) In General.--The Secretary of Veterans Affairs, in consultation 
with the Secretary of Defense and the Secretary of Homeland Security, 
shall enter into partnerships with nonprofit mental health 
organizations to facilitate post-traumatic growth among veterans who 
have experienced trauma.
    (b) Consultation.--Before entering into a partnership under 
subsection (a), the Secretary of Veterans Affairs shall consult with 
the National Institute of Mental Health, the National Alliance on 
Mental Illness, the American Psychological Association, the 
Posttraumatic Growth Research Group, and organizations that represent 
veterans.
    (c) Selection of Partners.--The Secretary of Veterans Affairs shall 
ensure that each organization with which the Secretary enters into a 
partnership under subsection (a) has a demonstrated history of success 
with programs to facilitate post-traumatic growth, including--
            (1) long-term follow-up with veterans who have participated 
        in such a program for not less than one year after completion 
        of the program; and
            (2) sustained positive, clinically significant outcomes for 
        veterans who have participated in such a program for not less 
        than 180 days after completion of the program.
    (d) Outcomes From Partners.--The Secretary of Veterans Affairs 
shall require each nonprofit mental health organization that enters 
into a partnership with the Secretary under subsection (a) to submit to 
the Secretary a description of the outcomes from such partnership, 
including the following:
            (1) The number of veterans who participate in programs of 
        the organization to facilitate post-traumatic growth, including 
        the number of veterans who drop out before completion of the 
        program.
            (2) The types of mental or behavioral health conditions of 
        veterans who participate in such programs.
            (3) The percentage of veterans who experience significant 
        post-traumatic growth.
            (4) Such other topics as the Secretary may require to track 
        post-traumatic growth.
    (e) Post-Traumatic Growth.--
            (1) In general.--For purposes of this section, ``post-
        traumatic growth'' means positive responses described in 
        paragraph (3) experienced after, and often as a result of, a 
        traumatic event or a major life crisis.
            (2) Measurement of growth.--Post-traumatic growth under 
        this section shall be measured through self-reported scales, 
        use of the post-traumatic stress disorder checklist set forth 
        in the most recent edition of the Diagnostic and Statistical 
        Manual of Mental Disorders published by the American 
        Psychiatric Association, and such other metrics as the 
        Secretary considers necessary.
            (3) Positive responses described.--Positive responses 
        described in this paragraph are positive responses in one or 
        more areas of life, including the following:
                    (A) An appreciation of and for life.
                    (B) Improved relationships with others.
                    (C) Realization of new possibilities in life.
                    (D) Realization of personal strength.
                    (E) Spiritual change.
                    (F) Such other areas that the Secretary, in 
                consultation with organizations specified in subsection 
                (b), considers necessary.

SEC. 204. PROGRESS OF DEPARTMENT OF VETERANS AFFAIRS IN MEETING GOALS 
              AND OBJECTIVES OF NATIONAL STRATEGY FOR PREVENTING 
              VETERAN SUICIDE.

    (a) In General.--The Secretary of Veterans Affairs shall develop 
metrics to track progress on each of the 14 goals and 43 objectives 
outlined in the National Strategy for Preventing Veteran Suicide, 2018-
2028 prepared by the Office of Mental Health and Suicide Prevention of 
the Department of Veterans Affairs.
    (b) Metrics.--The metrics developed under subsection (a) shall 
include measures of both performance and effectiveness.
    (c) Initial Report.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a report 
        that contains the metrics developed under subsection (a).
            (2) Elements.--The report submitted under paragraph (1) 
        shall include the following:
                    (A) An explanation of why the metrics developed 
                under subsection (a) were chosen.
                    (B) An assessment of how accurately those metrics 
                will reflect the goals and objectives specified in such 
                subsection.
    (d) Annual Report.--Not later than one year after the submittal of 
the report under subsection (b), and annually thereafter, the Secretary 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
report that contains--
            (1) an assessment of the progress of the Department in 
        meeting the goals and objectives specified in subsection (a);
            (2) a description of any action to be taken by the 
        Department if those goals and objectives are not being met;
            (3) a description of any changes to those goals and 
        objectives;
            (4) an identification of any new programs or partnerships 
        that have resulted from the implementation of the National 
        Strategy for Preventing Veteran Suicide, 2018-2028;
            (5) an assessment of the effectiveness of the National 
        Strategy for Preventing Veterans Suicide, 2018-2028 at reducing 
        veteran suicide; and
            (6) such other topics as the Secretary considers necessary.

SEC. 205. STUDY ON FEASIBILITY AND ADVISABILITY OF PROVIDING CERTAIN 
              COMPLEMENTARY AND INTEGRATIVE HEALTH SERVICES.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall complete 
a study on the feasibility and advisability of providing complementary 
and integrative health treatments described in subsection (b) at all 
facilities of the Department of Veterans Affairs.
    (b) Treatments Described.--Complementary and integrative health 
treatments described in this subsection shall consist of the following:
            (1) Yoga.
            (2) Meditation.
            (3) Acupuncture.
            (4) Chiropractic care.
            (5) Other treatments that show sufficient evidence of 
        efficacy at treating mental or physical health conditions, as 
        determined by the Secretary.
    (c) Provision of Treatment.--The Secretary may provide 
complementary and integrative health treatments under this section at a 
facility of the Department in person or by telehealth.
    (d) Report.--Not later than 90 days after the completion of the 
study under subsection (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 such study, 
including--
            (1) the results of such study; and
            (2) such recommendations regarding the furnishing of 
        complementary and integrative health treatments described in 
        subsection (b) as the Secretary considers appropriate.

SEC. 206. PROGRAM TO PROVIDE VETERANS ACCESS TO COMPLEMENTARY AND 
              INTEGRATIVE HEALTH SERVICES THROUGH ANIMAL THERAPY, AGRI-
              THERAPY, AND OUTDOOR SPORTS THERAPY.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall commence 
the conduct of a program to provide complementary and integrative 
health services described in subsection (b) to veterans from the 
Department of Veterans Affairs or through the use of non-Department 
entities for the treatment of post-traumatic stress disorder, 
depression, anxiety, or other conditions as determined by the 
Secretary.
    (b) Treatments Described.--Complementary and integrative health 
treatments described in this subsection shall consist of the following:
            (1) Equine therapy.
            (2) Other animal therapy.
            (3) Agri-therapy.
            (4) Outdoor sports therapy.
    (c) Eligible Veterans.--A veteran is eligible to participate in the 
program under this section if the veteran--
            (1) is enrolled in the system of patient enrollment of the 
        Department established and operated under section 1705(a) of 
        title 38, United States Code; and
            (2) has received health care under the laws administered by 
        the Secretary during the two-year period preceding the initial 
        participation of the veteran in the program.
    (d) Duration.--
            (1) In general.--The Secretary shall carry out the program 
        under this section for a two-year period beginning on the 
        commencement of the program.
            (2) Extension.--The Secretary may extend the duration of 
        the program under this section if the Secretary, based on the 
        results of the interim report submitted under subsection 
        (e)(1), determines that it is appropriate to do so.
    (e) Locations.--
            (1) In general.--The Secretary shall select not fewer than 
        five facilities of the Department at which to carry out the 
        program under this section.
            (2) Selection criteria.--In selecting facilities under 
        paragraph (1), the Secretary shall ensure that--
                    (A) the locations are in geographically diverse 
                areas; and
                    (B) not fewer than three facilities serve 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).
    (f) Reports.--
            (1) Interim report.--
                    (A) In general.--Not later than one year after the 
                commencement of the program under this section, 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 
                progress of the program.
                    (B) Elements.--The report required by subparagraph 
                (A) shall include the following:
                            (i) The number of participants in the 
                        program.
                            (ii) The types of therapy offered at each 
                        facility at which the program is being carried 
                        out.
                            (iii) An assessment of whether 
                        participation by a veteran in the program 
                        resulted in any changes in clinically relevant 
                        endpoints for the veteran with respect to the 
                        conditions specified in subsection (a).
                            (iv) An assessment of the quality of life 
                        of veterans participating in the program, 
                        including the results of a satisfaction survey 
                        of the participants in the program, 
                        disaggregated by treatment under subsection 
                        (b).
                            (v) The determination of the Secretary with 
                        respect to extending the program under 
                        subsection (c)(2).
                            (vi) Any recommendations of the Secretary 
                        with respect to expanding the program.
            (2) Final report.--Not later than 90 days after the 
        termination of the program under this section, 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 final report on the program.

SEC. 207. COMPTROLLER GENERAL REPORT ON MANAGEMENT BY DEPARTMENT OF 
              VETERANS AFFAIRS OF VETERANS AT HIGH RISK FOR SUICIDE.

    (a) In General.--Not later than 18 months 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 efforts of the Department of Veterans Affairs to manage 
veterans at high risk for suicide.
    (b) Elements.--The report required by subsection (a) shall include 
the following:
            (1) A description of how the Department identifies patients 
        as high risk for suicide, with particular consideration to the 
        efficacy of inputs into the Recovery Engagement and 
        Coordination for Health - Veterans Enhanced Treatment program 
        (commonly referred to as the ``REACH VET'' program) of the 
        Department, including an assessment of the efficacy of such 
        identifications disaggregated by age, gender, Veterans 
        Integrated Service Network, and, to the extent practicable, 
        medical center of the Department.
            (2) A description of how the Department intervenes when a 
        patient is identified as high risk, including an assessment of 
        the efficacy of such interventions disaggregated by age, 
        gender, Veterans Integrated Service Network, and, to the extent 
        practicable, medical center of the Department.
            (3) A description of how the Department monitors patients 
        who have been identified as high risk, including an assessment 
        of the efficacy of such monitoring and any follow-ups 
        disaggregated by age, gender, Veterans Integrated Service 
        Network, and, to the extent practicable, medical center of the 
        Department.
            (4) A review of staffing levels of suicide prevention 
        coordinators across the Veterans Health Administration.
            (5) A review of the resources and programming offered to 
        family members and friends of veterans who have a mental health 
        condition in order to assist that veteran in treatment and 
        recovery.
            (6) An assessment of such other areas as the Comptroller 
        General considers appropriate to study.

     TITLE III--PROGRAMS, STUDIES, AND GUIDELINES ON MENTAL HEALTH

SEC. 301. PROGRAM TO PROVIDE VETERANS ACCESS TO COMPUTERIZED COGNITIVE 
              BEHAVIORAL THERAPY.

    (a) In General.--Not later than 210 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall commence 
the conduct of a program to assess the feasibility and advisability of 
using computerized cognitive behavioral therapy to treat eligible 
veterans suffering from depression, anxiety, post-traumatic stress 
disorder, military sexual trauma, or substance use disorder who are 
already receiving evidence-based therapy from the Department of 
Veterans Affairs.
    (b) Eligible Veterans.--A veteran is eligible to participate in the 
program under this section if the veteran--
            (1) is enrolled in the system of patient enrollment of the 
        Department of Veterans Affairs established and operated under 
        section 1705(a) of title 38, United States Code; and
            (2) has received health care under the laws administered by 
        the Secretary during the two-year period preceding the initial 
        participation of the veteran in the program.
    (c) Duration.--The Secretary shall carry out the program under this 
section for a two-year period beginning on the commencement of the 
program.
    (d) Locations.--
            (1) In general.--The Secretary shall select not fewer than 
        three facilities of the Department of Veterans Affairs at which 
        to carry out the program under this section.
            (2) Selection criteria.--In selecting facilities under 
        paragraph (1), the Secretary shall ensure that--
                    (A) the locations are in geographically diverse 
                areas; and
                    (B) not fewer than two facilities serve 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).
    (e) Access to Chat.--In carrying out the program under this 
section, the Secretary shall ensure that veterans participating in the 
program have access via chat to a mental health provider 24 hours per 
day, seven days per week.
    (f) Promotion of Veterans Crisis Line.--The Secretary shall promote 
the availability of the Veterans Crisis Line to veterans participating 
in the program under this section.
    (g) Department Website.--In implementing the program under this 
section, the Secretary, to the extent feasible, shall use a website of 
the Department of Veterans Affairs to host the program.
    (h) Reports.--
            (1) Interim report.--
                    (A) In general.--Not later than one year after the 
                commencement of the program under this section, 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 
                progress of the program.
                    (B) Elements.--The report required by subparagraph 
                (A) shall include the following:
                            (i) The number of participants in the 
                        program.
                            (ii) An assessment of whether participation 
                        by a veteran in the program resulted in any 
                        changes in clinically relevant endpoints for 
                        the veteran with respect to the conditions 
                        specified in subsection (a).
                            (iii) Any recommendations of the Secretary 
                        with respect to extending or expanding the 
                        program.
            (2) Final report.--Not later than 90 days after the 
        termination of the program under this section, 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 final report on the program.
    (i) Veterans Crisis Line Defined.--In this section, the term 
``Veterans Crisis Line'' means the toll-free hotline for veterans 
established under section 1720F(h) of title 38, United States Code.

SEC. 302. STUDY ON CONNECTION BETWEEN LIVING AT HIGH ALTITUDE AND 
              SUICIDE RISK FACTORS AMONG VETERANS.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs, in 
consultation with Rural Health Resource Centers of the Office of Rural 
Health of the Department of Veterans Affairs, shall commence the 
conduct of a study on the connection between living at high altitude 
and the risk of developing depression or dying by suicide among 
veterans.
    (b) Completion of Study.--The study conducted under subsection (a) 
shall be completed not later than three years after the date of the 
commencement of the study.
    (c) Individual Impact.--The study conducted under subsection (a) 
shall be conducted so as to determine the effect of high altitude on 
suicide risk at the individual level, not at the State or county level.
    (d) Report.--Not later than 150 days after the completion of the 
study conducted under subsection (a), the Secretary shall submit to the 
Committee on Veterans' Affairs of the Senate and the Committee on 
Veterans' Affairs of the House of Representatives a report on the 
results of the study.
    (e) Follow-Up Study.--
            (1) In general.--If the Secretary determines through the 
        study conducted under subsection (a) that living at high 
        altitude is a risk factor for developing depression or dying by 
        suicide, the Secretary shall conduct an additional study to 
        identify the following:
                    (A) The most likely biological mechanism that makes 
                living at high altitude a risk factor for developing 
                depression or dying by suicide.
                    (B) The most effective treatment or intervention 
                for reducing the risk of developing depression or dying 
                by suicide associated with living at high altitude.
            (2) Report.--Not later than 150 days after completing the 
        study conducted under paragraph (1), the Secretary shall submit 
        to the Committee on Veterans' Affairs of the Senate and the 
        Committee on Veterans' Affairs of the House of Representatives 
        a report on the results of the study.

SEC. 303. ESTABLISHMENT BY DEPARTMENT OF VETERANS AFFAIRS AND 
              DEPARTMENT OF DEFENSE OF CLINICAL PRACTICE GUIDELINES FOR 
              COMORBID MENTAL HEALTH CONDITIONS.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Secretary of Veterans Affairs, in 
consultation with the Secretary of Defense and the Secretary of Health 
and Human Services, shall complete the development of clinical practice 
guidelines for the treatment of post-traumatic stress disorder, 
military sexual trauma, and traumatic brain injury that is comorbid 
with substance use disorder or chronic pain.
    (b) Work Group.--
            (1) Establishment.--In carrying out subsection (a), the 
        Secretary of Veterans Affairs, the Secretary of Defense, and 
        the Secretary of Health and Human Services shall create a 
        Trauma and Comorbid Substance Use Disorder or Chronic Pain Work 
        Group (in this section referred to as the ``Work Group'').
            (2) Membership.--The work group created under paragraph (1) 
        shall be comprised of individuals that represent Federal 
        Government entities and non-Federal Government entities with 
        expertise in the areas covered by the work group, including the 
        following:
                    (A) Academic institutions that specialize in 
                research for the treatment of conditions described in 
                subsection (a).
                    (B) The National Center for Posttraumatic Stress 
                Disorder of the Department of Veterans Affairs.
                    (C) The Office of the Assistant Secretary for 
                Mental Health and Substance Use of the Department of 
                Health and Human Services.
            (3) Relation to other work groups.--The Work Group shall be 
        created and conducted in the same manner as other work groups 
        for the development of clinical practice guidelines for the 
        Department of Veterans Affairs and the Department of Defense.
    (c) Matters Included.--In developing the clinical practice 
guidelines under subsection (a), the Work Group, in consultation with 
the Post Traumatic Stress Disorder Work Group, Concussion-mTBI Work 
Group, Opioid Therapy for Chronic Pain Work Group, and Substance Use 
Work Group, shall ensure that the clinical practice guidelines include 
the following:
            (1) Guidance with respect to the following:
                    (A) The treatment of patients with post-traumatic 
                stress disorder who are also experiencing a substance 
                use disorder or chronic pain.
                    (B) The treatment of patients experiencing a mental 
                health condition, including anxiety, depression, or 
                post-traumatic stress disorder as a result of military 
                sexual trauma who are also experiencing a substance use 
                disorder or chronic pain.
                    (C) The treatment of patients with traumatic brain 
                injury who are also experiencing a substance use 
                disorder or chronic pain.
            (2) Guidance with respect to the following:
                    (A) Appropriate case management for patients 
                experiencing post-traumatic stress disorder that is 
                comorbid with substance use disorder or chronic pain 
                who transition from receiving care while on active duty 
                in the Armed Forces to care from health care networks 
                outside of the Department of Defense.
                    (B) Appropriate case management for patients 
                experiencing a mental health condition, including 
                anxiety, depression, or post-traumatic stress disorder 
                as a result of military sexual trauma that is comorbid 
                with substance use disorder or chronic pain who 
                transition from receiving care while on active duty in 
                the Armed Forces to care from health care networks 
                outside of the Department of Defense.
                    (C) Appropriate case management for patients 
                experiencing traumatic brain injury that is comorbid 
                with substance use disorder or chronic pain who 
                transition from receiving care while on active duty in 
                the Armed Forces to care from health care networks 
                outside of the Department of Defense.
            (3) Guidance with respect to the treatment of patients who 
        are still members of the Armed Forces and are experiencing a 
        mental health condition, including anxiety, depression, or 
        post-traumatic stress disorder as a result of military sexual 
        trauma that is comorbid with substance use disorder or chronic 
        pain.
            (4) Guidance with respect to the assessment by the National 
        Academies of Sciences, Engineering, and Medicine of the 
        potential overmedication of veterans, as required pursuant to 
        the Senate report accompanying S. 1557, 115th Congress (Senate 
        Report 115-130), under the heading ``Overprescription 
        Prevention Report'' under the heading ``committee 
        recommendation''.
    (d) Rule of Construction.--Nothing in this section shall be 
construed to prevent the Secretary of Veterans Affairs and the 
Secretary of Defense from considering all relevant evidence, as 
appropriate, in creating the clinical practice guidelines required 
under subsection (a) or from ensuring that the final clinical practice 
guidelines developed under such subsection and subsequently updated, as 
appropriate, remain applicable to the patient populations of the 
Department of Veterans Affairs and the Department of Defense.

SEC. 304. UPDATE OF CLINICAL PRACTICE GUIDELINES FOR ASSESSMENT AND 
              MANAGEMENT OF PATIENTS AT RISK FOR SUICIDE.

    (a) In General.--Not later than two years after the date of the 
enactment of this Act, the Secretary of Veterans Affairs and the 
Secretary of Defense, through the Assessment and Management of Patients 
at Risk for Suicide Work Group (in this section referred to as the 
``Work Group''), shall issue an update to the VA/DOD Clinical Practice 
Guideline for Assessment and Management of Patients at Risk for 
Suicide.
    (b) Matters Included.--In carrying out the update under subsection 
(a), the Work Group shall ensure that the clinical practice guidelines 
updated under such subsection includes the following:
            (1) Enhanced guidance with respect to the following:
                    (A) Gender-specific risk factors for suicide and 
                suicidal ideation.
                    (B) Gender-specific treatment efficacy for 
                depression and suicide prevention.
                    (C) Gender-specific pharmacotherapy efficacy.
                    (D) Gender-specific psychotherapy efficacy.
            (2) Guidance with respect to the following:
                    (A) The efficacy of alternative therapies, other 
                than psychotherapy and pharmacotherapy, including the 
                following:
                            (i) Yoga therapy.
                            (ii) Meditation therapy.
                            (iii) Equine therapy.
                            (iv) Other animal therapy.
                            (v) Training and caring for service dogs.
                            (vi) Agri-therapy.
                            (vii) Art therapy.
                            (viii) Outdoor sports therapy.
                            (ix) Music therapy.
                            (x) Any other alternative therapy that the 
                        Work Group considers appropriate.
            (3) Guidance with respect to the findings of the Creating 
        Options for Veterans' Expedited Recovery Commission (commonly 
        referred to as the ``COVER Commission'') established under 
        section 931 of the Jason Simcakoski Memorial and Promise Act 
        (title IX of Public Law 114-198; 38 U.S.C. 1701 note).
    (c) Rule of Construction.--Nothing in this section shall be 
construed to prevent the Secretary of Veterans Affairs and the 
Secretary of Defense from considering all relevant evidence, as 
appropriate, in updating the VA/DOD Clinical Practice Guideline for 
Assessment and Management of Patients at Risk for Suicide, as required 
under subsection (a), or from ensuring that the final clinical practice 
guidelines updated under such subsection remain applicable to the 
patient populations of the Department of Veterans Affairs and the 
Department of Defense.

SEC. 305. PRECISION MEDICINE INITIATIVE OF DEPARTMENT OF VETERANS 
              AFFAIRS TO IDENTIFY AND VALIDATE BRAIN AND MENTAL HEALTH 
              BIOMARKERS.

    (a) In General.--Beginning not later than 18 months after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
develop and implement an initiative of the Department of Veterans 
Affairs to identify and validate brain and mental health biomarkers 
among veterans, with specific consideration for depression, anxiety, 
post-traumatic stress disorder, traumatic brain injury, and such other 
mental health conditions as the Secretary considers appropriate. Such 
initiative may be referred to as the ``Precision Medicine for Veterans 
Initiative''.
    (b) Model of Initiative.--The initiative under subsection (a) shall 
be modeled on the All of Us Precision Medicine Initiative administered 
by the National Institutes of Health with respect to large-scale 
collection of standardized data and open data sharing.
    (c) Use of Data.--
            (1) Privacy and security.--In carrying out the initiative 
        under subsection (a), the Secretary shall develop robust data 
        privacy and security measures to ensure that information of 
        veterans participating in the initiative is kept private and 
        secure.
            (2) Open platform.--
                    (A) Research purposes.--The Secretary shall make 
                de-identified data collected under the initiative 
                available for research purposes both within and outside 
                of the Department of Veterans Affairs.
                    (B) Data may not be sold.--Data collected under the 
                initiative may not be sold.
            (3) Standardization.--
                    (A) In general.--The Secretary shall ensure that 
                data collected under the initiative is standardized.
                    (B) Consultation.--The Secretary shall consult with 
                the National Institutes of Health and the Food and Drug 
                Administration to determine the most effective, 
                efficient, and cost-effective way of standardizing data 
                collected under the initiative.
                    (C) Manner of standardization.--Data collected 
                under the initiative shall be standardized in the 
                manner in which it is collected, entered into the 
                database, extracted, and recorded.
            (4) Measures of brain function or structure.--Any measures 
        of brain function or structure collected under the initiative 
        shall be collected with a device that is approved by the Food 
        and Drug Administration.
    (d) Inclusion of Initiative in Program.--The Secretary shall assess 
the feasibility and advisability of coordinating efforts of the 
initiative under subsection (a) with the Million Veterans Program of 
the Department.

SEC. 306. PREVENTATIVE AND COMPLEX DATA ANALYSIS BY DEPARTMENT OF 
              VETERANS AFFAIRS.

    (a) In General.--Chapter 1 of title 38, United States Code, is 
amended by adding at the end the following new section:
``Sec. 119. Contracting for preventative or complex statistical 
              analysis
    ``In order to carry out statistical analysis required under section 
302 of the Commander John Scott Hannon Veterans Mental Health Care 
Improvement Act of 2019, or any other preventative or complex 
statistical analysis required under this title or any other provision 
of law, the Secretary may contract with academic institutions or other 
qualified entities, as determined by the Secretary, to carry out the 
statistical analysis.''.
    (b) Clerical Amendment.--The table of sections at the beginning of 
chapter 1 of such title is amended by inserting after the item relating 
to section 118 the following new item:

``119. Contracting for preventative or complex statistical analysis.''.

     TITLE IV--OVERSIGHT OF MENTAL HEALTH CARE AND RELATED SERVICES

SEC. 401. STUDY ON EFFECTIVENESS OF SUICIDE PREVENTION AND MENTAL 
              HEALTH OUTREACH PROGRAMS OF DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) In General.--Not later than 180 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs shall enter 
into an agreement with a non-Federal Government entity to conduct a 
study on the effectiveness of the suicide prevention and mental health 
outreach materials prepared by the Department of Veterans Affairs and 
the suicide prevention and mental health outreach campaigns conducted 
by the Department.
    (b) Use of Focus Groups.--
            (1) In general.--The Secretary shall convene not fewer than 
        eight different focus groups to evaluate the effectiveness of 
        the suicide prevention and mental health materials and 
        campaigns as required under subsection (a).
            (2) Location of focus groups.--Focus groups convened under 
        paragraph (1) shall be held in geographically diverse areas as 
        follows:
                    (A) Not fewer than two in rural or highly rural 
                areas.
                    (B) Not fewer than one in each of the four 
                districts of the Veterans Benefits Administration.
            (3) Timing of focus groups.--Focus groups convened under 
        paragraph (1) shall be held at a variety of dates and times to 
        ensure an adequate representation of veterans with different 
        work schedules.
            (4) Number of participants.--Each focus group convened 
        under paragraph (1) shall include not fewer than five and not 
        more than 12 participants.
            (5) Representation.--Each focus group convened under 
        paragraph (1) shall, to the extent practicable, include 
        veterans of diverse backgrounds, including--
                    (A) veterans of all eras, as determined by the 
                Secretary;
                    (B) women veterans;
                    (C) minority veterans;
                    (D) Native American veterans, as defined in section 
                3765 of title 38, United States Code;
                    (E) veterans who identify as lesbian, gay, 
                bisexual, transgender, or queer (commonly referred to 
                as ``LGBTQ'');
                    (F) veterans who live in rural or highly rural 
                areas; and
                    (G) individuals transitioning from active duty in 
                the Armed Forces to civilian life.
    (c) Report.--
            (1) In general.--Not later than 90 days after the last 
        focus group meeting under subsection (b), 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 findings of the focus groups.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) Based on the findings of the focus groups, an 
                assessment of the effectiveness of current suicide 
                prevention and mental health outreach efforts of the 
                Department in reaching veterans as a whole as well as 
                specific groups of veterans (for example, women 
                veterans).
                    (B) Based on the findings of the focus groups, 
                recommendations for future suicide prevention and 
                mental health outreach efforts by the Department to 
                target specific groups of veterans.
                    (C) A plan to change the current approach by the 
                Department to suicide prevention and mental health 
                outreach or, if the Secretary decides not to change the 
                current approach, an explanation of the reason for 
                maintaining the current approach.
                    (D) Such other issues as the Secretary considers 
                necessary.
    (d) Representative Survey.--
            (1) In general.--Not later than one year after the last 
        focus group meeting under subsection (b), the Secretary shall 
        complete a representative survey of the veteran population that 
        is informed by the focus group data in order to collect 
        information about the effectiveness of the mental health and 
        suicide prevention outreach campaigns conducted by the 
        Department.
            (2) Veterans surveyed.--
                    (A) In general.--Veterans surveyed under paragraph 
                (1) shall include veterans described in subsection 
                (b)(5).
                    (B) Disaggregation of data.--Data of veterans 
                surveyed under paragraph (1) shall be disaggregated 
                by--
                            (i) veterans who have received care from 
                        the Department during the two-year period 
                        preceding the survey; and
                            (ii) veterans who have not received care 
                        from the Department during the two-year period 
                        preceding the survey.
    (e) Treatment of Contracts for Suicide Prevention and Mental Health 
Outreach Media.--
            (1) Focus groups.--
                    (A) In general.--The Secretary shall include in 
                each contract to develop media relating to suicide 
                prevention and mental health outreach a requirement 
                that the contractor convene focus groups of veterans to 
                assess the effectiveness of suicide prevention and 
                mental health outreach.
                    (B) Representation.--Each focus group required 
                under subparagraph (A) shall, to the extent 
                practicable, include veterans of diverse backgrounds, 
                including--
                            (i) veterans of all eras, as determined by 
                        the Secretary;
                            (ii) women veterans;
                            (iii) minority veterans;
                            (iv) Native American veterans, as defined 
                        in section 3765 of title 38, United States 
                        Code;
                            (v) veterans who identify as lesbian, gay, 
                        bisexual, transgender, or queer (commonly 
                        referred to as ``LGBTQ'');
                            (vi) veterans who live in rural or highly 
                        rural areas; and
                            (vii) individuals transitioning from active 
                        duty in the Armed Forces to civilian life.
            (2) Subcontracting.--
                    (A) In general.--The Secretary shall include in 
                each contract described in paragraph (1)(A) a 
                requirement that, if the contractor subcontracts for 
                the development of media, the contractor shall 
                subcontract with a subcontractor that has experience 
                creating impactful media campaigns that target 
                individuals age 18 to 34.
                    (B) Budget limitation.--Not more than two percent 
                of the budget of the Office of Mental Health and 
                Suicide Prevention of the Department for contractors 
                for suicide prevention and mental health media outreach 
                shall go to subcontractors described in subparagraph 
                (A).
    (f) Rural and Highly Rural Defined.--In this section, with respect 
to an area, the terms ``rural'' and ``highly rural'' have the meanings 
given those terms in the Rural-Urban Commuting Areas coding system of 
the Department of Agriculture.

SEC. 402. OVERSIGHT OF MENTAL HEALTH AND SUICIDE PREVENTION MEDIA 
              OUTREACH CONDUCTED BY DEPARTMENT OF VETERANS AFFAIRS.

    (a) Establishment of Goals.--
            (1) In general.--The Secretary of Veterans Affairs shall 
        establish goals for the mental health and suicide prevention 
        media outreach campaigns of the Department of Veterans Affairs 
        in raising awareness about mental health and suicide 
        prevention.
            (2) Use of metrics.--
                    (A) In general.--The goals established under 
                paragraph (1) shall be measured by metrics specific to 
                different media types as follows:
                            (i) Metrics relating to social media shall 
                        include the following:
                                    (I) Impressions.
                                    (II) Reach.
                                    (III) Engagement rate.
                                    (IV) Such other metrics as the 
                                Secretary considers necessary.
                            (ii) Metrics relating to television shall 
                        include the following:
                                    (I) Nielsen ratings.
                                    (II) Such other metrics as the 
                                Secretary considers necessary.
                            (iii) Metrics relating to email shall 
                        include the following:
                                    (I) Open rate.
                                    (II) Response rate
                                    (III) Click rate.
                                    (IV) Such other metrics as the 
                                Secretary considers necessary.
                    (B) Update.--The Secretary shall periodically 
                update the metrics under subparagraph (A) as more 
                accurate metrics become available.
            (3) Targets.--The Secretary shall develop targets to track 
        the metrics used under paragraph (2).
            (4) Consultation.--In establishing goals under paragraph 
        (1), the Secretary shall consult with the following:
                    (A) Relevant stakeholders, such as organizations 
                that represent veterans, as determined by the 
                Secretary.
                    (B) Mental health and suicide prevention experts.
                    (C) Such other persons as the Secretary considers 
                appropriate.
            (5) Initial report.--Not later than 180 days after the date 
        of the enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a report 
        detailing the goals established under paragraph (1) for the 
        mental health and suicide prevention media outreach campaigns 
        of the Department in raising awareness about mental health and 
        suicide prevention, including the metrics and targets for such 
        metrics by which those goals are to be measured under paragraph 
        (2).
            (6) Annual report.--Not later than one year after the 
        submittal of the report under paragraph (3), and annually 
        thereafter, the Secretary shall submit to the Committee on 
        Veterans' Affairs of the Senate and the Committee on Veterans' 
        Affairs of the House of Representatives a report detailing--
                    (A) the progress of the Department in meeting the 
                goals established under paragraph (1) and targets 
                developed under paragraph (3); and
                    (B) a description of action to be taken by the 
                Department to modify mental health and suicide 
                prevention media outreach campaigns if those goals and 
                targets are not being met.
    (b) Establishment of Oversight Process.--
            (1) In general.--Not later than 90 days after the date of 
        the enactment of this Act, the Secretary shall establish a 
        process to oversee the mental health and suicide prevention 
        media outreach campaigns of the Department.
            (2) Components of oversight process.--The process 
        established under paragraph (1) shall include the following 
        components:
                    (A) A delineation of the roles and responsibilities 
                of all suicide prevention officials within the Office 
                of Mental Health and Suicide Prevention of the Veterans 
                Health Administration.
                    (B) A schedule for creating, approving, 
                implementing, and evaluating all unpaid media and paid 
                media content relating to mental health and suicide 
                prevention.
                    (C) Lines of reporting, as the Secretary considers 
                necessary, to report to management information relating 
                to the mental health and suicide prevention media 
                outreach campaigns of the Department.
    (c) Contract Requirements.--The Secretary shall ensure that each 
contract into which the Secretary enters to develop mental health and 
suicide prevention outreach media includes requirements that the 
contractor--
            (1) track metrics used by the Secretary under subsection 
        (a)(2); and
            (2) not less frequently than quarterly, report such metrics 
        to the Office of Mental Health and Suicide Prevention of the 
        Veterans Health Administration.
    (d) Report on Use of Funds by Office of Mental Health and Suicide 
Prevention.--Not later than 180 days after the date of the enactment of 
this Act, and semiannually thereafter, the Secretary shall submit to 
the Committee on Appropriations and the Committee on Veterans' Affairs 
of the Senate and the Committee on Appropriations and the Committee on 
Veterans' Affairs of the House of Representatives a report containing 
the expenditures and obligations of the Office of Mental Health and 
Suicide Prevention of the Veterans Health Administration during the 
period covered by the report.

SEC. 403. ANNUAL REPORT ON PROGRESS OF DEPARTMENT OF VETERANS AFFAIRS 
              IN MEETING GOALS AND OBJECTIVES OF EXECUTIVE ORDER 13822.

    (a) In General.--Not later than 120 days after the date of the 
enactment of this Act, and annually thereafter, the Secretary of 
Veterans Affairs, in consultation with the Secretary of Defense and the 
Secretary of Homeland Security, shall submit to the Committee on 
Veterans' Affairs of the Senate and the Committee on Veterans' Affairs 
of the House of Representatives a report that contains the following:
            (1) An assessment of the progress of the Department of 
        Veterans Affairs, the Department of Defense, and the Department 
        of Homeland Security in meeting the goals and objectives 
        outlined in the report required under section 2(c) of Executive 
        Order 13822 (83 Fed. Reg. 1513; relating to supporting our 
        veterans during their transition from uniformed service to 
        civilian life) with respect to the implementation by the 
        Department of Veterans Affairs of the Joint Action Plan 
        required under section 2(b) of such Executive order.
            (2) A description of action to be taken by the Department 
        of Veterans Affairs, the Department of Defense, and the 
        Department of Homeland Security if those goals and objectives 
        are not being met.
            (3) An assessment of the effectiveness of Executive Order 
        13822 at improving the transition process for members of the 
        Armed Forces and veterans.
            (4) Such other topics as the Secretary of Veterans Affairs, 
        the Secretary of Defense, or the Secretary of Homeland Security 
        consider necessary.
    (b) Submittal by Secretary of Veterans Affairs.--The Secretary of 
Veterans Affairs shall submit each report required under paragraph (1) 
with respect to the Department of Veterans Affairs regardless of 
whether the Secretary of Defense or the Secretary of Homeland Security 
provides any information for the report.

SEC. 404. COMPTROLLER GENERAL MANAGEMENT REVIEW OF MENTAL HEALTH AND 
              SUICIDE PREVENTION SERVICES OF DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) In General.--Not later than three years after the date of the 
enactment of this Act, the Comptroller General of the United States 
shall submit to the Committee on Veterans' Affairs of the Senate and 
the Committee on Veterans' Affairs of the House of Representatives a 
management review of the mental health and suicide prevention services 
provided by the Department of Veterans Affairs.
    (b) Elements.--The management review required by subsection (a) 
shall include the following:
            (1) An assessment of the infrastructure under the control 
        of or available to the Office of Mental Health and Suicide 
        Prevention of the Department of Veterans Affairs or available 
        to the Department of Veterans Affairs for suicide prevention 
        efforts not operated by the Office of Mental Health and Suicide 
        Prevention.
            (2) A description of the management and organizational 
        structure of the Office of Mental Health and Suicide 
        Prevention, including roles and responsibilities for each 
        position.
            (3) A description of the operational policies and processes 
        of the Office of Mental Health and Suicide Prevention.
            (4) An assessment of suicide prevention practices and 
        initiatives available from the Department and through community 
        partnerships.
            (5) An assessment of the staffing levels at the Office of 
        Mental Health and Suicide Prevention, dissaggregated by type of 
        position, and including the location of any staffing 
        deficiencies.
            (6) An assessment of the Nurse Advice Line pilot program 
        conducted by the Department.
            (7) An assessment of recruitment initiatives in rural areas 
        for mental health professionals of the Department.
            (8) An assessment of strategic planning conducted by the 
        Office of Mental Health and Suicide Prevention.
            (9) An assessment of the communication, and the 
        effectiveness of such communication--
                    (A) within the central office of the Office of 
                Mental Health and Suicide Prevention;
                    (B) between that central office and any staff 
                member or office in the field, including chaplains, 
                attorneys, law enforcement personnel, and volunteers; 
                and
                    (C) between that central office, local facilities 
                of the Department, and community partners of the 
                Department, including first responders, community 
                support groups, and health care industry partners.
            (10) An assessment of how effectively the Office of Mental 
        Health and Suicide Prevention implements operational policies 
        and procedures.
            (11) An assessment of how the Department of Veterans 
        Affairs and the Department of Defense coordinate suicide 
        prevention efforts, and recommendations on how the Department 
        of Veterans Affairs and Department of Defense can more 
        effectively coordinate those efforts.
            (12) An assessment of such other areas as the Comptroller 
        General considers appropriate to study.

SEC. 405. COMPTROLLER GENERAL REPORT ON EFFORTS OF DEPARTMENT OF 
              VETERANS AFFAIRS TO INTEGRATE MENTAL HEALTH CARE INTO 
              PRIMARY CARE CLINICS.

    (a) Initial Report.--
            (1) In general.--Not later than two years after the date of 
        the enactment of this Act, the Comptroller General of the 
        United States shall submit to the Committee on Veterans' 
        Affairs of the Senate and the Committee on Veterans' Affairs of 
        the House of Representatives a report on the efforts of the 
        Department of Veterans Affairs to integrate mental health care 
        into primary care clinics of the Department.
            (2) Elements.--The report required by subsection (a) shall 
        include the following:
                    (A) An assessment of the efforts of the Department 
                to integrate mental health care into primary care 
                clinics of the Department.
                    (B) An assessment of the effectiveness of such 
                efforts.
                    (C) An assessment of how the health care of 
                veterans is impacted by such integration.
                    (D) A description of how care is coordinated by the 
                Department between specialty mental health care and 
                primary care, including a description of the following:
                            (i) How documents and patient information 
                        are transferred and the effectiveness of those 
                        transfers.
                            (ii) How care is coordinated when veterans 
                        must travel to different facilities of the 
                        Department.
                            (iii) How a veteran is reintegrated into 
                        primary care after receiving in-patient mental 
                        health care.
                    (E) An assessment of how the integration of mental 
                health care into primary care clinics is implemented at 
                different types of facilities of the Department.
                    (F) Such recommendations on how the Department can 
                better integrate mental health care into primary care 
                clinics as the Comptroller General considers 
                appropriate.
                    (G) An assessment of such other areas as the 
                Comptroller General considers appropriate to study.
    (b) Community Care Integration Report.--
            (1) In general.--Not later than two years after the date on 
        which the Comptroller General submits the report required under 
        subsection (a)(1), the Comptroller General 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 efforts of the Department to integrate community-based 
        mental health care into the Veterans Health Administration.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) An assessment of the efforts of the Department 
                to integrate community-based mental health care into 
                the Veterans Health Administration.
                    (B) An assessment of the effectiveness of such 
                efforts.
                    (C) An assessment of how the health care of 
                veterans is impacted by such integration.
                    (D) A description of how care is coordinated 
                between providers of community-based mental health care 
                and the Veterans Health Administration, including a 
                description of how documents and patient information 
                are transferred and the effectiveness of those 
                transfers between--
                            (i) the Veterans Health Administration and 
                        providers of community-based mental health 
                        care; and
                            (ii) providers of community-based mental 
                        health care and the Veterans Health 
                        Administration.
                    (E) An assessment of any disparities in the 
                coordination of community-based mental health care into 
                the Veterans Health Administration by location and type 
                of facility.
                    (F) An assessment of the military cultural 
                competency of health care providers providing 
                community-based mental health care to veterans.
                    (G) Such recommendations on how the Department can 
                better integrate community-based mental health care 
                into the Veterans Health Administration as the 
                Comptroller General considers appropriate.
                    (H) An assessment of such other areas as the 
                Comptroller General considers appropriate to study.
            (3) Community-based mental health care defined.--In this 
        subsection, the term ``community-based mental health care'' 
        means mental health care paid for by the Department but 
        provided by a non-Department health care provider at a non-
        Department facility, including care furnished under section 
        1703 of title 38, United States Code (as in effect on the date 
        specified in section 101(b) of the Caring for Our Veterans Act 
        of 2018 (title I of Public Law 115-182)).

SEC. 406. JOINT MENTAL HEALTH PROGRAMS BY DEPARTMENT OF VETERANS 
              AFFAIRS AND DEPARTMENT OF DEFENSE.

    (a) Report on Mental Health Programs.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, and annually thereafter, the 
        Secretary of Veterans Affairs and the Secretary of Defense 
        shall submit to the Committee on Armed Services and the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Armed Services and the Committee on Veterans' Affairs of the 
        House of Representatives a report on mental health programs of 
        the Department of Veterans Affairs and the Department of 
        Defense and joint programs of the Departments.
            (2) Elements.--The report required by paragraph (1) shall 
        include the following:
                    (A) A description of mental health programs 
                operated by the Department of Veterans Affairs, 
                including the following:
                            (i) Transition assistance programs.
                            (ii) Clinical mental health initiatives, 
                        including--
                                    (I) the Million Veterans Program; 
                                and
                                    (II) centers of excellence of the 
                                Department of Veterans Affairs for 
                                traumatic brain injury and post-
                                traumatic stress disorder.
                            (iii) Programs that may secondarily improve 
                        mental health, including employment, housing 
                        assistance, and financial literacy programs.
                            (iv) Research into mental health issues and 
                        conditions.
                    (B) A description of mental health programs 
                operated by the Department of Defense, including the 
                following:
                            (i) Transition assistance programs.
                            (ii) Clinical mental health initiatives, 
                        including the National Intrepid Center of 
                        Excellence.
                            (iii) Programs that may secondarily improve 
                        mental health, including employment, housing 
                        assistance, and financial literacy programs.
                            (iv) Research into mental health issues and 
                        conditions.
                    (C) A description of mental health programs jointly 
                operated by the Department of Veterans Affairs and the 
                Department of Defense, including the following:
                            (i) Transition assistance programs.
                            (ii) Clinical mental health initiatives.
                            (iii) Programs that may secondarily improve 
                        mental health, including employment, housing 
                        assistance, and financial literacy programs.
                            (iv) Research into mental health issues and 
                        conditions.
                    (D) Recommendations for coordinating mental health 
                programs of the Department of Veterans Affairs and the 
                Department of Defense to improve the effectiveness of 
                those programs.
                    (E) Recommendations for novel joint programming of 
                the Department of Veterans Affairs and the Department 
                of Defense to improve the mental health of members of 
                the Armed Forces and veterans.
    (b) Establishment of Joint Center of Excellence.--
            (1) In general.--Not later than two years after the date of 
        the enactment of this Act, the Secretary of Defense, in 
        consultation with the Secretary of Veterans Affairs, shall 
        establish a center of excellence to be known as the ``Joint 
        DOD/VA National Intrepid Center of Excellence Intrepid Spirit 
        Center'' (in this subsection referred to as the ``Center'').
            (2) Duties.--The Center shall conduct joint mental health 
        programs of the Department of Veterans Affairs and the 
        Department of Defense.
            (3) Location.--The Center shall be established in a 
        location that--
                    (A) is geographically distant from already existing 
                and planned Intrepid Spirit Centers of the Department 
                of Defense; and
                    (B) is in a rural or highly rural area (as 
                determined through the use of the Rural-Urban Commuting 
                Areas coding system of the Department of Agriculture).

                       TITLE V--MEDICAL WORKFORCE

       Subtitle A--Improvement of Mental Health Medical Workforce

SEC. 501. TREATMENT OF PSYCHOLOGISTS.

    (a) Treatment as Title 38 Employees.--Section 7401 of title 38, 
United States Code, is amended--
            (1) in paragraph (1) by inserting ``psychologists,'' after 
        ``chiropractors,''; and
            (2) in paragraph (3), by striking ``psychologists,''.
    (b) Inclusion in Contracts for Scarce Medical Specialist 
Services.--Section 7409(a) of title 38, United States Code, is amended 
by inserting ``psychologists,'' after ``chiropractors,''.

SEC. 502. STAFFING IMPROVEMENT PLAN FOR PSYCHIATRISTS AND PSYCHOLOGISTS 
              OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Staffing Plan.--Not later than 270 days after the date of the 
enactment of this Act, the Secretary of Veterans Affairs, in 
consultation with the Inspector General of the Department 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 plan to address staffing shortages of psychiatrists 
and psychologists of the Department of Veterans Affairs, including 
filling any open positions.
    (b) Elements.--The plan required by subsection (a) shall include 
the following:
            (1) The number of positions for psychiatrists and 
        psychologists of the Department that need to be filled to meet 
        demand, disaggregated by Veterans Integrated Service Network 
        and medical center.
            (2) An identification of the steps that the Secretary will 
        take in each Veterans Integrated Service Network to address 
        such shortages, include the following:
                    (A) A description of any region-specific hiring 
                incentives to be used by the Secretary in consultation 
                with the directors of Veterans Integrated Service 
                Networks and medical centers of the Department.
                    (B) A description of any local retention or 
                engagement incentives to be used by directors of 
                Veterans Integrated Service Networks.
            (3) Such recommendations for legislative or administrative 
        action as the Secretary considers necessary to aid in 
        addressing staffing shortages of psychiatrists and 
        psychologists of the Department.

SEC. 503. OCCUPATIONAL SERIES AND STAFFING IMPROVEMENT PLAN FOR 
              LICENSED PROFESSIONAL MENTAL HEALTH COUNSELORS AND 
              MARRIAGE AND FAMILY THERAPISTS OF DEPARTMENT OF VETERANS 
              AFFAIRS.

    (a) Occupational Series.--Not later than one year after the date of 
the enactment of this Act, the Secretary of Veterans Affairs, in 
consultation with the Office of Personnel Management, shall develop an 
occupational series for licensed professional mental health counselors 
and marriage and family therapists of the Department of Veterans 
Affairs.
    (b) Staffing Plan.--
            (1) In general.--Not later than 270 days after the date of 
        the enactment of this Act, the Secretary shall submit to the 
        Committee on Veterans' Affairs of the Senate and the Committee 
        on Veterans' Affairs of the House of Representatives a plan to 
        address staffing shortages of licensed professional mental 
        health counselors and marriage and family therapists of the 
        Department of Veterans Affairs.
            (2) Elements.--The plan required by paragraph (1) shall 
        include the following:
                    (A) The number of positions for licensed 
                professional mental health counselors and marriage and 
                family therapists of the Department that need to be 
                filled to meet demand, disaggregated by Veterans 
                Integrated Service Network and medical center.
                    (B) An identification of the steps that the 
                Secretary will take in each Veterans Integrated Service 
                Network to address such shortages, include the 
                following:
                            (i) A description of any region-specific 
                        hiring incentives to be used by the Secretary 
                        in consultation with the directors of Veterans 
                        Integrated Service Networks and medical centers 
                        of the Department.
                            (ii) A description of any local retention 
                        or engagement incentives to be used by 
                        directors of Veterans Integrated Service 
                        Networks.
                    (C) Such recommendations for legislative or 
                administrative action as the Secretary, in consultation 
                with the Inspector General of the Department of 
                Veterans Affairs, considers necessary to aid in 
                addressing staffing shortages of licensed professional 
                mental health counselors and marriage and family 
                therapists of the Department.
    (c) Report.--Not later than one year after the submittal of the 
plan required by subsection (b), 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 setting 
forth the number of licensed professional mental health counselors and 
marriage and family therapists hired by the Department during the one-
year period preceding the submittal of the report, disaggregated by 
Veterans Integrated Service Network and medical center.

SEC. 504. STAFFING IMPROVEMENT PLAN FOR PEER SPECIALISTS OF DEPARTMENT 
              OF VETERANS AFFAIRS WHO ARE WOMEN.

    (a) Assessment of Capacity.--
            (1) In general.--Not later than 90 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs, 
        in consultation with the Inspector General of the Department of 
        Veterans Affairs, shall commence an assessment of the capacity 
        of peer specialists of the Department of Veterans Affairs who 
        are women.
            (2) Elements.--The assessment required by paragraph (1) 
        shall include an assessment of the following:
                    (A) The geographical distribution of peer 
                specialists of the Department who are women.
                    (B) The geographical distribution of women 
                veterans.
                    (C) The number and proportion of women peer 
                specialists who specialize in peer counseling on mental 
                health or suicide prevention.
                    (D) The number and proportion of women peer 
                specialists who specialize in peer counseling on non-
                mental health related matters.
    (b) Report.--Not later than one year after the assessment required 
by subsection (a) has commenced, 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 detailing 
the findings of the assessment.
    (c) Staffing Improvement Plan.--
            (1) In general.--Not later than 180 days after submitting 
        the report under subsection (b), the Secretary, in consultation 
        with the Inspector General, shall submit to the Committee on 
        Veterans' Affairs of the Senate and the Committee on Veterans' 
        Affairs of the House of Representatives a plan, based on the 
        results of the assessment required by subsection (a), to hire 
        additional qualified peer specialists who are women, with 
        special consideration for areas that lack peer specialists who 
        are women.
            (2) Elements.--The peer specialist positions included in 
        the plan required by paragraph (1)--
                    (A) shall be non-volunteer, paid positions; and
                    (B) may be part-time positions.

SEC. 505. ESTABLISHMENT OF DEPARTMENT OF VETERANS AFFAIRS READJUSTMENT 
              COUNSELING SERVICE SCHOLARSHIP PROGRAM.

    (a) In General.--Chapter 76 of title 38, United States Code, is 
amended by inserting after subchapter VIII the following new 
subchapter:

  ``SUBCHAPTER IX--READJUSTMENT COUNSELING SERVICE SCHOLARSHIP PROGRAM

``Sec. 7698. Requirement for program
    ``As part of the Educational Assistance Program, the Secretary 
shall carry out a scholarship program under this subchapter. The 
program shall be known as the Department of Veterans Affairs 
Readjustment Counseling Service Scholarship Program (in this subchapter 
referred to as the `Program').
``Sec. 7699. Eligibility; agreement
    ``(a) In General.--An individual is eligible to participate in the 
Program, as determined by the Readjustment Counseling Service of the 
Department, if the individual--
            ``(1) is accepted for enrollment or enrolled (as described 
        in section 7602 of this title) in, a program of study at an 
        accredited educational institution, school, or training program 
        leading to--
                    ``(A) a bachelor's, master's, or doctoral degree in 
                psychology, social work, or marriage and family 
                therapy; or
                    ``(B) a master's degree in mental health 
                counseling; and
            ``(2) enters into an agreement with the Secretary under 
        subsection (c).
    ``(b) Priority.--In selecting individuals to participate in the 
Program, the Secretary shall give priority to the following 
individuals:
            ``(1) An individual who agrees to be employed by a Vet 
        Center located in a community that is--
                    ``(A) designated as a medically underserved 
                population under section 330(b)(3) of the Public Health 
                Service Act (42 U.S.C. 254b(b)(3)); and
                    ``(B) in a state with a per capita population of 
                veterans of more than five percent according to the 
                National Center for Veterans Analysis and Statistics 
                and the Bureau of the Census.
            ``(2) An individual who is a veteran.
    ``(c) Agreement.--An agreement between the Secretary and a 
participant in the Program shall (in addition to the requirements set 
forth in section 7604 of this title) include the following:
            ``(1) An agreement by the Secretary to provide the 
        participant with a scholarship under the Program for a 
        specified number of school years during which the participant 
        pursues a program of study described in subsection (a)(1) that 
        meets the requirements set forth in section 7602(a) of this 
        title.
            ``(2) An agreement by the participant to serve as a full-
        time employee of the Department at a Vet Center for a three-
        year period during the six-year period following the completion 
        by the participant of such program of study (in this subchapter 
        referred to as the `period of obligated service').
    ``(d) Vet Center Defined.--In this section, the term `Vet Center' 
has the meaning given that term in section 1712A(h) of this title.
``Sec. 7699A. Obligated service
    ``(a) In General.--Each participant in the Program shall provide 
service as a full-time employee of the Department at a Vet Center (as 
defined in section 7699(c) of this title) for the period of obligated 
service set forth in the agreement of the participant entered into 
under section 7604 of this title.
    ``(b) Determination of Service Commencement Date.--(1) Not later 
than 60 days before the service commencement date of a participant, the 
Secretary shall notify the participant of that service commencement 
date.
    ``(2) The date specified in paragraph (1) with respect to a 
participant is the date for the beginning of the period of obligated 
service of the participant.
``Sec. 7699B. Breach of agreement: liability
    ``(a) Liquidated Damages.--(1) A participant in the Program (other 
than a participant described in subsection (b)) who fails to accept 
payment, or instructs the educational institution in which the 
participant is enrolled not to accept payment, in whole or in part, of 
a scholarship under the agreement entered into under section 7604 of 
this title shall be liable to the United States for liquidated damages 
in the amount of $1,500.
    ``(2) Liability under paragraph (1) is in addition to any period of 
obligated service or other obligation or liability under such 
agreement.
    ``(b) Liability During Program of Study.--(1) Except as provided in 
subsection (d), a participant in the Program shall be liable to the 
United States for the amount which has been paid to or on behalf of the 
participant under the agreement if any of the following occurs:
            ``(A) The participant fails to maintain an acceptable level 
        of academic standing in the educational institution in which 
        the participant is enrolled (as determined by the educational 
        institution under regulations prescribed by the Secretary).
            ``(B) The participant is dismissed from such educational 
        institution for disciplinary reasons.
            ``(C) The participant voluntarily terminates the program of 
        study in such educational institution before the completion of 
        such program of study.
    ``(2) Liability under this subsection is in lieu of any service 
obligation arising under the agreement.
    ``(c) Liability During Period of Obligated Service.--(1) Except as 
provided in subsection (d), if a participant in the Program does not 
complete the period of obligated service of the participant, the United 
States shall be entitled to recover from the participant an amount 
determined in accordance with the following formula: A=3F(t-s/t).
    ``(2) In the formula in paragraph (1):
            ``(A) `A' is the amount the United States is entitled to 
        recover.
            ``(B) `F' is the sum of--
                    ``(i) the amounts paid under this subchapter to or 
                on behalf of the participant; and
                    ``(ii) the interest on such amounts which would be 
                payable if at the time the amounts were paid they were 
                loans bearing interest at the maximum legal prevailing 
                rate, as determined by the Treasurer of the United 
                States.
            ``(C) `t' is the total number of months in the period of 
        obligated service of the participant.
            ``(D) `s' is the number of months of such period served by 
        the participant.
    ``(d) Limitation on Liability for Reductions-in-Force.--Liability 
shall not arise under subsection (c) if the participant fails to 
maintain employment as a Department employee due to a staffing 
adjustment.
    ``(e) Period for Payment of Damages.--Any amount of damages that 
the United States is entitled to recover under this section shall be 
paid to the United States within the one-year period beginning on the 
date of the breach of the agreement.''.
    (b) Conforming and Technical Amendments.--
            (1) Conforming amendments.--
                    (A) Establishment of program.--Section 7601(a) of 
                such title is amended--
                            (i) in paragraph (5), by striking ``and'';
                            (ii) in paragraph (6), by striking the 
                        period and inserting ``; and''; and
                            (iii) by adding at the end the following 
                        new paragraph:
            ``(7) the readjustment counseling service scholarship 
        program provided for in subchapter IX of this chapter.''.
                    (B) Eligibility.--Section 7602 of such title is 
                amended--
                            (i) in subsection (a)(1)--
                                    (I) by striking ``or VI'' and 
                                inserting ``VI, or IX''; and
                                    (II) by striking ``subchapter VI'' 
                                and inserting ``subchapter VI or IX''; 
                                and
                            (ii) in subsection (b), by striking ``or 
                        VI'' and inserting ``VI, or IX''.
                    (C) Application.--Section 7603(a)(1) of such title 
                is amended by striking ``or VIII'' and inserting 
                ``VIII, or IX''.
                    (D) Terms of agreement.--Section 7604 of such title 
                is amended by striking ``or VIII'' each place it 
                appears and inserting ``VIII, or IX''.
                    (E) Annual report.--Section 7632 of such title is 
                amended--
                            (i) in paragraph (1), by striking ``and the 
                        Specialty Education Loan Repayment Program'' 
                        and inserting ``the Specialty Education Loan 
                        Repayment Program, and the Readjustment 
                        Counseling Service Scholarship Program''; and
                            (ii) in paragraph (4), by striking ``and 
                        per participant in the Specialty Education Loan 
                        Repayment Program'' and inserting ``per 
                        participant in the Specialty Education Loan 
                        Repayment Program, and per participant in the 
                        Readjustment Counseling Service Scholarship 
                        Program''.
            (2) Table of sections.--The table of sections at the 
        beginning of chapter 76 of such title is amended by inserting 
        after the items relating to subchapter VIII the following:

  ``subchapter ix--readjustment counseling service scholarship program

``Sec.
``7698. Requirement for program.
``7699. Eligibility; agreement.
``7699A. Obligated service.
``7699B. Breach of agreement: liability.''.
    (c) Effective Date.--The Secretary of Veterans Affairs shall begin 
awarding scholarships under subchapter IX of chapter 76 of title 38, 
United States Code, as added by subsection (a), for programs of study 
beginning not later than one year after the date of the enactment of 
this Act.

SEC. 506. COMPTROLLER GENERAL REPORT ON READJUSTMENT COUNSELING SERVICE 
              OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--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 Readjustment Counseling Service of the Department of 
Veterans Affairs.
    (b) Elements.--The report required by subsection (a) shall include 
the following:
            (1) An assessment of the adequacy and types of treatment, 
        counseling, and other services provided at Vet Centers, 
        including recommendations on whether and how such treatment, 
        counseling, and other services can be expanded.
            (2) An assessment of the efficacy of outreach efforts by 
        the Readjustment Counseling Service, including recommendations 
        for how outreach efforts can be improved.
            (3) An assessment of barriers to care at Vet Centers, 
        including recommendations for overcoming those barriers.
            (4) An assessment of the efficacy and frequency of the use 
        of telehealth by counselors of the Readjustment Counseling 
        Service to provide mental health services, including 
        recommendations for how the use of telehealth can be improved.
            (5) An assessment of the feasibility and advisability of 
        expanding eligibility for services from the Readjustment 
        Counseling Service, including--
                    (A) recommendations on what eligibility criteria 
                could be expanded; and
                    (B) an assessment of potential costs and increased 
                infrastructure requirements if eligibility is expanded.
            (6) An assessment of the use of Vet Centers by members of 
        the reserve components of the Armed Forces who were never 
        activated and recommendations on how to better reach those 
        members.
            (7) An assessment of the use of Vet Centers by eligible 
        family members of former members of the Armed Forces and 
        recommendations on how to better reach those family members.
            (8) An assessment of the efficacy of group therapy and the 
        level of training of providers at Vet Centers in administering 
        group therapy.
    (c) Vet Center Defined.--In this section, the term ``Vet Center'' 
has the meaning given that term in section 1712A(h) of title 38, United 
States Code.

SEC. 507. EXPANSION OF REPORTING REQUIREMENTS ON READJUSTMENT 
              COUNSELING SERVICE OF DEPARTMENT OF VETERANS AFFAIRS.

    (a) Expansion of Annual Report.--Paragraph (2)(C) of section 
7309(e) of title 38, United States Code, is amended by inserting before 
the period at the end the following: ``, including the resources 
required to meet such unmet need, such as additional staff, additional 
locations, additional infrastructure, infrastructure improvements, and 
additional mobile Vet Centers''.
    (b) Biennial Report.--Such section is amended by adding at the end 
the following new paragraph:
    ``(3) For each even numbered year in which the report required by 
paragraph (1) is submitted, the Secretary shall include in such report 
a prediction of trends in demand for care, long-term investments 
required with respect to the provision of care, maintenance of 
infrastructure, and other capital investments with respect to the 
Readjustment Counseling Service, including Vet Centers, Mobile Vet 
Centers, and community access points.''.

SEC. 508. STUDIES ON ALTERNATIVE WORK SCHEDULES FOR EMPLOYEES OF 
              VETERANS HEALTH ADMINISTRATION.

    (a) Study of Veterans.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary of Veterans Affairs 
        shall conduct a study on the attitudes of eligible veterans 
        toward the Department of Veterans Affairs offering appointments 
        outside the usual operating hours of facilities of the 
        Department, including through the use of telehealth 
        appointments.
            (2) Eligible veteran defined.--In this subsection, the term 
        ``eligible veteran'' means a veteran who--
                    (A) is enrolled in the patient enrollment system of 
                the Department under section 1705(a) of title 38, 
                United States Code; and
                    (B) received health care from the Department at 
                least once during the two-year period ending on the 
                date of the commencement of the study under paragraph 
                (1).
    (b) Department Study.--
            (1) In general.--Not later than 180 days after the date of 
        the enactment of this Act, the Secretary shall conduct a study 
        on the feasibility and advisability of offering appointments 
        outside the usual operating hours of facilities of the 
        Department.
            (2) Study of employees.--The study required by paragraph 
        (1) shall include a study of the opinions of employees of the 
        Veterans Health Administration, including clinical, 
        nonclinical, and support staff, with respect to offering 
        appointments outside the usual operating hours of facilities of 
        the Department, including through the use of telehealth 
        appointments.

SEC. 509. SUICIDE PREVENTION COORDINATORS.

    The Secretary of Veterans Affairs shall ensure that each medical 
center of the Department of Veterans Affairs is staffed with not fewer 
than one suicide prevention coordinator.

Subtitle B--Direct Hiring Authorities for Certain Health Care Positions

SEC. 521. DIRECT HIRING AUTHORITIES FOR CERTAIN HEALTH CARE POSITIONS.

    (a) In General.--Subpart I of part III of title 5, United States 
Code, is amended by adding at the end the following:

    ``CHAPTER 103--DEPARTMENT OF VETERANS AFFAIRS HIRING AUTHORITIES

``Sec.
``10301. Department of Veterans Affairs personnel authorities.
``Sec. 10301. Department of Veterans Affairs personnel authorities
    ``(a) Flexibilities Relating to Appointments.--
            ``(1) In general.--The Secretary of Veterans Affairs 
        (referred to in this section as the `Secretary') shall 
        promulgate regulations to redesign the procedures that are 
        applied by the Department of Veterans Affairs in making 
        appointments to positions described in paragraphs (1) and (3) 
        of section 7401 of title 38 in order to--
                    ``(A) better meet mission needs;
                    ``(B) respond to managers' needs and the needs of 
                applicants;
                    ``(C) produce high-quality applicants;
                    ``(D) support timely decisions; and
                    ``(E) promote competitive job offers.
            ``(2) Waived requirements.--In redesigning the process by 
        which the appointments described in paragraph (1) shall be 
        made, the Secretary may waive the requirements of chapter 33, 
        and the regulations implementing that chapter, to the extent 
        necessary to achieve the objectives of this section, while 
        providing for the following:
                    ``(A) Fair, credible, and transparent methods of 
                establishing qualification requirements for, 
                recruitment for, and appointments to positions.
                    ``(B) Fair and open competition and equitable 
                treatment in the consideration and selection of 
                individuals to positions.
                    ``(C) Fair, credible, and transparent methods of 
                assigning, reassigning, detailing, transferring, or 
                promoting employees.
            ``(3) Implementation requirements.--In implementing this 
        subsection, the Secretary shall comply with the provisions of 
        section 2302(b)(11), regarding veterans' preference 
        requirements, in a manner consistent with that in which such 
        provisions are applied under chapter 33.
            ``(4) Training program.--The Secretary shall develop a 
        training program for Department of Veterans Affairs human 
        resource professionals to implement the requirements of this 
        subsection.
            ``(5) Indicators of effectiveness.--The Secretary shall 
        develop indicators of effectiveness to determine whether 
        appointment flexibilities under this subsection have achieved 
        the objectives described in paragraph (1).
    ``(b) Criteria for Use of New Personnel Authorities.--In the 
redesign of appointment procedures, as described in subsection (a), and 
with respect to the system of appointment flexibilities established 
under that subsection, the Secretary shall--
            ``(1) include a means for ensuring employee involvement 
        (for bargaining unit employees, through their exclusive 
        representatives) in that redesign and in the implementation of 
        that system;
            ``(2) provide for adequate training and retraining for 
        supervisors, managers, and employees in the implementation and 
        operation of that redesign and that system;
            ``(3) develop--
                    ``(A) a comprehensive management succession program 
                to provide training to employees to develop managers 
                for the agency; and
                    ``(B) a program to provide training to supervisors 
                on actions, options, and strategies that a supervisor 
                may use in administering that system;
            ``(4) include effective transparency and accountability 
        measures and safeguards to ensure that the management of that 
        system is fair, credible, and equitable, including appropriate 
        independent reasonableness reviews, internal assessments, and 
        employee surveys;
            ``(5) provide mentors to advise individuals on their career 
        paths and opportunities to advance and excel within their 
        fields;
            ``(6) develop appropriate procedures for warnings during 
        performance evaluations for employees who fail to meet 
        performance standards;
            ``(7) utilize the quadrennial strategic plan required under 
        section 7330C(b) of title 38; and
            ``(8) ensure that adequate agency resources are allocated 
        for the design, implementation, and administration of that 
        system.''.
    (b) Technical and Conforming Amendment.--The table of chapters for 
part III of title 5, United States Code, is amended by inserting after 
the item relating to chapter 102 the following:

``103. Department of Veterans Affairs Hiring Authorities....  10301.''.

              TITLE VI--IMPROVEMENT OF TELEHEALTH SERVICES

SEC. 601. EXPANDED TELEHEALTH FROM DEPARTMENT OF VETERANS AFFAIRS.

    (a) In General.--The Secretary of Veterans Affairs shall enter into 
partnerships, and expand existing partnerships, between the Department 
of Veterans Affairs, organizations that represent or serve veterans, 
nonprofit organizations, private businesses, and other interested 
parties for the expansion of telehealth capabilities and the provision 
of telehealth services to veterans through the award of grants under 
subsection (c).
    (b) Preference for Partnerships.--The Secretary shall give 
preference to entering into or expanding partnerships under subsection 
(a) with organizations that--
            (1) represent 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); or
            (2) operate in a medically underserved community (as 
        defined in section 799B of the Public Health Service Act (42 
        U.S.C. 295p)).
    (c) Award of Grants.--
            (1) In general.--In carrying out partnerships entered into 
        or expanded under this section with entities described in 
        subsection (a), the Secretary shall award grants to those 
        entities.
            (2) Maximum amount of grants.--The amount of a grant 
        awarded under this subsection may not exceed $75,000 per site 
        per year.
            (3) Use of grants.--
                    (A) In general.--Grants awarded to an entity under 
                this subsection shall be used for the following:
                            (i) Purchasing or upgrading hardware or 
                        software necessary for the provision of secure 
                        and private telehealth services.
                            (ii) Upgrading security protocols for 
                        consistency with the standardized telehealth 
                        security protocol implemented under section 
                        602(a)(2), or any other security requirements 
                        of the Department.
                            (iii) Training of employees, including 
                        payment of those employees for completing that 
                        training, with respect to--
                                    (I) military and veteran cultural 
                                competence, if the entity is not an 
                                organization that represents veterans; 
                                and
                                    (II) equipment required to provide 
                                telehealth services.
                            (iv) Upgrading existing infrastructure 
                        owned or leased by the entity to make rooms 
                        more conducive to telehealth care, including--
                                    (I) additional walls to create a 
                                new, private room;
                                    (II) soundproofing of existing 
                                rooms; or
                                    (III) new electrical or internet 
                                outlets in an existing room.
                            (v) Upgrading existing infrastructure to 
                        comply with the Americans with Disabilities Act 
                        of 1990 (42 U.S.C. 12101 et seq.).
                            (vi) Upgrading internet infrastructure.
                    (B) Exclusion.--Grants may not be used for the 
                purchase of new property or for major construction 
                projects, as determined by the Secretary.
    (d) Memoranda of Understanding or Agreement on Telehealth Access 
Points.--
            (1) In general.--An entity described in subsection (a) that 
        seeks to establish a telehealth access point for veterans but 
        does not require grant funding under this section to do so may 
        enter into a memorandum of understanding or memorandum of 
        agreement with the Department for the establishment of such an 
        access point.
            (2) Inspection.--The Secretary shall inspect the access 
        point proposed to be established under paragraph (1) to ensure 
        that it is adequately private, secure, and accessible for 
        veterans before the access point is established.
    (e) Assessment of Barriers to Access.--
            (1) In general.--Not later than 18 months after the date of 
        the enactment of this Act, the Secretary shall complete an 
        assessment of barriers faced by veterans in accessing 
        telehealth services from home.
            (2) Elements.--The assessment required by paragraph (1) 
        shall include the following:
                    (A) An assessment of current and potential future 
                cost barriers to veterans having internet access at 
                home.
                    (B) An assessment of current and potential future 
                barriers to veterans accessing broadband services at 
                home.
                    (C) A description of how the Department plans to 
                address the current and potential future cost and 
                access barriers described in subparagraphs (A) and (B).
                    (D) Such other matters related to internet access 
                for veterans in their homes as the Secretary considers 
                relevant.
            (3) Report.--Not later than 120 days after the completion 
        of the assessment required by paragraph (1), 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 assessment, including any 
        recommendations for legislative or administrative action based 
        on the results of the assessment.
    (f) Authorization of Appropriations.--There is authorized to be 
appropriated to the Secretary of Veterans Affairs $10,000,000 to carry 
out this section.

SEC. 602. IMPLEMENTATION OF NATIONAL PROTOCOL FOR TELEHEALTH SECURITY 
              AND INTERFACING INSTRUCTIONS.

    (a) National Telehealth Security Protocol.--
            (1) Assessment.--
                    (A) In general.--The Secretary of Veterans Affairs, 
                in consultation with industry experts, the Chairman of 
                the Federal Trade Commission, the Assistant Secretary 
                of Veterans Affairs for Information and Technology and 
                Chief Information Officer, and stakeholders, shall 
                conduct an assessment of current telehealth security 
                protocols.
                    (B) Elements.--The assessment conducted under 
                subparagraph (A) shall include the following:
                            (i) An assessment of current telehealth 
                        security protocols, including protocols used 
                        by--
                                    (I) the Department of Veterans 
                                Affairs;
                                    (II) other Federal agencies;
                                    (III) other health care providers; 
                                and
                                    (IV) such other organizations as 
                                the Secretary considers necessary to 
                                assess under such subparagraph.
                            (ii) A study of any current or future 
                        security risks--
                                    (I) faced by veterans using 
                                telehealth services; or
                                    (II) faced by the Department in 
                                furnishing those services.
                    (C) Timeline.--The Secretary shall complete the 
                assessment conducted under subparagraph (A) not later 
                than one year after the date of the enactment of this 
                Act.
            (2) Implementation.--Not later than 18 months after the 
        completion of the assessment under paragraph (1), the Secretary 
        shall, using guidance from the assessment, fully implement a 
        standardized telehealth security protocol at all facilities of 
        the Department.
            (3) Privacy and security.--The Secretary shall ensure that 
        the security protocol implemented under this subsection 
        protects the privacy and security of veterans, the health data 
        of veterans, and data from the Department.
    (b) National Telehealth Interfacing Instructions.--
            (1) Assessment.--
                    (A) In general.--The Secretary of Veterans Affairs, 
                in consultation with industry experts, organizations 
                that represent veterans, the Chief Veterans Experience 
                Officer, the Assistant Secretary of Veterans Affairs 
                for Information and Technology and Chief Information 
                Officer, and stakeholders, shall conduct an assessment 
                of current telehealth interfacing instructions.
                    (B) Elements.--The assessment conducted under 
                subparagraph (A) shall include an assessment of 
                interfacing instructions used by--
                            (i) the Department of Veterans Affairs;
                            (ii) other Federal agencies;
                            (iii) other health care providers; and
                            (iv) such other organizations as the 
                        Secretary considers necessary to assess under 
                        such subparagraph.
                    (C) Timeline.--The Secretary shall complete the 
                assessment conducted under subparagraph (A) not later 
                than one year after the date of the enactment of this 
                Act.
            (2) Implementation.--Not later than 18 months after the 
        completion of the assessment under paragraph (1), the Secretary 
        shall, using guidance from the assessment, fully implement 
        standardized telehealth interfacing instructions at all 
        facilities of the Department.
            (3) Navigation.--The Secretary shall ensure that the 
        telehealth interfacing instructions implemented under this 
        subsection are those that are easiest to navigate for veterans 
        and health care providers.
                                 <all>