    [Congressional Bills 119th Congress]
    [From the U.S. Government Publishing Office]
    [H.R. 9237 Introduced in House (IH)]

    <DOC>

    119th CONGRESS
      2d Session
                                    H. R. 9237

    To amend titles 10 and 38, United States Code, and other Federal laws,
        to improve benefits for veterans and the administration of the
                        Department of Veterans Affairs.

    _______________________________________________________________________

                        IN THE HOUSE OF REPRESENTATIVES

                                 June 10, 2026

     Mr. Bost (for himself, Mr. Bilirakis, Mr. Hudson, Mr. Lawler, Mr. Van
      Orden, Mrs. Miller-Meeks, Mr. Murphy, Mr. McGuire, Mr. Barrett, Mr.
        Bergman, Mr. Baird, Mr. Meuser, Ms. King-Hinds, Mrs. Kiggans of
    Virginia, Mr. Hamadeh of Arizona, Mr. Hill of Arkansas, Mr. Obernolte,
    Mr. Edwards, Mr. Moolenaar, Mr. Taylor, and Mr. Kelly of Pennsylvania)
     introduced the following bill; which was referred to the Committee on
    Veterans' Affairs, and in addition to the Committee on Armed Services,
    for a period to be subsequently determined by the Speaker, in each case
    for consideration of such provisions as fall within the jurisdiction of
                            the committee concerned

    _______________________________________________________________________

                                     A BILL

    To amend titles 10 and 38, United States Code, and other Federal laws,
        to improve benefits for veterans and the administration of the
                        Department of Veterans Affairs.

        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 ``Take Care of
    America's Veterans Act''.
        (b) Table of Contents.--The table of contents for this Act is as
    follows:

    Sec. 1. Short title; table of contents.
                             TITLE I--COMPENSATION

    Sec. 101. Major Richard Star Act.
    Sec. 102. Love Lives On Act.
    Sec. 103. Extension of increased dependency and indemnity compensation
                                to surviving spouses of veterans who die
                                from amyotrophic lateral sclerosis.
    Sec. 104. Sharri Briley and Eric Edmundson Veterans Benefits Expansion
                                Act of 2026.
    Sec. 105. Claims: prohibition on denial solely for certain reason;
                                improved efficiency of adjudications and
                                appeals.
    Sec. 106. Annual report on causes of death among veterans.
    Sec. 107. Plan for use of automation tools to process claims under laws
                                administered by the Secretary of Veterans
                                Affairs.
    Sec. 108. Reforms relating to Department of Veterans Affairs disability
                                ratings.
    Sec. 109. Improvements to temporary licensure requirements for contract
                                health care professionals who perform
                                medical disability examinations for the
                                Department of Veterans Affairs.
    Sec. 110. Disability examinations: study on access in rural areas;
                                review of training; review of inadequate or
                                unnecessary examinations.
    Sec. 111. Improvements to processing and outreach regarding claims
                                involving military sexual trauma.
    Sec. 112. Independent assessment of notices that the Secretary of
                                Veterans Affairs sends to claimants.
    Sec. 113. Independent assessment of forms that the Secretary of
                                Veterans Affairs sends to claimants.
                  TITLE II--EDUCATION AND ECONOMIC OPPORTUNITY

    Sec. 201. Vets Opportunity Act.
    Sec. 202. Improvements to process for making payments to automobile
                                sellers for automobiles purchased for
                                certain disabled veterans.
    Sec. 203. Monthly housing stipend under the Post-9/11 Educational
                                Assistance Program for individuals who
                                pursue summer programs of education solely
                                through distance learning.
    Sec. 204. Clarification regarding inclusion of medically necessary
                                automobile adaptations in Department of
                                Veterans Affairs definition of ``medical
                                services''.
    Sec. 205. Digital communications: Solid Start program; educational
                                assistance.
    Sec. 206. Improvements to Transition Assistance Program and
                                Skillbridge.
    Sec. 207. Transition Assistance Program: presentation in preseparation
                                counseling to promote benefits available to
                                veterans.
    Sec. 208. Elimination of requirement that on-campus educational and
                                vocational counseling is provided by
                                certain Department of Veterans Affairs
                                employees.
    Sec. 209. Expansion of entitlement for payment for licensing or
                                certification tests for veterans entitled
                                to educational assistance.
    Sec. 210. Increase of amount of educational assistance paid by the
                                Secretary of Veterans Affairs for first
                                year of a full-time program of
                                apprenticeship or other on-job training.
    Sec. 211. Improving emerging technology opportunities for veterans.
                             TITLE III--HEALTH CARE

    Sec. 301. Extension and modification of transportation grant program of
                                Department of Veterans Affairs.
    Sec. 302. Veteran Caregiver Reeducation, Reemployment, and Retirement
                                Act.
    Sec. 303. Veterans TBI Breakthrough Exploration of Adaptive Care
                                Opportunities Nationwide Act.
    Sec. 304. Department of Veterans Affairs assignment of traveling
                                physicians to serve territories and
                                possessions.
    Sec. 305. Inclusion of adaptive prostheses and terminal devices for
                                sports and other recreational activities in
                                medical services furnished to eligible
                                veterans by the Secretary of Veterans
                                Affairs.
    Sec. 306. Modifications to and reauthorization of Staff Sergeant Parker
                                Gordon Fox Suicide Prevention Grant Program
                                of Department of Veterans Affairs.
    Sec. 307. Reports on the use of hyperbaric oxygen therapy.
    Sec. 308. Department of Veterans Affairs pilot program to provide
                                grants to mental health care providers for
                                the provision of mental health care for
                                veterans.
    Sec. 309. Furnishing of certain health services to veterans in the
                                Freely Associated States.
    Sec. 310. Modification of Precision Medicine for Veterans Initiative;
                                reporting on suicide by veterans and
                                members of the Armed Forces.
    Sec. 311. Establishment of the Blast Overpressure Task Force of the
                                Department of Veterans Affairs.
    Sec. 312. Extension of sharing of Department of Veterans Affairs and
                                Department of Defense Health Care
                                Resources; resource sharing oversight and
                                implementation plan.
    Sec. 313. Timely reporting of the death of a veteran.
    Sec. 314. Expansion of access by veterans to critical access hospitals
                                and affiliated clinics under the Veterans
                                Community Care Program.
    Sec. 315. Pilot platform for services for veterans; collection from
                                veterans of information related to social
                                determinants of health.
    Sec. 316. Improvements to Department of Veterans Affairs prosthetic and
                                rehabilitative items and service.
    Sec. 317. Improvement of submission of medical documentation to the
                                Secretary of Veterans Affairs by community
                                care providers.
    Sec. 318. Implementation of and report on efforts of Department of
                                Veterans Affairs to improve health care
                                appointment scheduling.
    Sec. 319. Pilot program on coordination of care between Department of
                                Veterans Affairs and Medicare program.
    Sec. 320. Fisher House availability.
    Sec. 321. Agreements between medical facilities of Department of
                                Veterans Affairs and rural medical
                                facilities.
    Sec. 322. Study on quality of care difference between mental health and
                                addiction therapy care provided by health
                                care providers of Department of Veterans
                                Affairs compared to non-Department
                                providers.
    Sec. 323. Lactation spaces in medical centers of the Department of
                                Veterans Affairs.
    Sec. 324. Research related to menopause, perimenopause, and mid-life
                                women's health: report; plan.
    Sec. 325. Pilot program on provision of opioid rescue medications to
                                veterans.
    Sec. 326. Establishment of Veterans Health Administration Policy
                                Advisory Commission.
    Sec. 327. Access to health care.
    Sec. 328. Research on health conditions of descendants of toxic-exposed
                                veterans.
    Sec. 329. Veterans Spinal Trauma Access to New Devices Act.
    Sec. 330. Department of Veterans Affairs pilot program to award grants
                                for the provision of service dogs to
                                veterans.
    Sec. 331. Authorization of major medical facility project of Department
                                of Veterans Affairs for fiscal year 2027 in
                                Manchester, New Hampshire.
    Sec. 332. Bowel and bladder care program of Department of Veterans
                                Affairs.
                             TITLE IV--ORGANIZATION

    Sec. 401. Authorization of appropriations to the Office of Information
                                and Technology of the Department of
                                Veterans Affairs for certain purposes.
    Sec. 402. Establishment of Under Secretary for Management and Chief
                                Financial Officer.
    Sec. 403. Department of Veterans Affairs acquisition reform and cost
                                assessment.
    Sec. 404. Improvement of telephone communication by Department of
                                Veterans Affairs.
    Sec. 405. Advancing Department of Veterans Affairs emergency response
                                to crisis.
    Sec. 406. Membership of Department of Veterans Affairs Geriatrics and
                                Gerontology Advisory Committee.
    Sec. 407. Scheduling of appointments under the Veterans Community Care
                                Program.
                           TITLE V--MEMORIAL AFFAIRS

    Sec. 501. Expansion of eligibility for Department of Veterans Affairs
                                memorial headstone or marker for certain
                                individuals.
    Sec. 502. Department of Veterans Affairs provision of additional burial
                                benefits when an urn or commemorative
                                plaque is furnished.
    Sec. 503. Fallen Servicemembers Religious Heritage Restoration Program.
       TITLE VI--VETERANS' ASSURING CRITICAL CARE EXPANSIONS TO SUPPORT
                                 SERVICEMEMBERS

           Subtitle A--Improvement of Veterans Community Care Program

    Sec. 601. Codification of requirements for eligibility standards for
                                access to community care from Department of
                                Veterans Affairs.
    Sec. 602. Requirement that Secretary notify veterans of eligibility for
                                care or denial of request for care under
                                Veterans Community Care Program.
    Sec. 603. Consideration under Veterans Community Care Program of
                                continuity of care and need for caregiver
                                or attendant.
    Sec. 604. Discussion of telehealth options under Veterans Community
                                Care Program.
    Sec. 605. Extension of deadline for submittal of claims by health care
                                entities and providers under prompt payment
                                standard.
    Sec. 606. Audit of representative sample of veterans receiving care and
                                services under Veterans Community Care
                                Program.
    Sec. 607. Information on wait time and drive time options for receipt
                                of care by veterans.
    Sec. 608. Establishment of period during which a referral under
                                Veterans Community Care Program remains
                                valid.
    Sec. 609. Updates to contracting requirements under Veterans Community
                                Care Program.
    Sec. 610. Publication of community care network sufficiency and payment
                                waiver requests and approvals.
    Sec. 611. Requirements relating to quality of community care providers.
    Sec. 612. Provider training.
    Sec. 613. Oversight authority over community care.
                  Subtitle B--Mental Health Treatment Programs

    Sec. 621. Veteran participation in certain mental health programs.
    Sec. 622. Access to mental health residential rehabilitation treatment
                                programs for veterans with spinal cord
                                injury or disorder.
                          Subtitle C--Staffing Matters

    Sec. 631. Treatment of psychologists.
    Sec. 632. Mentorship program for executive leadership teams at medical
                                centers of the Department of Veterans
                                Affairs.
    Sec. 633. Requirement for equivalent role postings for vacant positions
                                at Department of Veterans Affairs.
    Sec. 634. Improvements to Department of Veterans Affairs hiring
                                processes.
    Sec. 635. Department of Veterans Affairs telework policy.
    Sec. 636. Expansion of reimbursement of continuing professional
                                education expenses.
    Sec. 637. Department of Veterans Affairs personnel transparency.
    Sec. 638. Modification of authority of licensure of health care
                                professionals providing treatment via
                                telemedicine.
    Sec. 639. Provision of data on educational assistance programs of
                                Veterans Health Administration.
                     Subtitle D--Optimization of Workforce

    Sec. 641. Department of Veterans Affairs strategic human capital plan.
    Sec. 642. Department of Veterans Affairs reduction in force notice
                                requirement.
    Sec. 643. Detailed plans and justifications for reorganization of
                                offices.
    Sec. 644. Rule of construction.
             Subtitle E--Veterans Infrastructure and Transformation

    Sec. 651. Short title.
    Sec. 652. Modification of authority for sharing of health-care
                                resources of Department of Veterans Affairs
                                to include flexible space utilization and
                                streamlined service agreements.
    Sec. 653. Use of commercial construction and facilities code and
                                standards.
    Sec. 654. Feasibility study for full-service hospital of Department of
                                Veterans Affairs in certain States.
    Sec. 655. Report on strategic plan for infrastructure and capital
                                assets of Department of Veterans Affairs.
    Sec. 656. Permanent extension of pilot program on acceptance by the
                                Department of Veterans affairs of donated
                                facilities and related improvements.
    Sec. 657. Authority to accept donations of construction services, minor
                                construction or nonrecurring maintenance
                                projects, and targeted contributions.
    Sec. 658. Report on use of additional authorities relating to
                                recruitment and retention of personnel.
    Sec. 659. Reports on key capital asset investments, activities, and
                                performance of Department of Veterans
                                Affairs.
    Sec. 660. Development of streamlined procurement model; report.
    Sec. 661. Submission and notification of cost estimates for medical
                                facility leases.
    Sec. 662. Report on capital asset and information technology needs of
                                the research and development program of
                                Department of Veterans Affairs.
    Sec. 663. Improving prevention, detection, and reporting of waste,
                                fraud, and abuse in Department of Veterans
                                Affairs capital asset projects and
                                activities.
    Sec. 664. Report on long-term care physical infrastructure needs of
                                Department of Veterans Affairs.
                     Subtitle F--Other Health Care Matters

    Sec. 671. Prescription, delivery, distribution, and dispensation of
                                controlled substance medications by covered
                                health care professionals of Department of
                                Veterans Affairs via telemedicine.
    Sec. 672. Copayments for limited supplies of medications.
    Sec. 673. Plan on establishment of interactive, online self-service
                                module for care.
    Sec. 674. Modification of requirements for Center for Innovation for
                                Care and Payment of the Department of
                                Veterans Affairs and transfer of authority.
    Sec. 675. Report on improvements to clinical appeals process.
    Sec. 676. Plan on increasing accessibility of care for veterans with
                                spinal cord injury or disorder.

                             TITLE I--COMPENSATION

    SEC. 101. MAJOR RICHARD STAR ACT.

        (a) Concurrent Receipt Generally.--Section 1414(b) of title 10,
    United States Code, is amended by striking paragraph (2) and inserting
    the following new paragraphs:
                ``(2) Combat-related disability retirees.--
                        ``(A) In general.--A member retired under chapter
                    61 of this title with a combat-related disability who
                    is entitled for any month to retired pay under chapter
                    61 of this title and is also entitled for that month to
                    veterans' disability compensation under title 38, is
                    entitled to be paid both without regard to sections
                    5304 and 5305 of title 38, as provided by subparagraphs
                    (B) and (C).
                        ``(B) Career retirees.--In the case of a member
                    retired under chapter 61 of this title who has a
                    combat-related disability that is not a qualifying
                    service-connected disability (as defined in subsection
                    (a)(2)) and who, at the time of the member's
                    retirement, had 20 years or more of service otherwise
                    creditable under section 1405 of this title or at least
                    20 years of service computed under section 12732 of
                    this title, the member may receive, without regard to
                    sections 5304 and 5305 of title 38, both--
                                ``(i) the amount of retired pay to which
                            the member would have been entitled under any
                            other provision of law based on the member's
                            service in the uniformed services if the member
                            had not been retired under chapter 61 of this
                            title; and
                                ``(ii) veterans' disability compensation
                            under title 38.
                        ``(C) Disability retirees with less than 20 years
                    of service.--In the case of a member retired under
                    chapter 61 of this title with a combat-related
                    disability and who, at the time of the member's
                    retirement, had less than 20 years of service otherwise
                    creditable under section 1405 of this title or less
                    than 20 years of service computed under section 12732
                    of this title, the member may receive, without regard
                    to sections 5304 and 5305 of title 38, the lesser of--
                                ``(i) both--
                                        ``(I) the retired pay for which the
                                    member is eligible under chapter 61 of
                                    this title; and
                                        ``(II) veterans' disability
                                    compensation under title 38; or
                                ``(ii) both--
                                        ``(I) an amount equal to the
                                    product of the retired pay base
                                    computed under section 1406(b) or 1407
                                    of this title and the retired pay
                                    multiplier determined under section
                                    1409 of this title, as such base pay
                                    and multiplier would be computed if the
                                    member had 20 years of service
                                    creditable under section 1405 of this
                                    title; and
                                        ``(II) veterans' disability
                                    compensation under title 38.
                        ``(D) Combat-related disability defined.--In this
                    paragraph, the term `combat-related disability' has the
                    meaning given that term in subsection (e) of section
                    1413a of this title and as determined under the
                    criteria and procedures used for purposes of such
                    section.
                ``(3) Exclusion of other retirees.--Subsection (a) does not
            apply to a member retired under chapter 61 of this title if the
            member is not covered by paragraph (1) or (2).''.
        (b) Technical and Conforming Amendments.--
                (1) Coordination with combat-related special compensation
            program.--Section 1414(d) of title 10, United States Code, is
            amended by striking ``qualified retiree under this section''
            and inserting ``qualified retiree under subsection (a) or is
            entitled to a payment under subsection (b)(2)''.
                (2) Amendments reflecting end of concurrent receipt phase-
            in period.--Section 1414 of title 10, United States Code, is
            further amended--
                        (A) in subsection (a)(1)--
                                (i) by striking the second sentence; and
                                (ii) by striking subparagraphs (A) and (B);
                        (B) by striking subsection (c) and redesignating
                    subsections (d) and (e) as subsections (c) and (d),
                    respectively; and
                        (C) in subsection (d), as redesignated, by striking
                    paragraphs (3) and (4).
                (3) Section heading.--The heading of section 1414 of such
            title is amended to read as follows:
    ``Sec. 1414. Members eligible for retired pay who are also eligible for
                  veterans' disability compensation: concurrent receipt''.
                (4) Conforming amendment.--Section 1413a(f) of such title
            is amended by striking ``Subsection (d)'' and inserting
            ``Subsection (c)''.
        (c) Effective Date.--The amendments made by this section shall take
    effect on January 1, 2027, and shall apply to payments for months
    beginning on or after that date.

    SEC. 102. LOVE LIVES ON ACT.

        (a) Modification of Entitlement to Veterans Dependency and
    Indemnity Compensation for Surviving Spouses Who Remarry.--Section
    103(d) of title 38, United States Code, is amended--
                (1) in paragraph (2)(B)--
                        (A) by inserting ``(i)'' before ``The remarriage'';
                        (B) in clause (i), as designated by subparagraph
                    (A), by striking ``Notwithstanding the previous
                    sentence'' and inserting the following:
        ``(ii) Notwithstanding clause (i)''; and
                        (C) by adding at the end the following new clause:
        ``(iii) Notwithstanding clause (ii), the remarriage of a surviving
    spouse shall not bar the furnishing of benefits under section 1311 or
    1562 of this title to the surviving spouse of a veteran.''; and
                (2) in paragraph (5)--
                        (A) by striking subparagraph (A); and
                        (B) by renumbering subparagraphs (B) through (E) as
                    subparagraphs (A) through (D), respectively.
        (b) Continued Eligibility for Survivor Benefit Plan for Certain
    Surviving Spouses Who Remarry.--Section 1450(b)(2) of title 10, United
    States Code, is amended--
                (1) by striking ``An annuity'' and inserting the following:
                        ``(A) In general.--(A) Subject to subparagraph (B),
                    an annuity''; and
                (2) by adding at the end the following new subparagraph:
                        ``(B) Treatment of survivors of members who die on
                    active duty.--The Secretary may not terminate payment
                    of an annuity for a surviving spouse described in
                    subparagraph (A) or (B) of section 1448(d)(1) solely
                    because that surviving spouse remarries. In the case of
                    a surviving spouse who remarried before reaching age 55
                    and before the date of the enactment of Take Care of
                    America's Veterans Act, the Secretary shall resume
                    payment of the annuity to that surviving spouse--
                                ``(i) except as provided by clause (ii),
                            for each month that begins on or after the date
                            that is one year after such date of enactment;
                            or
                                ``(ii) on the first day of the first month
                            beginning after such date of enactment, in the
                            case of a surviving spouse who elected to
                            transfer payment of that annuity to a surviving
                            child or children under the provisions of
                            section 1448(d)(2)(B) of title 10, United
                            States Code, as in effect on December 31,
                            2019.''.
        (c) Expansion of Definition of Dependent Under TRICARE Program to
    Include a Remarried Widow or Widower Whose Subsequent Marriage Has
    Ended.--Section 1072(2) of title 10, United States Code, is amended--
                (1) in subparagraph (H), by striking ``; and'' and
            inserting a semicolon;
                (2) in subparagraph (I)(v), by striking the period at the
            end and inserting ``; and''; and
                (3) by adding at the end the following new subparagraph:
                        ``(J) a remarried widow or widower whose subsequent
                    marriage has ended due to death, divorce, or
                    annulment.''.

    SEC. 103. EXTENSION OF INCREASED DEPENDENCY AND INDEMNITY COMPENSATION
                  TO SURVIVING SPOUSES OF VETERANS WHO DIE FROM AMYOTROPHIC
                  LATERAL SCLEROSIS.

        (a) Extension.--Section 1311(a)(2) of title 38, United States Code,
    is amended--
                (1) by inserting ``(A)'' before ``The rate''; and
                (2) by adding at the end the following new subparagraph:
        ``(B) A veteran whom the Secretary determines died from amyotrophic
    lateral sclerosis shall be treated as a veteran described in
    subparagraph (A) without regard for how long the veteran had such
    disease prior to death.''.
        (b) Applicability.--Subparagraph (B) of section 1311(a)(2) of title
    38, United States Code, as added by subsection (a), shall apply to a
    veteran who dies from amyotrophic lateral sclerosis on or after October
    1, 2022.

    SEC. 104. SHARRI BRILEY AND ERIC EDMUNDSON VETERANS BENEFITS EXPANSION
                  ACT OF 2026.

        (a) Increase in Rates of Certain Disability Compensation and
    Dependency and Indemnity Compensation Under Laws Administered by
    Secretary of Veterans Affairs.--
                (1) Increase to rates of wartime disability compensation.--
                        (A) In general.--Section 1114 of title 38, United
                    States Code, is amended by adding at the end the
                    following new subsection:
        ``(u) In the case of a veteran eligible for a monthly aid and
    attendance allowance under subsection (r) or subsection (t) of this
    section, the Secretary shall, in addition to the total amount of
    compensation for which the veteran is eligible under this section, pay
    the veteran a supplemental monthly allowance at the rate of $833.33.''.
                        (B) Effective date; applicability.--Subsection (u)
                    of such section (as added by subparagraph (A)) shall
                    take effect on December 1, 2026, and shall apply to
                    months beginning on or after such date.
                (2) Increase to rates of dependency and indemnity
            compensation.--Section 5312 of such title is amended by adding
            at the end the following new subsection:
        ``(d)(1) Whenever there is an increase in benefit amounts payable
    under title II of the Social Security Act (42 U.S.C. 401 et seq.) as a
    result of a determination made under section 215(i) of such Act (42
    U.S.C. 415(i)), the Secretary shall, except as provided in paragraph
    (2), effective on the date of such increase in benefit amounts,
    increase the dollar amounts in effect for the payment of dependency and
    indemnity compensation by the Secretary under paragraph (1) and
    paragraph (3) of section 1311(a) of this title, as such amounts were in
    effect immediately before the date of such increase in benefit amounts
    payable under title II of the Social Security Act, by a percentage
    equal to the sum of--
                ``(A) the percentage by which such benefit amounts are
            increased; and
                ``(B) one percent.
        ``(2) Whenever there is an increase under paragraph (1) in amounts
    in effect for the payment of dependency and indemnity compensation, the
    Secretary shall publish such amounts, as increased pursuant to such
    paragraph, in the Federal Register at the same time as the material
    required by section 215(i)(2)(D) of the Social Security Act (42 U.S.C.
    415(i)(2)(D)) is published by reason of a determination under section
    215(i) of such Act (42 U.S.C. 415(i)).
        ``(3) The requirement to increase, pursuant to paragraph (1), the
    amounts in effect for the payment of dependency and indemnity
    compensation under paragraph (1) and paragraph (3) of section 1311 (a)
    of this title by the Secretary shall--
                ``(A) take effect on December 1, 2026, and shall apply with
            respect to months beginning on or after such date; and
                ``(B) terminate after the date on which the third increase
            to such amounts pursuant to such paragraph occurs.''.
        (b) Modification of Waivers of Fees Collected for Housing Loans
    Guaranteed, Insured, or Made by the Secretary of Veterans Affairs.--
    Section 3729(b)(2) of such title is amended, in the loan fee table--
                (1) in subparagraph (E), by striking ``0.50'' both places
            it appears and inserting ``1.42''; and
                (2) in subparagraph (I), by striking ``0.50'' each place it
            appears and inserting ``1.0''.
        (c) Home Affordability for Guard and Reserve.--
                (1) Eligibility of certain members of the reserve
            components and the national guard for guaranteed housing
            loans.--
                        (A) Expanded definition of ``active duty'' for
                    purposes of housing loans.--Section 3701(b) of title
                    38, United States Code, is amended by adding at the end
                    the following new paragraph:
                ``(9) The term `active duty' has the meanings as follows:
                        ``(A) In the case of members of the regular
                    components of the Armed Forces, the meaning given such
                    term in section 101(21)(A).
                        ``(B) In the case of members of the reserve
                    components of the Armed Forces--
                                ``(i) service on active duty (as defined in
                            section 101(d) of title 10), inactive-duty
                            training (as defined in section 101(d) of title
                            10), or annual training duty; or
                                ``(ii) service on active duty under a call
                            or order to active duty under section 688,
                            12301(a), 12301(d), 12301(g), 12301(h), 12302,
                            12304, 12304a, or 12304b of title 10 or section
                            713 of title 14, but not including inactive
                            duty training (as defined in section 101(d) of
                            title 10) or annual training duty.
                        ``(C) In the case of a member of the Army National
                    Guard of the United States or Air National Guard of the
                    United States, in addition to service described in
                    subparagraph (B), full-time service--
                                ``(i) in the National Guard of a State for
                            the purpose of organizing, administering,
                            recruiting, instructing, or training the
                            National Guard;
                                ``(ii) in the National Guard when
                            performing full-time National Guard duty (as
                            defined in section 101 of title 32); or
                                ``(iii) in the National Guard when
                            performing active duty (as defined in section
                            101 of title 32).''.
                        (B) Retroactive applicability to service
                    performed.--The amendments made by this subsection
                    shall apply with respect to any service performed on or
                    after September 11, 2001.
                (2) Expansion of eligibility for guaranteed housing loans
            to certain additional personnel upon payment of additional loan
            fee.--
                        (A) Expansion to individuals with at least 14 days
                    of service.--Section 3701(b) of title 38, United States
                    Code, is amended by inserting after paragraph (7) the
                    following new paragraph:
                ``(8) The term `veteran' also includes, for purposes of
            home loans (subject to the additional loan fee in section
            3729(b)(4)(J) of this title), an individual who--
                        ``(A) is not otherwise eligible for the benefits of
                    this chapter;
                        ``(B) has completed a total service of at least 14
                    days on active duty under paragraph (B) or (C) of
                    paragraph (9); and
                        ``(C) following completion of such service,
                    continued to serve until the completion of entry level
                    and skill training (as defined in section 3301(3) of
                    this title).''.
                        (B) Basic entitlement.--Section 3702(a)(2) of title
                    38, United States Code, is amended by adding at the end
                    the following:
                ``(H) Each individual described in section 3701(b)(8) of
            this title.''.
                        (C) Additional loan fee for such individuals.--
                    Section 3729(b)(4) of title 38, United States Code, is
                    amended by adding at the end the following new
                    subparagraph:
                ``(J) In the case of a housing loan in which the veteran
            has eligibility under section 3701(b)(8) of this title and does
            not otherwise have eligibility, the loan fee table in paragraph
            (2) shall be applied to the veteran or other obligor (as
            applicable) by adding 1.00 to the percentage in the table.''.
                        (D) Notification to personnel.--The Secretary of
                    Veterans Affairs shall provide information about this
                    benefit to the Secretary of Defense to ensure that each
                    member of a reserve component or a member of the Army
                    National Guard of the United States or Air National
                    Guard of the United States who completes entry level
                    and skill training (as defined in section 3301(3) of
                    title 38, United States Code) after the date of the
                    enactment of this Act is notified of their eligibility
                    for housing loan benefits under chapter 37 of such
                    title, including eligibility (subject to the additional
                    loan fee) under section 3701(b)(8) of such title.

    SEC. 105. CLAIMS: PROHIBITION ON DENIAL SOLELY FOR CERTAIN REASON;
                  IMPROVED EFFICIENCY OF ADJUDICATIONS AND APPEALS.

        (a) Prohibition on Denial of Claims for Benefits Under Laws
    Administered by Secretary of Veterans Affairs on Sole Basis That
    Veteran Failed to Appear for Certain Medical Examination.--Subsection
    (d) of section 5103A of title 38, United States Code, is amended--
                (1) in the heading, by striking ``Compensation Claims'' and
            inserting ``Claims for Benefits'';
                (2) in paragraph (2), by striking ``treat an examination or
            opinion as being necessary to make a decision on a claim for
            purposes of'' and inserting ``provide for a medical examination
            or obtain a medical opinion under''; and
                (3) by adding at the end the following new paragraph:
        ``(3) If a veteran fails to appear for a medical examination
    provided by the Secretary in conjunction with a claim for a benefit
    under a law administered by the Secretary, the Secretary may not deny
    such claim on the sole basis that such veteran failed to appear for
    such medical examination.''.
        (b) Improvements to Efficiency of Adjudications and Appeals of
    Claims for Benefits Under Laws Administered by Secretary of Veterans
    Affairs.--
                (1) Annual report on length of adjudications.--
                        (A) In general.--Section 5109B of title 38, United
                    States Code, is amended--
                                (i) by striking ``The Secretary'' and
                            inserting ``(a) In General.--The Secretary'';
                            and
                                (ii) by adding at the end the following new
                            subsection:
        ``(b) Annual Report.--The Secretary shall submit to the Committees
    on Veterans' Affairs of the House of Representatives and the Senate an
    annual report that includes, with respect to the period covered by the
    report--
                ``(1) the average length of time a claim (or an issue
            within a claim) that was remanded by the Board of Veterans'
            Appeals was or has been pending before the Secretary after such
            remand;
                ``(2) the number of cases that advanced on the docket by
            reason of a motion that was filed under section 7107(b) of this
            title and on which the Board ruled, disaggregated by--
                        ``(A) whether a motion was granted or denied; and
                        ``(B) the reason provided for the motion; and
                ``(3) the number of appeals dismissed by the Board,
            disaggregated by--
                        ``(A) whether or not the dismissal was by reason of
                    the death of the appellant; and
                        ``(B) in the case of a dismissal by reason of the
                    death of the appellant, whether or not such death was a
                    result of suicide.''.
                        (B) Deadline.--The Secretary of Veterans Affairs
                    shall submit the first report required by subsection
                    (b) of section 5109B of such title (as added by
                    subparagraph (A)) by not later than one year after the
                    date of the enactment of this Act.
                (2) Guidelines for advancement of cases on docket of
            board.--Not later than one year after the date of the enactment
            of this Act, the Secretary of Veterans Affairs, in consultation
            with the Board of Veterans' Appeals and the General Counsel of
            the Department of Veterans Affairs, shall prescribe guidelines
            for the advancement of a case on the docket of the Board on a
            motion for earlier consideration and determination under
            section 7107(b)(3) of title 38, United States Code. Such
            guidelines shall include the type of evidence that may be
            submitted with the motion for the advancement of the case to
            show grounds for such a motion.
                (3) Requirement to track certain claims for benefits.--
                        (A) In general.--Chapter 51 of title 38, United
                    States Code, is amended by inserting after section
                    5109B the following new section:
    ``Sec. 5109C. Requirement to track and maintain information on certain
                  claims for benefits; notice of certain assignments
        ``(a) In General.--The Secretary shall use technology to track and
    maintain information (including information with respect to timeliness)
    on--
                ``(1) claims for benefits under the laws administered by
            the Secretary (including issues within such claims) that are--
                        ``(A) continuously pursued in accordance with--
                                ``(i) sections 5104C(a) and 5110(a)(2) of
                            this title; or
                                ``(ii) any other policy established by the
                            Secretary;
                        ``(B) filed in the National Work Queue (or any
                    successor system) but have not been assigned to an
                    office of the Veterans Benefits Administration for
                    adjudication;
                        ``(C) afforded expeditious treatment by the
                    Veterans Benefits Administration pursuant to section
                    5109B of this title or any other policy established by
                    the Secretary;
                        ``(D) remanded by the Board of Veterans' Appeals to
                    the Secretary pursuant to section 7104 of this title;
                    or
                        ``(E) pending a hearing by the Board of Veterans'
                    Appeals under section 7107 of this title;
                ``(2) instances in which an adjudicator of the Veterans
            Benefits Administration does not comply with a relevant
            decision of the Board of Veterans' Appeals to remand a claim
            for benefits under the laws administered by the Secretary (or
            an issue within such a claim), including any such instance in
            which the relevant decision concerned a failure on the part of
            the agency of original jurisdiction to satisfy the duty of the
            Secretary to assist under section 5103A of this title;
                ``(3) supplemental claims under section 5108 of this title
            that are filed--
                        ``(A) in accordance with section 5104C(a) and
                    section 5110(a)(2) of this title; and
                        ``(B) after the date of the applicable final
                    decision of the Secretary with respect to a claim for
                    benefits under the laws administered by the Secretary
                    (or an issue within such a claim); and
                ``(4) first notices submitted to the Secretary of the death
            of individuals in receipt of benefits under the laws
            administered by the Secretary, disaggregated by such
            individuals who were--
                        ``(A) assigned a fiduciary; and
                        ``(B) not assigned a fiduciary.
        ``(b) Annual Report.--(1) The Secretary shall submit to the
    Committees on Veterans' Affairs of the House of Representatives and the
    Senate an annual report that includes all information maintained and
    tracked pursuant to subsection (a).
        ``(2) The first report required by paragraph (1) shall be submitted
    by not later than one year after the date of the enactment of the Take
    Care of America's Veterans Act.''.
                        (B) Clerical amendment.--The table of sections at
                    the beginning of such chapter is amended by inserting
                    after the item relating to section 5109B the following
                    new item:

    ``5109C. Requirement to track and maintain information on certain
                                claims for benefits; notice of certain
                                assignments.''.
                (4) Improvements to board of veterans' appeals.--
                        (A) Authority to aggregate certain claims.--
                                (i) In general.--Section 7104(a) of such
                            title is amended by inserting after the second
                            sentence the following new sentence: ``If the
                            Chairman of the Board determines that more than
                            one appeal involves common questions of law or
                            fact, the Chairman may aggregate such appeals
                            to decide such questions of law or fact.''.
                                (ii) Effective date.--The amendment made by
                            clause (i) shall take effect on the date of the
                            enactment of this Act and apply beginning on
                            the date 90 days after the date on which the
                            Secretary of Veterans Affairs submits to the
                            Committees on Veterans' Affairs of the Senate
                            and House of Representatives a copy of the
                            policies and procedures required under
                            paragraph (7)(D)(i)(II).
                                (iii) Sunset.--The authority to aggregate
                            appeals pursuant to clause (i) shall expire on
                            the date that is three years after the date on
                            which the Secretary of Veterans Affairs
                            completes the development of the policies and
                            procedures required under paragraph
                            (7)(D)(i)(II).
                        (B) Requirement to ensure substantial compliance
                    with certain decisions.--Such section is further
                    amended--
                                (i) by redesignating subsection (f) as
                            subsection (g); and
                                (ii) by inserting after subsection (e) the
                            following new subsection (f):
        ``(f)(1) The Secretary, acting through a member of the Board, shall
    ensure substantial compliance with any decision of the Board to remand
    a claim.
        ``(2) The agency of original adjudication may waive the requirement
    under paragraph (1) with respect to a decision of the Board to remand a
    claim to the Secretary, if a member of the Board determines--
                ``(A) evidence added to the evidentiary record after the
            date of such decision is sufficient to resolve the issues
            underlying such decision; or
                ``(B) such decision was unnecessary.
        ``(3) If the Secretary waives such requirement, the applicable
    member of the Board shall include, pursuant to subsection (d), a
    determination of such waiver in the decision of the Board.''.
                        (C) Definition of aggregate; report.--Such section
                    is further amended by adding at the end the following
                    new subsections:
        ``(h) Not later than three years after the date on which the
    Secretary of Veterans Affairs completes the development of the policies
    and procedures required under paragraph (7)(D)(i)(II), and every five
    years thereafter, the Secretary shall submit to the Committees on
    Veterans' Affairs of the Senate and House of Representatives a report
    on the aggregation of claims by the Board under subsection (a). Each
    such report shall include--
                ``(1) an identification of each instance in which the Board
            aggregated appeals during the period covered by the report,
            including, for each such instance, the number of appeals that
            were aggregated;
                ``(2) an assessment of whether the aggregation of appeals
            has contributed to improved efficiency at the Board with
            issuing decisions on appeals; and
                ``(3) such other matters as the Secretary determines
            appropriate.
        ``(i) In this section, the term `aggregate'--
                ``(1) means any practice or procedure to collect common
            issues, claims, or appeals by multiple parties for the purposes
            of resolving such issues, claims, or appeals; and
                ``(2) includes the use of joinder, consolidation,
            intervention, class actions, and any other multiparty
            proceedings.''.
                (5) Expansion of jurisdiction of court of appeals for
            veterans claims.--Section 7252 of title 38, United States Code,
            is amended--
                        (A) by redesignating subsections (b) and (c) as
                    subsections (d) and (e), respectively; and
                        (B) by inserting after subsection (a) the following
                    new subsections:
        ``(b)(1) In an appeal over which the Court has jurisdiction
    pursuant to section 7266 of this title, if the appellant files a
    request for class certification pursuant to the rules prescribed by the
    Court pursuant to section 7264 of this title, the Court shall have
    supplemental jurisdiction over any claim for benefits under the laws
    administered by the Secretary--
                ``(A) filed by a claimant who satisfies the definition of
            the class contained in such request (including a claimant who
            has filed a claim for benefits under such laws that are
            specified in such request); and
                ``(B) regarding which--
                        ``(i) the agency of original jurisdiction has
                    issued a nonfinal decision; and
                        ``(ii) the claimant has filed a notice of
                    disagreement under section 5104C(a) or section 7105 of
                    this title, including any case in which a claimant has
                    filed a supplemental claim within one year of a Board
                    decision under section 5110(a)(2)(D) and 5108 of this
                    title following a notice of disagreement and decision
                    of the Board.
        ``(2) A claimant may submit a request for administrative review of
    such a claim under section 5104C(a) of this title during the period
    beginning on the date on which the named claimant of the motion for
    class action review submits to the Court a motion for class action
    review and ending on the date that is 60 days after the later of the
    following dates:
                ``(A) The date on which the Court issues a final decision
            with respect to such claim.
                ``(B) The date on which the Court issues a final decision
            with respect to such motion for class action review.
        ``(3) In the case of a claimant whose claim is decided by the Board
    during the period when the Court is reviewing the motion for class
    action review the deadline for such claimant to file an appeal to the
    Court with respect to the decision of the Board shall be tolled if the
    Court denies the motion for class action review.
        ``(c)(1) In the case of a claim for benefits under the laws
    administered by the Secretary, the Court may remand a matter to the
    Board of Veterans' Appeals for the limited purpose of ordering the
    Board to address a question of law or fact if the Court determines the
    Board failed to--
                ``(A) address, in the relevant decision of the Board, an
            issue that--
                        ``(i) the claimant or the representative of the
                    claimant raised; or
                        ``(ii) was reasonably raised by the evidentiary
                    record of the claim; or
                ``(B) provide adequate reasons or bases for the decision of
            the Board with respect to such question.
        ``(2) The Court shall issue Rules that provide for each of the
    following:
                ``(A) When and how a party to an appeal (either the
            appellant or the Secretary) may request that the Court issue a
            limited remand.
                ``(B) The period of time within which the Board is required
            to issue a decision on the relevant question identified in a
            limited remand.
                ``(C) Guidelines for when the Court may grant a request for
            a limited remand.
                ``(D) Guidelines for when the Court may decide sua sponte
            to issue a limited remand without a request from any party.
                ``(E) A requirement that the parties to an appeal for which
            a limited remand is issued provide notice to the Court when the
            Board issues its decision on the relevant question identified
            in the limited remand.
        ``(3) With respect to any matter remanded to the Board pursuant to
    paragraph (1), the Court shall--
                ``(A) retain jurisdiction over such matter; and
                ``(B) stay the proceedings of the Court on such matter
            until the date on which the Board issues the decision required
            by such remand.''.
                (6) Study and report on common questions of law or fact
            before board of veterans' appeals.--
                        (A) Study.--The Chairman of the Board of Veterans'
                    Appeals shall carry out a study to identify questions
                    of law or fact the Board commonly considers when
                    reviewing appeals pursuant to section 7104 of title 38,
                    United States Code, for which precedential guidance
                    would assist the Board in issuing final decisions on
                    such appeals. The Chairman may use artificial
                    intelligence and other technology in carrying out such
                    study.
                        (B) Report.--Not later than one year after the date
                    of the enactment of this Act, the Chairman of the Board
                    of Veterans Appeals shall submit to the Committees on
                    Veterans Affairs of the House of Representatives and
                    the Senate a report that includes the findings of the
                    study required by subparagraph (A).
                (7) Independent assessment of potential modifications to
            authority of board of veterans' appeals.--
                        (A) Agreement.--Not later than 30 days after the
                    date of the enactment of this Act, the Secretary of
                    Veterans Affairs shall seek to enter into an agreement
                    with an FFRDC under which the FFRDC shall conduct an
                    assessment of the feasibility of modifying the
                    authority of the Board of Veterans' Appeals established
                    under chapter 71 of title 38, United States Code, to
                    permit the Board to issue precedential decisions with
                    respect to questions of law or fact arising in matters
                    before the Board.
                        (B) Report; briefings.--If the Secretary fails to
                    finalize an agreement with an FFRDC under subparagraph
                    (A) before the date that is 180 days after the date on
                    which the Secretary enters negotiations with respect to
                    such agreement, the Secretary shall--
                                (i) submit to the Committees on Veterans'
                            Affairs of the House of Representatives and the
                            Senate a report that includes--
                                        (I) an explanation of the reasons
                                    the Secretary failed to satisfy such
                                    requirement; and
                                        (II) an estimate of the date on
                                    which the Secretary will finalize the
                                    agreement under subparagraph (A); and
                                (ii) not less frequently than once every 60
                            days after the date on which the Secretary
                            failed to satisfy such requirement, provide to
                            the Committees on Veterans' Affairs of the
                            House of Representatives and the Senate a
                            briefing on the progress of the Secretary
                            toward finalizing such agreement.
                        (C) Assessment.--An FFRDC that enters into an
                    agreement under subparagraph (A) shall, in consultation
                    with veterans service organizations, veterans' and
                    survivors' advocate groups, relevant legal experts, and
                    the Chair of the Administrative Conference of the
                    United States (or the designee or designees of such
                    Chair) submit to the Secretary a written assessment
                    that includes the following:
                                (i) The determination of the FFRDC of
                            whether modifying the authority of the Board to
                            permit the Board to issue precedential
                            decisions with respect to questions of law or
                            fact arising in matters before the Board is
                            feasible.
                                (ii) An assessment of the authority of the
                            Board of Veterans' Appeals to aggregate, for
                            review, more than one appeal under chapter 71
                            of such title that involves common questions of
                            law or fact pursuant to section 7104 of such
                            title, as amended by paragraph (4)(A).
                                (iii)(I) The recommendations of the FFRDC
                            with respect to rules or principles to which
                            the Board should adhere when aggregating
                            appeals for review pursuant to section 7104(a)
                            of title 38, United States Code, as so amended,
                            including--
                                        (aa) whether the use of an opt-out
                                    system is appropriate in a class
                                    certification described in section
                                    7104(a) of title 38, United States
                                    Code, as amended;
                                        (bb) whether aggregation described
                                    in clause (ii) is better carried out by
                                    one member, or a panel of members, of
                                    the Board;
                                        (cc) whether such aggregation may
                                    be accomplished in accordance with
                                    section 7107 of title 38, United States
                                    Code; and
                                        (dd) how an accredited
                                    representative, attorney, or authorized
                                    agent may be selected to represent a
                                    class before the Board.
                                (II) The recommendations shall include, but
                            not be limited to, the following:
                                        (aa) How the Board should provide
                                    notice to claimants of the Board's
                                    intent to aggregate their claim.
                                        (bb) This shall include standards
                                    for ensuring that information provided
                                    to claimants regarding aggregation is
                                    written in plain language and clearly
                                    explains the potential effects of
                                    aggregation on adjudication timelines,
                                    appeal rights, and participation
                                    options.
                                        (cc) The options the Board should
                                    provide to claimants to opt out of
                                    participation in aggregation of their
                                    claim.
                                        (dd) The rights of the claimants to
                                    appeal decisions that arise out of
                                    aggregation of claims, and whether or
                                    not such rights may be limited by
                                    existing statute, regulation, or
                                    judicial decisions.
                                        (ee) Safeguards to ensure that
                                    aggregation of appeals does not
                                    diminish the requirement that each
                                    appeal be decided based on the
                                    individual facts, evidence, and
                                    circumstances specific to the claimant.
                                        (ff) Recommendations regarding
                                    quality review procedures and oversight
                                    mechanisms to monitor the impact of
                                    aggregation on claim accuracy,
                                    consistency, timeliness, and claimant
                                    outcomes.
                        (D) Report; implementation.--
                                (i) In general.--Not later than 90 days
                            after the Secretary receives the assessment
                            under subparagraph (C), the Secretary shall--
                                        (I) submit to the Committees on
                                    Veterans' Affairs of the Senate and
                                    House of Representatives a copy of such
                                    assessment; and
                                        (II) begin developing policies and
                                    procedures to implement the
                                    recommendations in the assessment with
                                    respect to the authority of the Board
                                    of Veterans' Appeals referred to in
                                    subparagraph (C).
                                (ii) Deadline.--The Secretary shall
                            complete the development of the policies and
                            procedures required under clause (i)(II) and
                            submit to the Committees on Veterans' Affairs
                            of the Senate and House of Representatives a
                            copy of such policies and procedures not later
                            than six months after the date on which the
                            Secretary begins developing such policies and
                            procedures.
                        (E) Definitions.--In this paragraph:
                                (i) The term ``FFRDC'' means a federally
                            funded research and development center.
                                (ii) The term ``veterans service
                            organization'' means an organization recognized
                            by the Secretary for the representation of
                            veterans under section 5902 of title 38, United
                            States Code.
        (c) Improvements to System for Adjudication of Claims for Benefits
    Under Laws Administered by Secretary of Veterans Affairs.--
                (1) Program for quality assurance in decisions of board of
            veterans' appeals; performance reviews.--
                        (A) In general.--Section 7101 of title 38, United
                    States Code, is amended by adding at the end the
                    following new subsection:
        ``(f)(1) The Chairman shall carry out a program to ensure quality
    in the decisions of the Board. Under such program, the Chairman shall--
                ``(A) develop policies and procedures for--
                        ``(i) measuring quality in such decisions;
                        ``(ii) maintaining data and identifying trends with
                    respect to--
                                ``(I) errors in such decisions;
                                ``(II) errors in decisions remanded or
                            returned to the Board by the Court of Appeals
                            for Veterans Claims; and
                                ``(III) specific members of the Board that
                            issued decisions that were subsequently vacated
                            by the Court of Appeals for Veterans Claims;
                            and
                        ``(iii) ensuring any such decision of the Board to
                    remand a claim for a benefit under a law administered
                    by the Secretary is necessary under any applicable law
                    or regulation;
                ``(B) with respect to a claim for such a benefit that is
            remanded to the Board by the Court of Appeals for Veterans
            Claims--
                        ``(i) inform any employee of the Board responsible
                    for drafting the decision of the Board with respect to
                    such claim that such decision was remanded;
                        ``(ii) provide any such employee with a copy of the
                    relevant order of the Court of Appeals for Veterans
                    Claims (including a copy of any accompanying joint
                    motion for remand); and
                        ``(iii) provide incentives to such employees to
                    review such relevant orders and joint motions for
                    remand; and
                ``(C) ensure, to the maximum extent practicable, that any
            error identified by the Board under such program is corrected
            before the date on which the Board issues the final decision
            associated with such error.
        ``(2) In developing policies and procedures to measure quality in
    decisions of the Board pursuant to clause (i) of subparagraph (A) of
    paragraph (1), the Chairman shall consider the data and trends
    maintained and identified pursuant to clause (ii) of such subparagraph.
        ``(3) The Chairman may use technology, including artificial
    intelligence, to maintain such data and identify such trends.
        ``(4) The Secretary shall submit to the Committees on Veterans'
    Affairs of the House of Representatives and the Senate an annual report
    on the program required by this subsection that includes, with respect
    to the period covered by the report, an identification of--
                ``(A) elements, if any of the process of the Board for
            reviewing an appeal under this chapter that lead to errors in
            decisions of the Board; and
                ``(B) the most common reasons that a claim for a benefit
            under a law administered by the Secretary was remanded to such
            Board by the Court of Appeals for Veterans Claims.''.
                        (B) Deadline.--The Secretary shall submit the first
                    report required by paragraph (2) of such section (as
                    added by subparagraph (A)) by not later than one year
                    after the date of the enactment of this Act.
                (2) Training program for certain employees of board of
            veterans' appeals; performance reviews.--
                        (A) Training program.--
                                (i) In general.--Chapter 71 of such title
                            (as amended by paragraph (1)) is further
                            amended by inserting after section 7101A the
                            following new section:
    ``Sec. 7101B. Training program for members of Board on timely and
                  correct adjudication of appeals
        ``(a) In General.--The Secretary, in conjunction with the Chairman
    of the Board of Veterans' Appeals, shall develop and carry out a
    program to provide Members of the Board training on timely and correct
    adjudication of appeals under this chapter.
        ``(b) Required Considerations.--In carrying out the program
    required by subsection (a), the Secretary shall consider the following:
                ``(1) Feedback, if any, from members of the Board and
            covered employees with respect to such program.
                ``(2) Data on errors in decisions of the Board maintained
            pursuant to the program for quality assurance required by
            subsection (f) of section 7101 of this title.
                ``(3) Any decision of the Court of Appeals for Veterans
            Claims to remand a claim for benefits under the laws
            administered by the Secretary to the Board for further action,
            including a joint motion to remand such claim.
        ``(c) Assessments of Effectiveness.--The Secretary, in conjunction
    with the Chairman of the Board of Veterans' Appeals, shall develop a
    method to assess, on an annual basis, the effectiveness of the training
    program under this section. In developing such method, the Secretary
    shall consider best practices for assessing the effectiveness of
    training programs, including the Kirkpatrick evaluation model.
        ``(d) Report.--The Secretary shall submit to the Committees on
    Veterans' Affairs of the House of Representatives and the Senate an
    annual report on the program required by subsection (a) that includes,
    with respect to the period covered by the report--
                ``(1) a statement of the topics of the training provided
            pursuant to this section, disaggregated by--
                        ``(A) mandatory training; and
                        ``(B) non-mandatory training; and
                ``(2) the results of the assessment of the effectiveness of
            such program required under subsection (c).
        ``(e) Covered Employee Defined.--In this section, the term `covered
    employee' means an employee of the Board who is--
                ``(1) not a member of the Board; and
                ``(2) responsible for drafting decisions of the Board.''.
                                (ii) Clerical amendment.--The table of
                            sections at the beginning of such chapter is
                            amended by inserting after the item relating to
                            section 7101A the following new item:

            ``7101B. Training program for Members of Board on timely and
                                correct adjudication of appeals.''.
                        (B) Performance reviews of members of the board.--
                    Section 7101A of such title is amended--
                                (i) in subparagraph (B) of subsection
                            (c)(1) by striking ``not less often than once
                            every three years'' and inserting ``not less
                            often than annually''; and
                                (ii) by adding at the end the following new
                            subsection:
        ``(h)(1) With respect to any performance review of a covered
    employee, the Secretary may not consider the timeliness or quality of
    work of any Member of the Board.
        ``(2) In this subsection, the term `covered employee' has the
    meaning given such term in section 7101B of this title.''.
                (3) Decisions of board to remand.--
                        (A) Information relating to decisions to remand.--
                    Section 7104 of such title is amended in subsection
                    (d)--
                                (i) by redesignating paragraphs (1) through
                            (3) as paragraphs (2) through (4),
                            respectively; and
                                (ii) by inserting before paragraph (2) (as
                            so redesignated), the following new paragraph:
                ``(1) with respect to a claim that the Board remands for
            further action, a statement of the specific reasons such claim
            was remanded, including any failure on the part of the
            Secretary to comply with--
                        ``(A) the Secretary's duty to assist under section
                    5103A of this title; and
                        ``(B) the Secretary's duty to notify under section
                    5103 of this title;''.
                        (B) Notice of remanded decision for certain
                    employees.--Such section is further amended in--
                                (i) subsection (e)--
                                        (I) by redesignating paragraphs (1)
                                    through (3) as subparagraphs (A)
                                    through (C), respectively;
                                        (II) by striking ``After'' and
                                    inserting ``(1) After''; and
                                        (III) by adding at the end the
                                    following new paragraph:
        ``(2) If, pursuant to a decision on an appeal, the Board remands a
    claim for a benefit under a law administered by the Secretary for
    further action, the Secretary shall, to the maximum extent practicable,
    issue a copy of such decision to each employee of the Veterans Benefits
    Administration who committed the error resulting in the decision of the
    Board to remand, when applicable.''; and
                                (ii) in subsection (g), as redesignated by
                            section 3(d)(2)(A), by striking ``under
                            subsection (e)'' and inserting ``under
                            paragraph (1) of subsection (e)''.
                (4) Annual reports for board of veterans' appeals.--
                        (A) In general.--Chapter 71 of title 38, United
                    States Code, is amended by inserting after section 7114
                    the following new section:
    ``Sec. 7115. Annual report on Board of Veterans' Appeals
        ``The Chairman of the Board shall submit to the Committees on
    Veterans' Affairs of the House of Representatives and the Senate an
    annual report that includes, for each decision of the Board to remand a
    claim for a benefit under a law administered by the Secretary to the
    Secretary for further adjudication during the period covered by the
    report, a statement of the reasons for such decision of the Board,
    disaggregated by decisions on--
                ``(1) claims with a rating decision dated on or after
            February 19, 2019; and
                ``(2) claims with a rating decision dated before such
            date.''.
                        (B) Deadlines.--The Secretary shall submit the
                    first reports required by subsections (a) and (b) of
                    section 7115 of such title (as added by paragraph (1))
                    by not later than one year after the date of the
                    enactment of this Act.
                        (C) Clerical amendment.--The table of sections at
                    the beginning of such chapter is amended by inserting
                    after the item relating to section 7114 the following
                    new item:

    ``7115. Annual report on Board of Veterans' Appeals''.
                (5) Plan for improvements to quality in decisions of
            board.--
                        (A) In general.--Not later than six months after
                    the date of the enactment of this Act, the Secretary of
                    Veterans Affairs, in consultation with the Chairman of
                    the Board of Veterans' Appeals and the head of the
                    Office of Administrative Review of the Veterans
                    Benefits Administration, shall develop a plan to--
                                (i) improve the quality of decisions of the
                            Board to remand, pursuant to section 7104 of
                            title 38, United States Code, claims for a
                            benefit under a law administered by the
                            Secretary to the Secretary for further action;
                            and
                                (ii) mitigate the number of such decisions
                            that are unnecessary under any applicable law
                            or regulation.
                        (B) Report.--The Secretary shall submit to the
                    Committees on Veterans' Affairs of the House of
                    Representatives and the Senate a report on such plan by
                    not later than six months after the date of the
                    enactment of this Act.
        (d) Notice of Avoidable Deferrals of Claims for Benefits Under Laws
    Administered by the Secretary of Veterans Affairs; Study and Report on
    Certain Opinions of Department of Veterans Affairs Office of General
    Counsel.--
                (1) Notice of avoidable deferrals.--Not later than one year
            after the date of the enactment of this Act, the Secretary of
            Veterans Affairs shall develop policies, procedures, and
            technological capabilities to ensure that each employee of the
            Veterans Benefits Administration that commits an avoidable
            deferral with respect to a claim for benefits under the laws
            administered by the Secretary of Veterans Affairs in the
            National Work Queue is notified of any avoidable deferrals that
            such employee commits with respect to the same claim.
                (2) Study and report on certain ogc opinions.--
                        (A) Study.--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 the General
                    Counsel of the Department of Veterans Affairs and the
                    Chairman of the Board of Veterans' Appeals, shall
                    complete a study to identify--
                                (i) issues about which an opinion from the
                            Office of the General Counsel of the Department
                            would foster consistency in the decisions of
                            the Secretary with respect to claims for
                            benefits under the laws administered by the
                            Secretary; and
                                (ii) issues raised in appeals of such
                            decisions to the United States Court of Appeals
                            for Veterans Claims before the date of the
                            enactment of this Act about which the Office of
                            the General Counsel has had inconsistent
                            opinions in matters involving substantially
                            similar questions of law or fact.
                        (B) Report.--Not later than one year after the date
                    of the enactment of this Act, the Secretary of Veterans
                    Affairs shall submit to the Committees on Veterans'
                    Affairs of the Senate and House of Representatives a
                    report that includes--
                                (i) the findings of the study required by
                            subparagraph (A);
                                (ii) a statement of which issues identified
                            pursuant to such study about which the Office
                            of the General Counsel of the Department
                            intends to publish an opinion; and
                                (iii) a timeline for the publication of any
                            such opinion.

    SEC. 106. ANNUAL REPORT ON CAUSES OF DEATH AMONG VETERANS.

        (a) In General.--Subchapter II of chapter 5 of title 38, United
    States Code, is amended by adding at the end the following new section:
    ``Sec. 534. Annual report on causes of death among veterans
        ``(a) In General.--The Secretary shall submit to the Committees on
    Veterans' Affairs of the House of Representatives and the Senate an
    annual report that contains data and information on causes of death
    among veterans.
        ``(b) Elements.--Such report shall include--
                ``(1) for each veteran that died during the period covered
            by the report an identification of--
                        ``(A) whether such veteran had a service-connected
                    disability rated as total;
                        ``(B) the primary cause of death;
                        ``(C) the secondary cause of death, if applicable;
                    and
                        ``(D) the manner of death;
                ``(2) for each primary cause of death identified pursuant
            to paragraph (1), a statement of the total number of veterans
            that died from such primary cause of death during the period
            covered by the report; and
                ``(3) for each manner of death identified pursuant to
            paragraph (1), a statement of the total number of veterans that
            died in such manner during the period covered by the report.
        ``(c) Sunset.--This section shall terminate on the date that is
    five years after the date of the enactment of the Take Care of
    America's Veterans Act.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 5 of such title is amended by inserting after the item relating
    to section 533 the following new item:

            ``534. Annual report on causes of death among veterans''.

    SEC. 107. PLAN FOR USE OF AUTOMATION TOOLS TO PROCESS CLAIMS UNDER LAWS
                  ADMINISTERED BY THE SECRETARY OF VETERANS AFFAIRS.

        (a) In General.--Not later than one year after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall submit
    to the Committees on Veterans' Affairs of the Senate and House of
    Representatives the plan of the Secretary to make available, to the
    maximum extent practicable, an automation tool described in subsection
    (b) to elements of the Department of Veterans Affairs for the purpose
    of processing claims under laws administered by the Secretary.
        (b) Automation Tool Described.--An automation tool described in
    this subsection is a technology developed for the Compensation Service
    of the Veterans Benefits Administration that--
                (1) automates the retrieval of the service record or health
            records of a veteran;
                (2) compiles evidence relevant to the determination of a
            claim for benefits under laws administered by the Secretary;
                (3) provides automated decision support relevant to such a
            determination;
                (4) automates information sharing between Federal agencies;
            and
                (5) assists in generating correspondence regarding such a
            claim.
        (c) Analysis.--In developing the plan required under subsection
    (a), the Secretary shall conduct an analysis of each of the following:
                (1) The feasibility and benefits of the use of an
            automation tool described in subsection (b) by elements of the
            Department for the purpose of processing claims under laws
            administered by the Secretary.
                (2) Any modification to an existing automation tool that
            could render such tool usable for such purpose by such an
            element.
                (3) Any requirement of any such element pertaining to such
            purpose that cannot be addressed by using an automation tool.
                (4) The extent to which the technology offices of such
            elements may need to collaborate with the technology office
            responsible for developing an automation tool in the course of
            the development and use of the tool by the element for such
            purpose.
                (5) A timeline for modifying and implementing any
            automation tool for use by such elements for such purpose.
        (d) Priority.--In providing or expanding an automation tool
    described in subsection (b) to elements of the Department pursuant to
    the plan required under subsection (a), the Secretary shall give
    priority to the following elements:
                (1) The Compensation Service.
                (2) The Pension and Fiduciary Service of the Veterans
            Benefits Administration.
                (3) The Education Service of the Veterans Benefits
            Administration.
                (4) Program offices of the Veterans Benefits
            Administration, as determined by the Secretary.
                (5) The Debt Management Center.
                (6) The Board of Veterans' Appeals.
        (e) Other Requirements Relating to Technology at Department of
    Veterans Affairs.--
                (1) Automatic notices regarding benefits for certain
            children of veterans.--
                        (A) In general.--Not later than one year after the
                    date of the enactment of this Act, the Secretary of
                    Veterans Affairs shall implement policies, processes,
                    and technological capabilities, including in the
                    National Work Queue (or successor system), to ensure
                    that, in the case of any covered situation, a claims
                    processors is made aware of, and assigned to address,
                    such covered situation.
                        (B) Definitions.--In this subsection:
                                (i) The term ``covered situation'' means--
                                        (I) any increase in the amount of
                                    dependency compensation paid to a
                                    beneficiary for a child under the laws
                                    administered by the Secretary; and
                                        (II) any educational assistance
                                    paid to the child of a veteran under
                                    the laws administered by the Secretary.
                                (ii) The term ``child'' has the meaning
                            given such term in section 101(4)(A)(iii) of
                            title 38, United States Code.
                (2) Correct labeling of documents.--Not later than one year
            after the date of the enactment of this Act, the Secretary
            shall submit to the Committees on Veterans' Affairs of the
            Senate and House of Representatives a plan to ensure that
            documents in the Veterans Benefits Management System (or any
            successor system) are correctly labeled when such documents are
            uploaded, including when such documents are labeled using
            automation tools.

    SEC. 108. REFORMS RELATING TO DEPARTMENT OF VETERANS AFFAIRS DISABILITY
                  RATINGS.

        (a) Ratings for Sleep Apnea.--
                (1) In general.--The Secretary of Veterans Affairs shall
            revise the schedule for rating disabilities adopted and applied
            under section 1155 of title 38, United States Code, as follows:
                        (A) A grade of disability of 0 percent shall be
                    assigned for sleep apnea syndrome when the syndrome is
                    asymptomatic, with or without treatment.
                        (B) A grade of disability of 10 percent shall be
                    assigned for sleep apnea syndrome when treatment yields
                    incomplete relief.
                        (C) A grade of disability of 50 percent shall be
                    assigned for sleep apnea syndrome only if--
                                (i) treatment is either ineffective or the
                            veteran is unable to use the prescribed
                            treatment due to comorbid conditions; and
                                (ii) there is no end-organ damage.
                        (D) A grade of disability of 100 percent shall be
                    assigned for sleep apnea syndrome only if there is also
                    end-organ damage.
                (2) Qualifying comorbid conditions.--For purposes of
            paragraph (1)(C)(i), a comorbid condition is a condition that,
            in the opinion of a qualified medical provider, directly
            impedes or prevents the use of, or implementation of, a
            recognized form of treatment intervention normally shown to be
            effective.
        (b) Ratings for Tinnitus.--The Secretary of Veterans Affairs shall
    revise the schedule for rating disabilities adopted and applied under
    section 1155 of title 38, United States Code, as follows:
                (1) Except as provided in paragraph (2), tinnitus may not
            be assigned a separate compensable disability rating.
                (2) A grade of disability of 10 percent shall be assigned
            for tinnitus only when tinnitus is diagnosed as associated with
            service-connected (as defined in section 101(16) of title 38,
            United States Code) hearing loss that is otherwise
            noncompensable under the laws administered by the Secretary.
        (c) Applicability.--
                (1) In general.--The revisions to the schedule for rating
            disabilities adopted and applied under section 1155 of title
            38, United States Code, made pursuant to this section shall
            apply with respect to claims filed after the date of the
            enactment of this Act.
                (2) Protection of existing ratings.--The revisions to the
            schedule for rating disabilities made pursuant to this section
            may not serve as the basis for reducing, discontinuing, or
            otherwise adversely affecting compensation that was in effect
            on the day before the date of the enactment of this Act.

    SEC. 109. IMPROVEMENTS TO TEMPORARY LICENSURE REQUIREMENTS FOR CONTRACT
                  HEALTH CARE PROFESSIONALS WHO PERFORM MEDICAL DISABILITY
                  EXAMINATIONS FOR THE DEPARTMENT OF VETERANS AFFAIRS.

        (a) Expansion.--Section 504 of the Veterans' Benefits Improvements
    Act of 1996 (Public Law 104-275; 38 U.S.C. 5101 note), as amended by
    paragraph (1) of subsection (a) of section 2002 of the Johnny Isakson
    and David P. Roe, M.D. Veterans Health Care and Benefits Improvement
    Act of 2020 (Public Law 116-315; 38 U.S.C. 5101 note), is further
    amended, subject to the sunset in paragraph (4) of such subsection, by
    striking paragraph (2) of subsection (c) and inserting the following:
                ``(2) Health care professional described.--A health care
            professional described in this paragraph is a person who is
            eligible for appointment to a position in the Veterans Health
            Administration covered by section 7402(b) of title 38, United
            States Code, who--
                        ``(A) has a current and unrestricted license to
                    practice the health care profession for which they are
                    licensed;
                        ``(B) is not barred from practicing such health
                    care profession in any State, the District of Columbia,
                    or a Commonwealth, territory, or possession of the
                    United States; and
                        ``(C) is performing authorized duties for the
                    Department pursuant to a contract entered into under
                    subsection (a).
                ``(3) Source of funds.--Expenses of carrying out this
            section, including payments for examination travel and
            incidental expenses under the terms and conditions set forth by
            section 111 of this title, shall be reimbursed to the accounts
            available for the general operating expenses of the Veterans
            Benefits Administration and information technology systems from
            amounts available to the Secretary for payment of compensation
            and pensions.
                ``(4) Mechanism for transmittal of evidence introduced by
            applicants during examinations.--The Secretary shall establish
            a mechanism whereby a health care professional who conducts
            medical examinations or opinions under section 5103A(d) of this
            title may transmit to a veteran's claims file, evidence
            introduced by the applicant during a medical examination or in
            conjunction with a medical opinion that examiner used to inform
            such medical examination or opinion.''.
        (b) Delayed Sunset of Amendment.--Paragraph (4) of subsection (a)
    of section 2002 of the Johnny Isakson and David P. Roe, M.D. Veterans
    Health Care and Benefits Improvement Act of 2020 (Public Law 116-315;
    38 U.S.C. 5101 note) is amended by striking ``On the date that is five
    years after the date of the enactment of this Act'' and inserting ``On
    September 30, 2033''.
        (c) Conforming Amendment.--Paragraph (2) of such subsection is
    amended by striking ``physicians assistants, nurse practitioners,
    audiologists, and psychologists'' and inserting ``health care
    professionals''.
        (d) Report.--Not later than 15 months after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall submit
    to the Committees on Veterans' Affairs of the Senate and House of
    Representatives a report regarding the use of the authority under
    section 504 of the Veterans' Benefits Improvements Act of 1996 (Public
    Law 104-275; 38 U.S.C. 5101 note), as temporarily amended by section
    2002(a)(1) of the Johnny Isakson and David P. Roe, M.D. Veterans Health
    Care and Benefits Improvement Act of 2020 (Public Law 116-315; 38
    U.S.C. 5101 note) and this section. Such report shall include, with
    respect to the one-year period after the date of the enactment of this
    Act, the following elements:
                (1) The number of examinations conducted pursuant to a
            contract under such authority.
                (2) The cost, timeliness, and legal adequacy of such
            examinations, disaggregated by--
                        (A) health care professional; and
                        (B) contract.
                (3) The number of such examinations conducted in each
            State, the District of Columbia, or a Commonwealth, territory,
            or possession of the United States.
                (4) The numbers of each kind of health care professionals
            who conducted such examinations.
                (5) The number of examinations that were erroneously
            conducted by a health care professional--
                        (A) without such a contract; or
                        (B) unauthorized to enter into such a contract.
                (6) The plan of the Secretary to correct errors in the use
            of such authority.

    SEC. 110. DISABILITY EXAMINATIONS: STUDY ON ACCESS IN RURAL AREAS;
                  REVIEW OF TRAINING; REVIEW OF INADEQUATE OR UNNECESSARY
                  EXAMINATIONS.

        (a) Study on Improvements to Department of Veterans Affairs Covered
    Medical Disability Examinations in Rural Areas.--
                (1) Study required.--Not later than one year after the date
            of the enactment of this Act, the Secretary of Veterans Affairs
            shall complete a study on access by veterans who reside in
            rural and highly rural areas to covered medical disability
            examinations.
                (2) Elements.--
                        (A) In general.--The study conducted under
                    paragraph (1) shall include the following:
                                (i) A comparison of the average number of
                            days to complete covered medical disability
                            examinations, disaggregated by type of
                            examination, for veterans who reside in rural
                            and highly rural areas compared to an average
                            time for veterans who reside in other areas to
                            complete a covered medical disability
                            examination, by either contractors or employees
                            of the Department.
                                (ii) A root cause analysis of differences
                            identified pursuant to clause (i).
                                (iii) The plan of the Secretary for the
                            following year to improve access described in
                            paragraph (1), which shall include a plan for
                            the pursuit of a commercial or industry-
                            standard solution or technology that could
                            enable housebound veterans or veterans who live
                            in rural areas to receive examinations without
                            traveling long distances.
                        (B) Number of days to complete defined.--For
                    purposes of subparagraph (A)(i), the term ``number of
                    days to complete'' means the number of days in the
                    period--
                                (i) beginning on the date on which a
                            contractor or employee of the Department
                            received a request from the Secretary to
                            conduct a covered medical disability
                            examination; and
                                (ii) ending on the date on which the
                            examination was completed.
                (3) Report on study.--Not later than one year after the
            date of the enactment of this Act, the Secretary shall submit
            to the Committee on Veterans' Affairs of the Senate and the
            Committee on Veterans' Affairs of the House of Representatives
            a report on the findings of the Secretary with respect to the
            study completed under paragraph (1).
                (4) Definitions.--In this subsection:
                        (A) The term ``covered medical disability
                    examination'' means a medical nexus examination or
                    medical opinion for the purposes of adjudicating a
                    claim for a benefit under chapter 11 or 15 of title 38,
                    United States Code, regardless of whether conducted by
                    an employee or a contractor of the Department.
                        (B) The terms ``rural'' and ``highly rural'' have
                    the meanings given those terms under the rural-urban
                    commuting areas coding system of the Department of
                    Agriculture.
        (b) Review of Training for Veterans Service Representatives and
    Rating Veterans Service Representatives.--
                (1) Review required.--The Secretary of Veterans Affairs
            shall conduct a comprehensive review of the training provided
            to Veterans Service Representatives (VSRs) and Rating Veterans
            Service Representatives (RVSRs) regarding covered medical
            disability examinations for the purpose of claims adjudication.
                (2) Scope of review.--The review shall include, at minimum,
            an evaluation of training and policies relating to--
                        (A) assessing the adequacy of covered medical
                    disability examinations for claims adjudication;
                        (B) determining the necessity of medical disability
                    examinations where claims can be adjudicated based on
                    existing evidence without ordering additional
                    examinations;
                        (C) relevant statutes, judicial decisions,
                    regulations, and Department policies, including--
                                (i) the duty to assist claimants;
                                (ii) evidentiary standards regarding
                            causation;
                                (iii) required elements and standards for
                            covered medical disability examinations,
                            including the need for reasoned medical
                            opinions; and
                                (iv) the absence of statutory or regulatory
                            presumptions of service connection in covered
                            medical disability examinations; and
                        (D) input from impacted Department employees,
                    including duly appointed labor representatives.
                (3) Second-level review for new employees.--The Secretary
            shall evaluate the effectiveness of current policies requiring
            a second level of review of claims decisions made by new
            Veterans Service Representatives and Rating Veterans Service
            Representatives before such employees are authorized to order
            covered medical disability examinations, including any
            applicable accuracy thresholds.
                (4) Report to congress.--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 findings of the Secretary with respect
            to the review conducted under paragraph (1), the data used by
            the Secretary to support such findings, and such
            recommendations as the Secretary may have for improvements to
            training or policies.
                (5) Comptroller general of the united states review of
            findings.--Not later than 180 days after the date on which the
            Secretary submits the report under paragraph (4), the
            Comptroller General of the United States shall conduct a review
            of the findings and recommendations contained in the report.
                (6) Modification of reports by the board of veterans'
            appeals and united states court of appeals for veterans
            claims.--
                        (A) Board of veterans' appeals.--Section 7101(d)(2)
                    of title 38, United States Code, is amended--
                                (i) in subparagraph (F), by striking ``;
                            and'' and inserting a semicolon;
                                (ii) in subparagraph (G), by striking the
                            period at the end and inserting ``; and''; and
                                (iii) by adding at the end the following
                            new subparagraph:
                        ``(H) a summary of recurring issues that result in
                    the Board remanding appeals back to the agency of
                    original jurisdiction.''.
                        (B) United states court of appeals for veterans
                    claims.--Section 7288(b) of title 38, United States
                    Code, is amended by adding at the end the following new
                    paragraph:
                ``(16) A summary of recurring issues that result in
            remands.''.
                (7) Definition of covered medical disability examination.--
            In this subsection, the term ``covered medical disability
            examination'' means a medical examination or medical opinion
            that the Secretary determines necessary for the purposes of
            adjudicating a claim for a benefit under chapter 11 or 15 of
            title 38, United States Code, regardless of whether conducted
            by an employee or a contractor of the Department.
        (c) Review and Priority Processing of Claims With Inadequate or
    Unnecessary Examinations.--
                (1) Review.--Not later than 1 year after the date of the
            enactment of this Act and not less frequently than once every
            three months thereafter, the Secretary of Veterans Affairs
            shall review a random and representative sample of all covered
            medical disability examinations completed during the previous
            three-month period.
                (2) Further sample requirements.--Under each review
            required by paragraph (1), the Secretary shall ensure the
            review includes--
                        (A) a statistically significant sample of covered
                    medical disability examinations completed by employees
                    of the Department of Veterans Affairs; and
                        (B) a statistically significant sample of covered
                    medical disability examinations completed by each
                    contractor that provides such examinations for the
                    Department.
                (3) Analysis.--Under each review required by paragraph (1),
            the Secretary shall--
                        (A) analyze the samples specified in paragraph (2);
                    and
                        (B) pursuant to such analysis, identify--
                                (i) the percentage of examinations that
                            were adequate for purposes of adjudicating the
                            particular claim for a benefit under chapter 11
                            or 15 of title 38, United States Code, for
                            which the examination was ordered by the
                            Department; and
                                (ii) the percentage of examinations
                            considered overdeveloped for purposes of
                            adjudicating claims for a benefit under chapter
                            11 or 15 of title 38, United States Code, for
                            which the examination was ordered by the
                            Department.
                (4) Priority processing.--
                        (A) In general.--Except as provided for in
                    subparagraph (B), if during a review under paragraph
                    (1) the Secretary finds any covered medical disability
                    examination to be not adequate for adjudicating a
                    claim, the Secretary shall ensure the claimant examined
                    by that examination--
                                (i) receives another examination, if
                            necessary, on a priority basis; and
                                (ii) receives priority processing for the
                            entirety of impacted claim.
                        (B) Exception.--The Secretary is not required to
                    furnish an additional examination under subparagraph
                    (A) if the Secretary determines such an examination to
                    be unnecessary for purposes of adjudicating the claim.
                (5) Comptroller general of the united states study.--The
            Comptroller General of the United States shall conduct a review
            of the methodology and effectiveness of the Departments review
            required in paragraph (1).
                (6) Covered medical disability examination defined.--In
            this subsection, the term ``covered medical disability
            examination'' means a medical examination or opinion for the
            purposes of adjudicating a claim for a benefit under chapter 11
            or 15 of title 38, United States Code, regardless of whether
            conducted by an employee or a contractor of the Department.
        (d) Review and Plan Regarding Department of Veterans Affairs
    Scheduling of Medical Examinations.--
                (1) Review required.--Not later than one year after the
            date of the enactment of this Act, the Secretary of Veterans
            Affairs shall complete a review of scheduling request tools,
            contracts, and systems used by employees and contractors of the
            Department of Veterans Affairs to order and conduct medical
            disability examinations.
                (2) Plan required.--Not later than one year 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
            ensure the following:
                        (A) Systems and processes used by the Department
                    enable seamless and clear communication of requirements
                    between the claims processors who request medical
                    disability examinations and the persons who conduct
                    such examinations, including through a contract.
                        (B) Medical disability examiners, including through
                    a contract, have access to the medical records and
                    claims information they need to conduct exams that are
                    adequate for purposes of rating claims for benefits
                    under laws administered by the Secretary.
                        (C) Claimants or appellants for whom a medical
                    disability examination is requested of the Department
                    have agency in determining when and where the
                    examination is conducted.
                        (D) Claimants or appellants for whom a medical
                    disability examination is requested of the Department
                    have a seamless experience when scheduling their
                    examinations without regard to who conducts the
                    examinations.
                        (E) The Department conducts customer satisfaction
                    and experience surveys of claimants or appellants who
                    attend medical disability examinations provided under
                    laws administered by the Secretary.

    SEC. 111. IMPROVEMENTS TO PROCESSING AND OUTREACH REGARDING CLAIMS
                  INVOLVING MILITARY SEXUAL TRAUMA.

        (a) Evaluation of Claims Involving Military Sexual Trauma.--
                (1) In general.--Subchapter VI of chapter 11 of such title
            is amended by inserting after section 1166 the following new
            section:
    ``Sec. 1166A. Evaluation of claims involving military sexual trauma
        ``(a) Notice and Opportunity to Supply Evidence.--The Secretary may
    not deny a claim of a veteran for compensation under this chapter for
    military sexual trauma without first--
                ``(1) advising the veteran of the evidence that would
            constitute credible corroborating evidence of the military
            sexual trauma; and
                ``(2) allowing the veteran an opportunity to furnish such
            corroborating evidence.
        ``(b) Point of Contact.--The Secretary shall ensure that each
    document provided to a veteran relating to a claim for compensation
    under this chapter for a military sexual trauma includes contact
    information for an appropriate point of contact with the Department.
        ``(c) Specialized Teams.--The Secretary shall ensure that all
    claims for compensation under this chapter for a military sexual trauma
    are reviewed and processed by a specialized team established under
    section 1166 of this title.
                ``(1) The Secretary shall ensure that not less than
            annually, the policies and procedures employed by the
            specialized team established under section 1166 of this title
            are reviewed by medical or mental health professionals as the
            Secretary considers appropriate to determine whether the
            current standard of evidentiary review for acceptable
            documentation adequately evaluates the likelihood a military
            sexual trauma occurred.
                ``(2) The Secretary shall also conduct periodic quality
            reviews of claims processed by the specialized teams
            established under section 1166 to identify inconsistencies,
            training deficiencies, or procedural shortcomings and implement
            corrective actions as appropriate.''.
                (2) Outreach.--
                        (A) In general.--Not later than 180 days after the
                    date of the enactment of this Act, the Secretary of
                    Veterans Affairs shall implement, with input from the
                    veteran community, an informative outreach program for
                    veterans regarding the standard of proof for evaluation
                    of claims relating to military sexual trauma, including
                    requirements for a medical examination and opinion.
                        (B) Targeted outreach.--In implementing the program
                    under subparagraph (A), the Secretary shall, to the
                    extent practicable, target outreach to veterans who
                    submitted a claim relating to military sexual trauma
                    that was denied.
                (3) Clerical amendment.--The table of sections at the
            beginning of chapter 11 of such title is amended by inserting
            after the item relating to section 1166 the following new item:

    ``1166A. Evaluation of claims involving military sexual trauma.''.
        (b) Communications From the Department of Veterans Affairs to
    Individuals Who Have Experienced Military Sexual Trauma.--
                (1) Review working group.--
                        (A) In general.--The Secretary of Veterans Affairs
                    shall establish a working group to review
                    correspondence relating to military sexual trauma.
                        (B) Membership.--The working group established
                    under subparagraph (A) shall be composed of members who
                    shall be appointed by the Secretary from among
                    employees of the Department of Veterans Affairs who are
                    experts in military sexual trauma and mental health, of
                    whom--
                                (i) one or more shall be appointed from
                            among mental health providers of the Veterans
                            Health Administration;
                                (ii) one or more shall be appointed from
                            among experts on sexual assault and sexual
                            harassment of the Veterans Benefits
                            Administration; and
                                (iii) one or more shall be appointed from
                            among experts on sexual assault and sexual
                            harassment of the Board of Veterans' Appeals.
                        (C) Duties.--The working group established under
                    subparagraph (A) shall--
                                (i) review standard correspondence, which
                            may include templates for notices under
                            sections 5103, 5104, 5104B, and 7104 of title
                            38, United States Code, from the Department to
                            individuals who have experienced military
                            sexual trauma for sensitivity; and
                                (ii) ensure that the correspondence--
                                        (I) treats such individuals with
                                    dignity and respect; and
                                        (II) does not re-traumatize such
                                    individuals.
                        (D) Individual who has experienced military sexual
                    trauma defined.--In this subsection, the term
                    ``individual who has experienced military sexual
                    trauma'' means--
                                (i) an individual who has filed a claim for
                            compensation under chapter of title 38, United
                            States Code, relating to military sexual
                            trauma;
                                (ii) a veteran who has been awarded
                            compensation under such chapter relating to
                            military sexual trauma; or
                                (iii) a member of the Armed Forces
                            (including a member of the National Guard or
                            Reserves), a former member of the Armed Forces,
                            or a veteran who is receiving care from the
                            Department relating to military sexual trauma.
                (2) Contents of certain written communications to
            individuals who have experienced military sexual trauma.--
                        (A) Notice to claimants of required information and
                    evidence.--Section 5103 of title 38, United States
                    Code, is amended by adding at the end the following new
                    subsection:
        ``(c) Written Communications to Individuals Who Have Experienced
    Military Sexual Trauma.--
                ``(1) The Secretary shall ensure that any written
            communication under this section from the Department to an
            individual who has experienced military sexual trauma includes
            each of the following:
                        ``(A) Contact information for each of the
                    following:
                                ``(i) The military sexual trauma
                            coordinator of the Veterans Benefits
                            Administration.
                                ``(ii) The military sexual trauma
                            coordinator of the Veterans Health
                            Administration.
                                ``(iii) The Veterans Crisis Line.
                                ``(iv) The facility of the Veterans Health
                            Administration closest to where the individual
                            resides.
                                ``(v) The Readjustment Counseling Service
                            location closest to where the individual
                            resides.
                        ``(B) Information on the eligibility of the
                    individual for services provided through the
                    Readjustment Counseling Service location described in
                    subparagraph (A)(v).
                ``(2) In this subsection:
                        ``(A) The term `individual who has experienced
                    military sexual trauma' means--
                                ``(i) an individual who has filed a claim
                            for compensation under chapter 11 of this title
                            relating to military sexual trauma;
                                ``(ii) a veteran who has been awarded
                            compensation under such chapter relating to
                            military sexual trauma; or
                                ``(iii) a member of the Armed Forces
                            (including a member of the National Guard or
                            Reserves), a former member of the Armed Forces,
                            or a veteran who is receiving care from the
                            Department relating to military sexual trauma.
                        ``(B) The term `military sexual trauma' has the
                    meaning given that term in section 1166(d)(2) of this
                    title.
                        ``(C) The term `Veterans Crisis Line' means the
                    toll-free hotline for veterans established under
                    section 1720F(h) of this title.''.
                        (B) Decisions and notices of decisions.--Section
                    5104 of title 38, United States Code, is amended by
                    adding at the end the following new subsection:
        ``(e)(1) The Secretary shall ensure that any written communication
    under this section from the Department to an individual who has
    experienced military sexual trauma includes each of the following:
                ``(A) Contact information for each of the following:
                        ``(i) The military sexual trauma coordinator of the
                    Veterans Health Administration.
                        ``(ii) The Veterans Crisis Line.
                        ``(iii) The facility of the Veterans Health
                    Administration closest to where the individual resides.
                        ``(iv) The Readjustment Counseling Service location
                    closest to where the individual resides.
                ``(B) Information on the eligibility of the individual for
            services provided through the Readjustment Counseling Service
            location described in subparagraph (A)(iv).
        ``(2) The Secretary shall ensure that any written communication
    under this section from the Department to an individual who has
    experienced military sexual trauma that includes notification of an
    award of compensation under chapter 11 of this title relating to
    military sexual trauma includes--
                ``(A) the contact information described in paragraph (1);
            and
                ``(B) the contact information for the military sexual
            trauma coordinator of the Veterans Benefits Administration.
        ``(3) In this subsection:
                ``(A) The term `individual who has experienced military
            sexual trauma' means--
                        ``(i) an individual who has filed a claim for
                    compensation under chapter 11 of this title relating to
                    military sexual trauma;
                        ``(ii) a veteran who has been awarded compensation
                    under such chapter relating to military sexual trauma;
                    or
                        ``(iii) a member of the Armed Forces (including a
                    member of the National Guard or Reserves), a former
                    member of the Armed Forces, or a veteran who is
                    receiving care from the Department relating to military
                    sexual trauma.
                ``(B) The term `military sexual trauma' has the meaning
            given that term in section 1166(d)(2) of this title.
                ``(C) The term `Veterans Crisis Line' means the toll-free
            hotline for veterans established under section 1720F(h) of this
            title.''.
                        (C) Higher-level review by the agency of original
                    jurisdiction.--Section 5104B of title 38, United States
                    Code, is amended by adding at the end the following new
                    subsection:
        ``(f) Written Communications to Individuals Who Have Experienced
    Military Sexual Trauma.--
                ``(1) The Secretary shall ensure that any written
            communication under this section from the Department to an
            individual who has experienced military sexual trauma includes
            each of the following:
                        ``(A) Contact information for each of the
                    following:
                                ``(i) The military sexual trauma
                            coordinator of the Veterans Health
                            Administration.
                                ``(ii) The Veterans Crisis Line.
                                ``(iii) The facility of the Veterans Health
                            Administration closest to where the individual
                            resides.
                                ``(iv) The Readjustment Counseling Service
                            location closest to where the individual
                            resides.
                        ``(B) Information on the eligibility of the
                    individual for services provided through the
                    Readjustment Counseling Service location described in
                    subparagraph (A)(iv).
                ``(2) The Secretary shall ensure that any written
            communication under this section from the Department to an
            individual who has experienced military sexual trauma that
            includes notification of an award of compensation under chapter
            11 of this title relating to military sexual trauma includes--
                        ``(A) the contact information described in
                    paragraph (1); and
                        ``(B) the contact information for the military
                    sexual trauma coordinator of the Veterans Benefits
                    Administration.
                ``(3) In this subsection:
                        ``(A) The term `individual who has experienced
                    military sexual trauma' means--
                                ``(i) an individual who has filed a claim
                            for compensation under chapter 11 of this title
                            relating to military sexual trauma;
                                ``(ii) a veteran who has been awarded
                            compensation under such chapter relating to
                            military sexual trauma; or
                                ``(iii) a member of the Armed Forces
                            (including a member of the National Guard or
                            Reserves), a former member of the Armed Forces,
                            or a veteran who is receiving care from the
                            Department relating to military sexual trauma.
                        ``(B) The term `military sexual trauma' has the
                    meaning given that term in section 1166(d)(2) of this
                    title.
                        ``(C) The term `Veterans Crisis Line' means the
                    toll-free hotline for veterans established under
                    section 1720F(h) of this title.''.
                        (D) Board of veterans' appeals.--Section 7104 of
                    title 38, United States Code, is amended by adding at
                    the end the following new subsection:
        ``(g)(1) The Secretary shall ensure that any written communication
    under this section from the Department to an individual who has
    experienced military sexual trauma include each of the following:
                ``(A) Contact information for each of the following:
                        ``(i) The military sexual trauma coordinator of the
                    Veterans Health Administration.
                        ``(ii) The Veterans Crisis Line.
                        ``(iii) The facility of the Veterans Health
                    Administration closest to where the individual resides.
                        ``(iv) The Readjustment Counseling Service location
                    closest to where the individual resides.
                ``(B) Information on the eligibility of the individual for
            services provided through the Readjustment Counseling Service
            location described in subparagraph (A)(iv).
        ``(2) The Secretary shall ensure that any written communication
    under this section from the Department to an individual who has
    experienced military sexual trauma that includes notification of an
    award of compensation under chapter 11 of this title relating to
    military sexual trauma includes--
                ``(A) the contact information described in paragraph (1);
            and
                ``(B) the contact information for the military sexual
            trauma coordinator of the Veterans Benefits Administration.
        ``(3) In this subsection:
                ``(A) The term `individual who has experienced military
            sexual trauma' means--
                        ``(i) an individual who has filed a claim for
                    compensation under chapter 11 of this title relating to
                    military sexual trauma;
                        ``(ii) a veteran who has been awarded compensation
                    under such chapter relating to military sexual trauma;
                    or
                        ``(iii) a member of the Armed Forces (including a
                    member of the National Guard or Reserves), a former
                    member of the Armed Forces, or a veteran who is
                    receiving care from the Department relating to military
                    sexual trauma.
                ``(B) The term `military sexual trauma' has the meaning
            given that term in section 1166(d)(2) of this title.
                ``(C) The term `Veterans Crisis Line' means the toll-free
            hotline for veterans established under section 1720F(h) of this
            title.''.
        (c) Study on Training and Processing Relating to Claims for
    Disability Compensation Relating to Military Sexual Trauma.--
                (1) Study required.--The Secretary of Veterans Affairs
            shall conduct a study on--
                        (A) the quality of training provided to personnel
                    of the Department of Veterans Affairs who review claims
                    for disability compensation under chapter 11 of title
                    38, United States Code, for disabilities relating to
                    military sexual trauma; and
                        (B) the quality of the procedures of the Department
                    for reviewing the accuracy of the processing of such
                    claims.
                (2) Elements.--The study required by subsection (a) shall
            include the following:
                        (A) With respect to the quality of training
                    described in paragraph (1) of such subsection:
                                (i) Whether the Department ensures
                            personnel complete such training on time.
                                (ii) Whether the training has resulted in
                            improvements to the processing of claims
                            described in such subsection and issue-based
                            accuracy.
                                (iii) Such recommendations as the Secretary
                            may have for improving the training.
                        (B) With respect to the quality of procedures
                    described in paragraph (2) of such subsection:
                                (i) Whether the procedures of the
                            Department for reviewing the accuracy of the
                            processing of claims described in such
                            subsection comport with generally accepted
                            statistical methodologies to ensure reasonable
                            accuracy of such reviews.
                                (ii) Whether such procedures adequately
                            include mechanisms to correct errors found in
                            such reviews.
                                (iii) A summary of quality assurance
                            reviews and reports conducted as part of such
                            procedures.
                                (iv) Such recommendations as the Secretary
                            may have for improving such procedures.
                (3) Report required.--Not later than one year 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 findings of the Secretary with respect
            to the study conducted under paragraph (1).
        (d) Annual Special Focus Review of Claims for Disability
    Compensation for Disabilities Relating to Military Sexual Trauma.--
                (1) Annual special focus review.--
                        (A) In general.--Each year, the Under Secretary for
                    Benefits of the Department of Veterans Affairs shall
                    conduct a special focus review on the accuracy of the
                    processing of claims for disability compensation under
                    chapter 11 of title 38, United States Code, for
                    disabilities relating to military sexual trauma.
                        (B) Elements.--Each review conducted under
                    subparagraph (A) shall include a review of the
                    following:
                                (i) A statistically significant, nationally
                            representative sample of all claims for
                            benefits under the laws administered by the
                            Secretary of Veterans Affairs relating to
                            military sexual trauma filed during the fiscal
                            year preceding the fiscal year in which the
                            report is submitted.
                                (ii) The accuracy of each decision made
                            with respect to each claim described in clause
                            (i).
                                (iii) The types of benefit entitlement
                            errors found, disaggregated by category.
                                (iv) Trends from year to year.
                                (v) Training completion rates for personnel
                            of the Department who process claims described
                            in subparagraph (A).
                (2) Reprocessing of claims.--If the Under Secretary finds,
            pursuant to a special focus review conducted under paragraph
            (1)(A), that an error was made with respect to the entitlement
            of a veteran to a benefit under the laws administered by the
            Secretary, the Secretary shall return the relevant claim of the
            veteran to the appropriate office of the Department for
            reprocessing to ensure that the veteran receives an accurate
            decision with respect to the claim.
                (3) Report.--Section 5501(b) of the Johnny Isakson and
            David P. Roe, M.D. Veterans Health Care and Benefits
            Improvement Act of 2020 (Public Law 116-315; 134 Stat. 5048) is
            amended--
                        (A) in paragraph (1), by striking ``through 2027''
                    and inserting ``until the date described in section
                    109(d)(4) of the Take Care of America's Veterans Act'';
                    and
                        (B) in paragraph (2), by adding at the end the
                    following new subparagraph:
                        ``(I) The findings of the most recent special focus
                    review conducted under subsection (d)(1)(A) of section
                    109 of the Take Care of America's Veterans Act,
                    including--
                                ``(i) the elements under subsection
                            (d)(1)(B) of such section;
                                ``(ii) the number of claims returned for
                            reprocessing under subsection (d)(2) of such
                            section; and
                                ``(iii) the number of claims described in
                            clause (ii) for which the decision relating to
                            service-connection or entitlement to
                            compensation changed as a result of
                            reprocessing the claim.''.
                (4) Sunset.--On the date that is 5 years after the
            enactment of this Act, paragraph (1)(A) shall cease to be in
            effect.
        (e) Working Group on Medical Examinations for Claims for Disability
    Compensation for Disabilities Relating to Military Sexual Trauma.--
                (1) In general.--Not later than 90 days after the date of
            the enactment of this Act, the Secretary of Veterans Affairs
            shall establish a working group on medical examinations for
            claims for disability compensation under chapter 11 of title
            38, United States Code, for disabilities relating to military
            sexual trauma (in this section referred to as the ``working
            group'').
                (2) Membership.--The working group shall be composed of the
            following:
                        (A) Staff of the operations center for military
                    sexual trauma of the Department of Veterans Affairs who
                    have experience reviewing the quality of medical
                    examinations in support of claims for disability
                    compensation under chapter 11 of title 38, United
                    States Code.
                        (B) Staff of the Medical Disability Examination
                    Office of the Department.
                        (C) Veterans service officers who have experience
                    with claims described in paragraph (1).
                        (D) Medical examiners who have experience with such
                    claims.
                        (E) Staff of the Veterans Experience Office of the
                    Department.
                        (F) Such other individuals as the Secretary
                    considers appropriate.
                (3) Duties.--Not later than 180 days after the date of the
            enactment of this Act, the working group shall--
                        (A) review the quality of medical examinations
                    described in paragraph (1);
                        (B) review the feasibility of minimizing re-
                    examinations for conditions relating to military sexual
                    trauma; and
                        (C) submit to the Under Secretary for Benefits of
                    the Department and the Secretary recommendations on how
                    to--
                                (i) eliminate re-traumatization of
                            individuals who file claims described in
                            paragraph (1); and
                                (ii) reduce the overdevelopment of such
                            claims.
                (4) Report.--Not later than one year after the date of the
            enactment of this Act, the Secretary shall submit to Congress a
            report that includes the following:
                        (A) The views of the working group on efforts by
                    the Department to eliminate re-traumatization of
                    individuals who file claims described in subsection
                    (a).
                        (B) Legislative proposals to improve the experience
                    of such individuals in pursuing such claims.
                        (C) The recommendations submitted under paragraph
                    (3)(C).
                        (D) The plan of the Under Secretary for Benefits of
                    the Department and the Secretary to implement such
                    recommendations.
                (5) Review and implementation.--Not later than one year
            after the date of the enactment of this Act, the Under
            Secretary for Benefits of the Department and the Secretary
            shall--
                        (A) review the recommendations submitted under
                    paragraph (3)(C); and
                        (B) implement the recommendations that, as
                    determined by the Under Secretary and the Secretary,
                    would improve the claims process for individuals who
                    file claims described in paragraph (1).
        (f) Military Sexual Trauma Claims Performance Dashboard.--
                (1) Establishment.--The Secretary of Veterans Affairs shall
            establish an interactive performance dashboard displaying
            information about claims relating to military sexual trauma
            submitted to the Secretary for benefits under laws administered
            by the Secretary.
                (2) Elements.--The dashboard established pursuant to
            paragraph (1) shall cover the following:
                        (A) Claims relating to military sexual trauma
                    submitted to the Secretary for benefits under laws
                    administered by the Secretary that have been submitted,
                    completed, or appealed, including appeals pending at
                    the agency of jurisdiction and at the Board of
                    Veterans' Appeals.
                        (B) For comparison purposes with subparagraph (A),
                    claims not relating to military sexual trauma submitted
                    to the Secretary for benefits under laws administered
                    by the Secretary that have been submitted, completed,
                    or appealed.
                        (C) Overall, cumulative information relating to
                    claims relating to military sexual trauma submitted to
                    the Secretary for benefits under laws administered by
                    the Secretary, including the following:
                                (i) Average number of days a claim is
                            pending review.
                                (ii) Average number of days for completed
                            adjudication.
                                (iii) Total number of pending claims,
                            disaggregated by whether the claims have been
                            partially adjudicated or not adjudicated at
                            all.
                                (iv) Total number of claims completely
                            adjudicated.
                                (v) Of the number specified in clause (iv),
                            the percentage that were approved, denied, or
                            appealed.
                        (D) The total number of claims relating to military
                    sexual trauma submitted to the Secretary for benefits
                    under laws administered by the Secretary.
                        (E) The methods used for submittal of claims
                    relating to military sexual trauma to the Secretary for
                    benefits under laws administered by the Secretary.
                        (F) The most frequent reasons the Secretary denies
                    a claim relating to military sexual trauma submitted to
                    the Secretary for a benefit under a law administered by
                    the Secretary.
                        (G) The most frequent conditions or disabilities
                    for which a claim relating to military sexual trauma is
                    denied.
                        (H) The most frequent conditions or disabilities
                    for which a claim relating to military sexual trauma is
                    submitted to the Secretary for disability compensation
                    under chapter 11 of title 38, United States Code,
                    including the grant rate for such contentions.
                (3) Additional resource information.--The Secretary shall
            make available via the performance dashboard established
            pursuant to subsection (a) the following information:
                        (A) Veterans Crisis Line contact information.
                        (B) Information regarding the availability of
                    services from military sexual trauma coordinators of
                    the Veterans Health Administration.
                        (C) Information regarding the availability of
                    services from military sexual trauma coordinators of
                    the Veterans Benefits Administration.
                        (D) Information on availability of specialized
                    care, services, and benefits from the Department for
                    individuals who have experienced military sexual
                    trauma.
                        (E) Such additional information as the Secretary
                    considers appropriate.
                (4) Availability.--The Secretary shall ensure that the
            dashboard established pursuant to paragraph (1) is available to
            the public from the website of the Department of Veterans
            Affairs and is updated not less frequently than once every 30
            days.
                (5) Reporting requirements.--(A) Not later than 2 years
            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--
                        (i) the annual cost to implement the dashboard
                    required by paragraph (2);
                        (ii) areas for improvement of the dashboard; and
                        (iii) such additional information as the Secretary
                    considers appropriate.
                (B) Not later than 180 days after the date of the enactment
            of this Act, the Secretary shall commence providing, on a
            quarterly basis, to the Committee on Veterans' Affairs of the
            Senate and the Committee on Veterans' Affairs of the House of
            Representatives a quarterly briefing on the Department's
            processing of military sexual trauma-related claims.
                (6) Definition.--In this section, the term ``military
            sexual trauma'' has the meaning given such term in section
            1166(d)(2) of title 38, United States Code.

    SEC. 112. INDEPENDENT ASSESSMENT OF NOTICES THAT THE SECRETARY OF
                  VETERANS AFFAIRS SENDS TO CLAIMANTS.

        (a) Agreement.--Not later than 30 days after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall seek to
    enter into an agreement with an FFRDC for an assessment of notices that
    the Secretary sends to claimants.
        (b) Assessment.--An FFRDC that enters into an agreement under
    subsection (a) shall submit to the Secretary a written assessment of
    such notices. The assessment shall include the following:
                (1) The determination of the FFRDC, made in consultation
            with covered entities, whether each such notice may be feasibly
            altered to reduce paper consumption by, and costs to, the
            Federal Government.
                (2) The recommendations of the FFRDC regarding how the
            Secretary may make such notices clearer to claimants, better
            organized, and more concise.
        (c) Report; Implementation.--Not later than 90 days after the
    Secretary receives the assessment under subsection (b), the Secretary
    shall--
                (1) submit to the Committees on Veterans' Affairs of the
            Senate and House of Representatives a copy of such assessment;
            and
                (2) implement the recommendations in the assessment that
            are in compliance with the laws administered by the Secretary.
        (d) Deadline for Implementation.--The Secretary shall complete the
    implementation of such recommendations pursuant to subsection (c)(2) by
    not later than one year after the date on which the Secretary commences
    such implementation.
        (e) Definitions.--In this section:
                (1) The term ``FFRDC'' means a federally funded research
            and development center.
                (2) The term ``covered entities'' includes--
                        (A) the Secretary of Veterans Affairs;
                        (B) an expert in laws administered by the Secretary
                    of Veterans Affairs;
                        (C) a veterans service organization recognized
                    under section 5902 of title 38, United States Code;
                        (D) an entity that advocates for veterans; and
                        (E) an entity that advocates for the survivors of
                    veterans.
                (3) The terms ``claimant'' and ``notice'' have the meanings
            given such terms in section 5100 of title 38, United States
            Code.

    SEC. 113. INDEPENDENT ASSESSMENT OF FORMS THAT THE SECRETARY OF
                  VETERANS AFFAIRS SENDS TO CLAIMANTS.

        (a) Agreement.--Not later than 30 days after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall seek to
    enter into an agreement with an FFRDC for an assessment of forms that
    the Secretary sends to claimants.
        (b) Assessment.--An FFRDC that enters into an agreement under
    subsection (a) shall submit to the Secretary a written assessment, made
    in consultation with covered entities, of such forms. The assessment
    shall include the recommendations of the FFRDC regarding how the
    Secretary may make such forms clearer to claimants and better
    organized.
        (c) Report; Implementation.--Not later than 90 days after the
    Secretary receives the assessment under subsection (b), the Secretary
    shall--
                (1) submit to the Committees on Veterans' Affairs of the
            Senate and House of Representatives a copy of such assessment;
            and
                (2) implement the recommendations in the assessment that
            are in compliance with the laws administered by the Secretary.
        (d) Deadline for Implementation.--The Secretary shall complete the
    implementation of such recommendations pursuant to subsection (c)(2) by
    not later than two years after the date on which the Secretary
    commences such implementation.
        (e) Definitions.--In this section:
                (1) The term ``FFRDC'' means a federally funded research
            and development center.
                (2) The term ``covered entities'' includes--
                        (A) the Secretary of Veterans Affairs;
                        (B) an expert in laws administered by the Secretary
                    of Veterans Affairs;
                        (C) a veterans service organization recognized
                    under section 5902 of title 38, United States Code;
                        (D) an entity that advocates for veterans; and
                        (E) an entity that advocates for survivors of
                    veterans.
                (3) The term ``claimant'' has the meaning given such term
            in section 5100 of title 38, United States Code.

                  TITLE II--EDUCATION AND ECONOMIC OPPORTUNITY

    SEC. 201. VETS OPPORTUNITY ACT.

        (a) Repayment of Members of the Armed Forces for Contributions
    Towards Post-9/11 Educational Assistance: Timing; Mechanism for
    Individuals Not Eligible for a Monthly Housing Stipend.--
                (1) In general.--Subsection (f) of section 3327 of title
            38, United States Code, is amended--
                        (A) in paragraph (3), by striking ``together'' and
                    all that follows through ``before'' and inserting ``not
                    later than 60 days after''; and
                        (B) by adding at the end the following new
                    paragraph:
                ``(4) Additional assistance for an individual not eligible
            for a monthly housing stipend.--In the case of an individual
            making an election under subsection (a) who is described by
            subparagraph (A), (C), or (E) of paragraph (1) of that
            subsection, and who is not eligible for a monthly stipend
            payable under section 3313(c) of this title, the educational
            assistance payable to the individual under this chapter shall
            be paid--
                        ``(A) in a lump sum calculated by multiplying--
                                ``(i) the total amount of contributions
                            described in paragraph (1)(A) with regards to
                            such individual; and
                                ``(ii) the sum of the number of months
                            described in subclauses (I) and (II) of
                            paragraph (1)(B)(i) with regards to such
                            individual; and
                        ``(B) to the individual not later than 60 days
                    after the exhaustion of the individual's entitlement to
                    educational assistance under this chapter.''.
                (2) Technical corrections and conforming amendment.--Such
            subsection is further amended--
                        (A) by striking ``paragraphs (2) through (7)'' and
                    inserting ``paragraphs (2) through (6)''; and
                        (B) in paragraph (1), in the heading, by inserting
                    ``for an individual eligible for a monthly housing
                    stipend'' after ``Additional assistance''.
                (3) Effective date.--The amendments made by this section
            shall take effect on August 1, 2027.
        (b) Treatment of Certain Independent Study Programs Under
    Educational Assistance Programs of Department of Veterans Affairs.--
                (1) In general.--Section 3680A(a)(4)(A)(ii)(III) of such
            title is amended--
                        (A) by inserting ``that requires regular and
                    substantive interaction between students and
                    instructors'' after ``course of study'';
                        (B) in item (aa), by striking ``; or'' and
                    inserting a semicolon;
                        (C) in item (bb), by striking ``; and'' and
                    inserting ``; or''; and
                        (D) by adding at the end by following new item:
                                                ``(cc) an institution of
                                            higher education, as such term
                                            is defined in section 102 of
                                            the Higher Education Act of
                                            1965 (20 U.S.C. 1002), that is
                                            approved to participate or is
                                            participating in the student
                                            financial assistance programs
                                            authorized by title IV of that
                                            Act; and''.
                (2) Applicability.--The amendment made by paragraph (1)
            shall apply with respect to a quarter, semester, or term, as
            applicable, that begins on or after August 1, 2027.
                (3) Oversight.--During the first six years beginning on the
            date of enactment of this Act, the Secretary, in coordination
            with State approving agencies, shall, every two years, conduct
            risk-based surveys or reviews of institutions approved pursuant
            to section 3680A(a)(4)(A)(ii)(III)(cc) of title 38, United
            States Code, as added by paragraph (1).
                (4) GAO report.--Not later than 3 years after the date of
            enactment of this Act, the Comptroller General of the United
            States shall submit to the Committees on Veterans' Affairs of
            the Senate and House of Representatives a report on the
            oversight and implementation of the amendments made by
            paragraph (1), including--
                        (A) the effectiveness of oversight activities
                    conducted by the Department of Veterans Affairs and
                    State approving agencies;
                        (B) institutional compliance with applicable
                    requirements under chapter 36 of title 38, United
                    States Code;
                        (C) participation and outcomes of veterans enrolled
                    in programs approved pursuant to section
                    3680A(a)(4)(A)(ii)(III)(cc) of such title, as added by
                    paragraph (1); and
                        (D) any recommendations to improve oversight,
                    program integrity, or educational outcomes for
                    veterans.
                (5) Applicability.--To the extent practicable for any
            program requiring practical, laboratory, clinical, shop, or
            hands on competencies, the online portion of instruction may
            not substitute for the supervised in person training necessary
            to demonstrate such competencies.
        (c) Absence From Certain Education Due to Certain Service.--
                (1) Options.--Section 3691A of such title is amended by
            striking paragraph (1) of subsection (a) and inserting the
            following:
        ``(1) A covered member may, after receiving orders to enter a
    period of covered service--
                ``(A) withdraw from covered education;
                ``(B) take a leave of absence from covered education; or
                ``(C) subject to subsection (d), enter into an agreement
            with the institution concerned to complete a course of covered
            education to the satisfaction of such institution concerned.''.
                (2) Conforming amendment.--Such subsection is further
            amended, in paragraph (2)(A), by striking ``or takes a leave of
            absence'' and inserting ``, takes a leave of absence, or enters
            into an agreement''.
                (3) Agreement.--Such section is further amended--
                        (A) by redesignating subsection (d) as subsection
                    (e); and
                        (B) by inserting, after subsection (c), the
                    following new subsection (d):
        ``(d) Agreement With Institution Concerned.--A covered member may
    enter into an agreement under subsection (a) only if the covered member
    has completed at least half of a course of covered education.''.
                (4) Section heading.--Such section is further amended by
            striking the heading and inserting ``Absence from certain
            education due to certain service''.
                (5) Table of sections.--The table of sections at the
            beginning of chapter 36 of such title is amended by striking
            the item relating to section 3691A and inserting the following
            new item:

    ``3691A. Absence from certain education due to certain service.''.
        (d) Department of Veterans Affairs Compliance Surveys.--Section
    3693 of such title is amended--
                (1) in subsection (c)--
                        (A) by striking ``not more than 10 business days of
                    notice'';
                        (B) by striking ``this section.'' and inserting
                    ``this section--''; and
                        (C) by adding at the end the following new
                    paragraphs:
                ``(1) in the case of an educational institution or training
            establishment with a time stamp database collection feature,
            not fewer than 10, and not more than 15, business days of
            notice; and
                ``(2) in the case of any other educational institution or
            training establishment, not more than 10 business days of
            notice.''; and
                (2) by striking subsection (d) and inserting the following
            new subsection (d):
        ``(d) Definitions.--In this section:
                ``(1) The terms `educational institution' and `training
            establishment' have the meanings given such terms in section
            3452 of this title.
                ``(2) The term `school certifying official' means an
            employee of an educational institution with primary
            responsibility for certifying veteran enrollment at the
            educational institution.''.
        (e) Notification of School Certifying Officials of Handbook
    Updates.--
                (1) In general.--Not later than 14 business days after
            updating the school certifying official handbook of the
            Department of Veterans Affairs, the Secretary of Veterans
            Affairs shall provide notice to all school certifying officials
            of such update.
                (2) School certifying official defined.--The term ``school
            certifying official'' means an employee of an educational
            institution with primary responsibility for certifying veteran
            enrollment at the educational institution.

    SEC. 202. IMPROVEMENTS TO PROCESS FOR MAKING PAYMENTS TO AUTOMOBILE
                  SELLERS FOR AUTOMOBILES PURCHASED FOR CERTAIN DISABLED
                  VETERANS.

        (a) Timeliness of Payments.--Section 3902 of title 38, United
    States Code, is amended, in subsection (a)--
                (1) by inserting ``(1)'' before ``The Secretary''; and
                (2) by adding at the end the following new paragraph:
        ``(2) The Secretary shall--
                ``(A) make payments under this section in compliance with
            regulations prescribed under section 3903(a) of title 31,
            except that no interest penalties shall be required to be paid
            under this section; and
                ``(B) in the case of any payment under this section that is
            not processed during the period of 30 days following receipt by
            the Secretary of the final invoice for such payment, the
            Secretary shall publish in the Federal Register the number of
            days required to process the payment.''.
        (b) Centralization of Process for Making Payments.--Such section is
    amended by adding at the end the following new subsection:
        ``(f)(1) The Secretary shall process payments under this section
    through one office of the Department that the Secretary determines has
    the capacity and expertise to make such payments in compliance with
    regulations described in subsection (a)(2).
        ``(2) The Secretary shall accurately track and resolve payments due
    to sellers under this section that are more than 90 days overdue.''.
        (c) Reporting.--The Secretary of Veterans Affairs shall submit to
    the Committees on Veterans' Affairs of the Senate and House of
    Representatives, and publish on a publicly accessible website of the
    Department of Veterans Affairs, four semiannual reports after the date
    of the enactment of this Act, regarding the administration of section
    3902 of title 38, United States Code, as amended by this section. Each
    such report shall include, with respect to the period of six months
    preceding the date of the report, the following elements:
                (1) The average and median number of days between receipt
            of a invoice for payment under such section by the Claims
            Intake Center of the Department and the day when the Secretary
            makes such payment, disaggregated by whether the claim was
            under review or being processed by--
                        (A) the Veterans Health Administration;
                        (B) the Veterans Benefits Administration; or
                        (C) the seller.
                (2) Improvements to information technology of the
            Department that the Secretary determines would reduce the time
            required for such review or processing.
        (d) GAO Report; Briefing.--
                (1) Report.--Not later than 180 days after the day the
            Secretary completes centralization under subsection (f) of
            section 3902 of title 38, United States Code, as added by this
            section, the Comptroller General of the United States shall
            review such centralization and publish a report containing the
            results of such review. Such report shall include the
            determinations of the Comptroller General regarding the
            following:
                        (A) The capacity of the office determined by the
                    Secretary under such subsection, to carry out
                    processing described in such subsection, including--
                                (i) a comprehensive assessment of employees
                            of the Department who carry out chapter 39 of
                            such title;
                                (ii) a comprehensive skills assessment
                            indicating what resources the Secretary
                            requires to otherwise improve such
                            centralization, including additional funds,
                            employees, or contractors; and
                                (iii) a review of systems of information
                            technology, including systems in use or to be
                            acquired, to carry out such centralization.
                        (B) Recommendations to improve such processing.
                        (C) Estimated costs to the United States to
                    implement such recommendations.
                (2) Briefing.--Not later than 30 days after publishing the
            report under paragraph (1), the Comptroller General shall
            provide to the Committees on Veterans' Affairs of the House of
            Representatives and Senate a briefing on such report. Such
            briefing shall include any response from the Secretary to the
            Comptroller General regarding the recommendations in the
            report.

    SEC. 203. MONTHLY HOUSING STIPEND UNDER THE POST-9/11 EDUCATIONAL
                  ASSISTANCE PROGRAM FOR INDIVIDUALS WHO PURSUE SUMMER
                  PROGRAMS OF EDUCATION SOLELY THROUGH DISTANCE LEARNING.

        (a) In General.--Section 3313(c)(1)(B) of title 38, United States
    Code, is amended--
                (1) in clause (i), by striking ``and (iii)'' and inserting
            ``, (iii), and (iv)'';
                (2) by redesignating clause (iv) as clause (v); and
                (3) by inserting after clause (iii) the following new
            clause (iv):
                                ``(iv) In the case of an individual
                            pursuing, solely through distance learning, a
                            program of education that is shorter than 12
                            weeks during the summer, for each month the
                            individual pursues the program of education, a
                            monthly housing stipend equal to the product
                            of--
                                        ``(I) the national average of the
                                    monthly amount of the basic allowance
                                    for housing payable under section 403
                                    of title 37 for a member with
                                    dependents in pay grade E-5, multiplied
                                    by
                                        ``(II) the lesser of--
                                                ``(aa) 1.0 and
                                                ``(bb) the number of course
                                            hours borne by the individual
                                            in pursuit of the program of
                                            education, divided by the
                                            minimum number of course hours
                                            required for full-time pursuit
                                            of the program of education,
                                            rounded to the nearest multiple
                                            of 10.''.
        (b) Effective Date.--The amendments made by subsection (a) shall
    apply to a program of education beginning on or after August 1, 2027.

    SEC. 204. CLARIFICATION REGARDING INCLUSION OF MEDICALLY NECESSARY
                  AUTOMOBILE ADAPTATIONS IN DEPARTMENT OF VETERANS AFFAIRS
                  DEFINITION OF ``MEDICAL SERVICES''.

        Section 1701(6)(I) of title 38, United States Code, is amended to
    read as follows:
                ``(I) The provision of any medically necessary automobile
            adaptations for driver or passenger use, including--
                        ``(i) ramp and kneeling systems;
                        ``(ii) raised doors or lowered floors;
                        ``(iii) raised roofs;
                        ``(iv) air conditioning;
                        ``(v) occupied and unoccupied mobility lifts;
                        ``(vi) ingress or egress accessibility
                    modifications;
                        ``(vii) wheelchair tiedowns; and
                        ``(viii) adapted seating.''.

    SEC. 205. DIGITAL COMMUNICATIONS: SOLID START PROGRAM; EDUCATIONAL
                  ASSISTANCE.

        (a) Improvement to Certain Outreach Under Solid Start Program of
    Department of Veterans Affairs.--Section 6320(b) of title 38, United
    States Code, is amended--
                (1) in paragraph (1)(B)--
                        (A) by striking ``calling'' and inserting
                    ``communicating with''; and
                        (B) by inserting ``through the use of tailored
                    lines of communication, including mailings, text
                    messaging, virtual chatting, and other electronic forms
                    of messaging'' after ``Armed Forces''; and
                (2) in paragraph (2), by striking ``tailored mailings'' and
            inserting ``tailored lines of communication, including
            mailings, text messaging, virtual chatting, and other
            electronic forms of messaging,''.
        (b) Department of Veterans Affairs Use of Tailored Lines of
    Communication for Correspondence Relating to Educational Assistance
    Benefits.--Section 3680 of title 38, United States Code, is amended by
    adding at the end the following new subsection:
        ``(i)(1) The Secretary shall provide a mechanism by which an
    eligible veteran or eligible person may use tailored lines of
    communication to send and receive correspondence with the Department of
    Veterans related to entitlement to and use of educational assistance
    benefits under the laws administered by the Secretary. The Secretary
    shall ensure that an eligible veteran or eligible person is provided
    with an opportunity to opt into sending and receiving such
    correspondence using such lines of communication rather than by mail.
        ``(2) The Secretary shall provide to eligible veterans and eligible
    persons who are enrolled in a course or program of education or
    training notice of the opportunity to opt in to sending and receiving
    correspondence using tailored lines of communication pursuant to
    paragraph (1).
        ``(3) In this subsection, the term `tailored lines of
    communication' includes mailings, text messaging, virtual chatting, and
    other electronic forms of messaging.''.

    SEC. 206. IMPROVEMENTS TO TRANSITION ASSISTANCE PROGRAM AND
                  SKILLBRIDGE.

        (a) Transition Assistance Program: Amendments; Pilot Program;
    Reports.--
                (1) Special operations forces.--Subsection (a) of section
            1142 of title 10, United States Code, is amended, in paragraph
            (1), by inserting ``(including each member of the special
            operations forces)'' after ``armed forces''.
                (2) Requirement of preseparation counseling: number of
            days.--Such subsection is further amended, in paragraph (1)--
                        (A) by inserting ``(A)'' before ``Within''; and
                        (B) by adding at the end the following new
                    subparagraph:
                ``(B) The Secretary concerned shall ensure that a member
            described in subparagraph (A) receives preseparation counseling
            in the following amounts:
                        ``(i) In the case of a member who has accepted an
                    offer of full-time employment, or has enrolled in a
                    program of education or vocational training, that shall
                    commence after the member separates, retires, or is
                    discharged, not fewer than three days.
                        ``(ii) In the case of a member other than a member
                    described in clause (i), not fewer than five days.''.
                (3) Repeat attendance.--Such subsection is further amended
            by adding at the end the following new paragraph:
                ``(6) A member who received preseparation counseling under
            this section may, before separation, retirement, or discharge,
            request to receive, on a space-available basis, such
            preseparation counseling a second time.''.
                (4) Pathways: standardization; establishment of pathway for
            members of the reserve components.--Such section is further
            amended, in paragraph (1) of subsection (c), in the matter
            preceding subparagraph (A)(1)--
                        (A) by striking ``Each Secretary concerned'' and
                    inserting ``The Secretaries of Defense and Homeland
                    Security''; and
                        (B) by striking ``pathways for members of the
                    military department concerned'' and inserting
                    ``pathways, standardized across the armed forces''.
                (5) Pathways: record of pathway assignment.--Such
            subsection is further amended by adding at the end the
            following new paragraph:
                ``(4) The Secretary concerned shall ensure that the pathway
            in which a member is placed, and the reasons for such
            placement, are noted in the service record of such member.''.
                (6) Coordination between departments of defense, veterans
            affairs, and labor.--Such section is further amended, in
            subsection (d)--
                        (A) by striking the heading and inserting
                    ``Transmission of Certain Information to Other
                    Departments'';
                        (B) by inserting ``(1)'' before ``In the case'';
                    and
                        (C) by adding at the end the following new
                    paragraphs:
                ``(2) Before a member described in subsection (a)
            separates, retires, or is discharged, the Secretary concerned
            shall transmit to the Secretary of Veterans Affairs the
            Department of Defense Form DD-2648 regarding such member.
                ``(3)(A) In the case of a member described in subsection
            (a) whom the Secretary determined as tier 3 status the
            Secretary concerned shall, before the member separates,
            retires, or is discharged, provide such member with the contact
            information of an employee of the Department of Veterans
            Affairs and an employee of the Department of Labor; and
                ``(B) Each employee described in subparagraph (A) shall
            contact the member described in such subparagraph not later
            than 60 days after such member separates, retires, or is
            discharged.
                ``(C) The Secretary of Veterans Affairs and the Secretary
            of Labor shall each submit to the Committees on Armed Services
            and on Veterans' Affairs of the Senate and House of
            Representatives an annual report that identifies the number of
            times, and reasons why, an employee of the department under the
            jurisdiction of such Secretary failed to carry out subparagraph
            (B) in the year preceding the date of the report.
                ``(D) The Secretary of Defense and Secretary of Homeland
            Security shall prescribe regulations to ensure that, for
            purposes of this paragraph, each Secretary concerned uses the
            same definition of the term `at risk for a difficult transition
            to civilian life'.''.
                (7) Report.--Not later than two years after the date of the
            enactment of this Act and annually thereafter for four years,
            the Secretary of Defense shall submit to the Committees on
            Armed Services, and the Committees on Veterans' Affairs, of the
            Senate and House of Representatives, a report on data recorded
            with such tracking system during the year preceding the date of
            such report. Such a report shall include a list of the seven
            military installations located inside the continental United
            States, and three military installations located outside the
            continental United States, where members are least likely to
            receive preseparation counseling in accordance with such time
            periods.
                        (A) The number of members who, in the course of
                    such preseparation counseling, were referred to another
                    Federal agency or department.
                        (B) The Federal agencies or departments to which
                    members were so referred.
                        (C) The number of members who should have been, but
                    were not, so referred, and reasons why such referrals
                    did not occur.
                        (D) The number of members who receive such
                    preseparation counseling and apply for unemployment
                    compensation under subchapter II of chapter 85 of title
                    5, United States Code.
                        (E) The total amount of such unemployment
                    compensation paid to members separating from the Armed
                    Forces.
                        (F) The frequency with which the commander of the
                    military installation received a briefing regarding
                    attendance of members in accordance with statutory
                    requirements of the Transition Assistance Program.
                (8) Contracting: standardization.--Such section is further
            amended by adding at the end the following new subsection:
        ``(f) Contracting.--A Secretary concerned may enter into an
    agreement with an entity under which such entity shall provide
    preseparation counseling under this section. If more than one Secretary
    seeks to enter into such an agreement, such Secretaries concerned
    shall, to the extent practicable, seek to enter into such agreements
    with the same entity.''.
                (9) Annual report on tap participation.--The frequency with
            which the commander of the military installation received a
            briefing regarding attendance of members in accordance with
            statutory requirements of the Transition Assistance Program.
        (b) Skillbridge: GAO Study.--
                (1) Study required.--The Comptroller General of the United
            States shall conduct a study of the Skillbridge programs under
            section 1143(e) of title 10, United States Code.
                (2) Report.--Not later than two years after the date of the
            enactment of this Act, the Comptroller General shall submit to
            the Committees on Armed Services, and the Committees on
            Veterans' Affairs, of the Senate and House of Representatives,
            a report regarding such study. Such report shall include
            observations and recommendations of the Comptroller regarding,
            with respect to members and employers who participate in
            Skillbridge--
                        (A) differences in criteria for participation
                    between the Armed Forces;
                        (B) other differences in Skillbridge programs
                    between the Armed Forces;
                        (C) best practices in Skillbridge programs across
                    the Armed Forces, including--
                                (i) the selection of employers; and
                                (ii) the development of contracts; and
                        (D) the feasibility of making Skillbridge programs
                    uniform across the Armed Forces.

    SEC. 207. TRANSITION ASSISTANCE PROGRAM: PRESENTATION IN PRESEPARATION
                  COUNSELING TO PROMOTE BENEFITS AVAILABLE TO VETERANS.

        (a) In General.--Section 1142(b) of title 10, United States Code,
    is amended by adding at the end the following new paragraph:
                ``(20) A presentation that promotes the benefits available
            to veterans under the laws administered by the Secretary of
            Veterans Affairs. Such presentation--
                        ``(A) shall be standardized;
                        ``(B) shall, before implementation, be reviewed and
                    approved by the Secretary of Veterans Affairs and
                    Secretary of Defense in collaboration with veterans
                    service organizations that provide claims assistance
                    under the benefits delivery at discharge program of the
                    Department of Veterans Affairs;
                        ``(C) shall be submitted by the Secretary of
                    Veterans Affairs to the Committees on Veterans' Affairs
                    and Armed Services of the Senate and the House of
                    Representatives for review at least 90 days before
                    implementation;
                        ``(D) where available, shall be presented with the
                    participation of--
                                ``(i) an employee or representative of the
                            Department of Veterans Affairs assisted by a
                            representative of a veterans service
                            organization recognized under section 5902 of
                            title 38; or
                                ``(ii) an employee or representative of the
                            Department of Veterans Affairs assisted by an
                            individual recognized under section 5903 of
                            such title and authorized by the Secretary
                            concerned to so participate;
                        ``(E) shall include information on how a veterans
                    service organization may assist the member in filing a
                    claim described in paragraph (19);
                        ``(F) may not encourage the member to join a
                    particular veterans service organization; and
                        ``(G) may not be longer than one hour.''.
        (b) Annual Report.--Not less frequently than once each year after
    the date of the enactment of this Act, the Secretary of Veterans
    Affairs shall submit, to the Committees on Armed Services of the Senate
    and House of Representatives, and to the Committees on Veterans'
    Affairs of the Senate and House of Representatives, a report that--
                (1) identifies each veterans service organization that
            participated in a presentation under paragraph (20) of section
            1142(b) of title 10, United States Code, as added by subsection
            (a);
                (2) contains the number of members of the Armed Forces who
            attended such presentations; and
                (3) includes any recommendations of the Secretary regarding
            changes to such presentation or to such paragraph.

    SEC. 208. ELIMINATION OF REQUIREMENT THAT ON-CAMPUS EDUCATIONAL AND
                  VOCATIONAL COUNSELING IS PROVIDED BY CERTAIN DEPARTMENT
                  OF VETERANS AFFAIRS EMPLOYEES.

        (a) In General.--Section 3697B(a) of title 38, United States Code,
    is amended--
                (1) by striking the second sentence;
                (2) by inserting ``(1)'' before ``The Secretary''; and
                (3) by adding at the end the following new paragraph:
        ``(2) Any individual providing services under paragraph (1) on
    behalf of the Department who is not an employee of the Department shall
    be subject to the same oversight, training, and accountability
    standards applicable to Department employees providing such
    services.''.
        (b) Expansion of VetSuccess on Campus Program to at Least One
    Location in Each State.--
                (1) In general.--The Secretary of Veterans Affairs shall
            ensure that the VetSuccess on Campus program of the Department
            of Veterans Affairs is located in every State.
                (2) Counselors.--In carrying out paragraph (1), the
            Secretary shall ensure that at least one counselor of the
            VetSuccess on Campus program is located in each State,
            notwithstanding the number of individuals in a State or at an
            educational institution who may qualify to participate in the
            program.
                (3) Preference.--In carrying out this section, the
            Secretary shall give preference to educational institutions
            that have the largest populations of students who are pursuing
            programs of education at such institutions with educational
            assistance provided under laws administered by the Secretary.
                (4) State defined.--In this section, the term ``State'' has
            the meaning given such term in section 101 of title 38, United
            States Code.

    SEC. 209. EXPANSION OF ENTITLEMENT FOR PAYMENT FOR LICENSING OR
                  CERTIFICATION TESTS FOR VETERANS ENTITLED TO EDUCATIONAL
                  ASSISTANCE.

        Section 3315 of title 38, United States Code, is amended--
                (1) in subsection (a), by striking ``educational assistance
            under this chapter'' and inserting ``covered assistance'';
                (2) in subsection (b)(3), by striking ``under this
            chapter'' and inserting ``with respect to covered assistance'';
                (3) in subsection (c), in the matter preceding paragraph
            (1), by striking ``under this chapter'' and inserting ``with
            respect to covered assistance''; and
                (4) by adding at the end the following new subsection:
        ``(d) Warnings.--Before providing any payment to or on behalf of an
    individual described in subsection (a), the Secretary shall provide
    notice to the individual a warning that use of entitlement under this
    section for a licensing or certification test may not lead to a license
    or certification.
        ``(e) Covered Assistance Defined.--In this section, the term
    `covered assistance' means educational assistance available under--
                ``(1) this chapter, chapter 30 of this title, chapter 35 of
            this title, or chapter 1606 of title 10; or
                ``(2) any other provision of law providing educational
            assistance to a veteran, or to another individual in connection
            with the service of a veteran in the Armed Forces.''.

    SEC. 210. INCREASE OF AMOUNT OF EDUCATIONAL ASSISTANCE PAID BY THE
                  SECRETARY OF VETERANS AFFAIRS FOR FIRST YEAR OF A FULL-
                  TIME PROGRAM OF APPRENTICESHIP OR OTHER ON-JOB TRAINING.

        Section 3313(g)(3)(B) of title 38, United States Code, is amended--
                (1) in the matter preceding clause (i), by inserting
            ``using educational assistance under this chapter''; and
                (2) in clause (i)(II), by striking ``80 percent'' and
            inserting ``100 percent''.

    SEC. 211. IMPROVING EMERGING TECHNOLOGY OPPORTUNITIES FOR VETERANS.

        (a) Inclusion of Emerging Technologies in High Technology
    Program.--
                (1) In general.--Section 3699C of title 38, United States
            Code, is amended--
                        (A) in the section heading by striking ``High
                    technology'' and inserting ``High technology and
                    emerging technology'';
                        (B) by striking ``high technology'' and inserting
                    ``high technology or emerging technology'' each place
                    such term appears; and
                        (C) in subsection (c)(4) by adding at the end the
                    following new subparagraph:
        ``(E) Such criteria shall also identify which technologies of
    critical importance, such as artificial intelligence and semiconductor
    manufacturing, shall be treated as emerging technologies for purposes
    of this section.''.
                (2) Clerical amendment.--The table of sections at the
            beginning of chapter 36 of such title is amended by striking
            the item relating to section 3699C and inserting the following
            new item:

    ``3699C. High technology and emerging technology program.''.
                (3) Conforming amendments.--Section 3680A of title 38,
            United States Code, is amended in subsections (a)(4)(B) and
            (d)(8) by striking ``high technology'' each place such term
            appears and inserting ``high technology or emerging
            technology''.
        (b) Employment Rate Calculation for VET-TEC High Technology and
    Emerging Technology Program.--Section 3699C of title 38, United States
    Code, is amended--
                (1) in subsection (f)--
                        (A) in the matter preceding paragraph (1) by
                    inserting after ``House of Representatives'' the
                    following: ``, and make available to the public,''; and
                        (B) in paragraph (3) by adding at the end the
                    following: ``Such rate shall be calculated as a
                    fraction, the denominator of which is the number of
                    covered individuals who completed such a program during
                    such year and the numerator of which is the number of
                    individuals counted in the denominator who are employed
                    on the date that is 180 days after the date on which
                    the individual completed the program, and expressed as
                    a percentage. Notwithstanding the previous sentence,
                    the numerator shall not count a case in which the
                    individual is employed by the same organization that
                    was the provider of the individual's program of
                    education or a case in which the individual is
                    employed, by a parent or affiliate of such
                    organization, as an instructor for a substantially
                    similar program of education. To the maximum extent
                    practicable, the Secretary shall also report the rates
                    of full-time employment, part-time employment, and
                    self-employment.''; and
                (2) in subsection (g) by adding at the end the following
            new paragraph:
        ``(3) The Secretary on an ongoing basis shall solicit, collect, and
    analyze feedback about the program from covered individuals who
    participate in the program and from the GI Bill School Feedback Tool.
    The Secretary shall use such feedback to evaluate and improve the
    implementation of the program.''.

                             TITLE III--HEALTH CARE

    SEC. 301. EXTENSION AND MODIFICATION OF TRANSPORTATION GRANT PROGRAM OF
                  DEPARTMENT OF VETERANS AFFAIRS.

        Section 307 of the Caregivers and Veterans Omnibus Health Services
    Act of 2010 (Public Law 111-163; 38 U.S.C. 1710 note) is amended--
                (1) in subsection (a)--
                        (A) in paragraph (2), by adding at the end the
                    following new subparagraphs:
                        ``(C) Indian tribes.
                        ``(D) Tribal organizations.
                        ``(E) Native Hawaiian organizations.
                        ``(F) County veterans service organizations.'';
                        (B) in paragraph (3), in the matter preceding
                    subparagraph (A), by striking ``State veterans service
                    agency or veterans service organization awarded'' and
                    inserting ``recipient of''; and
                        (C) by amending paragraph (4) to read as follows:
                ``(4) Maximum amount.--
                        ``(A) In general.--Except as provided in
                    subparagraphs (B) and (C), the amount of a grant under
                    this section may not exceed $50,000.
                        ``(B) Off-road communities.--In the case of a
                    county that has more than five communities that are off
                    the road system, the amount of a grant awarded with
                    respect to that county under this section may be
                    increased by an amount not to exceed 50 percent of the
                    amount specified in subparagraph (A).
                        ``(C) Purchasing a vehicle.--
                                ``(i) Amount.--The amount of a grant
                            awarded under this section to a recipient may
                            be increased by not more than $80,000 if the
                            recipient is purchasing a vehicle to comply
                            with requirements under the Americans with
                            Disabilities Act of 1990 (42 U.S.C. 12101 et
                            seq.) in carrying out this section.
                                ``(ii) Limitations.--The Secretary may
                            prescribe limitations on the number of vehicles
                            purchased by each recipient under this
                            section.'';
                (2) by striking subsection (d);
                (3) by redesignating subsections (b) and (c) as subsections
            (d) and (e), respectively;
                (4) by inserting after subsection (a) the following new
            subsections:
        ``(b) Additional Services.--
                ``(1) Nearby rural areas.--In addition to providing
            innovative transportation options to veterans in highly rural
            areas, a recipient of a grant under this section may use
            amounts provided under the grant to provide innovative
            transportation options to veterans in nearby rural areas.
                ``(2) Priority.--A recipient of a grant under this section
            shall prioritize the provision of innovative transportation
            options to veterans in highly rural areas, and shall
            demonstrate to the Secretary such priority, and may only
            provide services under paragraph (1) to veterans in nearby
            rural areas if--
                        ``(A) it does not impede the services provided to
                    veterans in highly rural areas; and
                        ``(B) the grantee has excess capacity and resources
                    available to provide such services to veterans in
                    nearby rural areas.
        ``(c) Eligibility of Previous Areas.--Areas eligible for assistance
    under the grant program under this section on the day before the date
    of the enactment of the Supporting Rural Veterans Access to Healthcare
    Services Act shall remain eligible for such assistance on and after
    such date of enactment.''; and
                (5) in subsection (e), as redesignated by paragraph (2)--
                        (A) by redesignating paragraph (2) as paragraph
                    (5); and
                        (B) by striking paragraph (1) and inserting the
                    following:
                ``(1) Indian tribe; tribal organization.--The terms `Indian
            tribe' and `Tribal organization' have the meanings given those
            terms in section 4 of the Indian Self-Determination and
            Education Assistance Act (25 U.S.C. 5304).
                ``(2) Native hawaiian organization.--The term `Native
            Hawaiian organization' has the meaning given that term in
            section 6207 of the Elementary and Secondary Education Act of
            1965 (20 U.S.C. 7517).
                ``(3) Nearby.--The term `nearby', with respect to a rural
            area, includes rural areas adjacent to a highly rural area and
            rural areas geographically between the highly rural area and
            the nearest Department of Veterans Affairs medical center.
                ``(4) Rural; highly rural.--The terms `rural' and `highly
            rural' have the meanings given those terms under the Rural-
            Urban Commuting Areas (RUCA) coding system of the Department of
            Agriculture.''.

    SEC. 302. VETERAN CAREGIVER REEDUCATION, REEMPLOYMENT, AND RETIREMENT
                  ACT.

        (a) Extension of Period of Medical Care Coverage for Caregivers
    Designated as Primary Providers of Personal Care Services for
    Veterans.--Section 1781(a)(4) of title 38, United States Code, is
    amended by inserting before the comma at the end the following: ``,
    including during the 180-day period following discharge from the
    program under section 1720G(a) of this title unless the designation of
    the individual was revoked due to fraud, abuse, mistreatment, or other
    misconduct''.
        (b) Employment and Other Benefits for Caregivers Designated as
    Primary Providers of Personal Care Services for Veterans.--
                (1) Employment assistance.--Section 1720G of title 38,
            United States Code, is amended by adding at the end the
            following new subsection:
        ``(e) Employment Assistance.--(1) The Secretary shall, subject to
    paragraph (2), provide to an individual designated as a primary
    provider of personal care services under subsection (a)(7)(A)
    employment assistance as follows:
                ``(A) Reimbursement of fees associated with certifications
            or relicensure necessary for such employment.
                ``(B) For purposes of gaining credit for continuing
            professional education requirements, access to training modules
            of the Department at no cost.
                ``(C) In consultation with the Secretary of Defense and the
            Secretary of Labor, access to existing employment assistance
            resources and programs as considered appropriate.
        ``(2) An individual described in paragraph (1) shall have access to
    assistance described in such paragraph--
                ``(A) while participating in the program established under
            subsection (a)(1); and
                ``(B) during the 180-day period following the date on which
            the individual is no longer participating in such program
            unless the designation of such individual under subsection
            (a)(7)(A) was revoked for fraud, abuse, mistreatment, or other
            misconduct.
        ``(3) The maximum lifetime amount that may be reimbursed for an
    individual under paragraph (1)(A) is $1,000.''.
                (2) Expansion of available services.--Subsection
            (a)(3)(A)(ii) of such section is amended--
                        (A) in subclause (V), by striking ``; and'' and
                    inserting a semicolon;
                        (B) in subclause (VI)--
                                (i) in the matter preceding item (aa), by
                            inserting ``or agreements'' after
                            ``contracts'';
                                (ii) in item (aa), by inserting ``,
                            including retirement planning services,'' after
                            ``services''; and
                                (iii) in item (bb), by striking the period
                            at the end and inserting ``; and''; and
                        (C) by adding at the end the following new
                    subclause:
                        ``(VII) such instruction, preparation, training,
                    and support as the Secretary considers appropriate to
                    assist in transitioning away from caregiving during the
                    180-day period following the date on which the family
                    caregiver is no longer participating in the program
                    required by paragraph (1), unless such designation was
                    revoked for fraud, abuse, or mistreatment, or other
                    misconduct.''.
                (3) Assistance returning to workforce.--Subclause (VI) of
            such subsection is further amended--
                        (A) in item (aa), by striking ``; and'' and
                    inserting a semicolon; and
                        (B) by adding at the end the following new item:
                                ``(cc) assistance returning to the
                            workforce upon discharge or dismissal from the
                            program required by paragraph (1) unless such
                            designation was revoked for fraud, abuse,
                            mistreatment, or other misconduct; and''.
                (4) Bereavement counseling and support.--Subsection
            (a)(3)(A)(i)(III) of such section is amended by inserting
            before the semicolon the following: ``, including bereavement
            counseling and support following the death of the eligible
            veteran''.
                (5) Study on provision of returnship program.--
                        (A) In general.--Not later than one year after the
                    date of the enactment of this Act, the Secretary of
                    Veterans Affairs, in partnership with the Secretary of
                    Labor, shall complete a study on the feasibility and
                    advisability of conducting a returnship program to
                    assist individuals who are designated as a primary
                    provider of personal care services under section
                    1720G(a)(7)(A) of title 38, United States Code, or who
                    were discharged from such program, in returning to the
                    workforce.
                        (B) Report.--Not later than 180 days after
                    completion of the study under subparagraph (A), the
                    Secretary shall submit to the Committee on Veterans'
                    Affairs of the Senate and the Committee on Veterans'
                    Affairs of the House of Representatives a report on the
                    study.
                (6) Study on incorporating former caregivers into workforce
            of department of veterans affairs.--
                        (A) In general.--Not later than one year after the
                    date of the enactment of this Act, the Secretary of
                    Veterans Affairs shall complete a study on barriers and
                    incentives to hiring individuals who were designated as
                    a primary provider of personal care services under
                    section 1720G(a)(7)(A) of title 38, United States Code,
                    at facilities of the Department of Veterans Affairs to
                    address staffing needs.
                        (B) Report.--Not later than 180 days after
                    completion of the study under subparagraph (A), the
                    Secretary shall submit to the Committee on Veterans'
                    Affairs of the Senate and the Committee on Veterans'
                    Affairs of the House of Representatives a report on the
                    study, which shall include--
                                (i) a plan for increasing employment
                            opportunities at facilities of the Department
                            for individuals who were designated as a
                            primary provider of personal care services
                            under section 1720G(a)(7)(A) of title 38,
                            United States Code; and
                                (ii) such recommendations for legislative
                            or administrative action as the Secretary
                            considers appropriate.
        (c) Comptroller General Report on Efforts of Department of Veterans
    Affairs in Supporting Family Caregivers Transitioning Away From
    Caregiving.--Not later than two years after the date of the enactment
    of this Act, the Comptroller General of the United States shall submit
    to Congress a report assessing the efforts of the Secretary of Veterans
    Affairs to support individuals serving as family caregivers under
    section 1720G(a) of title 38, United States Code, in transitioning away
    from caregiving, either by assisting those individuals with retirement
    planning or returning to work.
        (d) Report on Feasibility and Advisability of Establishing a
    Retirement Plan or Retirement Savings for Family Caregivers of Certain
    Veterans.--Not later than one year after the date of the enactment of
    this Act, the Secretary of Veterans Affairs, in consultation with the
    Secretary of the Treasury and the heads of such other relevant entities
    as the Secretary of Veterans Affairs determines necessary, shall submit
    to Congress a report on the feasibility and advisability of, for
    individuals serving as family caregivers under section 1720G(a) of
    title 38, United States Code--
                (1) establishing an individual retirement plan (as defined
            in section 7701(a)(37) of the Internal Revenue Code of 1986 (26
            U.S.C. 7701(a)(37))) or similar retirement plan; or
                (2) permitting such individuals to join an already
            established pathway to retirement savings.

    SEC. 303. VETERANS TBI BREAKTHROUGH EXPLORATION OF ADAPTIVE CARE
                  OPPORTUNITIES NATIONWIDE ACT.

        (a) Department of Veterans Affairs Grant Program for Supplemental
    Neurorehabilitation Approaches to Chronic Mild TBI Treatment.--
                (1) Grant program.--
                        (A) In general.--The Secretary of Veterans Affairs
                    shall carry out a three-year program (to be known as
                    the ``TBI Innovation Grant Program'') under which the
                    Secretary shall award grants to eligible entities
                    described in paragraph (2) for the development,
                    implementation, and evaluation of approaches and
                    methodologies for prospective randomized control trials
                    for neurorehabilitation treatments for the treatment of
                    chronic mild traumatic brain injury (in this Act
                    referred to as ``mTBI'') in veterans.
                        (B) Relationship to other department activities.--
                    The grant program required under subparagraph (A) shall
                    be carried out in a manner that--
                                (i) supplements, and does not supplant,
                            other clinical care and research of the
                            Department of Veterans Affairs relating to
                            mTBI; and
                                (ii) facilitates, as practicable,
                            coordination with Veterans Health
                            Administration facilities for referral,
                            continuity of care, and dissemination of
                            findings.
                (2) Eligible entities described.--An eligible entity
            described in this paragraph is any of the following:
                        (A) A nonprofit organization with demonstrated
                    capability to conduct clinical trials and to deliver or
                    research effective neurorehabilitation treatments for
                    mTBI, including through patient care delivery.
                        (B) An academic institution that conducts
                    significant research on mTBI and has demonstrated
                    capability to conduct clinical trials relating to
                    neurorehabilitation treatments.
                        (C) A non-Department health care provider with
                    expertise in neurorehabilitative therapies and
                    demonstrated capability to conduct clinical trials and
                    to evaluate mTBI treatments through patient care
                    delivery.
                        (D) A partnership or consortium of two or more
                    entities described in subparagraphs (A) through (C).
                (3) Use of funds.--An eligible entity in receipt of a grant
            under this subsection shall use such grant to support
            activities that include--
                        (A) designing and testing novel or integrative
                    treatments for mTBI that prioritize patient-centered
                    care, including non-pharmacological therapies;
                        (B) conducting clinical studies and assessments to
                    measure the effectiveness of funded approaches to--
                                (i) improve mental health outcomes among
                            veterans;
                                (ii) reduce suicidality, and common risk
                            factors for completing suicide, including
                            depression and substance use disorders among
                            veterans; and
                                (iii) mitigate long-term effects of mTBI
                            and, to the extent outcomes are collected under
                            the applicable clinical protocol, measure
                            durability of outcomes at approximately six
                            months following completion of treatment;
                        (C) providing training for clinicians and outreach
                    to veterans and their families to improve awareness and
                    accessibility of innovative mTBI treatments, including
                    information on available Department resources and
                    pathways to access such resources; and
                        (D) establishing partnerships with community
                    organizations, academic institutions, and health care
                    facilities, including, as practicable, coordination
                    with Veterans Health Administration facilities to
                    facilitate referral of eligible veterans, continuity of
                    care, and dissemination of aggregate findings.
                (4) Limitation on grant amount.--The Secretary may not
            award an eligible entity a grant under this section in an
            amount that exceeds $5,000,000 for any fiscal year.
                (5) Program administration.--
                        (A) Applications.--An eligible entity desiring a
                    grant under this subsection shall submit to the
                    Secretary an application in such form, at such time,
                    and containing such information and assurances as the
                    Secretary determines appropriate, including a detailed
                    description of--
                                (i) activities proposed to be conducted
                            using the grant;
                                (ii) expected outcomes of such activities;
                                (iii) plans for evaluating the
                            effectiveness of such activities;
                                (iv) how the eligible entity will
                            coordinate, as practicable, with Veterans
                            Health Administration facilities for referral
                            and continuity of care for veterans who
                            participate in activities carried out using
                            grant funds, and for dissemination of aggregate
                            findings;
                                (v) the budget of the entity for the use of
                            the grant, including a narrative justification
                            and an identification of the estimated amount
                            of grant funds to be used for administrative or
                            overhead costs; and
                                (vi) assurances of compliance with
                            applicable Federal laws and regulations
                            relating to human subjects protections and
                            patient safety.
                        (B) Priority.--In awarding grants under this
                    subsection, the Secretary shall give priority to
                    eligible entities that have demonstrated the capacity
                    to coordinate with the Department to facilitate
                    referral and continuity of care for veterans who
                    participate in activities carried out using grant
                    funds.
                        (C) Periodic reports.--As a condition of receiving
                    a grant under this section, an eligible entity shall,
                    not less frequently than annually during the grant
                    period and not later than 180 days after the end of the
                    grant period, submit to the Secretary a report that
                    includes, with respect to the period covered by the
                    report--
                                (i) a description of how the eligible
                            entity used such grant;
                                (ii) a summary of the progress of
                            activities funded with amounts from such grant;
                                (iii) measured outcomes relating to such
                            activities;
                                (iv) a detailed accounting of expenditures
                            of grant funds, including administrative or
                            overhead costs;
                                (v) to the extent collected under the
                            applicable clinical protocol or in the ordinary
                            course of care, a description of any adverse
                            events and serious adverse events, including
                            self-harm or suicide-related events; and
                                (vi) a description of actions taken
                            pursuant to the coordination plan described in
                            subparagraph (A)(iv).
                        (D) Oversight; annual evaluations.--The Secretary
                    shall--
                                (i) ensure rigorous oversight of the grant
                            program under this section, including by
                            monitoring financial compliance and timely
                            receipt of the reports required under
                            subparagraph (B); and
                                (ii) on an annual basis until the
                            termination date specified in paragraph (9)(A),
                            evaluate the efficacy of activities carried out
                            using grant funds based on the reports
                            submitted under subparagraph (B) and other
                            appropriate information.
                        (E) Rule of construction.--Nothing in this section
                    shall be construed to authorize the Secretary to
                    require prior approval of, or changes to, any clinical
                    protocol, study design, outcome measures, or follow-up
                    schedule of an eligible entity that receives a grant
                    under this section, except as necessary to ensure
                    compliance with applicable Federal laws and regulations
                    relating to human subjects protections and patient
                    safety.
                        (F) Enforcement authority.--The Secretary may
                    suspend, modify, or terminate a grant awarded under
                    this section, if the Secretary determines that the
                    recipient of such grant has failed to comply with
                    reporting requirements under subparagraph (B) or other
                    applicable terms and conditions of the grant.
                (6) Available amounts; authorization of appropriations.--
                        (A) Available amounts.--The Secretary may carry out
                    the program under this section using amounts available
                    to the Secretary for general mental health care
                    programs, if the use of such amounts supplements, and
                    does not supplant, amounts otherwise available for
                    Department mental health and traumatic brain injury
                    programs.
                        (B) Authorization of appropriations.--There is
                    authorized to be appropriated to the Secretary
                    $10,000,000 for each of fiscal years 2026 through 2028
                    to carry out this section.
                (7) Duration; annual review.--
                        (A) Duration.--The authority of the Secretary to
                    carry out the grant program under this section shall
                    terminate on the date that is three years after the
                    date of the enactment of this Act, except that the
                    Secretary may continue to use amounts made available to
                    carry out this section after such date solely for the
                    purpose of administering activities and obligations
                    incurred before such termination date.
                        (B) Annual review.--During such three-year period,
                    the Secretary shall, on an annual basis, review the
                    effectiveness of the grant program to determine the
                    potential of such grant program for continuation or
                    expansion.
        (b) Department of Veterans Affairs Grant Program for Independent
    Third-party Research Studies and Treatment With Respect to Supplemental
    Neurorehabilitation Treatments for MTBI.--
                (1) Establishment.--The Secretary of Veterans Affairs shall
            establish and carry out a research grant program to award
            grants to eligible entities described in paragraph (2) to be
            used to carry out studies and applied programs on approaches
            and methodologies for the treatment of mTBI in veterans.
                (2) Eligible entities described.--An eligible entity
            described in this paragraph is any of the following:
                        (A) A nonprofit organization that has demonstrated
                    the capability to conduct clinical trials and to
                    evaluate traumatic brain injury treatments through
                    patient care delivery.
                        (B) An academic institution that conducts
                    significant research on traumatic brain injury and has
                    demonstrated the capability to conduct clinical trials
                    relating to neurorehabilitation treatments.
                        (C) A partnership or consortium of two or more
                    entities described in subparagraphs (A) and (B).
                (3) Applications.--An eligible entity desiring a grant
            under this section shall submit to the Secretary an application
            in such form, at such time, and containing such information and
            assurances as the Secretary determines appropriate, including a
            summary of--
                        (A) the research and treatment activities proposed
                    to be carried out using grant funds;
                        (B) the methodology to be used for such activities;
                        (C) the expected outcomes of such activities;
                        (D) how the eligible entity will coordinate, as
                    practicable, with Veterans Health Administration
                    facilities for referral and continuity of care for
                    veterans who participate in activities carried out
                    using grant funds, and for dissemination of aggregate
                    findings;
                        (E) the budget of the entity for the use of the
                    grant, including a narrative justification and an
                    identification of the estimated amount of grant funds
                    to be used for administrative or overhead costs; and
                        (F) assurances of compliance with applicable
                    Federal laws and regulations relating to human subjects
                    protections and patient safety.
                (4) Administration.--
                        (A) Grant categories.--In carrying out the grant
                    program under this subsection, each fiscal year the
                    Secretary shall--
                                (i) subject to the requirement under
                            subparagraph (B), award four grants for
                            exploratory or pilot research and treatment
                            projects, each of which shall be in an amount
                            of not more than $625,000; and
                                (ii) award five grants for collaborative or
                            multidisciplinary research and treatment
                            initiatives, each of which shall be in an
                            amount of not more than $1,500,000.
                        (B) Priority.--Of the grants awarded under
                    subparagraph (A)(i), the Secretary shall award not
                    fewer than three to nonprofit organizations.
                        (C) Enforcement authority.--The Secretary may
                    suspend, modify, or terminate a grant awarded under
                    this subsection, if the Secretary determines that the
                    recipient of such grant has failed to comply with the
                    applicable terms and conditions of the grant.
                (5) Agreement with independent organization.--
                        (A) In general.--The Secretary shall seek to enter
                    into an agreement with an independent organization that
                    is not a component of the Department and that has
                    demonstrated expertise in randomized controlled trials,
                    neurorehabilitation outcomes evaluation, and research
                    integrity, under which the organization agrees to--
                                (i) administer the research grant program
                            under this subsection;
                                (ii) carry out studies and implement
                            efforts that include--
                                        (I) analyzing data from mTBI
                                    treatment methodologies developed
                                    pursuant to the research grant program
                                    to assess the effect, among veterans,
                                    of such methodologies on enhanced brain
                                    health outcomes, mental health, and
                                    long-term recovery, including, to the
                                    extent outcomes are collected under the
                                    applicable clinical protocol,
                                    durability of outcomes at approximately
                                    six months following completion of
                                    treatment;
                                        (II) identifying data-driven best
                                    practices and providing recommendations
                                    for further research or clinical
                                    application, including recommendations
                                    for dissemination to Veterans Health
                                    Administration clinicians and
                                    facilities (as appropriate); and
                                        (III) randomized, controlled
                                    clinical trials to--
                                                (aa) validate and deliver
                                            treatments;
                                                (bb) establish a standard
                                            of care; and
                                                (cc) improve access to such
                                            treatments for veterans;
                                (iii) submit to the Secretary not less
                            frequently than annually a report describing
                            activities carried out under this section,
                            including outcome data and methodology; and
                                (iv) make available to the Secretary all
                            data and findings from the grants made under
                            this section, consistent with applicable
                            Federal law, regulation, and Department
                            policies relating to patient protections, data
                            security, and privacy.
                        (B) Rule of construction.--Nothing in this section
                    shall be construed to authorize the Secretary, or an
                    independent organization that enters into an agreement
                    with the Secretary under subparagraph (A), to require
                    prior approval of, or changes to, any clinical
                    protocol, study design, outcome measures, or follow-up
                    schedule established by an eligible entity that
                    receives a grant under this section, except as
                    necessary to ensure compliance with applicable Federal
                    laws and regulations relating to human subjects
                    protections and patient safety.
                        (C) Report.--An agreement under subparagraph (A)
                    shall include a requirement that the independent
                    organization submits to Congress and the Secretary a
                    comprehensive report that includes--
                                (i) the findings of the studies required
                            under such agreement;
                                (ii) recommendations with respect to the
                            expansion of successful TBI treatment
                            methodologies and standard of care
                            recommendations, if any, developed pursuant to
                            the research grant program; and
                                (iii) to the extent available from the
                            reports and study materials of grant
                            recipients, a summary of--
                                        (I) the durability of outcomes at
                                    approximately six months following
                                    completion of treatment, if collected
                                    under the applicable clinical protocol;
                                        (II) adverse events and serious
                                    adverse events, including self-harm or
                                    suicide-related events, if collected
                                    under the applicable clinical protocol
                                    or in the ordinary course of care; and
                                        (III) aggregate expenditures of
                                    grant funds, including administrative
                                    or overhead costs.
                        (D) Surveys.--The Secretary may conduct surveys of
                    any independent organization that enters into an
                    agreement with the Secretary under subparagraph (A) in
                    order to assess the effectiveness of such organization
                    in administering the research grant program under this
                    subsection.
                (6) Available amounts; authorization of appropriations.--
                        (A) Available amounts.--The Secretary may use
                    amounts available to the Secretary for the operating
                    budget of the National Center for Posttraumatic Stress
                    Disorder to carry out the research grant program under
                    this subsection, if the use of such amounts
                    supplements, and does not supplant, amounts otherwise
                    available for Department programs and services.
                        (B) Authorization of appropriations.--There is
                    authorized to be appropriated to the Secretary
                    $10,000,000 for each of fiscal years 2026 through 2028
                    to carry out this subsection.
                (7) Termination date.--The authority of the Secretary to
            carry out the research grant program under this section shall
            terminate on the date that is three years after the date of the
            enactment of this Act.
        (c) Reports to Congress.--Not later than two years after the date
    on which the Secretary commences the research grant program under
    subsection (a), and on an annual basis thereafter until the termination
    date specified in paragraph (8) of such subsection, the Secretary shall
    submit to Congress a report on the grant programs under subsections (a)
    and (b). Each such report shall include--
                (1) the findings of the studies under subsection (a)(6)(B);
                (2) a description of any agreement entered into by the
            Secretary under subsection (b)(5)(A);
                (3) recommendations of the Secretary with respect to policy
            and programmatic improvements to services of the Department to
            treat mTBI among veterans;
                (4) any findings derived from surveys conducted under
            subsection (b)(5)(D), including any recommendations of the
            Secretary for improvements to the structure, oversight,
            administration, or performance of the independent organization
            that enters into an agreement with the Secretary under
            subsection (b)(5)(A); and
                (5) such other matters as the Secretary determines
            appropriate.
        (d) Definitions.--In this section:
                (1) The terms ``chronic mild traumatic brain injury'' and
            ``mTBI'' mean a mild traumatic brain injury with symptoms that
            persist for not fewer than six months after the inciting
            injury, as determined using validated clinical criteria.
                (2) The term ``nonprofit organization''--
                        (A) means an organization described in section
                    501(c)(3) of the Internal Revenue Code of 1986 and
                    exempt from taxation under section 501(a) of such Code;
                    and
                        (B) includes such an organization that is a
                    hospital, nonprofit health system, academic medical
                    center, or clinic that delivers neurorehabilitation
                    care or conducts clinical research relating to mTBI.
                (3) The term ``veteran'' has the meaning given such term in
            section 101 of title 38, United States Code.

    SEC. 304. DEPARTMENT OF VETERANS AFFAIRS ASSIGNMENT OF TRAVELING
                  PHYSICIANS TO SERVE TERRITORIES AND POSSESSIONS.

        (a) In General.--Subchapter I of chapter 74 of title 38, United
    States Code, is amended by adding at the end the following new section:
    ``Sec. 7415. Traveling physicians
        ``(a) In General.--(1) The Secretary may assign a physician
    appointed under section 7401 or section 7431 of this title to serve as
    a traveling physician for a period of not more than one year at a time.
    A physician assigned to serve as a traveling physician under this
    section may be assigned to provide health care to veterans residing in
    American Samoa, Guam, the Commonwealth of the Northern Mariana Islands,
    the Commonwealth of Puerto Rico, the Virgin Islands of the United
    States, or any other territory or possession of the United States at
    Department facilities or other approved facilities located in such
    territory or possession.
        ``(2) The Secretary may assign multiple physicians to serve as
    traveling physicians under this section and may assign each such
    physician to serve in a specific territory or possession.
        ``(b) Coordination of Care.--In providing care under this section,
    traveling physicians shall coordinate with non-Department medical
    providers to the extent practicable and necessary to ensure high
    quality and coordinated care for veterans receiving hospital care and
    medical services.
        ``(c) Pay.--In addition to pay under section 7431 of this title,
    the Secretary shall provide a relocation or retention bonus to
    traveling physicians under this section. Such relocation or retention
    bonus shall be substantially similar to a relocation or retention bonus
    offered under section 7410(a) of this title, as the Secretary considers
    appropriate.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    such chapter is amended by inserting after the item relating to section
    7414 the following new item:

    ``7415. Traveling physicians.''.
        (c) Technical and Conforming Amendments.--Title 38, United States
    Code, is further amended as follows:
                (1) In section 7410(a)(1), by--
                        (A) by striking ``retention allowances'' and
                    inserting ``retention bonuses''; and
                        (B) by striking the second comma after ``section
                    7401(1) of this title''; and
                (2) In section 7431(e)(5)(B), by striking ``retention
            allowances'' and inserting ``retention bonuses''.

    SEC. 305. INCLUSION OF ADAPTIVE PROSTHESES AND TERMINAL DEVICES FOR
                  SPORTS AND OTHER RECREATIONAL ACTIVITIES IN MEDICAL
                  SERVICES FURNISHED TO ELIGIBLE VETERANS BY THE SECRETARY
                  OF VETERANS AFFAIRS.

        Section 1701 of title 38, United States Code, is amended, in
    paragraph (6)(F)(i), by inserting ``(including adaptive prostheses and
    terminal devices for sports and other recreational activities that are
    determined to be clinically appropriate by the Secretary)'' after
    ``artificial limbs''.

    SEC. 306. MODIFICATIONS TO AND REAUTHORIZATION OF STAFF SERGEANT PARKER
                  GORDON FOX SUICIDE PREVENTION GRANT PROGRAM OF DEPARTMENT
                  OF VETERANS AFFAIRS.

        (a) Coordination by Secretary.--Subsection (b) of section 201 of
    the Commander John Scott Hannon Veterans Mental Health Care Improvement
    Act of 2019 (Public Law 116-171; 38 U.S.C. 1720F note) is amended by
    striking the second sentence.
        (b) Use of Grant Funds.--Subsection (c) of such section is
    amended--
                (1) in the subsection heading, by inserting ``; Use of
            Grant Funds'' after ``Grants''; and
                (2) by adding at the end the following new paragraphs:
                ``(3) Renewal of grant amounts.--
                        ``(A) In general.--In determining whether to renew
                    a grant awarded under this section to an eligible
                    entity, the Secretary shall consider, among such other
                    factors as the Secretary may consider appropriate--
                                ``(i) the compliance by the eligible entity
                            in administering pre- and post-intervention
                            assessments required under subsection (e)(6);
                            and
                                ``(ii) any demonstrated improvements in
                            participant outcomes.
                        ``(B) Additional amounts.--Based on a consideration
                    of the factors described in subparagraph (A), the
                    Secretary may award amounts, not to exceed $250,000 per
                    grantee per fiscal year, to a grantee in addition to
                    the maximum amount under paragraph (2)(A) based on a
                    performance-based metric established by the
                    Secretary.''.
        (c) Priority for New Recipients.--Subsection (d) of such section is
    amended--
                (1) in the subsection heading, by striking ``and
            Preference'' and inserting ``, Preference, and Priority'';
                (2) in paragraph (1)(A)--
                        (A) in clause (iv), by striking the semi-colon at
                    the end and inserting ``; and'';
                        (B) by striking clause (v); and
                        (C) by redesignating clause (vi) as clause (v); and
                (3) by adding at the end the following new paragraph:
                ``(3) Priority for new recipients.--To the maximum extent
            practicable, the Secretary shall prioritize grants for eligible
            entities that have satisfied the requirements provided under
            subsection (f) and are located in States in which a grant has
            not been awarded under this section.''.
        (d) Requirements for Receipt of Grants.--Subsection (e) of such
    section is amended--
                (1) in paragraph (3)--
                        (A) by redesignating subparagraphs (B) and (C) as
                    subparagraphs (C) and (D), respectively; and
                        (B) by inserting after subparagraph (A) the
                    following new subparagraph (B):
                        ``(B) coordinate with the Secretary to develop a
                    plan for communication between the entity and local
                    mental health providers of the Department regarding
                    whether veterans receiving assistance under this
                    section from the entity are attending appointments to
                    ensure continuity of care;''; and
                (2) by adding at the end the following new paragraph:
                ``(6) Assessments.--An eligible entity receiving a grant
            under this section shall conduct a pre- and post-intervention
            assessment with respect to each eligible individual who
            receives suicide prevention services pursuant to such grant
            across all relevant metrics, as determined by the Secretary.
                ``(7) Metrics and outcomes.--An eligible entity receiving a
            grant under this section shall collect and submit to the
            Secretary such metrics and outcome data as the Secretary may
            require, including--
                        ``(A) throughput measures, including the number of
                    veterans screened, referred, connected to care, and
                    retained in services under the grant program;
                        ``(B) reductions in severity scale measurements,
                    including reductions in suicidality identified through
                    applicable inventories or assessments; and
                        ``(C) such other quantifiable metrics as the
                    Secretary determines appropriate.''.
        (e) Training and Technical Assistance.--Subsection (g) of such
    section is amended--
                (1) in paragraph (1)--
                        (A) in the matter preceding subparagraph (A), by
                    inserting ``, or interested in receiving such grants,''
                    after ``this section''; and
                        (B) in subparagraph (A), by inserting ``, including
                    training on how to properly use the Columbia Protocol
                    (also known as the Columbia-Suicide Severity Rating
                    Scale (C-SSRS)) and other screening tools selected by
                    the Secretary'' after ``management''; and
                (2) by adding at the end the following new paragraphs:
                ``(3) Training for department employees.--The Secretary
            shall provide training to employees of the Department as the
            Secretary considers appropriate on the grant program under this
            section.''.
        (f) Briefing for Local VAMCS.--Subsection (h) of such section is
    amended by adding at the end the following new paragraph:
                ``(5) Briefing for local vamcs.--Not less frequently than
            once per year, unless the Secretary determines that such
            frequency is not advisable, the Secretary shall provide, to the
            appropriate personnel of each medical center of the Department
            identified on the grantee's application under this section, a
            briefing about the grant program under this section in order to
            improve coordination between such recipient and personnel.''.
        (g) Duration.--Subsection (j) of such section is amended by
    striking ``September 30, 2026'' and inserting ``September 30, 2029''.
        (h) Reports.--Subsection (k)(2) is amended--
                (1) in the paragraph heading, by striking ``Final report''
            and inserting ``Annual reports''; and
                (2) in subparagraph (B)--
                        (A) by redesignating clauses (iii) and (iv) as (v)
                    and (vi), respectively; and
                        (B) by adding the following new clauses (iii) and
                    (iv):
                                ``(iii) A description of the Secretary's
                            compliance with the requirement to train
                            employees of the Department under subsection
                            (g)(3).
                                ``(iv) An optional description and
                            inclusion of subjective or narrative stories of
                            community or individual impact to allow grant
                            recipients to share meaningful
                            accomplishments.''.
        (i) Referral for Care.--Subsection (m) of such section is amended
    by adding at the end the following new paragraph:
                ``(4) Required response or action.--(A) If the Secretary
            receives a referral under paragraph (1) for additional care,
            the Secretary shall review such referral and contact the
            veteran not later than 72-hours following the referral.
                ``(B) If the Secretary receives a referral under paragraph
            (2) for emergent suicide care, the Secretary shall review such
            referral and contact the veteran not later than 24 hours
            following the referral by such entity under subsection
            (m)(1).''.
        (j) Reauthorization.--Subsection (p) of such section is amended--
                (1) by striking ``section a total'' and inserting
            ``section--
                ``(1) a total'';
                (2) by striking the period at the end and inserting ``;
            and''; and
                (3) by adding at the end the following new paragraph:
                ``(2) a total of $200,000,000 for fiscal years 2027 through
            2029.''.
        (k) Technical Correction to Definitions.--Subsection (q)(5) of such
    section is amended, in the first sentence--
                (1) by striking ``Medical services'' and inserting ``The
            term `emergency treatment' means medical services''; and
                (2) by striking ``was rendered'' and inserting
            ``rendered''.
        (l) Identification of Demand for Other Services and Support.--
    Subsection (e) of such section, as amended, is further amended--
                (1) by redesignating paragraphs (5) and (6) as (6) and (7),
            respectively; and
                (2) by adding after paragraph (4) the following new
            paragraph:
                ``(5) Demand for other services and support.--An entity
            receiving a grant under this section shall submit to the
            Secretary information concerning--
                        ``(A) the number of individuals seeking services
                    from the entity who are not eligible individuals and
                    the most common reason such individuals are not
                    eligible individuals;
                        ``(B) a description of the types of services that
                    eligible individuals or individuals described in
                    subparagraph (A) require based on any screening
                    conducted by the entity; and
                        ``(C) any actions taken by the entity to provide
                    the services described in subparagraph (B) or to refer
                    the individual or eligible individual to another entity
                    for the receipt of such services.''.
        (m) Suicide Prevention Services.--
                (1) Required use of certain screening protocol.--Subsection
            (q)(11)(A)(ii) of such section is amended by adding at the end
            the following new sentence: ``In the case of a recipient of a
            grant awarded under this section on or after the date of the
            enactment of the Take Care of America's Veterans Act, such
            screening shall be Columbia Protocol (also known as the
            Columbia-Suicide Severity Rating Scale (C-SSRS)) or the Patient
            Health Questionnaire-9 (PHQ9), or a successor screening tool
            selected by the Secretary.'';
                (2) Transportation.--Subsection (q)(11)(A) of such section
            is amended--
                        (A) by redesignating clause (xi) as clause (xii);
                    and
                        (B) by inserting after clause (x) the following new
                    clause:
                                ``(xi) Transportation and rideshare
                            services for eligible individuals to use for
                            appointments.''.
        (n) Eligible Individuals.--Subsection (q)(4)(C) of such section is
    amended by striking ``clauses (i) through (iv)'' and inserting
    ``clauses (i) through (vi)''.
        (o) Effective Date.--The amendments made by this section shall take
    effect on--
                (1) the effective date of award following the date the
            Secretary publishes a notice of funding opportunity for the
            program required by section 201(a) of the Commander John Scott
            Hannon Veterans Mental Health Care Improvement Act of 2019
            (Public Law 116-171; (38 U.S.C. 1720F)), if the Secretary
            determines such amendments do not require rulemaking; or
                (2) the effective date of award following the date the
            Secretary publishes a notice of funding opportunity following
            the effective date of subsequent rulemaking, if the Secretary
            determines such amendments do require rulemaking.

    SEC. 307. REPORTS ON THE USE OF HYPERBARIC OXYGEN THERAPY.

        (a) GAO Report on the Use of Hyperbaric Oxygen Therapy to Treat
    Traumatic Brain Injury and Post-traumatic Stress Disorder.--Not later
    than one year after the date of the enactment of this Act, the
    Comptroller General of the United States shall submit to the Committees
    on Veterans' Affairs of the Senate and House of Representatives an
    update to the report titled ``Research on Hyperbaric Oxygen Therapy to
    Treat Traumatic Brain Injury and Post-Traumatic Stress Disorder'' (GAO-
    16-154). Such report shall include the assessment of the Comptroller
    General of clinical trials conducted, since the publication of such
    report--
                (1) regarding the use of hyperbaric oxygen therapy to treat
            traumatic brain injury and post-traumatic stress disorder; and
                (2) by--
                        (A) the Secretary of Veterans Affairs;
                        (B) the Secretary of Defense; and
                        (C) private entities.
        (b) Follow-up Study.--
                (1) In general.--Not later than 180 days after the date of
            the enactment of this Act, the Secretary shall conduct a
            systematic review of published research literature on the off-
            label use of hyperbaric oxygen therapy to treat post-traumatic
            stress disorder and traumatic brain injury among veterans and
            nonveterans.
                (2) Elements.--The review conducted under paragraph (1)
            shall include the following:
                        (A) An analysis of available research literature
                    published after the review completed pursuant to
                    section 702 of the Commander John Scott Hannon Veterans
                    Mental Health Care Improvement Act (Public Law 116-
                    171);
                        (B) An assessment of the current parameters for
                    research on the use by the Department of Veterans
                    Affairs of hyperbaric oxygen therapy, including--
                                (i) tests and questionnaires used to
                            determine the efficacy of such therapy; and
                                (ii) metrics for determining the success of
                            such therapy.
                        (C) A comparative analysis of tests and
                    questionnaires used to study post-traumatic stress
                    disorder and traumatic brain injury in other research
                    conducted by the Department of Veterans Affairs, other
                    Federal agencies, and entities outside the Federal
                    Government.
                        (D) A market assessment of available hyperbaric
                    oxygen therapy facilities or units within facilities to
                    assess the most effective locations and practices,
                    including--
                                (i) an analysis of whether multi-person
                            chambers could reduce per-veteran costs;
                                (ii) an analysis of areas with lower prices
                            compared to a national average; and
                                (iii) an identification of not fewer than
                            two VISNs in which the provision or furnishing
                            of hyperbaric oxygen therapy would benefit the
                            most number of veterans at the lowest cost to
                            the Department.

    SEC. 308. DEPARTMENT OF VETERANS AFFAIRS PILOT PROGRAM TO PROVIDE
                  GRANTS TO MENTAL HEALTH CARE PROVIDERS FOR THE PROVISION
                  OF MENTAL HEALTH CARE FOR VETERANS.

        (a) Establishment.--The Secretary of Veterans Affairs shall carry
    out a three-year pilot program under which the Secretary shall make
    grants to eligible mental health care providers for the provision of
    mental health care, including evidence-based mental health care
    delivered in person or via telehealth.
        (b) Eligibility.--To be eligible to receive a grant under the pilot
    program, a mental health care provider shall--
                (1) be a non-profit organization;
                (2) have operated at least one outpatient mental health
            facility in the United States for a continuous period of at
            least three years;
                (3) be licensed or certified under applicable state law to
            provide outpatient mental health services;
                (4) be accredited by--
                        (A) the Joint Commission on Accreditation of
                    Healthcare Organizations;
                        (B) the Commission on Accreditation of
                    Rehabilitation Facilities; or
                        (C) any other nationally recognized accrediting
                    body the Secretary determines appropriate; and
                (5) submit to the Secretary an application that includes
            such information and assurances as the Secretary may require,
            including--
                        (A) an identification of the outpatient facility or
                    facilities where the mental health care services will
                    be provided;
                        (B) a plan for providing clinicians at each
                    facility in receipt of grant funds with units of
                    continuing education with respect to veterans issues;
                    and
                        (C) an identification of the percentage of the
                    operating budget for each such facility that was
                    provided through Federal grants during the fiscal year
                    preceding the year during which the application is
                    submitted.
        (c) Use of Funds.--
                (1) In general.--The recipient of a grant under the pilot
            program shall use the grant--
                        (A) to deliver evidence-based mental health care
                    for veterans in person or via telehealth.
                        (B) to operate or expand an existing outpatient
                    mental health facility or establish a new outpatient
                    mental health facility for the purpose of providing
                    such care;
                        (C) to encourage veterans who are eligible for
                    enrollment in the patient enrollment system under
                    section 1705 of title 38, United States Code, to enroll
                    in such system and to receive medical services
                    furnished by the Department of Veterans Affairs;
                        (D) to support activities necessary to deliver or
                    sustain care, including--
                                (i) outreach;
                                (ii) care coordination;
                                (iii) veteran engagement;
                                (iv) clinician training;
                                (v) implementation support; and
                                (vi) program evaluation; and
                        (E) to support continuous quality improvement and
                    outcomes measurement activities, including the
                    collection and reporting of clinical outcomes and
                    operational metrics; and
                        (F) to support activities of the program that are
                    not billable, reimbursable, or otherwise authorized by
                    law, including--
                                (i) outreach;
                                (ii) care coordination;
                                (iii) engagement;
                                (iv) implementation support; and
                                (v) program evaluation; and
                        (G) to provide services to individuals for which
                    reimbursement is not otherwise available, including
                    such individuals who are--
                                (i) uninsured;
                                (ii) ineligible for health care furnished
                            by the Department of Veterans Affairs; or
                                (iii) in receipt of health care that is not
                            reimbursable as of the date of the enactment of
                            this Act.
                (2) Limitations on use of grant funds.--The recipient of a
            grant under the pilot program may not--
                        (A) charge an eligible veteran a fee associated
                    with the receipt of mental health care funded by such
                    grant;
                        (B) refuse to provide mental health care to an
                    eligible veteran on the basis that the veteran is not
                    eligible for reimbursement for such care under another
                    payer source; or
                        (C) use grant funds to--
                                (i) duplicate payments made under any
                            contract or agreement to which the Department
                            is a party as of the date of the enactment of
                            this Act; or
                                (ii) pay for the same clinical services or
                            service units that are otherwise billable to a
                            Federal payer, including the Veterans Community
                            Care Program under section 1703 of title 38,
                            United States Code, or any other public or
                            private health plan.
                (3) Rules of construction.--Nothing in this subsection may
            be construed to--
                        (A) prohibit a grant recipient from seeking
                    reimbursement from non-Department payers for mental
                    health services provided by the grant recipient, except
                    that grant funds shall not be used to supplant or
                    duplicate a reimbursement otherwise available under
                    Federal law; or
                        (B) authorize double billing or duplicate payments
                    for the same clinical service or unit of service.
                (4) Spouse and dependent care.--A recipient may use grant
            funds to provide care to spouses and dependent children of a
            veteran when such services are integral to achieving a
            successful clinical outcome. Permissible services include--
                        (A) family therapy;
                        (B) couples therapy;
                        (C) group therapy;
                        (D) family psychoeducation; and
                        (E) other counseling services the Secretary
                    determines are clinically necessary.
        (d) Selection of Facilities.--In awarding grants under the pilot
    program, the Secretary--
                (1) shall ensure that grants are distributed geographically
            evenly among rural and urban areas;
                (2) may consider the proportion of veterans historically
            served by the grant recipient; and
                (3) may prioritize outpatient mental health facilities
            located in areas that the Secretary determines--
                        (A) are medically underserved;
                        (B) have large veteran populations;
                        (C) are located near military installations; or
                        (D) have large numbers of veterans at high risk of
                    suicide.
        (e) Amount of Grant.--
                (1) In general.--
                        (A) In general.--Except as provided in subparagraph
                    (B), no grant under the pilot program for a facility
                    for any fiscal year may exceed $1,500,000.
                        (B) Limitation.--In the case of an outpatient
                    mental health facility for which at least 50 percent of
                    the operating budget of the facility for the preceding
                    fiscal year was provided through Federal grants, no
                    grant under the pilot program for the facility for any
                    fiscal year may exceed the lesser of--
                                (i) 50 percent of the operating budget of
                            the facility; or
                                (ii) $1,500,000.
                (2) Multiple grants.--The recipient of a grant under the
            pilot program--
                        (A) may apply for, and receive, grants for more
                    than one facility of the recipient for any fiscal year;
                    and
                        (B) may apply for, and receive, a grant for a
                    facility that has already received a grant under the
                    pilot program.
        (f) Regulations; Accountability.--The Secretary shall prescribe
    regulations to carry out this section, which shall include a
    requirement that each recipient of a grant under the pilot program
    shall--
                (1) demonstrate the capacity to provide accountability;
                (2) demonstrate clinical outcomes;
                (3) justify the effective use of any private investment
            funds or Federal grant funds through data collection and
            reporting metrics; and
                (4) collect standardized outcome measures including symptom
            improvement and program completion.
        (g) Continuity of Care.--A recipient of a grant under the pilot
    program shall adhere to the continuity of care model established by the
    Secretary to the Veterans Community Care Program.
        (h) Report.--Not later than 180 days after the completion of the
    pilot program under this section, the Secretary shall submit to
    Congress a report on the pilot program that includes the following:
                (1) The number of veterans who received mental health care
            under the program.
                (2) An identification of the types of mental health care
            provided and the time period for which such care was provided.
                (3) An identification and summary of program outcomes.
                (4) The number of veterans who received mental health care
            under the program and subsequently enrolled in the patient
            enrollment system under section 1705 of title 38, United States
            Code.
                (5) An identification of any obstacles faced by grant
            recipients in providing mental health care under the program.
                (6) A summary of clinical outcomes based on pre- and post-
            client functioning--
                        (A) the number of veterans who improved clinically
                    based on relevant clinical evaluation metrics that the
                    Secretary determines appropriate;
                        (B) the degree of clinical improvement based on
                    such relevant clinical evaluation metrics;
                        (C) the total number of veterans participating in
                    the program; and
                        (D) any other outcome metrics as the Secretary
                    determines appropriate.
                (7) Findings with respect to the sustainability of the
            program.
        (i) Authorization of Appropriations.--There is authorized to be
    appropriated to the Secretary to carry out the pilot program under this
    section $20,000,000 for each of fiscal years 2027 through 2029.

    SEC. 309. FURNISHING OF CERTAIN HEALTH SERVICES TO VETERANS IN THE
                  FREELY ASSOCIATED STATES.

        (a) Requirement to Furnish Certain Health Services to Veterans in
    the Freely Associated States.--
                (1) Agreements required.--Consistent with section 1724(f)
            of title 38, United States Code, and section 209(a)(4)(A) of
            the Compact of Free Association Amendments Act of 2024 (48
            U.S.C. 1988(a)(4)(A)), the Secretary of Veterans Affairs shall
            work expeditiously with the governments of the Freely
            Associated States to enter into the agreements described in
            such sections.
                (2) Inclusion of telehealth and mail order pharmacy
            services required.--Consistent with such sections and with the
            agreements required by paragraph (1), the Secretary shall
            furnish to veterans in the Freely Associated States services
            that include, at a minimum--
                        (A) medical services authorized to be provided
                    under chapter 17 of title 38, United States Code, which
                    can be administered through telehealth; and
                        (B) pharmaceutical products authorized to be
                    provided under such chapter, delivered by mail.
                (3) Implementation dates.--In carrying out paragraphs (1)
            and (2), the Secretary shall--
                        (A) initiate outreach to each such government not
                    later than 30 days after the date of the enactment of
                    this Act;
                        (B) enter into each agreement required by paragraph
                    (1) not later than one year after the date of the
                    enactment of this Act; and
                        (C) begin furnishing the services required by
                    subparagraphs (A) and (B) of paragraph (2) not later
                    than one year after the date of the enactment of this
                    Act.
                (4) Beneficiary travel.--Section 111(h)(1) of title 38,
            United States Code, is amended by striking ``the Secretary may
            make payments'' and inserting ``beginning not later than one
            year after the date of the enactment of the Take Care of
            America's Veterans Act, the Secretary shall make payments''.
                (5) Reports.--Not less frequently than quarterly, the
            Secretary shall submit to the appropriate committees of
            Congress a report on the implementation of this section and the
            cost of such implementation. Until the Secretary has entered
            into the agreements required by paragraph (1) and begun
            furnishing the services required by subparagraphs (A) and (B)
            of paragraph (2), the report shall also describe the technical
            and logistical factors that have prevented or impeded the
            Secretary from doing so.
                (6) Definitions.--In this subsection:
                        (A) Appropriate committees of congress.--The term
                    ``appropriate committees of Congress'' means--
                                (i) the Committee on Veterans' Affairs and
                            the Committee on Appropriations of the Senate;
                            and
                                (ii) the Committee on Veterans' Affairs and
                            the Committee on Appropriations of the House of
                            Representatives.
                        (B) Freely associated states.--The term ``Freely
                    Associated States'' has the meaning given such term in
                    section 1724(f) of title 38, United States Code.
        (b) Assignment of Traveling Physicians to Serve Veterans in Freely
    Associated States.--
                (1) In general.--Subchapter I of chapter 74 of title 38,
            United States Code, is amended by adding at the end the
            following new section:
    ``Sec. 7415. Traveling physicians for veterans in Freely Associated
                  States
        ``The Secretary may assign a physician appointed under section 7401
    of this title to serve as a traveling physician for a period of not
    more than one year. A traveling physician shall provide health care to
    veterans residing in the Freely Associated States (as defined in
    section 1724(f) of this title).''.
                (2) Clerical amendment.--The table of sections at the
            beginning of such chapter is amended by inserting after the
            item relating to section 7414 the following new item:

    ``7415. Traveling physicians for veterans in Freely Associated
                                States.''.

    SEC. 310. MODIFICATION OF PRECISION MEDICINE FOR VETERANS INITIATIVE;
                  REPORTING ON SUICIDE BY VETERANS AND MEMBERS OF THE ARMED
                  FORCES.

        (a) Modification of Precision Medicine for Veterans Initiative.--
    Section 305 of the Commander John Scott Hannon Veterans Mental Health
    Care Improvement Act of 2019 (Public Law 116-171; 38 U.S.C. 1712A note)
    is amended--
                (1) in subsection (a), by striking ``and such other mental
            health conditions'' and inserting ``repetitive low-level blast
            exposure, dementia, and such other brain and mental health
            conditions'';
                (2) in subsection (d)(4), by adding at the end the
            following new subparagraph:
                        ``(E) Data-sharing partnership.--
                                ``(i) In general.--The Secretary shall work
                            with the Secretary of Defense to establish a
                            data-sharing partnership between the Department
                            of Veterans Affairs and the Department of
                            Defense.
                                ``(ii) Storage.--The partnership
                            established under clause (i) shall be stored in
                            the open platform made available under this
                            paragraph.
                                ``(iii) Data.--The data supplied by the
                            Secretary of Defense under the partnership
                            established under clause (i) shall include
                            relevant data throughout the Department of
                            Defense relating to low-level repetitive blast
                            exposure and traumatic brain injury collected
                            by the Armed Forces and other appropriate
                            entities, as determined jointly by the
                            Secretary of Defense and the Secretary of
                            Veterans Affairs.''; and
                (3) by adding at the end the following new subsections:
        ``(f) Repetitive Low-level Blast Exposure Research.--In carrying
    out the initiative under subsection (a), the Secretary shall prioritize
    research--
                ``(1) to identify and validate biomarkers associated with
            repetitive low-level blast exposure and traumatic brain injury;
                ``(2) to evaluate clinical and non-clinical interventions
            that improve cognitive function, quality of life, and mental
            health outcomes among veterans with symptoms associated with
            repetitive low-level blast exposure;
                ``(3) to improve the diagnosis, treatment, and care
            coordination for veterans with a history of low-level
            repetitive blast exposure or traumatic brain injury, including
            veterans who performed duties or tasks associated with
            increased risk of low-level repetitive blast exposure; and
                ``(4) to develop evidence-based strategies to reduce
            suicide risk among veterans with a history of low-level
            repetitive blast exposure or traumatic brain injury.
        ``(g) Assistance and Report by National Academies of Sciences,
    Engineering, and Medicine.--Not later than 180 days after the date of
    the enactment of the Take Care of America's Veterans Act, the Secretary
    of Veterans Affairs shall seek to enter into a contract with the
    National Academies of Sciences, Engineering, and Medicine under which
    the National Academies shall--
                ``(1) work in tandem with the initiative under subsection
            (a) on validation of brain and mental health biomarkers among
            veterans; and
                ``(2) not less frequently than once every two years, 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 work completed under paragraph (1).
        ``(h) Assessment.--
                ``(1) In general.--The Secretary of Veterans Affairs shall
            conduct an assessment of all translational research studies in
            progress and planned under the initiative under subsection (a),
            including research under subsection (f).
                ``(2) Report.--Not later than 60 days after completion of
            the assessment 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 assessment.
        ``(i) Reports.--
                ``(1) In general.--Not less frequently than once every two
            years, the Secretary of Veterans Affairs shall submit to the
            Committee on Veterans' Affairs of the Senate and the Committee
            on Veterans' Affairs of the House of Representatives a report
            on the initiative under subsection (a).
                ``(2) Recommendations.--Each report required by paragraph
            (1) may include recommendations for immediate administrative
            and legislative action to improve the initiative under
            subsection (a).
        ``(j) Authorization of Appropriations.--There is authorized to be
    appropriated to the Secretary of Veterans Affairs $5,000,000 to carry
    out the initiative under subsection (a) for each of fiscal years 2027
    through 2032.''.
        (b) Inclusion of Information in Reports on Suicide Prevention Among
    Veterans and Members of the Armed Forces.--
                (1) Inclusion of information in national veteran suicide
            prevention annual report.--Section 149(a)(4)(B) of the Senator
            Elizabeth Dole 21st Century Veterans Healthcare and Benefits
            Improvement Act (Public Law 118-210; 38 U.S.C. 1709B note) is
            amended by adding at the end the following:
                                ``(iv) Military occupation data of veterans
                            who attempt or commit suicide.''.
                (2) Inclusion of information in department of defense
            annual report.--The Secretary of Defense shall include in the
            annual report of the Defense Suicide Prevention Office, or
            successor office, information on--
                        (A) occupational data of members of the Armed
                    Forces who attempt suicide; and
                        (B) outcomes of suicide prevention interventions
                    among members of the Armed Forces.

    SEC. 311. ESTABLISHMENT OF THE BLAST OVERPRESSURE TASK FORCE OF THE
                  DEPARTMENT OF VETERANS AFFAIRS.

        (a) Establishment.--Not later than 180 days after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall appoint,
    through the Department of Veterans Affairs-Department of Defense Joint
    Executive Committee under section 320 of title 38, United States Code,
    the Blast Overpressure Task Force of the Department of Veterans Affairs
    (in this section referred to as the ``Task Force'').
        (b) Membership.--Each member of the Task Force appointed under
    subsection (a) shall be a member of the Health Executive Committee
    under subsection (b)(2) of such section who, at the time of
    appointment, is involved in research regarding the mitigation and
    treatment of blast overpressure or blast exposure.
        (c) Duties.--The duties of the Task Force are the following:
                (1) To improve how the Secretary of Veterans Affairs, in
            consultation with the Secretary of Defense, provides health
            care and other benefits to veterans or members of the Armed
            Forces diagnosed with traumatic brain injury, post-traumatic
            stress disorder, or other symptoms, from blast overpressure or
            blast exposure.
                (2) To align research agendas and acquisition strategies of
            the Department regarding such health care.
                (3) To establish physiological and cognitive performance
            baselines for such veterans and members.
                (4) To prioritize translational research regarding such
            veterans and members, including research regarding--
                        (A) sleep therapy;
                        (B) blast-related gut health;
                        (C) mobile diagnostics;
                        (D) vestibular dysfunction and balance impairment;
                        (E) autonomic nervous system dysregulation;
                        (F) cumulative mild traumatic brain injury;
                        (G) neuroinflammation and glial activation; and
                        (H) any other issue determined appropriate by the
                    Secretary.
                (5) To monitor sensory decline (including with regards to
            vision, hearing, and vestibular function) and stress-related
            impairments among such veterans and members.
                (6) To support continuity of such care by integrating
            mobile and longitudinal diagnostic tools.
        (d) Reports.--The Task Force shall issue annual reports to the
    Committees on Veterans' Affairs and on Armed Services of the Senate and
    House of Representatives. Each such report shall include the following
    elements:
                (1) Details of research initiatives, coordination outcomes,
            and clinical advancements of the Task Force.
                (2) Recommendations of the Task Force regarding--
                        (A) how claims processors of the Department of
                    Veterans Affairs should evaluate evidence that links
                    such conditions to active military, naval, air, or
                    space service; and
                        (B) best practices regarding the evaluation of
                    neurological injuries in examinations for benefits
                    under chapters 11 or 15 of title 38, United States
                    Code.
        (e) Sunset.--The Task Force shall terminate on September 30, 2029.

    SEC. 312. EXTENSION OF SHARING OF DEPARTMENT OF VETERANS AFFAIRS AND
                  DEPARTMENT OF DEFENSE HEALTH CARE RESOURCES; RESOURCE
                  SHARING OVERSIGHT AND IMPLEMENTATION PLAN.

        (a) Extension.--Section 8111(d)(3) of title 38, United States Code,
    is amended by striking ``September 30, 2026'' and inserting ``September
    30, 2027''.
        (b) Oversight.--
                (1) Justification.--Such section is further amended in
            subsection (a)--
                        (A) by inserting ``(1)'' before ``To the maximum
                    extent practicable, the Secretary''; and
                        (B) by adding at the end the following new
                    paragraph:
                ``(2) If the Secretary of Veterans Affairs elects not to
            enter into such an agreement or contract, notwithstanding
            paragraph (1), the Secretary and the Department of Veterans
            Affairs-Department of Defense Joint Executive Committee shall
            submit to the Committees on Veterans' Affairs of the House of
            Representatives and the Senate a written justification for such
            election.''.
                (2) Form of information.--If the Committee on Veterans'
            Affairs of the House of Representatives or the Senate requests
            information from the Secretary of Veterans Affairs regarding
            section 8111 of title 38, United States Code, the Secretary
            shall provide such information in the form requested by such
            committee, including underlying records, datasets,
            methodologies, contracts, and communications, and may not be
            limited to summaries or briefing materials in lieu of original
            source documents unless authorized by the requesting committee.
                (3) Interference with transmission of information.--In
            response to such a request, no official or employee of the
            Department of Veterans Affairs shall--
                        (A) withhold, screen, or alter responsive
                    information;
                        (B) delay or condition production on initial
                    clearance or political review;
                        (C) require a nondisclosure agreement unless
                    required by law;
                        (D) substitute summaries for requested 2 records;
                    or
                        (E) otherwise impede or interfere with direct
                    transmission of information to the Committee on
                    Veterans' Affairs of the House of Representatives or
                    the Senate.
                (4) Classified information.--If the Secretary of Veterans'
            Affairs determines that any information regarding such section
            requested by the Committee on Veterans' Affairs of the House of
            Representatives or the Senate is classified, the Secretary
            shall make arrangements to present such information to the
            Chair and Ranking Member of the such committee using
            appropriate security measures.
        (c) Implementation Plan and Report.--
                (1) Joint resource sharing implementation plan.--Not later
            than 90 days after the date of the enactment of this Act, the
            Secretary of Veterans Affairs, in coordination with the
            Secretary of Defense, shall submit to the Committees on
            Veterans' Affairs of the House of Representatives and the
            Senate a Joint Resource Sharing Implementation Plan. Such plan
            shall include--
                        (A) a comprehensive inventory of all agreements
                    under section 8111 of title 38, United States Code;
                        (B) a standardized reimbursement methodology;
                        (C) capacity assessments of Department of Veterans
                    Affairs and Department of Defense facilities; and
                        (D) identification of priority regions for
                    expansion.
                (2) Report.--Not later than 2 years after date of the
            enactment of this Act, the Comptroller General shall submit a
            report to Congress on the implementation of section 8111 of
            title 38, United States Code. Such report shall include--
                        (A) a description of use and effectiveness of
                    agreements under such section;
                        (B) a description of the role and output of the
                    Joint Executive Committee under such section;
                        (C) an evaluation of the effectiveness of
                    coordination of care and sharing of resources by the
                    Department of Veterans Affairs and the Department of
                    Defense under such section; and
                        (D) a description of any statutory, operational, or
                    cultural barriers to the implementation of such
                    section.

    SEC. 313. TIMELY REPORTING OF THE DEATH OF A VETERAN.

        (a) Findings.--Congress finds the following:
                (1) States and counties have reported significant delays in
            the signing of death certificates for veterans who pass away
            from natural causes.
                (2) Such delays, caused by the refusal of, or postponement
            by, physicians of the Department of Veterans Affairs have, in
            some cases, lasted as long as eight weeks.
                (3) Such delays prevent the timely burial of deceased
            veterans and access to survivor benefits.
        (b) Timely Certification of the Death of a Veteran.--
                (1) In general.--
                        (A) VA physician, nurse practitioner, or physician
                    assistant.--Subject to subparagraph (B), a physician,
                    nurse practitioner, or physician assistant employed by
                    the Secretary of Veterans Affairs who is the primary
                    care provider of a veteran who dies of natural causes
                    shall certify the death of such veteran not later than
                    two business days after such physician, nurse
                    practitioner, or physician assistant learns of such
                    death.
                        (B) Coroner or medical examiner.--If a physician,
                    nurse practitioner, or physician assistant described in
                    subparagraph (A) cannot comply with such paragraph with
                    respect to a death described in such paragraph, a
                    coroner or medical examiner in the jurisdiction where
                    such death occurred may certify such death.
                (2) Report.--
                        (A) In general.--Not later than one year after the
                    date of the enactment of this Act, and annually
                    thereafter for the following five years, 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 regarding
                    compliance with paragraph (1).
                        (B) Elements.--Each report required under
                    subparagraph (A) shall include, with respect to the
                    year preceding the date of the report, the following
                    elements:
                                (i) The percentage of cases in which a
                            physician, nurse practitioner, or physician
                            assistant employed by the Secretary complied
                            with paragraph (1)(A).
                                (ii) The number of cases in which such a
                            physician, nurse practitioner, or physician
                            assistant could not so comply.
                                (iii) An identification of the most common
                            reasons why such a physician, nurse
                            practitioner, or physician assistant could not
                            so comply.
                (3) Rule of construction.--Nothing in this section shall be
            construed to authorize a physician assistant or nurse
            practitioner to certify a death in any State in which such
            authority is not permitted under State or local law.

    SEC. 314. EXPANSION OF ACCESS BY VETERANS TO CRITICAL ACCESS HOSPITALS
                  AND AFFILIATED CLINICS UNDER THE VETERANS COMMUNITY CARE
                  PROGRAM.

        (a) Pilot Program to Improve Care Coordination for Veterans From
    Critical Access Hospitals and Affiliated Clinics.--
                (1) In general.--Not later than one year after the date of
            the enactment of this Act, the Secretary of Veterans Affairs
            shall commence a five-year pilot program to improve care
            coordination for eligible veterans who receive care from a
            critical access hospital or a provider-based rural health
            clinic affiliated with such hospital (in this section referred
            to as the ``pilot program'').
                (2) Contracts, agreements, or other arrangements.--
                        (A) In general.--In carrying out the pilot program,
                    the Secretary shall enter into contracts, agreements,
                    or other arrangements with facilities participating in
                    the pilot program to reimburse critical access
                    hospitals and affiliated clinics for outpatient health
                    care and medical services provided to eligible
                    veterans.
                        (B) Elements.--The Secretary, in coordination with
                    participating critical access hospitals, shall ensure
                    that any contract, agreement, or other arrangement
                    entered into under subparagraph (A) establishes
                    criteria, as the Secretary considers appropriate, to
                    ensure--
                                (i) the provision of timely, safe, and
                            high-quality health care services to
                            participants in the pilot program, including
                            through timely sharing of pertinent medical
                            record and other information between medical
                            facilities participating in the pilot program
                            and medical facilities of the Department of
                            Veterans Affairs;
                                (ii) the provision of health care services
                            through the pilot program is in accordance with
                            the medical benefits package of the Department;
                                (iii) no additional charges are imposed on
                            veterans participating in the pilot program or
                            the health care insurer of such veterans for
                            any medical service for which payment is made
                            by the Secretary;
                                (iv) appropriate reimbursement rates,
                            including through the consideration of cost-
                            based reimbursements; and
                                (v) such other considerations as the
                            Secretary considers appropriate.
                (3) Locations.--The Secretary shall ensure participation in
            the pilot program is open to all qualified facilities located
            in States that are designated by the Centers for Medicare &
            Medicaid Services as frontier States.
                (4) Authorization for care.--The Secretary shall provide
            eligible veterans opting to participate in the pilot program a
            one-year authorization from the Department to receive
            outpatient services at facilities participating in the pilot
            program.
                (5) Outreach.--
                        (A) Eligible veterans.--Not less frequently than
                    annually during each year in which the pilot program is
                    carried out, the Secretary shall conduct direct
                    outreach to eligible veterans in areas in which the
                    pilot program is carried out to notify such veterans of
                    their ability to participate in the pilot program.
                        (B) Hospitals.--The Secretary shall conduct direct
                    outreach to critical access hospitals in areas in which
                    the pilot program is carried out to notify those
                    hospitals of their ability to participate in the pilot
                    program.
                (6) Staff.--The Secretary shall ensure that each medical
            facility of the Department within the catchment area of a
            location in which the pilot program is carried out has
            sufficient dedicated staff to handle--
                        (A) administrative and technical challenges that
                    arise from the pilot program;
                        (B) care coordination and follow up with the
                    veteran and the facility participating in the pilot
                    program after an episode of care; and
                        (C) timely records return following an episode of
                    care.
                (7) Limitation.--The Secretary may not extend the pilot
            program beyond the five-year period specified under subsection
            (a) or expand the pilot program to additional States or convert
            the pilot program into a permanent authority unless expressly
            authorized by a subsequent Act of Congress.
                (8) Report.--
                        (A) In general.--Not later than one year after the
                    date of the enactment of this Act, and annually
                    thereafter for the duration of the pilot program, the
                    Secretary shall submit to the Committee on Veterans'
                    Affairs of the Senate and the Committee on Veterans
                    Affairs of the House of Representatives a report on the
                    pilot program.
                        (B) Elements.--
                                (i) In general.--Each report required under
                            subparagraph (A) shall contain the
                            recommendation of the Secretary for the
                            expansion or continuation of the pilot program.
                                (ii) Initial report.--The initial report
                            required under clause (i) shall contain--
                                        (I) a description of the outreach
                                    conducted to critical access hospitals
                                    concerning the pilot program;
                                        (II) a list of facilities that have
                                    opted to participate in the pilot
                                    program;
                                        (III) information, by facility,
                                    regarding total obligations and
                                    expenditures, utilization average time
                                    from authorization to care, timeliness
                                    regarding medical records return and
                                    claim payment, emergency department
                                    utilization, veteran satisfaction, and
                                    any effect on care furnished by
                                    Department facilities; and
                                        (IV) a list of the barriers, if
                                    any, cited by facilities that opted not
                                    to participate in the pilot program.
                                (iii) Subsequent reports.--Each report
                            required under clause (i) after the initial
                            report shall contain--
                                        (I) an updated list of facilities
                                    participating in the pilot program;
                                        (II) the number of veterans
                                    participating in the pilot program,
                                    disaggregated by facility;
                                        (III) an overview of the types of
                                    care received through the pilot
                                    program;
                                        (IV) feedback from the facilities
                                    participating in the pilot program,
                                    with identifying information removed,
                                    regarding the status of the pilot
                                    program, challenges in participating in
                                    the pilot program, and the interest of
                                    the facility in continued participation
                                    in such a program; and
                                        (V) any additional information that
                                    the Secretary determines relevant or
                                    necessary.
                (9) Definitions.--In this subsection:
                        (A) Critical access hospital.--The term ``critical
                    access hospital'' has the meaning given that term in
                    section 1861(mm) of the Social Security Act (42 U.S.C.
                    1395x(mm)).
                        (B) Eligible veteran.--The term ``eligible
                    veteran'' means a veteran--
                                (i) enrolled in the patient enrollment
                            system of the Department of Veterans Affairs
                            established and operated under section 1705(a)
                            of title 38, United States Code;
                                (ii) who has received care at a facility of
                            the Department or in-network provider under the
                            Veterans Community Care Program under section
                            1703 of such title during the previous two-year
                            period;
                                (iii) who lives within 35 miles of a
                            critical access hospital; and
                                (iv) who would be eligible for care or
                            services under the Veterans Community Care
                            Program.
        (b) Action Plan to Address Barriers to Care for Veterans Living in
    Rural Areas.--
                (1) In general.--Not later than one year after the date of
            the enactment of this Act, the Secretary of Veterans Affairs
            shall develop and submit to the Committee on Veterans' Affairs
            of the Senate and the Committee on Veterans' Affairs of the
            House of Representatives a comprehensive action plan to
            identify, address, and eliminate barriers to accessing care for
            veterans residing in rural, highly rural, and frontier areas.
                (2) Elements.--In developing the action plan required under
            paragraph (1), the Secretary shall--
                        (A) consult with health care providers that provide
                    care in the community under the laws administered by
                    the Secretary, State Offices of Rural Health, Tribal
                    health authorities, and other relevant stakeholders in
                    rural, highly rural, and frontier areas as the
                    Secretary determines appropriate;
                        (B) assess barriers to care in the community for
                    veterans residing in rural and highly rural areas,
                    including challenges with respect to--
                                (i) network adequacy;
                                (ii) provider participation;
                                (iii) geographic distance;
                                (iv) transportation;
                                (v) information technology;
                                (vi) physical infrastructure;
                                (vii) outreach and understanding of
                            eligibility for such care;
                                (viii) timeliness of referrals,
                            authorization, and medical documentation
                            exchange; and
                                (ix) any other matter the Secretary
                            determines appropriate;
                        (C) list specific and measurable strategies and
                    actions to address the barriers and challenges assessed
                    under subparagraph (B), to include the consideration
                    of--
                                (i) expanding participation in the Veterans
                            Community Care Program under section 1703 of
                            title 38, United States Code, among providers
                            in rural, highly rural, and frontier areas;
                                (ii) physically locating health care
                            facilities of the Department of Veterans
                            Affairs within the same building or on the
                            campuses of other health care facilities
                            located in rural, highly rural, or frontier
                            areas;
                                (iii) enhancing transportation assistance;
                                (iv) increasing reimbursement rates,
                            including through cost-based reimbursements;
                            and
                                (v) improving coordination with State,
                            Tribal, and local partners; and
                        (D) assess legislative and regulatory barriers, if
                    any, to addressing the barriers assessed under
                    subparagraph (B).
                (3) Implementation.--Not later than 90 days after
            submitting the action plan under paragraph (1), the Secretary
            shall begin implementation of the plan and shall ensure full
            implementation not later than two years after the date of the
            enactment of this Act.
        (c) Outreach.--
                (1) Outreach to veterans.--Not later than one year after
            the date of the enactment of this Act, and annually thereafter,
            the Secretary of Veterans Affairs, through the Office of Rural
            Health (or successor office) and the Office of Integrated
            Veteran Care (or successor office), shall conduct outreach to
            veterans residing in rural, highly rural, and frontier areas
            regarding--
                        (A) opportunities to seek care through facilities
                    and programs of the Department of Veterans Affairs,
                    including via telehealth, existing programs provided
                    through grantees or contractors of the Department, Vet
                    Centers (as defined in section 1712A of title 38,
                    United States Code), and volunteer programs and
                    services for transportation;
                        (B) opportunities to seek care though the Veterans
                    Community Care Program under section 1703 of title 38,
                    United States Code;
                        (C) opportunities to seek care at critical access
                    hospitals with contracts, partnerships, or agreements
                    with the Department of Veterans Affairs; and
                        (D) any other matters the Secretary considers
                    appropriate.
                (2) Outreach to providers.--Not later than one year after
            the date of the enactment of this Act, and annually thereafter,
            the Secretary of Veterans Affairs, through the Office of Rural
            Health (or successor office) and the Office of Integrated
            Veteran Care (or successor office), shall--
                        (A) conduct outreach to health care facilities and
                    critical access hospitals in rural areas regarding--
                                (i) the Veterans Community Care program
                            under section 1703 of title 38, United States
                            Code, and the pilot program under subsection
                            (a) of this section; and
                                (ii) any other matters the Secretary
                            considers appropriate; and
                        (B) seek to enter into contracts, partnerships,
                    agreements, or other arrangements with health care
                    facilities and critical access hospitals in rural
                    areas.
                (3) Critical access hospital defined.--In this section, the
            term ``critical access hospital'' has the meaning given that
            term in section 1861(mm) of the Social Security Act (42 U.S.C.
            1395x(mm)).

    SEC. 315. PILOT PLATFORM FOR SERVICES FOR VETERANS; COLLECTION FROM
                  VETERANS OF INFORMATION RELATED TO SOCIAL DETERMINANTS OF
                  HEALTH.

        (a) Pilot Program on Establishment or Enhancement of Community
    Integration Platform for Veterans.--
                (1) In general.--Commencing not later than 18 months after
            the date of the enactment of this Act, the Secretary, acting
            through the Center for Innovation for Care and Payment of the
            Department of Veterans Affairs, shall carry out a pilot program
            under which the Secretary shall establish a new, or enhance an
            existing, interoperable community integration platform to
            coordinate local support services for veterans through other
            governmental and nongovernmental organizations (in this section
            referred to as the ``pilot program'').
                (2) Elements of pilot program.--In carrying out the pilot
            program, the Secretary shall ensure that the community
            integration platform established or enhanced under the pilot
            program--
                        (A) permits veterans to identify and connect with
                    covered entities that furnish covered services;
                        (B) permits covered entities to identify and
                    connect with veterans in need of covered services;
                        (C) utilizes, to the extent practicable, existing
                    interoperable technology networks;
                        (D) prioritizes connectivity with appropriate
                    existing technology networks developed by public or
                    private organizations that comply with, as applicable,
                    standards adopted by the Secretary of Health and Human
                    Services under section 3004 of the Public Health
                    Service Act (42 U.S.C. 300jj-14), for the provision of
                    covered services;
                        (E) ensures that--
                                (i) reasonable measures are taken to
                            promote connectivity and interoperable exchange
                            among covered entities and between covered
                            entities and veterans; and
                                (ii) appropriate privacy and security
                            protections are in place, in accordance with
                            applicable Federal and State privacy law;
                        (F) is accessible by employees of the Department,
                    covered entities, and veterans;
                        (G) connects covered entities and veterans for
                    purposes of communication, service coordination, and
                    consumer assistance, referral and capacity management,
                    outcome tracking and reporting, and related services;
                    and
                        (H) is accessible via a web-based platform for all
                    veterans and via a non-web-based alternative platform
                    or process for veterans who are unable to easily and
                    reliably access the web-based platform.
                (3) Locations.--
                        (A) Initial locations.--The Secretary shall carry
                    out the pilot program at not fewer than five medical
                    facilities of the Department of Veterans Affairs
                    selected by the Secretary for purposes of the pilot
                    program.
                        (B) Expansion.--The Secretary may expand beyond
                    initial sites for the pilot program selected under
                    paragraph (1) not before two years after the date of
                    enactment, not before thirty days after briefing the
                    Committees on Veterans' Affairs of the Senate and the
                    House of the expansion plan, and after demonstrated
                    success.
                        (C) Variety of facilities.--In selecting facilities
                    under subparagraph (A), the Secretary shall ensure the
                    selection of a variety of different types of
                    facilities, including--
                                (i) frontier facilities;
                                (ii) under-resourced facilities;
                                (iii) facilities at which there are
                            existing efforts to coordinate with community
                            resources; and
                                (iv) facilities located in communities with
                            an established community-based veteran service
                            coordination network capable of integration
                            with the pilot program.
                (4) Procurement of technology.--In carrying out the pilot
            program, the Secretary shall ensure full and open competition
            in the procurement of any services or technology and shall not
            enter into an exclusive national contract for the operation of
            the community integration platform under the pilot program. In
            procuring technology under this section, the Secretary may
            prioritize, to the maximum extent practicable, technologies,
            platforms, or capabilities that are already deployed,
            validated, interoperable, or otherwise in operational use
            within medical centers or other components of the Department,
            unless the Secretary determines and documents that an
            alternative solution would better achieve the purposes of this
            section.
                (5) Application process.--
                        (A) In general.--The Secretary may require covered
                    entities that seek to participate in the pilot program
                    to submit to the Secretary an application therefore in
                    such form, in such manner, and containing such
                    commitments and information as the Secretary considers
                    necessary to carry out this section.
                        (B) Review.--
                                (i) In general.--The Secretary shall review
                            the applications of covered entities submitted
                            under subparagraph (A) to ensure that the
                            participation of such entities would be safe
                            and appropriate for veterans participating in
                            the pilot program.
                                (ii) Due diligence.--In reviewing
                            applications under clause (i), the Secretary
                            shall conduct due diligence consistent with how
                            the Secretary conducts due diligence for
                            public-private partnerships under other laws
                            administered by the Secretary.
                (6) Screening and tracking of participants.--
                        (A) In general.--The Secretary shall require
                    veterans participating in the community integration
                    platform under the pilot program to provide information
                    regarding social determinants of health using the ICD-
                    10 diagnostic codes Z55 through Z63 and Z75 (as in
                    effect on the date of the enactment of this Act) in a
                    standardized risk assessment or screening tool and such
                    other information as the Secretary considers necessary
                    to administer the pilot program.
                        (B) Informed consent.--Information collected under
                    the pilot program with respect to a veteran shall be
                    obtained with the informed consent of the veteran and
                    used solely for purposes of care coordination, service
                    delivery, or program evaluation under the pilot
                    program.
                        (C) Tracking of information.--
                                (i) In general.--The Secretary shall
                            track--
                                        (I) the number of referrals of
                                    veterans to covered entities through
                                    the community integration platform
                                    under the pilot program;
                                        (II) the response time of covered
                                    entities to which such veterans are
                                    referred; and
                                        (III) the outcome of the initial
                                    meeting by a veteran and a covered
                                    entity to which the veteran is
                                    referred, including a description of
                                    the services that are provided to the
                                    veteran by such entity.
                                (ii) Tracking by entities.--The Secretary
                            may require covered entities participating in
                            the pilot program to track the information
                            required under clause (i) in a medium
                            determined appropriate by the Secretary.
                (7) Coordination and integration of programs.--
                        (A) Coordination with existing networks.--In
                    carrying out the pilot program, the Secretary shall
                    coordinate with existing community networks.
                        (B) Coordination and integration with state
                    medicaid programs.--The Secretary may consult and
                    coordinate with the Secretary of Health and Human
                    Services and with States regarding existing Federal and
                    State programs, but nothing in this section shall be
                    construed to authorize the Secretary of Veterans
                    Affairs to administer, direct, or modify a State
                    Medicaid program or waiver.
                (8) Performance benchmarks.--The Secretary shall establish
            performance benchmarks for the pilot program, including
            measures of referral completion, timeliness of service
            connection, and veteran-reported satisfaction.
                (9) Report and briefings.--
                        (A) Report.--Not later than three years after the
                    commencement of the pilot program, the Secretary shall
                    submit to the appropriate committees of Congress a
                    report analyzing the needs of veterans for covered
                    services reflected by the use of such services under
                    the community integration platform under the pilot
                    program, including an assessment of--
                                (i) the need for such services that is
                            being met through such platform; and
                                (ii) the need for such services that is not
                            being met through such platform.
                        (B) Briefing on entities not selected.--Not later
                    than 180 days after the commencement of the pilot
                    program, and not less frequently than once every 180
                    days thereafter until the conclusion of the pilot
                    program, the Secretary shall brief the appropriate
                    committees of Congress on the covered entities that
                    submitted an application to participate in the pilot
                    program but were not selected for participation and the
                    reason those entities were not selected.
                (10) Comptroller general evaluation, report, and
            recommendations.--
                        (A) Evaluation.--The Comptroller General of the
                    United States shall conduct an evaluation that measures
                    the overall impact of the community integration
                    platform established or enhanced under the pilot
                    program with respect to--
                                (i) changes in individual and population
                            health outcomes among veterans;
                                (ii) changes in access to health care or
                            social services among veterans; and
                                (iii) such other factors as the Comptroller
                            General considers appropriate.
                        (B) Report and recommendations.--
                                (i) In general.--Not later than four years
                            after the commencement of the pilot program,
                            the Comptroller General shall--
                                        (I) submit to Congress a report on
                                    the evaluation conducted under
                                    subparagraph (A);
                                        (II) make such report publicly
                                    available; and
                                        (III) based on such evaluation,
                                    make recommendations to the Secretary
                                    on how to improve and sustain the
                                    community integration platform
                                    established or enhanced under the pilot
                                    program.
                                (ii) Elements of report.--The report under
                            clause (i)(I) shall include data on--
                                        (I) what covered sources under the
                                    pilot program are being utilized the
                                    most;
                                        (II) what requests for services
                                    under the pilot program cannot be met;
                                    and
                                        (III) the impact of the provision
                                    of services under the pilot program on
                                    health outcomes of veterans.
                (11) Limitations.--(A) The Secretary may not use the pilot
            program established under subsection (a) to supplant services
            otherwise required to be furnished by the Department under
            title 38, United States Code.
                (B) No covered entity participating in the pilot program
            established under subsection (a) may receive access to
            personally identifiable information, protected health
            information, or social determinants information of a veteran
            without the veteran's informed written consent, and such
            information may be used only for the specific referral or
            service authorized by the veteran.
                (12) Definitions.--In this subsection:
                        (A) Appropriate committees of congress.--The term
                    ``appropriate committees of Congress'' means the
                    Committee on Veterans' Affairs of the Senate and the
                    Committee on Veterans' Affairs of the House of
                    Representatives.
                        (B) Community integration platform.--The term
                    ``community integration platform'' means an
                    interoperable platform or network of interoperable
                    systems used to enable the coordination, alignment, and
                    connection of covered entities and veterans at the
                    local level for purposes of communication, service
                    coordination, and referral management of covered
                    services.
                        (C) Covered entity.--The term ``covered entity''
                    means any of the following entities or providers that
                    have entered into an agreement with the Secretary to
                    participate in the pilot program:
                                (i) A community-based organization that--
                                        (I) accepts referrals from health
                                    care organizations; and
                                        (II) provides covered services.
                                (ii) A public or private health care
                            provider organization.
                                (iii) A public or private funded payor of
                            health care services, including home- or
                            community-based services.
                                (iv) A State, local, territorial, or Tribal
                            health or social services agency.
                                (v) A State public housing authority or
                            housing finance agency.
                                (vi) A public health information exchange
                            or public health information network, as
                            defined by the Secretary.
                                (vii) A faith-based service provider.
                                (viii) Any other similar entity, as
                            determined by the Secretary.
                        (D) Covered services.--The term ``covered
                    services'' means any of the following:
                                (i) Nutritional assistance.
                                (ii) Housing.
                                (iii) Health care, including preventive
                            health intervention, chronic disease
                            management, and behavioral health care.
                                (iv) Transportation.
                                (v) Job training and employment.
                                (vi) Child development or care.
                                (vii) Caregiving and respite care.
                                (viii) Disability assistance.
                                (ix) Suicide prevention.
                                (x) Sexual assault services.
                                (xi) Legal aid.
                                (xii) Transition assistance for veterans
                            newly separated or discharged from active
                            military, naval, air, or space service (as
                            defined in section 101(24) of title 38, United
                            States Code).
                                (xiii) Assistance with utilities necessary
                            for safe habitation.
                                (xiv) Other services directly related to
                            health care access, suicide prevention,
                            homelessness prevention, food insecurity,
                            transportation to health care, or assistance
                            separating from military service and reentering
                            civilian life, as expressly authorized under
                            laws administered by the Secretary.
                        (E) Secretary.--The term ``Secretary'' means the
                    Secretary of Veterans Affairs.
                        (F) State.--The term ``State'' has the meaning
                    given that term in section 101 of title 38, United
                    States Code.
        (b) Collection of Information From Veterans Related to Social
    Determinants of Health.--
                (1) In general.--The Secretary of Veterans Affairs shall
            collect from veterans enrolled in the system of annual patient
            enrollment of the Department of Veterans Affairs established
            and operated under section 1705(a) of title 38, United States
            Code, as part of routine screenings of such veterans under the
            laws administered by the Secretary, information related to
            social determinants that may factor into the health of such
            veterans.
                (2) Social determinants of health.--
                        (A) In general.--The information collected under
                    subsection (a) shall include standardized definitions
                    for identifying social determinants of health needs
                    identified in the ICD-10 diagnostic codes Z55 through
                    Z63 and Z75 (as in effect on the date of enactment of
                    this Act).
                        (B) Incorporation of measures.--Definitions
                    included under subparagraph (A) with respect to
                    identifying social determinants of health needs shall
                    incorporate measures for quantifying the relative
                    severity of any such social determinant of health need
                    identified in an individual.

    SEC. 316. IMPROVEMENTS TO DEPARTMENT OF VETERANS AFFAIRS PROSTHETIC AND
                  REHABILITATIVE ITEMS AND SERVICE.

        (a) Prosthetic and Rehabilitative Items and Services Formulary.--
                (1) In general.--Chapter 17 of title 38, United States
            Code, is amended by inserting after section 1709C the following
            new section:
    ``Sec. 1709D. Prosthetic and Rehabilitative Items and Services
                  Formulary
        ``(a) In General.--The Secretary shall establish a list of
    prosthetic and rehabilitative items and services, which may be referred
    to as the `Prosthetic and Rehabilitative Items and Services Formulary'
    or the `Formulary', for purposes of furnishing medical services under
    section 1701(6)(F) of this title pursuant to section 1710 of this
    title.
        ``(b) Requirements.--
                ``(1) Input.--In developing the Formulary, the Secretary
            shall solicit input from veterans and the public.
                ``(2) Availability of items.--The Secretary shall ensure
            that all items and services included in the Formulary are
            available at or through all facilities of the Department.
                ``(3) Items to be included.--In developing the Formulary,
            the Secretary shall rely on the best available evidence to
            identify which items and services should be included on the
            Formulary.
        ``(c) Publication and Communication.--
                ``(1) Publication and update.--The Secretary shall publish
            the Formulary on a website of the Department and shall update
            the Formulary periodically.
                ``(2) Communication.--The Secretary shall communicate to
            veterans the contents of the Formulary and information about
            how to appeal decisions regarding the provision of items and
            services on the Formulary.
        ``(d) Contracts.--The Secretary shall enter into such contracts as
    the Secretary considers necessary to support the availability of items
    and services included in the Formulary.
        ``(e) Training.--The Secretary shall ensure the availability of
    training on the Formulary for clinicians and other staff of the
    Department.
        ``(f) Exceptions.--
                ``(1) In general.--The Secretary shall establish a process
            for clinicians of the Department to request, prescribe, and
            furnish prosthetic and rehabilitative items and services that
            are not included on the Formulary when medically necessary.
                ``(2) Monitoring of non-formulary items and services.--The
            Secretary shall monitor requests and prescriptions for and the
            furnishing of prosthetic and rehabilitative items and services
            under paragraph (1)--
                        ``(A) to ensure that such items and services are
                    being consistently and appropriately prescribed at all
                    facilities of the Department; and
                        ``(B) to determine whether such items or services
                    should be added to the Formulary.
                ``(3) Prior authorization for non-formulary procurement.--
            The Secretary shall establish a prior authorization process for
            the procurement of prosthetic and rehabilitative items that are
            not included on the Formulary or available through a national
            contract.
                ``(4) Open market procurement.--The Secretary shall ensure
            that procurement of items that are not included on the
            Formulary or available through a national contract is permitted
            only if a clinician determines the item is medically necessary.
        ``(g) Consideration.--In developing the Formulary, the Secretary
    shall consider how the approach of the Pharmacy Benefits Management
    Services of the Department for formulary management and medication
    safety can be adapted to support the efficient and effective
    administration of the Formulary.
        ``(h) Enterprise Procurement and Ordering System.--
                ``(1) In general.--The Secretary shall implement an
            enterprise electronic ordering system for prosthetic and
            rehabilitative items and services furnished under this section.
                ``(2) Systems elements.--The system required under
            paragraph (1) shall--
                        ``(A) enable the automated ordering of items
                    included on the Formulary;
                        ``(B) provide visibility of contract pricing and
                    availability across all facilities of the Department;
                        ``(C) allow enterprise loading of nationally
                    contracted products;
                        ``(D) provide procurement analytics to monitor
                    compliance with national contracts and reduce open
                    market purchasing; and
                        ``(E) contain all data elements required for the
                    Federal Electronic Healthcare Record in a searchable
                    format.
                ``(3) Implementation.--The Secretary shall ensure that the
            system required under paragraph (1) is implemented across all
            medical centers of the Department by not later than three years
            after the date of the enactment of this section.
        ``(i) Program Management.--
                ``(1) In general.--The Secretary shall ensure that the
            Prosthetic and Sensory Aids Service of the Department maintains
            adequate staffing to administer the Formulary and associated
            procurement programs.
                ``(2) Staffing included.--Staffing required under paragraph
            (1) shall include--
                        ``(A) dedicated program managers for major
                    prosthetic product categories; and
                        ``(B) full-time clinical staff responsible for
                    clinical evaluations and practice recommendations.
        ``(j) Report to Congress.--Not later than two years after the date
    of the enactment of this section, 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 describing--
                ``(1) rates of compliance by the Department with national
            prosthetic contracts;
                ``(2) open market purchasing trends of the Department;
                ``(3) utilization of the Formulary across facilities of the
            Department; and
                ``(4) steps taken by the Department to improve enterprise
            procurement efficiency.''.
                (2) Clerical amendment.--The table of sections at the
            beginning of such chapter is amended by inserting after the
            item relating to section 1709C the following new item:

    ``1709D. Prosthetic and rehabilitative items and services formulary''.
        (b) Report.--
                (1) In general.--Not later than one year after the date of
            the enactment of this Act, the Secretary of Veterans Affairs
            shall submit to the Committee on Veterans' Affairs of the
            Senate and the Committee on Veterans' Affairs of the House of
            Representatives a report containing a comprehensive operational
            and technology assessment of the Prosthetic and Rehabilitative
            Items and Services Formulary established under section 1709D of
            title 38, United States Code, as added by subsection (a).
                (2) Elements.--The report required by paragraph (1) shall
            identify potential impacts of the Prosthetic and Rehabilitative
            Items and Services Formulary on--
                        (A) access by veterans to prosthetic and
                    rehabilitative items and services;
                        (B) clinician workload;
                        (C) procurement timelines; and
                        (D) innovation adoption.

    SEC. 317. IMPROVEMENT OF SUBMISSION OF MEDICAL DOCUMENTATION TO THE
                  SECRETARY OF VETERANS AFFAIRS BY COMMUNITY CARE
                  PROVIDERS.

        (a) In General.--The Secretary of Veterans Affairs shall ensure
    that each contract, agreement, or other arrangement through which the
    Secretary furnishes hospital care, medical services, or extended care
    services to eligible veterans through non-Department of Veterans
    Affairs entities or providers includes clear requirements, including
    requirements regarding timeliness, regarding the submission of medical
    documentation to the Secretary after a veteran receives such care or
    services from the non-Department entity or provider.
        (b) Internal Measures.--The Secretary shall establish such goals
    and related performance measures for medical centers of the Department
    as the Secretary determines appropriate in obtaining medical
    documentation from non-Department entities or providers under
    subsection (a).
        (c) Training.--The Secretary may establish goals and related
    performance measures for the completion by non-Department entities or
    providers of core training related to the submission to the Secretary
    of medical documentation under subsection (a) and may monitor the
    completion of such training.
        (d) Outreach.--The Secretary shall ensure that communications by
    the Secretary with non-Department entities or providers contain clear
    and accurate information regarding requirements for submitting medical
    documentation under subsection (a) and completing the core training
    described in subsection (c).
        (e) Submission of Goals, Measures, and Materials.--Not later than
    one year after the date of the enactment of this Act, and not less
    frequently than annually thereafter for the following five years, the
    Secretary shall submit to the Committee on Veterans' Affairs of the
    Senate and the Committee on Veterans' Affairs of the House of
    Representatives copies of any goals, performance measures, training
    materials, or outreach materials pertaining to the submission of
    medical documentation under this section.

    SEC. 318. IMPLEMENTATION OF AND REPORT ON EFFORTS OF DEPARTMENT OF
                  VETERANS AFFAIRS TO IMPROVE HEALTH CARE APPOINTMENT
                  SCHEDULING.

        (a) In General.--Not later than one year after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall submit
    to the appropriate committees of Congress a plan to improve the process
    for scheduling appointments for health care from the Department of
    Veterans Affairs, including improvements for both patients and
    employees of the Department responsible for scheduling such
    appointments.
        (b) Elements of Plan.--
                (1) In general.--The plan required by subsection (a) shall
            include--
                        (A) such actions, resources, technology, and
                    process improvements as the Secretary determines
                    necessary to ensure the Department achieves, in a
                    timely manner, improved delivery of health care, access
                    to health care, customer experience and service
                    relating to the receipt of health care, and efficiency
                    with respect to the delivery of health care; and
                        (B) a proposed schedule and timeline to carry out
                    such plan.
                (2) Objectives.--
                        (A) In general.--The Secretary shall ensure that
                    the plan required by subsection (a) addresses the
                    following objectives:
                                (i) To develop or continue the development
                            of a scheduling system that enables both
                            personnel and patients of the Department to
                            view available appointments for care furnished
                            by the Department, including primary care,
                            mental health care, and all forms of specialty
                            care.
                                (ii) To develop or continue the development
                            of a self-service scheduling platform,
                            available for use by all patients of the
                            Department, which shall--
                                        (I) enable such patients to view
                                    available appointments and, subject to
                                    the process described in clause (iii),
                                    fully schedule appointments for all
                                    care furnished by the Department;
                                        (II) if a referral is required for
                                    an appointment, provide a method for
                                    the patient to request a referral and
                                    subsequently book an appointment if the
                                    referral is approved; and
                                        (III) provide such patients with
                                    the ability to cancel or reschedule
                                    appointments.
                                (iii) To create a process through which all
                            patients of the Department can telephonically
                            speak with a scheduler who can assist the
                            patient to determine appointment availability
                            and can fully schedule appointments on behalf
                            of the patient for all care furnished by the
                            Department.
                                (iv) To carry out such other functions,
                            oversight, metric development and tracking,
                            change management, cross-Department
                            coordination, and other related matters,
                            including improvements to employee-facing
                            information technology, training, and
                            processes, as the Secretary determines
                            appropriate as it relates to scheduling tools,
                            functions, and operations with respect to
                            health care appointments furnished by the
                            Department.
                        (B) Explanation of inability to implement certain
                    objectives, features, or services.--If the Secretary
                    determines that an objective under subparagraph (A), or
                    any feature or service in connection with that
                    objective, cannot be implemented or otherwise
                    incorporated into a final product pursuant to the plan
                    required by subsection (a), the Secretary shall include
                    with the plan submitted under such subsection a report
                    containing--
                                (i) an explanation as to why that
                            objective, feature, or service cannot be
                            implemented or incorporated, as the case may
                            be; and
                                (ii) a plan for implementing the plan
                            required by subsection (a) without that
                            objective, feature, or service.
        (c) Implementation.--Not later than two years after submitting to
    the appropriate committees of Congress the plan required by subsection
    (a), the Secretary shall fully implement the plan.
        (d) Coordination With Electronic Health Record Modernization
    Program.--In developing the plan required by subsection (a), the
    Secretary shall ensure that the elements and objectives of such plan
    set forth under subsection (b) are developed in consideration of the
    deployment schedule and capabilities of the Electronic Health Record
    Modernization Program of the Department to ensure a smooth transition
    to using the tools and features under such plan as relevant and
    appropriate.
        (e) Implementation Reports.--Not later than each of one year and
    two years after the date on which the Secretary submits the plan
    required by subsection (a), the Secretary shall submit to the
    appropriate committees of Congress a report on the progress of the
    Secretary in implementing such plan, including--
                (1) the costs incurred to implement the plan as of the date
            of the report;
                (2) the expected costs to complete implementation of the
            plan (including costs for management and technology);
                (3) the schedule for deployment of any capabilities
            developed pursuant to the plan; and
                (4) the goals and metrics achieved, challenges, and lessons
            learned in implementing the plan.
        (f) Rule of Construction.--Nothing in this section shall be
    construed to require the Secretary to include in the plan required by
    subsection (a) any technology or process that would preclude or impede
    the ability of a veteran to contact or schedule an appointment directly
    with a facility or provider through a non-online scheduling process,
    should the veteran choose to do so.
        (g) Definitions.--In this section:
                (1) Appropriate committees of congress.--The term
            ``appropriate committees of Congress'' means the Committee on
            Veterans' Affairs of the Senate and the Committee on Veterans'
            Affairs of the House of Representatives.
                (2) Fully schedule.--The term ``fully schedule'', with
            respect to an appointment for health care, means that the
            appointment booking is completed, rather than simply requested.

    SEC. 319. PILOT PROGRAM ON COORDINATION OF CARE BETWEEN DEPARTMENT OF
                  VETERANS AFFAIRS AND MEDICARE PROGRAM.

        (a) In General.--The Secretary, in consultation with the Secretary
    of Health and Human Services, shall carry out a pilot program (in this
    section referred to as the ``pilot program'') to coordinate, navigate,
    and manage care and benefits for covered veterans.
        (b) Purposes of Pilot Program.--The purposes of the pilot program
    are as follows:
                (1) To improve access to health care services for covered
            veterans from the Department of Veterans Affairs and under the
            Medicare program under title XVIII of the Social Security Act
            (42 U.S.C. 1395 et seq.).
                (2) To improve satisfaction with care received by covered
            veterans.
                (3) To improve quality of care received by covered
            veterans.
                (4) To lower costs to the Federal Government for care
            received by covered veterans.
                (5) To reduce gaps in care and duplication of services and
            expenses for covered veterans.
                (6) To improve care coordination for covered veterans,
            including coordination of patient information and medical
            records between providers and between the Department and the
            Centers for Medicare & Medicaid Services.
        (c) Locations.--The Secretary shall carry out the pilot program in
    not fewer than three but not more than five Veterans Integrated Service
    Networks with a significant number of covered veterans and geographic
    diversity, including--
                (1) locations that are in rural or highly rural areas, as
            determined through the use of the Rural-Urban Continuum codes
            of the Department of Agriculture; and
                (2) locations that are in medically underserved communities
            (as defined in section 799B of the Public Health Service Act
            (42 U.S.C. 295p)).
        (d) Case Manager.--In carrying out the pilot program, the Secretary
    shall assign each covered veteran participating in the pilot program a
    case manager responsible for--
                (1) coordinating with the veteran, the primary care team of
            the veteran, and any relevant care coordinators already
            assisting the veteran to develop an individualized needs
            assessment for the veteran and, based on such assessment, a
            care coordination plan with defined treatment goals; and
                (2) navigating the systems of care under the laws
            administered by the Secretary and under the Medicare program
            under title XVIII of the Social Security Act (42 U.S.C. 1395 et
            seq.).
        (e) Use of Existing Models.--In designing the pilot program, the
    Secretary may use existing models used by commercial health care
    programs to improve access, health outcomes, quality, and customer
    experience and lower per capita costs.
        (f) Contracting With Private Sector Entities.--
                (1) In general.--The Secretary, to the extent practicable,
            shall consider entering into contracts or agreements with
            private sector entities carrying out commercial health care
            programs for assistance in designing, implementing, and
            managing care and benefits under the pilot program, to include
            providing care coordination.
                (2) Notification.--If the Secretary determines that
            entering into contracts or agreements with private sector
            entities under paragraph (1) is not necessary or practicable,
            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) a notification of that determination;
                        (B) a description of the steps, if any, the
                    Secretary has taken to attempt to enter into a contract
                    or an agreement with a private sector entity;
                        (C) a justification for why the Secretary has
                    determined that such contract or agreement is not
                    necessary or practicable; and
                        (D) a plan for how the Secretary will carry out the
                    pilot program without entering into a contract or an
                    agreement with a private sector entity, including
                    through the use of employees of the Department of
                    Veterans Affairs or other government agencies,
                    nonprofit organizations, or other entities.
        (g) Metrics.--
                (1) In general.--The Secretary shall track metrics under
            the pilot program, including the following:
                        (A) The number of veterans participating in the
                    pilot program, disaggregated by Veterans Integrated
                    Service Network.
                        (B) Reliance on health care services administered
                    by the Secretary.
                        (C) Reliance on health care services administered
                    under the Medicare program under title XVIII of the
                    Social Security Act (42 U.S.C. 1395 et seq.).
                        (D) Quality of care, including patient outcomes.
                        (E) Cost of care.
                        (F) Access to care, including under the designated
                    access standards developed by the Secretary under
                    section 1703B of title 38, United States Code.
                        (G) Patient satisfaction.
                        (H) Provider satisfaction.
                        (I) Care coordination, including timely information
                    sharing and medical documentation return.
                (2) Elements.--In tracking metrics under paragraph (1), the
            Secretary shall track information relating to--
                        (A) whether care received by a covered veteran is
                    related to a service-connected disability (as defined
                    in section 101 of title 38, United States Code);
                        (B) the priority group under section 1705(a) of
                    title 38, United States Code, through which each
                    covered veteran was enrolled in the system of annual
                    patient enrollment of the Department of Veterans
                    Affairs under such section;
                        (C) the type of care and services provided to
                    covered veterans; and
                        (D) the demographics of covered veterans
                    participating in the pilot program, including age.
        (h) Supplement Not Supplant.--The services provided under the pilot
    program shall supplement, not supplant, the services provided under the
    education program under section 121 of the VA MISSION Act of 2018
    (Public Law 115-182; 38 U.S.C. 1701 note).
        (i) Duration.--The Secretary shall carry out the pilot program for
    a three-year period beginning on the commencement of the pilot program.
        (j) Reports.--
                (1) Development, implementation, results, and design of
            pilot program.--
                        (A) In general.--Not less frequently than
                    biannually during the two-year period beginning on the
                    date of the enactment of this Act, the Secretary shall
                    submit to the Committee on Veterans' Affairs of the
                    Senate and the Committee on Veterans' Affairs of the
                    House of Representatives a report on the development,
                    implementation, results, and design of the pilot
                    program, including information on the metrics tracked
                    under subsection (g).
                        (B) Final design.--One of the reports required
                    under subparagraph (A) shall contain a description of
                    the final design of the pilot program.
                (2) Results of pilot program.--
                        (A) In general.--Not later than one year after the
                    submission of the final report under paragraph (1), and
                    not less frequently than annually thereafter during the
                    duration of the pilot program, the Secretary shall
                    submit to the Committee on Veterans' Affairs of the
                    Senate and the Committee on Veterans' Affairs of the
                    House of Representatives a report on the results of the
                    pilot program.
                        (B) Final report.--In the final report submitted
                    under subparagraph (A), the Secretary shall include the
                    recommendation of the Secretary for whether the pilot
                    program should be extended or made permanent.
        (k) Definitions.--In this section:
                (1) Covered veteran.--The term ``covered veteran'' means a
            veteran who is enrolled in both the Medicare program under
            title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.)
            and the system of annual patient enrollment of the Department
            of Veterans Affairs under section 1705(a) of title 38, United
            States Code.
                (2) Secretary.--The term ``Secretary'' means the Secretary
            of Veterans Affairs.

    SEC. 320. FISHER HOUSE AVAILABILITY.

        Section 1708 of title 38, United States Code, is amended--
                (1) in subsection (a), by striking ``in connection with''
            and all that follows through the period at the end and
            inserting ``in accordance with this section.'';
                (2) in subsection (b)--
                        (A) in paragraph (2)--
                                (i) by inserting ``described in paragraph
                            (1)'' after ``family of a veteran''; and
                                (ii) by inserting ``such'' after
                            ``accompany''; and
                        (B) by adding at the end the following new
                    paragraphs:
                ``(3) On a space-available basis, a covered beneficiary who
            must travel a significant distance to receive care or services
            at a Department or non-Department facility.
                ``(4) On a space-available basis, a member of the family of
            a covered beneficiary described in paragraph (3) and others who
            accompany such a covered beneficiary who is receiving care or
            services and provide the equivalent of familial support for
            such beneficiary when the covered beneficiary or the family
            member is traveling to receive care or services at a Department
            or non-Department facility.
                ``(5) On a space-available basis, a veteran and a member of
            the family of a veteran and others who must travel a
            significant distance for a member of the veteran's family to
            receive care or services at a Department or non-Department
            facility.
                ``(6) On a space available basis, a covered beneficiary and
            a member of the family of a covered beneficiary and others who
            must travel a significant distance for a member of the covered
            beneficiary's family to receive care or services at a
            Department or non-Department facility.'';
                (3) by striking subsection (c) and redesignating
            subsections (d) and (e) as subsections (c) and (d),
            respectively;
                (4) in subsection (d), as so redesignated--
                        (A) in paragraph (2), by striking ``subsection
                    (d)'' and inserting ``subsection (c)'';
                        (B) in paragraph (3), by striking ``under
                    subsection (b)(2)'' and inserting ``or a covered
                    beneficiary under subsection (b)'';
                        (C) in paragraph (4), by striking ``and'' after the
                    semicolon;
                        (D) by redesignating paragraph (5) as paragraph
                    (6); and
                        (E) by inserting after paragraph (4) the following
                    new paragraph (5):
                ``(5) establishing criteria for providing access to
            temporary lodging facilities on a space-available basis under
            paragraphs (3) through (6) of subsection (b); and''; and
                (5) by adding at the end the following new subsection:
        ``(e) In this section:
                ``(1) The term `covered beneficiary' means a member of the
            uniformed services, including members of the armed services
            regardless of duty status.
                ``(2) The term `Fisher house' means a housing facility
            that--
                        ``(A) is located at, or in proximity to, a
                    Department medical facility;
                        ``(B) is available for residential use on a
                    temporary basis by patients of that facility and others
                    described in subsection (b); and
                        ``(C) is constructed by, and donated to the
                    Secretary by, the Zachary and Elizabeth M. Fisher Armed
                    Services Foundation or the Fisher House Foundation,
                    Inc.''.

    SEC. 321. AGREEMENTS BETWEEN MEDICAL FACILITIES OF DEPARTMENT OF
                  VETERANS AFFAIRS AND RURAL MEDICAL FACILITIES.

        (a) In General.--Not later than one year after the date of
    enactment of this Act, the Secretary of Veterans Affairs shall commence
    a 5-year pilot program to provide greater access to care for eligible
    veterans in rural areas and reduce the initial or long-term costs to
    the Department or the eligible entity of providing such care for
    eligible veterans.
        (b) Pilot Program.--In carrying out the pilot program, the
    Secretary shall ensure that each medical center of the Department
    participating in the pilot enters into or provides material support to
    an agreement with an eligible entity related to one or more of the
    following:
                (1) Co-location of Department and non- Department health
            care resources.
                (2) The provision of telehealth to eligible veterans by
            health care providers of the Department.
                (3) Leasing of space or equipment by or from the
            Department.
                (4) Training by health care providers of the Department of
            non-Department health care providers, subject to paragraph (4).
                (5) Care coordination for authorized care furnished by the
            eligible entity for eligible veterans.
                (6) Care coordination, including transportation
            coordination, for emergency treatment (as defined in section
            1725(h) of title 38, United States Code.
                (7) The provision by the eligible entity of hospital care,
            medical services, or extended care services under section 1703
            of this title.
                (8) Such other conditions or services directly related to
            health care as expressly authorized under laws administered by
            the Secretary.
        (c) Types of Arrangements.--An agreement under subsection (b) may
    include a lease or co-location agreement, a memorandum of
    understanding, a partnership agreement, a contract or agreement for the
    mutual use or exchange of use of health-care resources, or any other
    similar agreement or arrangement.
        (d) Report.--For each year of the pilot, the Secretary shall submit
    to the appropriate committees of Congress a report on the operation and
    performance of agreements entered into under subsection (a) including--
                (1) new agreements entered into, in the case of the initial
            report, since the date of the enactment of the Take Care of
            America's Veterans Act, and, in the case of any subsequent
            report, during the period following the previous report;
                (2) an assessment of the success of all agreements entered
            into pursuant to this Act in delivering services to eligible
            veterans, including--
                        (A) the number of eligible veterans, by region, who
                    received services under an agreement compared to the
                    previous five-year period;
                        (B) an evaluation of accessibility to services for
                    eligible veterans as compared to the accessibility of
                    services for those veterans prior to the implementation
                    of such agreements;
                        (C) an overview of best practices, including new
                    best practices, developed for such agreements and the
                    Department more broadly;
                        (D) the number of veterans receiving compensation
                    from the Department for a service-connected disability,
                    disaggregated by region, compared to the previous 5-
                    year period; and
                        (E) such other factors considered appropriate by
                    the Secretary of Veterans Affairs.
        (e) Definitions.--In this section:
                (1) Appropriate committees of congress.--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.
                (2) Eligible entity.--The term ``eligible entity'' means a
            non-Department entity or provider furnishing health care or
            health care services in a rural area.
                (3) Eligible veteran.--The term ``eligible veteran'' means
            a covered veteran under section 1703(b)16 of this title.
                (4) Material support.--The term ``material support'' means
            support provided by a health care provider or other staff of
            the Department to further the purpose or purposes of an
            agreement under subsection (a)(1) and may include--
                        (A) the use of time or resources of health care
                    providers of the Department;
                        (B) the obligation or receipt of funds; and
                        (C) such other support as the Secretary determines
                    appropriate.
                (5) Rural.--The term ``rural'', with respect to an area,
            means the area has a code other than 1 or 1.1 in the Rural-
            Urban Commuting Areas (RUCA) coding system of the Department of
            Agriculture.

    SEC. 322. STUDY ON QUALITY OF CARE DIFFERENCE BETWEEN MENTAL HEALTH AND
                  ADDICTION THERAPY CARE PROVIDED BY HEALTH CARE PROVIDERS
                  OF DEPARTMENT OF VETERANS AFFAIRS COMPARED TO NON-
                  DEPARTMENT PROVIDERS.

        (a) In General.--Not later than 90 days after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall seek to
    enter into an agreement with an independent and objective organization
    outside the Department of Veterans Affairs under which that
    organization shall--
                (1) conduct a study on the quality of care difference
            between mental health and addiction therapy care under the laws
            administered by the Secretary provided by health care providers
            of the Department compared to non-Department providers across
            various modalities, such as telehealth, in-patient, intensive
            out-patient, out-patient, and residential treatment; and
                (2) submit to the Committee on Veterans' Affairs of the
            Senate and the Committee on Veterans' Affairs of the House of
            Representatives and publish on a publicly available website a
            report containing the final results of such study.
        (b) Timing.--The Secretary shall ensure that the organization with
    which the Secretary enters into an agreement pursuant to subsection (a)
    is able to complete the requirements under such subsection by not later
    than 18 months after the date on which the agreement is entered into.
        (c) Elements.--The report submitted pursuant to subsection (a)(2)
    shall include an assessment of the following:
                (1) The amount of improvement in health outcomes from start
            of treatment to completion, including symptom scores and
            suicide risk using evidence-based scales, including the
            Columbia-Suicide Severity Rating Scale.
                (2) Whether providers of the Department and non-Department
            providers are using evidence-based practices in the treatment
            of mental health and addiction therapy care, including criteria
            set forth by the American Society of Addiction Medicine.
                (3) Potential gaps in coordination between providers of the
            Department and non-Department providers in responding to
            individuals seeking mental health or addiction therapy care,
            including the sharing of patient health records.
                (4) Implementation of veteran-centric care, including the
            level of satisfaction of patients with care and the competency
            of providers with the unique experiences and needs of the
            military and veteran population.
                (5) Whether veterans with co-occurring conditions receive
            integrated care to holistically address their needs.
                (6) Whether providers monitor health outcomes continually
            throughout treatment and at regular intervals for up to three
            years after treatment.
                (7) The average length of time to initiate services, which
            shall include a comparison of the average length of time
            between the initial point of contact after patient outreach to
            the point of initial service, as measured or determined by the
            Secretary.

    SEC. 323. LACTATION SPACES IN MEDICAL CENTERS OF THE DEPARTMENT OF
                  VETERANS AFFAIRS.

        (a) 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. 1720M. Lactation spaces in medical centers of the Department
        ``(a) Lactation Space Required.--The Secretary shall ensure that
    each medical center of the Department contains a lactation space.
        ``(b) No Unauthorized Entry.--Nothing in this section shall be
    construed to authorize an individual to enter a medical center of the
    Department or portion thereof that the individual is not otherwise
    authorized to enter.
        ``(c) Lactation Space Defined.--In this section, the term
    `lactation space' means a hygienic place, other than a bathroom, that--
                ``(1) is shielded from view;
                ``(2) is free from intrusion;
                ``(3) is accessible to disabled individuals (including such
            individuals who use wheelchairs);
                ``(4) contains a chair and a working surface;
                ``(5) is easy to locate;
                ``(6) is clearly identified with signage; and
                ``(7) is available for use by women veterans and members of
            the public to express breast milk.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    such chapter is amended by inserting after the item related to section
    1720L the following new item:

    ``1720M. Lactation spaces in medical centers of the Department.''.
        (c) Implementation.--The Secretary of Veterans Affairs shall ensure
    that--
                (1) not later than two years after the date of the
            enactment of this Act, not fewer than 80 percent of medical
            centers of the Department of Veterans Affairs are in compliance
            with section 1720M of title 38, United States Code, as added by
            subsection (a); and
                (2) not later than three years after such date of
            enactment, all medical centers of the Department are in
            compliance with such section.
        (d) Report.--
                (1) In general.--Not later than one year after the date of
            the enactment of this Act, and annually thereafter, the
            Secretary of Veterans Affairs shall submit to the Committee on
            Veterans' Affairs of the Senate and the Committee on Veterans'
            Affairs of the House of Representatives a report on the
            progress of the Secretary in meeting the requirements under
            section 1720M of title 38, United States Code, as added by
            subsection (a), including--
                        (A) a list of which medical centers of the
                    Department of Veterans Affairs currently have a
                    lactation space;
                        (B) a list of which medical centers of the
                    Department do not have a lactation space; and
                        (C) for each medical center listed under
                    subparagraph (B), a description of actions the
                    Department has taken to design and plan a lactation
                    space and a timeline for such lactation space to be
                    fully functional and open for use within the time
                    periods specified under subsection (c).
                (2) Termination.--The Secretary is not required to submit a
            report under paragraph (1) on or after the date on which the
            Secretary confirms in a report submitted under such paragraph
            that each medical center of the Department contains a lactation
            space.

    SEC. 324. RESEARCH RELATED TO MENOPAUSE, PERIMENOPAUSE, AND MID-LIFE
                  WOMEN'S HEALTH: REPORT; PLAN.

        (a) Definitions.--In this section:
                (1) Covered provider.--The term ``covered provider'' means
            a health care provider employed by the Department of Veterans
            Affairs.
                (2) Menopause.--The term ``menopause'' means the stage of a
            woman's life--
                        (A) when menstrual periods stop permanently and she
                    can no longer get pregnant; and
                        (B) that is not a disease state, but a normal part
                    of aging for women.
                (3) Mid-life.--The term ``mid-life'' means a life stage
            that--
                        (A) coincides with the menopausal transition in
                    women, which may be physical or emotional;
                        (B) encompasses the late reproductive age, which
                    can begin at approximately 35 years of age, to the late
                    postmenopausal stages of reproductive aging, which can
                    extend to approximately 65 years of age; and
                        (C) often marks the onset of many chronic diseases.
                (4) Perimenopause.--The term ``perimenopause'' means the
            time during a woman's life when levels of the hormone estrogen
            fall unevenly in a woman's body and is also called the
            menopausal transition.
                (5) Postmenopausal.--The term ``postmenopausal'' means the
            stage of a woman's life after a woman has been without a
            menstrual period for 12 months that lasts for the rest of a
            woman's life and reflects a time when women are at increased
            risk for osteoporosis and heart disease.
        (b) Evaluation of Certain Research Related to Menopause,
    Perimenopause, or Mid-life Women's Health.--
                (1) In general.--The Secretary of Veterans Affairs, shall
            evaluate--
                        (A) the results of completed research related to
                    menopause, perimenopause, or mid-life women's health
                    among women who are members of the uniformed services
                    or veterans;
                        (B) the status of such research that is ongoing;
                        (C) any gaps in knowledge and research on--
                                (i) treatments for menopause-related
                            symptoms, including hormone and non-hormone
                            treatments;
                                (ii) the safety and effectiveness of
                            treatments for menopause-related symptoms;
                                (iii) the impact of perimenopause and
                            menopause on the mental health of women who are
                            members of the uniformed services or veterans;
                        (D) the availability of and uptake of professional
                    training resources for covered providers relating to
                    mid-life women's health with respect to the care,
                    treatment, and management of perimenopause and
                    menopausal symptoms, and related support services; and
                        (E) the availability of and uptake of treatments
                    for women who are members of the uniformed services or
                    veterans who are experiencing perimenopause or
                    menopause.
                (2) Report; strategic plan.--Not later than 180 days after
            the date of the enactment of this Act, the Secretary of
            Veterans Affairs shall submit to Congress a report containing--
                        (A) the findings of the evaluation conducted under
                    paragraph (1);
                        (B) recommendations for improving professional
                    training resources described in paragraph (1)(D) for
                    covered providers; and
                        (C) a strategic plan that--
                                (i) resolves the gaps in knowledge and
                            research identified in the report; and
                                (ii) identifies topics in need of further
                            research relating to potential treatments for
                            menopause-related symptoms of women who are
                            members of the uniformed services or veterans.
                (3) Nonduplication and supplementation of efforts.--In
            carrying out activities under this section, the Secretary of
            Veterans Affairs shall ensure that such activities minimize
            duplication and supplement, not supplant, existing information-
            sharing efforts of the Department of Health and Human Services.
        (c) Sense of Congress on Additional Research Related to Menopause,
    Perimenopause, or Mid-life Women's Health.--It is the sense of Congress
    that the Secretary of Defense and the Secretary of Veterans Affairs
    should each conduct research related to menopause, perimenopause, or
    mid-life health regarding women who are members of the uniformed
    services or veterans.

    SEC. 325. PILOT PROGRAM ON PROVISION OF OPIOID RESCUE MEDICATIONS TO
                  VETERANS.

        (a) In General.--Commencing not later than 120 days after the date
    of the enactment of this Act, the Secretary of Veterans Affairs shall
    carry out a one-year pilot program under which the Secretary shall make
    covered medications available to any veteran at no charge (in this
    section referred to as the ``pilot program'').
        (b) Provision of Medication Prior to Confirmation of Status.--The
    Secretary may provide covered medication to an individual under the
    pilot program prior to confirming the status of the individual as a
    veteran if the individual provides contact information for the
    individual and a written self-attestation of veteran status.
        (c) Site Selection.--The Secretary shall prioritize carrying out
    the pilot program in geographical areas where data indicates a
    disproportionately high risk of overdose among the veteran population.
        (d) Limitation on Use of Information.--
                (1) In general.--In carrying out this section, the
            Secretary may only collect the personally identifiable
            information needed for prescribing covered medication under the
            pilot program, and any personally identifiable information
            collected under this section may be used solely for the purpose
            of delivering, evaluating, and enhancing the quality of health
            care.
                (2) Exclusion.--The Secretary may not use any personally
            identifiable information collected under this section--
                        (A) for the purpose of preventing a veteran from
                    employment;
                        (B) as evidence of a history of drug use; or
                        (C) as evidence that an individual is an unlawful
                    user of or addicted to any controlled substance.
        (e) Provision of Information.--The Secretary shall ensure that any
    individual who receives covered medication under the pilot program also
    receives--
                (1) information about addiction services, suicide
            prevention services, mental health services, and other related
            services provided by the Department of Veterans Affairs; and
                (2) information on the use and application of covered
            medications.
        (f) Report.--
                (1) In general.--Not later than 30 days before the
            completion of the pilot program under this section, the
            Secretary shall submit to Congress a report on the pilot
            program.
                (2) Elements.--The report required by paragraph (1) shall
            include the following:
                        (A) The number of veterans who received a covered
                    medication under the pilot program, disaggregated by
                    those enrolled in the system of annual patient
                    enrollment of the Department of Veterans Affairs under
                    section 1705(a) of title 38, United States Code, and
                    those not enrolled in such system.
                        (B) An assessment of the feasibility of expanding
                    the pilot program to provide covered medications to
                    immediate family members of veterans.
                        (C) Any considerations associated with continuing,
                    expanding, or making permanent the pilot program.
                        (D) Any other recommendations of the Secretary with
                    respect to modifying or continuing the pilot program.
        (g) Definitions.--In this section:
                (1) Covered medication.--The term ``covered medication''
            means any opioid overdose rescue medication, such as naloxone.
                (2) Veteran.--The term ``veteran'' has the meaning given
            that term in section 101 of title 38, United States Code.

    SEC. 326. ESTABLISHMENT OF VETERANS HEALTH ADMINISTRATION POLICY
                  ADVISORY COMMISSION.

        (a) In General.--Chapter 1 of title 38, United States Code, is
    amended by adding at the end the following new section:
    ``Sec. 120. Veterans Health Administration Policy Advisory Commission
        ``(a) Establishment.--There is established the Veterans Health
    Administration Policy Advisory Commission (in this section referred to
    as the `Commission').
        ``(b) Membership.--
                ``(1) Composition.--The Commission shall be composed of 17
            members appointed by the Comptroller General of the United
            States, of which not fewer than 2 shall be veterans.
                ``(2) Qualifications.--
                        ``(A) In general.--An individual is eligible for
                    appointment to the Commission under paragraph (1) if
                    the individual has significant expertise in operating
                    or advising large medical systems, including expertise
                    in quality of care, staffing issues, health information
                    technology, artificial intelligence in health care,
                    medical research, and managed care plans and networks.
                        ``(B) Experience of members.--In appointing members
                    under paragraph (1), the Comptroller General shall
                    select individuals from backgrounds that reflect the
                    broad diversity of health care received by veterans,
                    including nonprofit health systems, public and private
                    health systems, care furnished by the Veterans Health
                    Administration, and care furnished by the Department of
                    Defense.
                ``(3) Ethical disclosure.--A member of the Commission shall
            be considered an employee of Congress whose compensation is
            disbursed by the Secretary of the Senate for purposes of
            applying subchapter I of chapter 131 of title 5, United States
            Code, except that a member of the Commission is required to
            file public financial disclosure reports without regard to
            their number of days of service or rate of pay.
        ``(c) Period of Appointment; Vacancies.--
                ``(1) Vacancies.--
                        ``(A) In general.--A vacancy on the Commission
                    shall be filled in the manner in which the original
                    appointment was made and shall be subject to any
                    conditions that applied with respect to the original
                    appointment.
                        ``(B) Filling unexpired term.--An individual chosen
                    to fill a vacancy shall be appointed for the unexpired
                    term of the member replaced.
                ``(2) Expiration of terms.--The term of any member shall
            not expire before the date on which the member's successor
            takes office.
        ``(d) Meetings.--
                ``(1) Frequency.--The Commission shall meet at the call of
            the Chairman, but not less frequently than once per year.
                ``(2) Quorum.--A majority of the members of the Commission
            shall constitute a quorum, but a lesser number of members may
            hold meetings.
        ``(e) Chairman and Vice Chairman.--The Comptroller General shall
    designate one member of the Commission as Chairman and one member of
    the Commission as Vice Chairman, at the time of appointment of such
    member and for the term of appointment of such member, except that in
    the case of vacancy of the Chairmanship or Vice Chairmanship, the
    Comptroller General may designate another member for the remainder of
    that member's term.
        ``(f) Duties of the Commission.--
                ``(1) Review.--The Commission shall--
                        ``(A) review operations at the Veterans Health
                    Administration; and
                        ``(B) prepare reports for Congress based on such
                    review, including recommendations to Congress.
                ``(2) Topics to be reviewed.--In conducting a review under
            paragraph (1)(A), the Commission shall include periodic reviews
            of the following, taking into consideration other independent
            assessments in selecting topics to limit duplicative efforts:
                        ``(A) Information technology infrastructure at
                    medical facilities of the Department, including with
                    respect to electronic health record systems.
                        ``(B) Referrals to care at facilities of the
                    Department and under the Veterans Community Care
                    Program under section 1703 of this title, and factors
                    impacting those referrals.
                        ``(C) Access and wait times at medical facilities
                    of the Department and under the Veterans Community Care
                    Program, including both primary and specialty care, and
                    factors impacting those wait times.
                        ``(D) The quality of health care furnished by the
                    Department and through the Veterans Community Care
                    Program.
                        ``(E) Workforce issues, including workforce
                    performance, recruitment, and retention factors.
                        ``(F) Patient satisfaction and customer service at
                    medical facilities of the Department and through the
                    Veterans Community Care Program.
                        ``(G) The training of health care providers and the
                    standards of care at facilities of the Department and
                    in the Veterans Community Care Program.
                        ``(H) The long-term budgetary outlook of the
                    Veterans Health Administration, as well as key
                    components driving budgetary changes over time.
                        ``(I) The research program of the Department,
                    including both internal and external research.
                        ``(J) The interaction of care under the Medicare
                    program under title XVIII of the Social Security Act
                    (42 U.S.C. 1395 et seq.), the Medicaid program under
                    title XIX of such Act (42 U.S.C. 1396 et seq.), the
                    TRICARE program under chapter 55 of title 10, and
                    commercial health care plans with care furnished by the
                    Veterans Health Administration.
                ``(3) Use of existing data.--In carrying out the
            requirements of this subsection, the Commission, to the extent
            practicable, shall use existing data that has been compiled by
            the Department, compiled for the Department, or purchased by
            the Department, including--
                        ``(A) data described in subsection (c)(1) of
                    section 1704A of this title; and
                        ``(B) the results of the independent assessments
                    conducted under such section.
                ``(4) Issues regarding veteran health care delivery
            generally.--In carrying out the requirements of this
            subsection, the Commission shall review the effect of policies
            under this title on the delivery of health care services to
            veterans and assess the implications of changes in health care
            delivery for veterans under the laws administered by the
            Secretary.
                ``(5) Transmittal of certain reports.--If the Secretary or
            the Inspector General of the Department of Veterans Affairs
            submits to Congress (or a committee of Congress) a report that
            is required by law and that relates to policies for health care
            furnished under the laws administered by the Secretary, the
            Secretary shall transmit a copy of that report to the
            Commission.
                ``(6) Consultation and additional reviews and studies.--
                        ``(A) Consultation.--In carrying out the
                    requirements of this subsection, the Commission shall
                    consult periodically with the chairmen and ranking
                    members of the Committee on Veterans' Affairs of the
                    Senate and the Committee on Veterans' Affairs of the
                    House of Representatives regarding the agenda of the
                    Commission and progress towards achieving that agenda.
                        ``(B) Additional reviews and reports.--The
                    Commission may conduct additional reviews, and may
                    submit additional reports to the Committee on Veterans'
                    Affairs of the Senate and the Committee on Veterans'
                    Affairs of the House of Representatives, from time to
                    time on such topics relating to the activities of the
                    Commission as may be requested by the Chairman and
                    members and as the Commission determines appropriate.
                        ``(C) Special studies.--The Commission may conduct
                    special studies requested by the chairman or ranking
                    member of the Committee on Veterans' Affairs of the
                    Senate or the Committee on Veterans' Affairs of the
                    House of Representatives and as the Commission
                    determines appropriate.
                ``(7) Coordination.--In carrying out reviews, preparing
            reports, and conducting studies under this section, the
            Commission shall, to the extent practicable, coordinate with
            the Inspector General of the Department to ensure the work of
            the Commission does not interfere with investigations or
            remediations underway by the Inspector General.
                ``(8) Budgetary considerations.--Before making any
            recommendations to Congress, the Commission shall examine the
            budget consequences of such recommendations, directly or
            through consultation with appropriate expert entities.
                ``(9) Report.--
                        ``(A) In general.--By not later than March 15 of
                    each year, the Commission shall submit to Congress a
                    report containing the results and recommendations from
                    the review conducted under paragraph (1).
                        ``(B) Inclusion of recommendations.--A
                    recommendation may be included in a report under
                    subparagraph (A) if a simple majority of the members of
                    the Commission vote to include the recommendation in
                    the report.
                ``(10) Limitation.--Nothing in this section shall be
            construed to authorize the Commission to direct, control,
            approve, suspend, delay, or administer any program, policy,
            contract, personnel action, budgetary decision, clinical
            decision, or operational activity of the Department. The
            Commission shall serve solely in an advisory capacity to
            Congress and to the Department on matters expressly authorized
            under laws administered by the Secretary.
        ``(g) Powers of Commission.--
                ``(1) In general.--The Commission may--
                        ``(A) employ and fix the compensation:
                                ``(i) of an Executive Director (at a rate
                            of pay not greater than that provided for level
                            III of the Executive Schedule under section
                            5314 of title 5) who is confirmed by two thirds
                            vote by members of the Commission; and
                                ``(ii) other such personnel as may be
                            necessary to carry out the duties of the
                            Commission, without regard to the provisions of
                            title 5 governing appointments in the
                            competitive service;
                        ``(B) seek such assistance and support as may be
                    required in the performance of its duties from
                    appropriate departments and agencies of the United
                    States or departments or agencies of a State;
                        ``(C) enter into a contract or conduct original
                    research only upon a written determination by the Chair
                    and Vice Chair that comparable information is
                    unavailable, insufficient, or outdated;
                        ``(D) make advance, progress, and other payments
                    that relate to the work of the Commission;
                        ``(E) provide transportation and subsistence for
                    individuals serving the Commission without
                    compensation; and
                        ``(F) prescribe such rules and regulations as the
                    Commission determines necessary with respect to the
                    internal organization and operation of the Commission.
                ``(2) Data collection.--In order to carry out its
            functions, the Commission shall--
                        ``(A) utilize existing information, both published
                    and unpublished, if possible, collected and assessed
                    either by its own staff or under other arrangements
                    made in accordance with this section;
                        ``(B) to the maximum extent practicable, rely on
                    existing data, reports, audits, evaluations, and
                    assessments prepared by the Department, the Inspector
                    General of the Department, the Government
                    Accountability Office, the Congressional Research
                    Service, the Congressional Budget Office, and other
                    relevant Federal entities before entering into any
                    contract or conducting original research; and
                        ``(C) adopt procedures allowing any interested
                    party to submit information for use by the Commission
                    in making reports and recommendations.
                ``(3) Information from federal agencies.--
                        ``(A) In general.--The Commission may secure
                    directly from any relevant department or agency of the
                    United States health care information the Chairman
                    determines would be helpful to enable the Commission to
                    carry out this section.
                        ``(B) Timing.--Upon request of the Chairman, the
                    head of a department or agency of the United States
                    shall furnish information requested under subparagraph
                    (A) to the Commission on an agreed upon schedule or not
                    later than 180 days after the date of the request.
        ``(h) Compensation.--
                ``(1) Members.--
                        ``(A) In general.--While conducting the business of
                    the Commission (including travel time), a member of the
                    Commission shall be entitled to compensation at the per
                    diem equivalent of the rate provided for level IV of
                    the Executive Schedule under section 5315 of title 5.
                        ``(B) Travel expenses.--While conducting the
                    business of the Commission away from home and the
                    regular place of business of the member, a member may
                    be allowed travel expenses, as authorized by the
                    Chairman.
                ``(2) Physician comparability allowance for personnel.--The
            Commission may provide a physician comparability allowance to
            physicians serving as personnel of the Commission in the same
            manner as physicians of the Federal Government may be provided
            such an allowance by an agency under section 5948 of title 5,
            and for such purpose, subsection (i) of such section shall
            apply to the Commission in the same manner as it applies to the
            Tennessee Valley Authority.
                ``(3) Treatment of personnel.--For purposes of pay (other
            than pay of members of the Commission) and employment benefits,
            rights, and privileges, all personnel of the Commission shall
            be treated as if they were employees of the United States
            Senate.
        ``(i) Detail of Federal Employees.--An employee of the Federal
    Government may be detailed to the Commission without reimbursement and
    without interruption or loss of civil service status or privileges.
        ``(j) Access of Congressional Support Agencies to Information.--The
    Commission shall provide to the Comptroller General, the Congressional
    Research Service, and the Congressional Budget Office unrestricted
    access to all deliberations, records, and nonproprietary data of the
    Commission not later than 30 days after such access is requested.
        ``(k) Authorization of Appropriations.--The Commission shall submit
    requests for appropriations in the same manner as the Comptroller
    General submits requests for appropriations, but amounts appropriated
    for the Commission shall be separate from amounts appropriated for the
    Comptroller General.
        ``(l) Termination.--
                ``(1) The Commission shall terminate on September 30, 2032.
                ``(2) Not later than 1 year before the date of termination
            under paragraph (1), the Commission shall submit to the
            Committees on Veterans' Affairs of the House of Representatives
            and the Senate a final assessment on whether the Commission
            should be continued, modified, or allowed to terminate.
                ``(3) A member of the Commission shall be appointed under
            subsection (b)(1) for a term of 5 years, except that the
            Comptroller General shall designate staggered terms for the
            members first appointed.
                ``(4) No funds may be obligated by the Commission after the
            date of termination under paragraph (1), except for activities
            necessary to close out the operations of the Commission.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    such chapter is amended by inserting after the item relating to section
    119 the following new item:

    ``120. Veterans Health Administration Policy Advisory Commission.''.
        (c) Initial Appointment.--Not later than 280 days after the date on
    which amounts are first appropriated to the Veterans Health
    Administration Policy Advisory Commission established under section 120
    of title 38, United States Code, as added by subsection (a), the
    Comptroller General of the United States shall make initial
    appointments of members to the Commission under subsection (b)(1) of
    such section.

    SEC. 327. ACCESS TO HEALTH CARE.

        (a) Connection to Veterans Health Administration When a Disability
    Claim Related to Military Sexual Trauma Is Submitted to Veterans
    Benefits Administration.--Section 2 of the MST Claims Coordination Act
    (Public Law 117-303; 38 U.S.C. 1166 note) is amended--
                (1) in subsection (a)(1)--
                        (A) in subparagraph (C), by striking ``; and'' and
                    inserting a semicolon; and
                        (B) by striking subparagraph (D) and inserting the
                    following:
                        ``(D) the contact information for the nearest
                    military sexual trauma coordinator for the veteran at
                    the Veterans Benefits Administration and a description
                    of the assistance such coordinator can provide;
                        ``(E) the contact information for the nearest
                    military sexual trauma coordinator for the veteran at
                    the Veterans Health Administration and a description of
                    the assistance such coordinator can provide;
                        ``(F) the types of services that individuals who
                    have experienced military sexual trauma are eligible to
                    receive from the Department of Veterans Affairs, such
                    as mental health counseling from providers trained in
                    military sexual trauma issues and peer support
                    services, including the nearest locations where such
                    services are furnished, including the nearest
                    Readjustment Counseling Service location, and the
                    contact information for the providers of such services;
                    and
                        ``(G) such other information on services, care, or
                    resources for military sexual trauma as the Secretary
                    determines appropriate.''; and
                (2) in subsection (d)--
                        (A) in paragraph (3)--
                                (i) in subparagraph (B), by striking ``;
                            and'' and inserting a semicolon;
                                (ii) in subparagraph (C), by striking the
                            period and inserting ``; and''; and
                                (iii) by adding at the end the following:
                        ``(D) submitting a claim for disability
                    compensation to the Veterans Benefits Administration
                    for a disability relating to military sexual trauma.'';
                    and
                        (B) by amending paragraph (5) to read as follows:
                ``(5) The term `military sexual trauma' with respect to
            eligibility for health care, has the meaning given such term in
            section 1166(d)(2) of title 38, United States Code.''.
        (b) Care Relating to Military Sexual Trauma for Individuals Who
    Withdraw From or Otherwise Do Not Complete Service at Service
    Academies.--
                (1) In general.--The Secretary of Veterans Affairs, in
            coordination with the Secretary of Defense, the Secretary of
            Homeland Security, and the Secretary of Transportation, shall
            ensure that each individual who withdraws from, or otherwise
            does not complete service at, a service academy is provided--
                        (A) information on the potential eligibility of
                    such individual for care and counseling relating to
                    military sexual trauma provided through the Department
                    of Veterans Affairs; and
                        (B) the option to receive copies of--
                                (i) the individual's service treatment
                            records or military personnel records that
                            document military sexual trauma;
                                (ii) reporting forms of the Department of
                            Defense, the Department of Homeland Security,
                            or the Department of Transportation on sexual
                            assault or sexual harassment for which the
                            individual was the victim; and
                                (iii) any investigative reports into
                            military sexual trauma that occurred during the
                            individual's service in the Armed Forces and
                            for which the individual was the victim, which
                            are in the possession of the Department of
                            Defense, the Department of Homeland Security,
                            or the Department of Transportation.
                (2) Definitions.--In this subsection:
                        (A) Military sexual trauma.--The term ``military
                    sexual trauma'' has the meaning given such term in
                    section 1166(d)(2) of title 38, United States Code.--
                        (B) Service academy.--The term ``service academy''
                    means any of the following:
                                (i) The United States Military Academy.
                                (ii) The United States Naval Academy.
                                (iii) The United States Air Force Academy.
                                (iv) The United States Coast Guard Academy.
                                (v) The United States Merchant Marine
                            Academy.

    SEC. 328. RESEARCH ON HEALTH CONDITIONS OF DESCENDANTS OF TOXIC-EXPOSED
                  VETERANS.

        (a) Research on Diagnosis and Treatment of Health Conditions of
    Descendants of Individuals Exposed to Toxic Substances While Serving in
    Armed Forces.--
                (1) Contract or agreement.--The Secretary of Veterans
            Affairs shall enter into a contract or interagency agreement
            with the Agency for Toxic Substances and Disease Registry (in
            this section referred to as the ``Agency'') to perform the
            services covered by this section.
                (2) Services.--Under a contract or agreement between the
            Secretary and the Agency under this section, the Agency shall--
                        (A) conduct a literature review on the health
                    effects on descendants of toxic-exposed veterans and
                    toxic-exposed members of the Armed Forces from their
                    toxic exposure and identify any gaps in knowledge or
                    research on such topic;
                        (B) not later than 180 days after completing the
                    literature review under subparagraph (A) establish and
                    maintain a publicly available report with information
                    on--
                                (i) the findings of the Agency with respect
                            to such literature review; and
                                (ii) the ongoing research and activities
                            directed by the Agency, including a review of
                            all relevant data to determine the strength of
                            evidence for a positive association between a
                            health condition researched and a toxic
                            exposure based on the categories set forth
                            under section 1173(c)(2) of title 38, United
                            States Code; and
                        (C) not later than 30 days after the date on which
                    the first review is published under subparagraph (B)
                    and not less frequently than once every year
                    thereafter, publish a new report containing the
                    information made available under clause (ii) of such
                    subparagraph.
                (3) Sunset.--On the date that is 7 years after the date of
            enactment of this Act.
                (4) Literature review.--
                        (A) In general.--In carrying out the literature
                    review under paragraph (2)(A), the Agency shall review
                    available literature to determine the association
                    between military toxic exposures and the incidence or
                    prevalence of birth defects among the descendants of
                    toxic-exposed veterans and toxic-exposed members of the
                    Armed Forces.
                        (B) Report.--Not later than one year after the date
                    of the enactment of this Act, the Agency shall submit
                    to the Secretary, the Committee on Veterans' Affairs of
                    the Senate, and the Committee on Veterans' Affairs of
                    the House of Representatives a report containing the
                    findings of the Agency with respect to the activities
                    of the Agency under paragraph (2)(A).
                        (C) Plan.--
                                (i) In general.--Not later than 180 days
                            after the date of the enactment of this Act,
                            the Agency shall submit to the Secretary and to
                            the Committee on Veterans' Affairs of the
                            Senate and the Committee on Veterans' Affairs
                            of the House of Representatives a plan
                            describing the Agency's proposed approach to
                            carrying out the literature review under
                            paragraph (2)(A).
                                (ii) Contents.--The plan submitted pursuant
                            to clause (i) shall include--
                                        (I) the scope and key research
                                    questions to be addressed; and
                                        (II) the methodology to be used in
                                    identifying, evaluating, and
                                    synthesizing relevant scientific and
                                    medical literature.
                (5) Consultation.--The Agency shall carry out the services
            covered by this subsection in consultation with such Federal,
            State, and research partners as the Agency and the Secretary
            jointly consider appropriate.
                (6) Prohibition on expansion of services.--Nothing in this
            section shall be construed to authorize the expansion of
            compensation or healthcare benefits furnished by the Department
            to the descendants of members of the Armed Forces.
        (b) Program for Monitoring Health of Descendants of Veterans and
    Members of the Armed Forces Subjected to Toxic Exposure in the Armed
    Forces.--
                (1) In general.--The Secretary of Veterans Affairs shall
            use the results of the literature review conducted under
            subsection (a)(2)(A) to establish a health monitoring or
            screening program for descendants of toxic-exposed veterans and
            toxic-exposed members of the Armed Forces, to assist in
            identifying potential patterns or signals, supporting public
            health surveillance, and facilitating epidemiologic and
            clinical research related to birth defects.
                (2) Requirements.--In carrying out the program required by
            paragraph (1), the Secretary shall--
                        (A) leverage Government data sets to improve the
                    program;
                        (B) recruit additional descendants;
                        (C) consult with relevant stakeholders to develop a
                    strategy to coordinate collection of information under
                    the program; and
                        (D) ensure data from the program is used to inform
                    basic research, translational research, and
                    epidemiological studies to help address data and
                    knowledge gaps identified in the literature review
                    conducted under subsection (a)(2)(A).
                (3) Mechanisms for administration.--The Secretary may
            administer the program required by paragraph (1) either
            directly or through such mechanisms as the Secretary considers
            appropriate, such as through the award of a grant or
            cooperative agreement.
                (4) Collection of information.--In administering the health
            monitoring program required by paragraph (1), the Secretary may
            collect, process, maintain, and consolidate information on
            birth defects among descendants of toxic-exposed veterans and
            toxic-exposed members of the Armed Forces, including biological
            samples, environmental factors, and personal and social
            factors.
                (5) Consultation.--The Secretary shall carry out the
            services covered by this section in consultation with such
            Federal, State, and research partners as the Department
            considers appropriate.
                (6) Sunset.--On the date that is 7 years after the date of
            enactment of this Act.
                (7) Prohibition on expansion of services.--No information
            collected by this program shall be used to inform the expansion
            of compensation or healthcare benefits furnished by the
            Department to the descendants of members of the Armed Forces,
            unless otherwise authorized by another Act of Congress on a
            date after the passage of this legislation.
        (c) Definitions.--In this subsection:
                (1) Active military, naval, air, or space service.--The
            term ``active military, naval, air, or space service'' has the
            meaning given such term in section 101 of title 38, United
            States Code.
                (2) Relevant stakeholders.--The term ``relevant
            stakeholders'' means--
                        (A) public health experts with experience in
                    developing and maintaining registries;
                        (B) epidemiologists with experience in studying
                    health effects of toxic exposure on the descendants of
                    toxic-exposed veterans;
                        (C) descendants of toxic-exposed veterans; and
                        (D) veterans service organizations.
                (3) Toxic-exposed member of the armed forces.--The term
            ``toxic-exposed member of the Armed Forces'' means a member of
            the Armed Forces who was subject to a toxic exposure in line of
            duty in the active military, naval, air, or space service.
                (4) Toxic-exposed veteran.--The term ``toxic-exposed
            veteran'' means a veteran who was subject to a toxic exposure
            in line of duty in the active military, naval, air, or space
            service.
                (5) Toxic exposure.--The terms ``toxic exposure'' and
            ``toxic-exposed veteran'' have the meanings given such terms in
            section 101 of title 38, United States Code.

    SEC. 329. VETERANS SPINAL TRAUMA ACCESS TO NEW DEVICES ACT.

        Section 1706 of title 38, United States Code, is amended by adding
    at the end the following new subsection:
        ``(d)(1) In managing the provision of hospital care and medical
    services under section 1710(a) of this title, the Secretary shall
    furnish (through direct provision of service, referral, or a telehealth
    program operated by the Department) a preventative health evaluation
    annually to any veteran with a spinal cord injury or disorder who
    elects to undergo the evaluation.
        ``(2) The evaluation described in paragraph (1) shall include the
    following:
                ``(A) An assessment of any circumstance or condition the
            veteran is experiencing that indicates a risk for any health
            complication related to the spinal cord injury or disorder,
            including a risk of comorbidities.
                ``(B) An assessment regarding chronic pain and, if
            applicable, the management of chronic pain.
                ``(C) An assessment regarding dietary management and weight
            management.
                ``(D) An assessment regarding prosthetic equipment,
            including which prosthetic equipment the veteran needs, how
            well any existing prosthetic equipment is functioning
            considering the needs of the veteran, and any safety concerns
            regarding the prosthetic equipment in use by or recommended to
            the veteran.
                ``(E) An assessment with respect to the provision of
            assistive technology, including spinal cord neuromodulation
            technology (such as non-invasive transcutaneous spinal
            stimulation), that could help maximize the veteran's voluntary
            motor or autonomic function, independence, or mobility,
            including suitability for home use and need for training,
            programming, and remote follow-up.
        ``(3)(A) In maintaining, prescribing, or amending any guidance,
    rules, or regulations issued by the Department regarding the
    requirements set out in this subsection, the Secretary shall consult
    with--
                ``(i) the spinal cord injury and disorder program managers
            of the Department;
                ``(ii) clinicians employed by the Department as specialists
            in spinal cord injuries and disorders;
                ``(iii) clinicians and technologists with demonstrated
            expertise in spinal cord neuromodulation therapies, including
            non-invasive transcutaneous approaches; and
                ``(iv) representatives of organizations recognzied under
            section 5902 of this title.
        ``(B) Before issuing any guidance, rules, or regulations regarding
    the requirements set out in this subsection, the Secretary shall
    consult with manufacturers of assistive technologies and other entities
    relevant to the provision of assistive technologies if the guidance,
    rules, or regulations would directly affect such manufacturers or
    entities.
        ``(C) The Secretary shall ensure, to the extent possible, that any
    veteran known by the Secretary to have a spinal cord injury or disorder
    receives information annually about the evaluation available under this
    subsection and the benefits to the veteran of choosing to undergo the
    evaluation.
        ``(4) As the Secretary determines clinically appropriate, the
    Secretary may provide training, programming, remote monitoring, and
    follow-up for assistive technologies through telehealth.
        ``(5) Not later than one year after the date of the enactment of
    the Take Care of America's Veterans Act, and every two years
    thereafter, the Secretary shall submit to the Committees on Veterans'
    Affairs of the Senate and the House of Representatives a report that
    includes the following:
                ``(A) For the period covered by the report--
                        ``(i) the number of veterans who--
                                ``(I) received medical care or hospital
                            services from the Department and used an
                            assistive technology;
                                ``(II) received medical care or hospital
                            services from the Department and were assessed
                            for the provision of an assistive technology;
                            and
                                ``(III) received medical care or hospital
                            services from the Department and were
                            prescribed an assistive technology.
                        ``(ii) for any assistive technology prescribed, an
                    identification of the category of such technology,
                    including spinal cord neuromodulation, and a summary of
                    functional outcomes associated with the prescription of
                    such technology, if available.
                ``(B) The year-to-year change (for the period covered by
            the report, including the two years immediately prior to year
            the report is submitted) in the percent of veterans with a
            spinal cord injury or disorder who received an evaluation under
            this subsection.
        ``(6) In reviewing the performance metrics of a Veterans Integrated
    Service Network for any year beginning after the date that is one year
    after the date of the enactment of the Veterans Spinal Trauma Access to
    New Devices Act, the Secretary shall consider the provision of
    evaluations under paragraph (1).
        ``(7) In this subsection, the term `assistive technology' means a
    powered medical device or electronic tool used to treat or alleviate
    symptoms or conditions caused by a spinal cord injury or disorder,
    including the following:
                ``(A) A personal mobility device, including a powered
            exoskeleton device.
                ``(B) A speech generating device.
                ``(C) A spinal cord neuromodulation technology, including
            non-invasive transcutaneous spinal stimulation using sensory
            (afferent) pathways, intended to improve voluntary motor
            function, autonomic function, independence, or quality of life.
                ``(D) Where clinically appropriate, and consistent with the
            prosthetic and sensory aids policies of the Department, an
            implantable spinal cord stimulation system that is approved by
            the Food and Drug Administration.''.

    SEC. 330. DEPARTMENT OF VETERANS AFFAIRS PILOT PROGRAM TO AWARD GRANTS
                  FOR THE PROVISION OF SERVICE DOGS TO VETERANS.

        (a) In General.--
                (1) Pilot program required.--Not later than 24 months after
            the date of the enactment of this Act, the Secretary of
            Veterans Affairs shall establish a pilot program under which
            the Secretary shall award grants, on a competitive basis based
            on the application elements listed in subsection (b)(2), to
            nonprofit entities to provide service dogs to eligible
            veterans.
                (2) Duration.--The Secretary shall carry out the pilot
            program during the three-year period beginning on the date on
            which the first grant is awarded under this section.
        (b) Applications.--
                (1) In general.--To be eligible to receive a grant under
            this section, a nonprofit entity shall submit an application to
            the Secretary at such time and in such manner as the Secretary
            may require.
                (2) Elements.--An application submitted by a nonprofit
            entity under paragraph (1) shall include the following:
                        (A) A proposal for the provision of service dogs to
                    eligible veterans, including how the nonprofit entity
                    will communicate with the Secretary to ensure an
                    increasing number of service dogs are provided to
                    veterans.
                        (B) A description of the following services or
                    commitments to be provided by the nonprofit entity:
                                (i) The training that will be provided to
                            eligible veterans.
                                (ii) The training of dogs that will serve
                            as service dogs.
                                (iii) Any additional support or services
                            that will be provided for such dogs and
                            eligible veterans.
                                (iv) The plan for publicizing the
                            availability of such service dogs through a
                            marketing campaign that targets eligible
                            veterans.
                                (v) The commitment to have humane standards
                            for animals.
                                (vi) The demonstrated experience of the
                            nonprofit entity in training service dogs in
                            compliance with the requirements of the
                            Americans with Disabilities Act of 1990 (42
                            U.S.C. 12101 et seq.).
        (c) Award of Grants.--
                (1) In general.--The Secretary shall award a grant to each
            nonprofit entity for which the Secretary has approved an
            application submitted under subsection (b)(1).
                (2) Agreement required.--Before the provision of any grant
            amounts to a nonprofit entity selected to receive a grant under
            this section, the Secretary shall enter into an agreement,
            containing such terms, conditions, and limitations as the
            Secretary determines appropriate, with such entity.
                (3) Maximum grant amount.--Except as provided in
            subparagraph (B), a grant awarded to a nonprofit entity under
            this section may not exceed $2,000,000 in a fiscal year.
                (4) Payments.--The Secretary shall establish intervals of
            payment for the administration of each grant awarded under this
            section.
        (d) Use of Funds.--
                (1) In general.--
                        (A) Requirement.--A recipient of a grant under this
                    section shall use the grant amounts to plan, develop,
                    implement, and manage one or more covered programs.
                        (B) Covered program defined.--In this paragraph,
                    the term ``covered program'' means a program under
                    which--
                                (i) service dogs are provided to
                            participants in the program; and
                                (ii) only eligible veterans are allowed to
                            participate in the program.
                (2) Administrative expenses.--The Secretary may establish a
            maximum amount for each grant awarded under this section that
            may be used by the recipient of the grant to cover
            administrative expenses.
                (3) Other conditions and limitations.--The Secretary may
            establish other conditions or limitations on the use of grant
            amounts under this section.
        (e) Requirements for Grant Recipients.--
                (1) Notifications and information.--A recipient of a grant
            under this section shall--
                        (A) notify each veteran who receives a service dog
                    through such grant that the service dog is being paid
                    for, in whole or in part, by the Department of Veterans
                    Affairs; and
                        (B) inform each such veteran of the benefits and
                    services available from the Secretary for the veteran
                    and the service dog.
                (2) Prohibition on certain fees.--A recipient of a grant
            under this section may not charge a fee to a veteran receiving
            a service dog through such grant.
        (f) Veterinary Insurance.--
                (1) In general.--The Secretary shall provide to each
            veteran who receives a service dog through a grant under this
            section a commercially available veterinary insurance policy
            for the service dog.
                (2) Continuation.--If the Secretary provides a veterinary
            insurance policy to a veteran under paragraph (1), the
            Secretary shall continue to provide the policy to the veteran
            without regard to the continuation or termination of the pilot
            program.
        (g) Training and Technical Assistance.--The Secretary may provide
    training and technical assistance regarding grant application and
    administration to recipients of grants under this section.
        (h) Oversight and Monitoring.--The Secretary--
                (1) may require each recipient of a grant under this
            section to provide, in such form as may be prescribed by the
            Secretary, such reports or answers in writing to specific
            questions, surveys, or questionnaires as the Secretary
            determines necessary to carry out the pilot program;
                (2) shall establish such oversight and monitoring
            requirement as the Secretary determines appropriate to ensure
            that grant amounts awarded under this section are used
            appropriately; and
                (3) may take such actions as the Secretary determines
            necessary and according to the terms of the grant agreement to
            address any issues identified through the enforcement of such
            requirements.
        (i) Definitions.--In this section:
                (1) Eligible veteran.--The term ``eligible veteran'' means
            a veteran (as defined in section 101 of title 38, United States
            Code) who--
                        (A) as determined by a physician, has one or more
                    disabilities, conditions, or diagnoses described in
                    paragraph (2); and
                        (B) is enrolled in the system of annual patient
                    enrollment of the Department of Veterans Affairs
                    established and operated under section 1705(a) of title
                    38, United States Code, or is otherwise entitled to
                    receive such care and services under subsection (c)(2)
                    of such section.
                (2) Disability, condition, diagnosis described.--A
            disability, condition, or diagnosis described in this
            subparagraph is any of the following:
                        (A) Blindness or visual impairment.
                        (B) Loss of use of a limb, paralysis, or other
                    significant mobility issue.
                        (C) Loss of hearing.
                        (D) Post-traumatic stress disorder.
                        (E) Traumatic brain injury.
                        (F) Any other disability, condition, or diagnosis
                    for which the Secretary determines, based on medical
                    judgment, that it is optimal for the veteran to manage
                    the disability, condition, or diagnosis and live
                    independently through the assistance of a service dog.
                (3) Pilot program.--The term ``pilot program'' means the
            pilot program required by subsection (a)(1).
                (4) Service dog.--The term ``service dog'' means any dog
            that is individually trained to do work or perform tasks that
            are--
                        (A) for the benefit of a veteran with a disability,
                    condition, or diagnosis described in paragraph (1)(B);
                    and
                        (B) directly related to the disability, condition,
                    or diagnosis of the veteran.
        (j) Authorization of Appropriations.--There is authorized to be
    appropriated to carry out this section $10,000,000 for each of the
    three consecutive fiscal years beginning the fiscal year in which the
    pilot program is established under subsection (a).
        (k) Termination.--
                (1) The authority to carry out a pilot program under this
            section shall terminate on September 30, 2029.
                (2) No funds may be obligated by the Secretary to carry out
            a pilot program under this section after the date of
            termination in paragraph (1), except for activities necessary
            to close operations of such pilot program.

    SEC. 331. AUTHORIZATION OF MAJOR MEDICAL FACILITY PROJECT OF DEPARTMENT
                  OF VETERANS AFFAIRS FOR FISCAL YEAR 2027 IN MANCHESTER,
                  NEW HAMPSHIRE.

        (a) Authorization of Major Medical Facility Project of Department
    of Veterans Affairs for Fiscal Year 2027 in Manchester, New
    Hampshire.--
                (1) In general.--The Secretary of Veterans Affairs shall
            carry out a major medical facility project for the replacement
            of a medical center, a new central utility plant, a community
            living center, a residential rehabilitation treatment facility,
            associated parking, and demolition of existing buildings in
            Manchester, New Hampshire.
                (2) Non-department federal entity waiver.--In order to
            reduce cost and expedite timelines, the Secretary may waive the
            requirements under section 8103(e) of title 38, United States
            Code, and section 1096 of the National Defense Authorization
            Act for Fiscal Year 2016 (Public Law 114-92; 38 U.S.C. 8103
            note) for a non-Department Federal entity to be engaged in
            project management and other activities for the project under
            paragraph (1).
                (3) Notification.--Not later than 60 days after making a
            waiver, modification, or substitution relating to the project
            under subsection (a), including a waiver under paragraph (2),
            the Secretary shall submit to the appropriate committees of
            Congress a notification describing the waiver, modification, or
            substitution and the reason for such waiver, modification, or
            substitution.
                (4) Authorization of appropriations.--There is authorized
            to be appropriated to the Secretary of Veterans Affairs for the
            Construction, Major Projects account $1,180,000,000 for the
            project under paragraph (1), to remain available until
            expended.
                (5) Appropriate committees of congress defined.--In this
            section 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.
        (b) Access to Information for Medical Facility Construction
    Projects and Leases.--
                (1) In general.--Subchapter I of chapter 81 of title 38,
            United States Code, is amended by inserting after section 8106
            the following:
    ``Sec. 8107. Access to information for medical facility construction
                  projects and leases
        ``(a) In General.--For any major construction project, lease, or
    enhanced-use lease for a medical facility of the Department, the
    Secretary shall ensure that the Committee on Veterans' Affairs of the
    Senate and the Committee on Veterans' Affairs of the House of
    Representatives are provided timely access to all information, records,
    documents, data, analyses, communications, contracts, agreements,
    project schedules, cost estimates, memoranda, briefings, reports, and
    other materials relating to the project or lease.
        ``(b) Prohibition on Withholding Information.--The Secretary may
    not withhold information under subsection (a) from the Committee on
    Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
    of the House of Representatives solely on the basis that the
    information is predecisional, deliberative, advisory, procurement-
    sensitive, or subject to an internal policy or directive of the
    Department.''.
                (2) Clerical amendment.--The table of sections at the
            beginning of such chapter is amended by inserting after the
            item relating to section 8106 the following new item:

    ``8107. Access to information for medical facility construction
                                projects and leases.''.

    SEC. 332. BOWEL AND BLADDER CARE PROGRAM OF DEPARTMENT OF VETERANS
                  AFFAIRS.

        (a) Findings; Sense of Congress.--
                (1) Findings.--Congress finds the following:
                        (A) Bowel care and bladder care are supportive and
                    necessary medical services for veterans with spinal
                    cord injuries and disorders when they are unable to
                    manage their bowel and bladder functions independently.
                        (B) Inadequate care will lead to complications and
                    problems such as autonomic dysreflexia that can be
                    potentially life-threatening and result in illness and
                    hospitalization.
                        (C) Bowel care and bladder care are essential to
                    support veterans with spinal cord injuries and
                    disorders in non-institutional settings, improve
                    quality of life, optimize health, and prevent
                    complications from neurogenic bowel and bladder.
                        (D) Family caregivers and individually employed
                    caregivers provide life-sustaining care for the bowel
                    and bladder care needs of veterans that allow them to
                    live in their communities.
                (2) Sense of congress.--It is the sense of Congress that--
                        (A) family caregivers and individually employed
                    caregivers should not be subjected to self-employment
                    taxes and treated as vendors or contractors for the
                    veterans to whom they provide care;
                        (B) veterans should not be forced to finish their
                    bowel and bladder care needs in a set period of time
                    that does not consider their individual needs; and
                        (C) veterans should not be subjected to ongoing
                    clinical determinations regarding their bowel and
                    bladder care needs absent a decision by their medical
                    care provider that such care is no longer needed.
        (b) In General.--The Secretary of Veterans Affairs shall establish
    a program to address the bowel and bladder care needs of covered
    veterans (in this section referred to as the ``program'').
        (c) Provision of Care.--
                (1) Clinical need.--The Secretary shall provide bowel and
            bladder care under the program to covered veterans based on
            clinical need, which may include covered veterans receiving aid
            and attendance benefits from the Department of Veterans
            Affairs.
                (2) Caregiver or agency.--A covered veteran may receive
            bowel and bladder care under the program through a qualified
            family member, an individually employed caregiver, or a
            contracted home health agency.
                (3) Individualized assessment.--The Secretary shall conduct
            an individualized assessment with respect to a covered veteran
            to determine the number of hours of bowel and bladder care
            needed by such veteran under the program.
                (4) Denial of care.--Before denying bowel and bladder care
            for any covered veteran under the program, the Secretary shall
            first obtain review of and concurrence with respect to such
            denial from a designated Spinal Cord Injuries and Disorders
            Center of the Department.
        (d) Coordination of Care and Benefits.--The Secretary shall ensure
    the program is coordinated with other programs and benefits of the
    Department for which the covered veteran is eligible to ensure that
    covered veterans and caregivers receive appropriate support without
    duplicating benefits or services.
        (e) Supportive Medical Training and Qualifications.--
                (1) In general.--The Secretary shall provide to each family
            member or individually employed caregiver providing care to a
            covered veteran under the program necessary supportive medical
            training to participate in and receive payment by the Secretary
            for the provision of such care.
                (2) Qualifications.--The Secretary shall establish such
            requirements, conditions, and qualifications for providers of
            care under the program as necessary to provide clinically
            appropriate bowel and bladder care to covered veterans and to
            ensure the financial and administrative integrity of the
            program.
        (f) Payment.--
                (1) In general.--The Secretary shall provide a monthly
            stipend to family members and individually employed caregivers
            and payment to contracted home health agencies for care
            provided to covered veterans under the program.
                (2) Limitation.--
                        (A) Family members and individually employed
                    caregivers.--The stipend for a family member or
                    individually employed caregiver for care provided to a
                    covered veteran under the program--
                                (i) shall be determined by the Secretary;
                                (ii) shall be based on the amount and
                            degree of assistance provided; and
                                (iii) may not exceed the fifth step of the
                            applicable grade of the General Schedule hourly
                            rate paid to nursing assistants who provide
                            such care at the medical facility of the
                            Department that is nearest to the residence of
                            such veteran.
                        (B) Home health agencies.--Payment to a home health
                    agency for care provided to a covered veteran under the
                    program may not exceed the payment rates of the
                    Department under section 17.4035 of title 38, Code of
                    Federal Regulations (relating to payment rates and
                    methodologies), or successor regulations.
        (g) Submission of Documentation.--Family members and individually
    employed caregivers providing care to covered veterans under the
    program shall provide such documentation and information in such format
    and under such terms as the Secretary may require as a condition of
    receiving payment under the program.
        (h) Continued Participation in Program.--If a covered veteran has
    been medically determined to require care under the program for a
    continuous period of three years or more, the veteran is deemed to
    require such care for life or until such time as the medical provider
    for such veteran determines the service is no longer needed.
        (i) Not Vendors or Contractors.--Family members and individually
    employed caregivers providing care to covered veterans under the
    program shall not be considered vendors or contractors for purposes of
    the program.
        (j) Limitation.--Care may not be provided under the program to a
    veteran who can perform the bowel and bladder functions of the veteran
    without assistance.
        (k) Covered Veteran Defined.--In this section, the term ``covered
    veteran'' means a veteran who--
                (1) is enrolled in the system of annual patient enrollment
            of the Department of Veterans Affairs established and operated
            under section 1705(a) of title 38, United States Code;
                (2) has a spinal cord injury or disorder; and
                (3) is dependent upon others for bowel and bladder care
            while residing in non-institutional settings.

                             TITLE IV--ORGANIZATION

    SEC. 401. AUTHORIZATION OF APPROPRIATIONS TO THE OFFICE OF INFORMATION
                  AND TECHNOLOGY OF THE DEPARTMENT OF VETERANS AFFAIRS FOR
                  CERTAIN PURPOSES.

        (a) Authorization of Appropriations.--There is authorized to be
    appropriated, and there is appropriated, to the Secretary of Veterans
    Affairs $500,000,000 for fiscal year 2026, to remain available until
    September 30, 2031, for deposit into the accounts of the Office of
    Information and Technology of the Department of Veterans Affairs for
    the purposes described in subsection (b).
        (b) Use of Funds.--Funds shall be allocated and expended only as
    follows:
                (1) $150,000,000 for Enterprise Logistics and Supply Chain
            Visibility -- To develop and deploy integrated, real-time
            enterprise-wide logistics systems, inventory visibility,
            pharmaceutical tracking, and medical supply chain resiliency
            capabilities. These systems shall support both routine veteran
            care operations and 4th Mission medical surge, patient
            movement, and emergency distribution requirements in
            consultation with DoD, FEMA, and other agencies.
                (2) $200,000,000 for Cybersecurity and Operational
            Resiliency -- For zero trust architecture implementation,
            threat detection, secure cloud hardening, endpoint protection,
            continuity of operations (COOP) platforms, and protection of
            mission-essential systems against cyber and physical
            disruptions. Funds shall prioritize high-risk legacy systems
            and medical device security.
                (3) $150,000,000 for Resilient Communications and Digital
            Records Modernization -- For interoperable, survivable
            communications infrastructure and targeted digitization/
            automation of high-volume paper-based workflows (claims,
            correspondence, administrative records) to reduce fraud risk
            and improve continuity during degraded or emergency
            environments. Funds shall not be used for broad Electronic
            Health Record Modernization expansion.
        (c) Oversight and Protection of Sensitive Information.--
                (1) The Secretary may obligate and expend amounts under
            this section in classified, controlled, or protected
            environments consistent with applicable law.
                (2) Not later than 90 days after the date of enactment of
            this Act, and annually thereafter until September 30, 2031, the
            Secretary shall provide to the Committees on Veterans' Affairs
            of the House of Representatives and the Senate a briefing and
            report on--
                        (A) activities carried out using funds made
                    available under this section;
                        (B) progress on improving cybersecurity,
                    resiliency, continuity, logistics, communications,
                    digitization, and mission assurance capabilities; and
                        (C) coordination with other Federal agencies, as
                    appropriate. Such reports may include a classified
                    annex.
                (3) Detailed implementation plan and quarterly briefings.--
                        (A) Not later than 90 days after the date of
                    enactment of this Act, the Secretary, acting through
                    the Office of Information and Technology, shall submit
                    to the Committees on Veterans' Affairs of the House of
                    Representatives and the Senate a comprehensive
                    implementation plan. The plan shall include--
                                (i) specific milestones, deliverables, and
                            performance metrics for each category of
                            activities in subsection (b);
                                (ii) a zero trust architecture strategy
                            with timelines and technical requirements;
                                (iii) a detailed expenditure plan by fiscal
                            quarter and by activity category; and(iv) any
                            proposed interagency or private-sector
                            partnerships.
                        (B) Not later than 30 days after the end of each
                    fiscal quarter through September 30, 2031, the
                    Secretary shall provide the Committees a briefing and
                    written report on--
                                (i) obligations and expenditures to date,
                            by category;
                                (ii) progress against the implementation
                            plan;
                                (iii) any deviations from the plan and
                            corrective actions; and
                                (iv) updated projections for remaining
                            funds. The initial briefing shall be in person;
                            subsequent briefings may be virtual unless
                            otherwise requested by the Committees. Reports
                            may include a classified annex.
        (d) Limitation.--Funds made available under this section may not be
    used for any purpose unrelated to information technology modernization,
    cybersecurity, operational resilience, logistics modernization,
    communications modernization, digitization, or fraud prevention
    activities of the Department.
        (e) Supplement, Not Supplant.--Amounts made available under this
    section shall supplement and not supplant other amounts otherwise
    authorized to be appropriated for the Office of Information and
    Technology of the Department of Veterans Affairs.
        (f) Rule of Construction.--Nothing in this section shall be
    construed to require the public disclosure of classified information,
    controlled unclassified information, operational details, cybersecurity
    architecture, contingency planning information, mission-essential
    system design, or information otherwise protected from disclosure under
    Federal law or Executive Order.
        (g) Reauthorization and Sunset.--
                (1) Reauthorization required.--The authority provided under
            this section to obligate or expend amounts appropriated
            pursuant to subsection (a) shall terminate on September 30,
            2031, unless subsequently reauthorized by law.
                (2) Limitation on new obligations after sunset.--Beginning
            on October 1, 2031, the Secretary may not initiate, award,
            enter into, renew, extend, or otherwise obligate funds for any
            new program, project, activity, contract, task order, or
            operational capability carried out pursuant to this section
            unless expressly authorized by a subsequent Act of Congress.
                (3) Continuation of existing activities.--Nothing in
            paragraph (2) shall be construed to prohibit the Secretary
            from--
                        (A) maintaining, sustaining, securing, operating,
                    completing, or supporting any program, project,
                    activity, contract, system, platform, infrastructure
                    capability, or operational activity lawfully initiated
                    using amounts obligated before September 30, 2031; or
                        (B) carrying out similar information technology
                    modernization, cybersecurity, continuity of operations,
                    logistics modernization, communications modernization,
                    operational resiliency, or mission assurance activities
                    using amounts otherwise authorized and appropriated
                    under any other provision of law.
        (h) Use of Existing Contracting Authorities.--The Secretary shall
    carry out the activities authorized under this section, to the maximum
    extent practicable, through contracts, task orders, delivery orders,
    interagency agreements, cooperative agreements, or other agreements
    entered into under existing authorities of title 38, United States
    Code, as applicable. Amounts made available under this section shall
    not be used to establish a new full-time equivalent position, hire
    additional employees of the Department, or otherwise increase the
    number of full-time equivalent employees of the Department, except to
    the extent the Secretary determines that such personnel are necessary
    for the oversight, management, cybersecurity supervision, acquisition
    administration, or operational integration of activities carried out
    under this section.

    SEC. 402. ESTABLISHMENT OF UNDER SECRETARY FOR MANAGEMENT AND CHIEF
                  FINANCIAL OFFICER.

        (a) Chief Financial Officer; Office of Budget.--Section 309 of
    title 38, United States Code, is amended to read as follows:
    ``Sec. 309. Under Secretary for Management and Chief Financial Officer
        ``(a) Under Secretary for Management and Chief Financial Officer.--
                ``(1) The Under Secretary for Management and Chief
            Financial Officer shall be the principal management and
            financial officer of the Department.
                ``(2) The Under Secretary shall report directly to the
            Secretary.
                ``(3) The Under Secretary shall serve as the Chief
            Financial Officer of the Department for purposes of chapter 9
            of title 31.
                ``(4) The Under Secretary shall exercise authority,
            direction, and control over the Office of Budget and such other
            offices as may be assigned by law or by the Secretary.
        ``(b) Duties.--The duties of the Under Secretary include the
    following:
                ``(1) To advise the Secretary on financial management of
            the Department.
                ``(2) To formulate, justify, execute, oversee, and certify
            the budget of the Department.
                ``(3) To control, account for, audit, and report on the
            finances of the Department.
                ``(4) To coordinate and assist the Chief Acquisition
            Officer with the life cycle of major acquisition programs of
            the Department.
                ``(5) To exercise the authority and carry out the functions
            specified in section 902 of title 31.
                ``(6) To ensure compliance with sections 1341, 1342, 1349,
            1350, and 1511 through 1519 of title 31.
                ``(7) To provide to Congress, or a congressional committee
            upon request, information regarding the budget, finances, and
            fiscal condition of the Department.
                ``(8) To serve as the head of the Office of Budget of the
            Department.
                ``(9) To establish and oversee Department-wide financial
            management policies, accounting systems, internal controls,
            enterprise risk management programs, strategic planning
            processes, and capital planning activities.
                ``(10) To oversee infrastructure investment planning,
            financial systems modernization, and business transformation
            initiatives of the Department.
        ``(c) Deputy Assistant Secretary.--(1) There is in the Department a
    Deputy Assistant Secretary for Infrastructure and Construction.
        ``(2) Such Deputy Assistant Secretary shall be a career appointee
    (as that term is defined in section 3132(a) of title 5) within the
    Senior Executive Service of the Department.
        ``(d) Office of Infrastructure and Construction.--There is an
    Office of Infrastructure and Construction in the Department.
        ``(e) Budget and Appropriations Affairs Office.--(1) There is
    within the Office of Management a Budget and Appropriations Affairs
    Office (in this subsection referred to as the `BAA office'). The
    Undersecretary shall appoint a head of the BAA Office who shall report
    exclusively to the Undersecretary.
        ``(2) The sole function of the BAA Office is to provide to Congress
    (or a congressional committee), accurate, timely, and certified
    information regarding the finances and budget of the Department.
        ``(3) Congress or a congressional committee may submit a request
    for information described in paragraph (2) directly to the BAA Office.
        ``(4) Paragraphs (2) and (3) notwithstanding, the Assistant
    Secretary for Congressional and Legislative Affairs may facilitate and
    transmit responses to requests described in paragraph (3) that are
    submitted to the BAA Office. Any response containing information
    described in paragraph (2) shall be prepared and certified by the BAA
    Office and may not be altered, delayed, withheld, edited, or modified
    by any other officer or employee of the Department prior to
    transmission to Congress or a congressional committee.
        ``(5) Not more than six full-time equivalent employees, including
    supervisors, may be assigned to the BAA Office.
        ``(f) Limitation on Authority to Appoint.--The Secretary may not
    establish an employee position--
                ``(1) that performs a function substantially similar to the
            function of the Budget and Appropriations Affairs Office
            established under section 309(e); and
                ``(2) that is not within the Office of Management.
        ``(g) Transfer of Functions.--(1) All functions, powers, duties,
    authorities, responsibilities, personnel, property, records, contracts,
    delegations, directives, regulations, administrative actions, and
    unobligated balances of appropriations relating to the Chief Financial
    Officer of the Department immediately before the effective date of this
    Act are transferred to the Under Secretary for Management and Chief
    Financial Officer.
        ``(2) Any delegation, determination, rule, regulation, order,
    permit, contract, agreement, certification, or other administrative
    action in effect immediately before the effective date of this Act
    shall continue in effect according to its terms until modified,
    superseded, terminated, or revoked.
        ``(g) References.--Any reference in any law, regulation, rule,
    directive, delegation, contract, agreement, determination, record, or
    other official document of the United States to the Chief Financial
    Officer of the Department shall be deemed to refer to the Under
    Secretary for Management and Chief Financial Officer.''.
        (b) Technical and Conforming Amendments.--
                (1) The table of sections for chapter 3 of title 38, United
            States Code, is amended accordingly.
                (2) The Secretary shall make such additional technical and
            conforming amendments to regulations, directives, delegations,
            organizational charters, manuals, and internal guidance as may
            be necessary to carry out this Act.

    SEC. 403. DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REFORM AND COST
                  ASSESSMENT.

        (a) Department of Veterans Affairs Acquisition Organization.--
                (1) Definitions.--Chapter 81 of title 38, United States
            Code, is amended by inserting after subchapter VI the following
            new subchapter:

       ``SUBCHAPTER VII--ACQUISITION ORGANIZATION, COST ASSESSMENT, AND
                               PROGRAM EVALUATION

    ``Sec. 8181. Definition of major acquisition program
        ``In this subchapter, the term `major acquisition program' means a
    program of the Department to acquire services, supplies, technology,
    systems, or a combination thereof, with an estimated total program
    cost, estimated by the Secretary, that exceeds--
                ``(1) $1,000,000,000 (adjusted pursuant to section 1908 of
            title 41) for the total life cycle cost of the program; or
                ``(2) $200,000,000 (adjusted pursuant to section 1908 of
            title 41) annually.''.
                (2) Assistant secretary for acquisition.--Section 308 of
            such title is amended--
                        (A) in subsection (a)(1), by striking ``seven'' and
                    inserting ``eight''; and
                        (B) in subsection (b)(10), by striking
                    ``Procurement functions'' and inserting ``Acquisition
                    functions''.
                (3) Acquisition organization.--Subchapter VII of chapter 81
            of such title, as added by paragraph (1), is amended by adding
            at the end the following new section:
    ``Sec. 8182. Acquisition organization
        ``(a) Assistant Secretary for Acquisition; Chief Acquisition
    Officer.--(1) The Secretary shall designate one of the Assistant
    Secretaries specified in subsection (a)(1) of section 308 of this title
    as the Assistant Secretary of Veterans Affairs for Acquisition, who
    shall focus solely on the administration of functions specified in
    subsection (b)(10) of such section.
        ``(2) Pursuant to section 1702(a) of title 41, the Secretary shall
    designate the Assistant Secretary of Veterans Affairs for Acquisition
    as the Chief Acquisition Officer of the Department.
        ``(b) Office of Acquisition.--(1) There is in the Department an
    Office of Acquisition.
        ``(2) The head of the Office of Acquisition shall be the Assistant
    Secretary of Veterans Affairs for Acquisition designated pursuant to
    subsection (a).
        ``(3) The Secretary shall take such actions as may be necessary to
    ensure that major acquisition program offices of the Department align
    under the Office of Acquisition and report directly to the Assistant
    Secretary of Veterans Affairs for Acquisition.
        ``(4) The budget of the Office of Acquisition, including budgets
    for major acquisition programs, shall be established in the budget
    justification materials submitted to Congress in support of the budget
    of the Department (as submitted with the budget of the President under
    section 1105(a) of title 31).
        ``(c) Deputy Assistant Secretary for Logistics.--(1) Pursuant to
    section 308(d) of this title, the Secretary shall appoint a Deputy
    Assistant Secretary of Veterans Affairs for Logistics, who shall report
    to the Assistant Secretary for Acquisition.
        ``(2) The Deputy Assistant Secretary of Veterans Affairs for
    Logistics shall be responsible for administration of logistics and
    supply chain operations of the Department.
        ``(d) Deputy Assistant Secretary for Procurement.--(1) Pursuant to
    section 308(d) of this title, the Secretary shall appoint a Deputy
    Assistant Secretary of Veterans Affairs for Procurement, who shall
    report to the Assistant Secretary for Acquisition.
        ``(2) The Deputy Assistant Secretary of Veterans Affairs for
    Procurement shall be responsible for all procurement and contracting
    organizations of the Department.
        ``(e) Deputy Assistant Secretary for Acquisition, Program
    Management, and Performance.--(1) Pursuant to section 308(d) of this
    title, the Secretary shall appoint a Deputy Assistant Secretary of
    Veterans Affairs for Acquisition, Program Management, and Performance,
    who shall report to the Assistant Secretary for Acquisition.
        ``(2) The Deputy Assistant Secretary for Acquisition, Program
    Management, and Performance shall be responsible for the following:
                ``(A) Lifecycle management.
                ``(B) Requirements planning.
                ``(C) Programming and budgeting.
                ``(D) Policy.
                ``(E) Performance standards.
                ``(F) Governance.
                ``(G) Enhancing the capabilities of the acquisition
            workforce.
        ``(f) Program Executive Officers.--(1) The Assistant Secretary for
    Acquisition shall appoint no fewer than four Program Executive
    Officers, each responsible for overseeing major acquisition programs in
    one of the following areas:
                ``(A) Medical.
                ``(B) Information technology.
                ``(C) Professional services.
                ``(D) Other areas not included in subparagraphs (A) through
            (C).
        ``(2) Each Program Executive Officer shall report directly to the
    Assistant Secretary for Acquisition and shall supervise the managers of
    major acquisition programs within their respective area, as appointed
    under section 8183 of this title.
        ``(3) Each Program Executive Officer shall be--
                ``(A) certified in project management at level three by--
                        ``(i) the Department;
                        ``(ii) the Federal Acquisition Institute pursuant
                    to section 1201 of title 41; or
                        ``(iii) the Department of Defense pursuant to
                    section 1701a of title 10; or
                ``(B) hold an equivalent certification by a private sector
            project management certification organization, as determined
            appropriate by the Secretary.''.
        (b) Department of Veterans Affairs Major Acquisition Program
    Managers.--Subchapter VII of chapter 81 of title 38, United States
    Code, as added by subsection (a), is amended by adding at the end the
    following new section:
    ``Sec. 8183. Major acquisition program managers
        ``(a) Appointments.--Not later than 30 days after any date on which
    the Secretary approves a major acquisition program to commence, the
    applicable Program Executive Officer shall appoint a manager to be
    responsible for administering such program.
        ``(b) Qualifications.--Each manager appointed pursuant to
    subsection (a) shall be--
                ``(1) certified in project management at level three by--
                        ``(A) the Department;
                        ``(B) the Federal Acquisition Institute pursuant to
                    section 1201 of title 41; or
                        ``(C) the Department of Defense pursuant to section
                    1701a of title 10; or
                ``(2) hold an equivalent certification by a private sector
            project management certification organization, as determined
            appropriate by the Secretary.
        ``(c) Duties.--Each manager appointed pursuant to subsection (a)
    for a major acquisition program shall--
                ``(1) report to the Assistant Secretary for Acquisition
            through the Program Executive Officer responsible for the major
            acquisition program; and
                ``(2) shall be responsible for, with respect to the major
            acquisition program--
                        ``(A) developing, in coordination with the Program
                    Executive Officer, a plan to administer major
                    acquisition program, which shall be known as the
                    `program baseline' for the major acquisition program,
                    that includes--
                                ``(i) a description of each acquisition
                            phase of the major acquisition program;
                                ``(ii) for each such acquisition phase,
                            requirements for advancing the major
                            acquisition program to a subsequent acquisition
                            phase; and
                                ``(iii) estimates of the cost, schedule,
                            and performance of the major acquisition
                            program that account for the entire life cycle
                            of the major acquisition program;
                        ``(B) ensuring the major acquisition program is in
                    compliance with such requirements and providing all
                    program documentation, including program baseline
                    documentation, cost, schedule, performance and risk
                    assessments, and other relevant materials, to
                    designated officials and relevant governance boards;
                        ``(C) developing resource requests and
                    justifications necessary to satisfy such requirements;
                    and
                        ``(D) on a continuous basis, assessing and managing
                    risks to satisfying the requirements of such program
                    baseline relating to cost and schedule.
        ``(d) Program Decision Authority.--The Secretary shall ensure
    that--
                ``(1) program decision authority for oversight of a major
            acquisition program is the Assistant Secretary for Acquisition;
            and
                ``(2) program management offices for major acquisition
            programs are independent of the Veterans Benefits
            Administration, the Veterans Health Administration, the
            National Cemetery Administration, and staff offices of the
            Department by reporting directly to the Assistant Secretary for
            Acquisition.
        ``(e) Program Decision Authority Notification Required.--Not later
    than 30 days after any date on which a major acquisition program
    concludes an acquisition phase, the manager of such program appointed
    pursuant to subsection (a) shall notify the program decision authority
    under subsection (c).''.
        (c) Department of Veterans Affairs Acquisition and Procurement
    Reorganization Matters.--
                (1) Organizational consolidation.--Not later than one year
            after the date of the enactment of this Act, the Secretary of
            Veterans Affairs shall organizationally consolidate under the
            Assistant Secretary of Veterans Affairs for Acquisition every
            activity of the Department of Veterans Affairs, including the
            Veterans Benefits Administration, the Veterans Health
            Administration, and the National Cemetery Administration, that
            relates to--
                        (A) acquisition;
                        (B) procurement and contracting; or
                        (C) logistics and supply chain.
                (2) Relocation.--Paragraph (1) shall not be construed to
            require the physical relocation of employees of the Department.
                (3) Plan and briefing.--
                        (A) In general.--Not later than 90 days after
                    commencing organizational consolidation under
                    subsection (a), the Secretary shall--
                                (i) submit to the Committee on Veterans'
                            Affairs of the Senate and the Committee on
                            Veterans' Affairs of the House of
                            Representatives a written plan to carry out
                            such organizational consolidation; and
                                (ii) provide such committees a briefing on
                            such plan.
                        (B) Contents.--The plan submitted pursuant to
                    subparagraph (A)(i) shall include the following:
                                (i) A timeline.
                                (ii) A plan for communication and training
                            activities for relevant Department personnel.
                                (iii) A plan for modification of relevant
                            Department policy and guidance.
                                (iv) Such other matters as the Secretary
                            considers relevant and appropriate.
        (d) Independent Verification and Validation of Major Acquisition
    Programs of Department of Veterans Affairs.--
                (1) Contracting authority.--Not later than 120 days after
            the date of the enactment of this Act, the Secretary of
            Veterans Affairs shall seek to enter into one or more contracts
            using competitive procedures with one or more entities to carry
            out the functions described in paragraph (3).
                (2) Eligibility.--
                        (A) In general.--An entity is not eligible to be
                    awarded a contract under this section unless the Chief
                    Acquisition Officer of the Department of Veterans
                    Affairs determines, at the time of evaluation of offers
                    submitted under paragraph (1), that the entity is
                    currently performing or has performed, during the
                    preceding three-year period, not fewer than three prime
                    contracts from either governmental or commercial health
                    care organizations for--
                                (i) the independent verification and
                            validation services or equivalent services,
                            including systems engineering and technical
                            advisory (SETA) support of major acquisition
                            programs; or
                                (ii) the independent verification and
                            validation or systems engineering and technical
                            advisory (SETA) support of the development or
                            acquisition of major acquisition programs or
                            defense systems, in accordance with guidance of
                            the Department of Defense relating to such
                            acquisition programs or such business systems.
                        (B) Past performance.--For any contract used to
                    demonstrate eligibility under subparagraph (A), an
                    entity must have performed the work at a satisfactory
                    or better level as indicated by the past performance
                    information in the Contractor Performance Assessment
                    Reporting System, or successor system.
                        (C) Demonstration of lack of conflict of
                    interest.--The Secretary shall revoke the eligibility
                    of an entity under this subsection if an entity does
                    not demonstrate clear and unmitigable evidence that the
                    entity does not have a conflict of interest with
                    respect to the effective performance of functions under
                    paragraph (3).
                        (D) No mitigation plans acceptable.--The Secretary
                    may not accept from an entity a plan to mitigate a
                    conflict of interest in order to ameliorate any
                    limitation or prohibition under this subsection.
                (3) Functions.--The functions specified in this subsection
            are the following:
                        (A) The independent verification and validation of
                    each major acquisition program project--
                                (i) when such major acquisition program is
                            initiated, with respect to its design and the
                            development of its requirements and
                            acquisition;
                                (ii) at the conclusion of such program; and
                                (iii) at any other intervals during such
                            program selected by the Chief Acquisition
                            Officer of the Department.
                        (B) The independent verification and validation of
                    other programs or projects of the Department selected
                    by the Chief Acquisition Officer of the Department, at
                    intervals selected by the Chief Acquisition Officer.
                (4) Funding.--The Chief Financial Officer of the Department
            shall ensure that each organizational subdivision of the
            Department that enters into a contract under paragraph (1)
            proportionally contributes amounts to fund each such contract.
                (5) Definitions.--In this section:
                        (A) Covered contract.--The term ``covered
                    contract'' means any prime or subcontract with the
                    Department, including--
                                (i) information technology support or
                            software or system design, development,
                            sustainment, or maintenance services;
                                (ii) professional or management consulting
                            services; or
                                (iii) advisory and assistance services.
                        (B) Independent verification validation.--The term
                    ``independent verification and validation'' means a
                    comprehensive inspection, a review, analysis, and
                    testing, or an assessment of systems, software, or
                    hardware, as applicable, performed by an entity awarded
                    a contract under paragraph (1)--
                                (i) to verify that the requirements of a
                            program, project or system, or a development
                            phase of such a program or project, are
                            correctly defined; and
                                (ii) to validate cost, schedule, and
                            performance baselines of current programs and
                            measure program effectiveness.
        (e) Department of Veterans Affairs Cost Assessment and Program
    Evaluation.--
                (1) In general.--Subchapter VII of chapter 81 of title 38,
            United States Code, as added by subsection (a) and amended by
            subsection (b), is further amended by adding at the end the
            following new section:
    ``Sec. 8184. Cost assessment and program evaluation
        ``(a) Director of Cost Assessment and Program Evaluation.--There is
    in the Department a Director of Cost Assessment and Program Evaluation,
    who shall report directly to the Secretary.
        ``(b) Responsibilities.--The responsibilities of the Director are
    as follows:
                ``(1) To develop policies and procedures for cost
            estimation and analysis of major acquisition programs of the
            Department.
                ``(2) To conduct independent cost estimates and analyses
            for major acquisition programs to support acquisition
            decisions, or any other acquisitions as directed by the
            Secretary,
                ``(3) To provide an independent cost estimate to the
            Assistant Secretary for Acquisition in advance of a decision to
            proceed with full-scale acquisition for a major acquisition
            program or any other program as directed by the Director.
                ``(4) To evaluate the effectiveness of major acquisition
            programs in meeting Department objectives.
                ``(5) Not less frequently than once each year, to submit to
            the Secretary and the Committee on Veterans' Affairs of the
            Senate and the Committee on Veterans' Affairs of the House of
            Representatives an annual report on cost estimation and program
            evaluation activities, including recommendations to improve
            acquisition efficiency. Such report shall include a list of all
            acquisitions where the independent cost estimate for a major
            acquisition program exceeded the budget request for the program
            by more than 5 percent.
        ``(c) Support and Resources.--The Chief Financial Officer of the
    Department shall provide to the Secretary such support and resources as
    may be necessary for the Secretary to ensure the effective
    establishment and functioning of the Director of Cost Assessment and
    Program Evaluation.''.
                (2) Report on monitoring of operating and support costs for
            major acquisition programs.--
                        (A) Report to secretary of veterans affairs.--Not
                    later than one year after the date of the enactment of
                    this Act, and not less frequently than once each year
                    thereafter until December 31, 2028, the Director of
                    Cost Assessment and Program Evaluation of the
                    Department of Veterans Affairs shall submit to the
                    Secretary of Veterans Affairs a report on systems and
                    methods for tracking and assessing operating and
                    support costs of major acquisition programs (as defined
                    in section 8181 of title 38, United States Code, as
                    added by subsection (a)), including recommendations for
                    establishing cost baselines.
                        (B) Transmittal to congress.--Not later than 30
                    days after receiving a report pursuant to subparagraph
                    (A), the Secretary shall submit to the Committee on
                    Veterans' Affairs of the Senate and the Committee on
                    Veterans' Affairs of the House of Representatives the
                    report received by the Secretary.
        (f) Improvements to Hiring of Entry-level Acquisition Positions in
    Department of Veterans Affairs.--
                (1) Priority use of internship programs for hiring into
            entry-level positions in acquisitions.--The Secretary of
            Veterans Affairs shall prioritize the use of acquisition
            internship programs to hire employees to entry-level positions
            relating to acquisition in the Department of Veterans Affairs.
                (2) Annual number of participants in acquisition internship
            programs.--
                        (A) In general.--Not later than September 30 of the
                    first fiscal year beginning after the date of the
                    enactment of this Act, the Secretary shall take such
                    actions as may be necessary to ensure that the annual
                    number of participants in acquisition internship
                    programs of the Department is--
                                (i) not fewer than twice the number of
                            participants in such programs during fiscal
                            year 2025; and
                                (ii) not more than 4 times the number of
                            participants in such programs during such
                            fiscal year.
                        (B) Termination.--The requirements of subparagraph
                    (A) shall terminate on the date on which the Secretary
                    certifies to the appropriate committees of Congress
                    that the projected number of graduates of acquisition
                    internship programs is sufficient to satisfy the human
                    capital needs of the Department with respect to
                    acquisition, taking into account the rate of attrition
                    and projected retirements of personnel.
                        (C) Appropriate committees of congress defined.--In
                    this subsection, the term ``appropriate committees of
                    Congress'' means the Committee on Veterans' Affairs of
                    the Senate and the Committee on Veterans' Affairs of
                    the House of Representatives.
        (g) Independent Analysis of Acquisition Process of Department of
    Veterans Affairs.--
                (1) Systems engineering analysis.--Not later than one year
            after the date of the enactment of this Act, the Secretary of
            Veterans' Affairs shall enter into a memorandum of
            understanding with the Executive Director of the Acquisition
            Research Center of the Department of Defense to conduct a
            systems engineering analysis of the acquisition process of the
            Department of Veterans Affairs.
                (2) Report.--Not later than one year after the date in
            which the Secretary enters into the memorandum of understanding
            required by paragraph (1), the Secretary shall submit to
            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 Executive Director with respect to the
            analysis conducted under such subsection.
        (h) Requirements Development Process.--
                (1) In general.--Subchapter VII of chapter 81 of title 38,
            United States Code, as added by subsection (a) and amended by
            subsections (b) and (e), is further amended by adding at the
            end the following new section:
    ``Sec. 8185. Requirements development process
        ``(a) Establishment of Process.--(1) The Secretary shall establish
    a standardized requirements development process for major acquisition
    programs.
        ``(2) The process established pursuant to paragraph (1) shall--
                ``(A) define and validate mission-driven requirements for
            major acquisition programs exceeding $200,000,000 annually or
            $1,000,000,000 in lifecycle costs, in coordination with the
            Assistant Secretary for Acquisition;
                ``(B) incorporate data-driven needs assessments,
            stakeholder input from relevant administrations, staff offices,
            and other elements of the Department, and alignment with
            statutory mandates, such as section 8121 of this title; and
                ``(C) ensure iterative validation of requirements through
            independent verification and validation, as described in
            section 8185 of this title, to confirm cost, schedule, and
            performance baselines.
        ``(b) Limitation on Personnel.--The Secretary shall implement the
    process established pursuant to subsection (a) using staff within the
    Office of Acquisition and other relevant offices of the Department, as
    established under section 8182 of this title, without creating new
    positions, unless a subsequent cost-benefit analysis, validated by the
    Director of Cost Assessment and Program Evaluation, justifies
    additional resources.''.
                (2) Report.--Not later than 180 days after 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
            requirements process established pursuant to section 8187 of
            such title, as added by paragraph (1) and a plan for
            implementation of such process, including timelines for
            integration with major acquisition program baselines.
        (i) Conforming Amendments.--Subchapter VI of chapter 81 of title
    38, United States Code, is amended--
                (1) in section 8171, by striking paragraphs (5) and (6);
            and
                (2) by striking section 8172.
        (j) Clerical Amendments.--The table of sections at the beginning of
    chapter 81 of title 38, United States Code, is amended--
                (1) by striking the item relating to section 8172; and
                (2) by adding at the end the following:

       ``subchapter vii--acquisition review, cost assessment, and program
                                   evaluation

    ``8181. Definition of major acquisition program.
    ``8182. Acquisition reorganization.
    ``8183. Major acquisition program managers.
    ``8184. Cost assessment and program evaluation.
    ``8185. Requirements development process.''.

    SEC. 404. IMPROVEMENT OF TELEPHONE COMMUNICATION BY DEPARTMENT OF
                  VETERANS AFFAIRS.

        (a) In General.--Chapter 63 of title 38, United States Code, is
    amended by adding at the end the following new section:
    ``Sec. 6321. Telephone communication
        ``(a) Calls Associated With Department.--Not later than one year
    after the date of the enactment of the Take Care of America's Veterans
    Act, the Secretary shall ensure, to the extent practicable and
    feasible, that any call made to a veteran, beneficiary, claimant, or
    other relevant individual by an employee or contractor of the
    Department regarding services or benefits furnished by the Department--
                ``(1) is made from a single, well-known telephone number;
            and
                ``(2) uses caller identification branding that indicates to
            the individual that the call is from or on behalf of the
            Department.
        ``(b) Call Centers for Health Care Appointments and Referrals.--
                ``(1) In general.--Not later than one year after the date
            of the enactment of the Take Care of America's Veterans Act,
            the Secretary shall ensure that the Veterans Health
            Administration has at least one call center in each of the time
            zones specified in paragraph (3) to address concerns regarding
            appointments and referrals for health care under the laws
            administered by the Secretary.
                ``(2) Existing efforts and call centers.--In carrying out
            paragraph (1), the Secretary--
                        ``(A) shall ensure coordination with existing
                    efforts of the Department to improve call center
                    operations; and
                        ``(B) may use existing call centers to meet the
                    requirements of such paragraph.
                ``(3) Time zones specified.--The time zones specified in
            this paragraph are the following:
                        ``(A) Eastern time.
                        ``(B) Central time.
                        ``(C) Mountain time.
                        ``(D) Pacific time.
                        ``(E) Alaska time.
                        ``(F) Hawaii time.
                ``(4) Clarification.--The Secretary is not required to
            ensure that the Veterans Health Administration has a call
            center in any location generally within a time zone specified
            in paragraph (3) that does not follow daylight saving time.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 63 of such title is amended by adding at the end the following
    new item:

    ``6321. Telephone communication.''.
        (c) Report.--Not later than 180 days after enactment, and annually
    for three years thereafter, the Secretary shall submit to the
    Committees on Veterans' Affairs a report on implementation, including
    call-answer rates, abandoned-call rates, average wait times, veteran
    complaints, spoofing or fraud-prevention measures, and any exceptions
    granted.

    SEC. 405. ADVANCING DEPARTMENT OF VETERANS AFFAIRS EMERGENCY RESPONSE
                  TO CRISIS.

        (a) Report on Emergency Management Roles for Department of Veterans
    Affairs.--
                (1) In general.--Not later than 180 days after the date of
            the enactment of this Act, the Secretary of Veterans Affairs
            shall submit to the Committee on Veterans' Affairs of the
            Senate and the Committee on Veterans' Affairs of the House of
            Representatives a report outlining the roles and
            responsibilities of all offices of the Department of Veterans
            Affairs involved with emergency management.
                (2) Consultation.--In preparing the report required by
            paragraph (1), the Secretary of Veterans Affairs shall consult
            with the Comptroller General of the United States, the
            Inspector General of the Department of Veterans Affairs, the
            Secretary of Homeland Security, the Secretary of Defense, and
            such other Federal agencies as the Secretary of Veterans
            Affairs considers relevant, to obtain insights from their
            experience and trends that they have found, and such
            recommendations as they may have with respect to the management
            by the Department of Veterans Affairs of emergency management
            functions.
                (3) Contents.--The report submitted pursuant to paragraph
            (1) shall include the following:
                        (A) A description of the organizational structure
                    of each office, both during normal operations and
                    during emergency or disaster operations.
                        (B) The roles and responsibilities of each office.
                        (C) A detailed description of roles and
                    responsibilities that are shared by both the Office of
                    Emergency Management of the Department and the Office
                    of Operations, Security, and Preparedness of the
                    Department, including an analysis of how each office
                    plays a part in emergency management functions.
                        (D) Recommendations for improving the structure and
                    alignment of relevant offices to better prepare the
                    Department for emergencies, remove redundancies, and
                    improve accountability.
                        (E) An analysis of the feasibility and advisability
                    of consolidating relevant offices into one centralized
                    emergency management office to improve communication
                    and streamline emergency preparedness and response
                    efforts of the Department.
        (b) Plan to Allow Fuel Sharing and Increased Coordination Between
    the Federal Emergency Management Agency and the Department of Veterans
    Affairs.--Not later than 90 days after the date of the enactment of
    this Act, the Secretary of Veterans Affairs shall, after consulting
    with the Administrator of the Federal Emergency Management Agency,
    submit to the Committee on Veterans' Affairs of the Senate, the
    Committee on Veterans' Affairs of the House of Representatives, the
    Committee on Homeland Security and Government Affairs of the Senate,
    and the Committee on Homeland Security of the House of Representatives
    a report regarding--
                (1) the current limitations preventing the Federal
            Emergency Management Agency from providing fuel or other
            resources to the Department of Veterans Affairs during
            emergencies;
                (2) whether the Department requires action by Congress to
            allow such resource provision to occur;
                (3) whether the Secretary has been unable to coordinate
            with the Administrator during prior emergencies or Fourth
            Mission activations due to a lack of authority for such
            coordination;
                (4) whether the Secretary requires action by Congress to
            address any of the issues mentioned under paragraph (3); and
                (5) whether the Secretary requires action by Congress to
            address the issue of Department employees or responders being
            unable to use Department-purchased fuel.

    SEC. 406. MEMBERSHIP OF DEPARTMENT OF VETERANS AFFAIRS GERIATRICS AND
                  GERONTOLOGY ADVISORY COMMITTEE.

        Section 7315 of title 38, United States Code, is amended, in
    subsection (a)--
                (1) in the second sentence, by striking ``and at least one
            representative of a national veterans service organization''
            and inserting ``, at least one individual who represents a
            national veterans service organization, at least one individual
            who has served veterans or families of veterans in a State
            home, and at least one individual who holds a professional
            license in nursing home administration''; and
                (2) by designating the first, second, and third sentences
            as paragraphs (1) through (3), respectively (and adjusting the
            margins accordingly).

    SEC. 407. SCHEDULING OF APPOINTMENTS UNDER THE VETERANS COMMUNITY CARE
                  PROGRAM.

        (a) In General.--
                (1) Electronic process.--Subsection (d) of section 3101 of
            the Johnny Isakson and David P. Roe, M.D. Veterans Health Care
            and Benefits Improvement Act of 2020 (Public Law 116-315; 38
            U.S.C. 1701 note) is amended to read as follows:
        ``(d) Electronic Process.--(1) The Secretary shall implement an
    electronic process through which a scheduler of the Department, using
    an information technology system, may schedule an appointment for
    health care furnished by the Department or through the Veterans
    Community Care Program, under section 1703 of this title, by a non-
    Department health care provider.
        ``(2) The electronic process under this subsection shall allow a
    scheduler, with regards to appointments described in--
                ``(A) either clause of subparagraph (A) of subsection
            (a)(1), to view, search, and sort such appointments by type of
            care, location, and date; and
                ``(B) clause (ii) of such subparagraph--
                        ``(i) to schedule such an appointment;
                        ``(ii) to provide referral and authorization
                    documents directly to a non-Department provider; and
                        ``(iii) to perform any other function the Secretary
                    determines necessary.
        ``(3) The Secretary shall ensure that the electronic process allows
    a scheduler to schedule an appointment for health care furnished by the
    Secretary through a health care provider of the Department.
        ``(4) The Secretary shall implement the electronic process through
    an existing agreement if practicable.
        ``(5) The Secretary shall submit to the Committees on Veterans'
    Affairs of the Senate and House of Representatives the following
    regarding the electronic process:
                ``(A) Not later than 90 days after the Secretary makes a
            determination under subparagraph (B)(iii) of paragraph (2), a
            briefing regarding the functions the Secretary has determined
            necessary.
                ``(B) Not later than six months after the date of the
            enactment of Take Care of America's Veterans Act, and
            semiannually thereafter during the following three years, a
            report regarding operation of the electronic process during
            both the semiannual period preceding the date of the report and
            the cumulative period since the date of the enactment of such
            Act. Such a report shall include the following for each such
            period:
                        ``(i) The number of non-Department health care
                    providers that participated in such electronic process,
                    disaggregated by--
                                ``(I) category of hospital care or medical
                            services provided; and
                                ``(II) medical center of the Department;
                        ``(ii) The number of appointments scheduled
                    pursuant to the electronic process, disaggregated by--
                                ``(I) category of hospital care or medical
                            services provided;
                                ``(II) medical center of the Department;
                            and
                                ``(III) month.
                        ``(iii) A comparison of the average wait time for
                    appointments scheduled through the electronic process
                    and through non-electronic methods, disaggregated by
                    medical center of the Department.
                        ``(iv) The rates at which veterans cancelled
                    appointments scheduled through the electronic process.
                        ``(v) The rates at which veterans did not appear
                    for appointments scheduled through the electronic
                    process.''.
                (2) Implementation.--
                        (A) Date.--The Secretary of Veterans Affairs shall
                    implement the electronic process under subsection (d)
                    of section 1703H of such title, as added by this
                    section, not later than two years after the date of the
                    enactment of this Act.
                        (B) Guidelines.--Not later than 90 days after the
                    date of the enactment of this Act, the Secretary of
                    Veterans Affairs shall establish guidelines. Such
                    guidelines shall include the following:
                                (i) Procedures for schedulers and other
                            employees of the Department involved in the
                            scheduling of appointments described in such
                            section.
                                (ii) A directive that employees described
                            in clause (i) use the electronic process to the
                            extent practicable.
                                (iii) A directive that employees described
                            in clause (i), when scheduling an appointment
                            for a covered veteran (as such term is used in
                            section 1703 of such title) for health care
                            furnished by the Secretary, inform such covered
                            veteran of available appointments though
                            providers of the Department and through
                            providers under the Veterans Community Care
                            Program when eligible.
                                (iv) Procedures for engaging with non-
                            Department health care providers in specialized
                            cases.
                                (v) Standards regarding timeliness and
                            accuracy.
                                (vi) Escalation protocols for scheduling
                            failures or delays.
                        (C) Training.--Not later than 180 days after the
                    date of the enactment of this Act, the Secretary shall
                    implement a mandatory training program for employees
                    described in subparagraph (B) regarding the guidelines
                    under subparagraph (B).
                        (D) Evaluation.--Not later than 60 days after the
                    date of the enactment of this Act, the Secretary shall
                    prescribe performance benchmarks and outcome-based
                    metrics for the electronic process under such section,
                    including--
                                (i) time between a referral and a scheduled
                            appointment;
                                (ii) patient satisfaction; and
                                (iii) the percentage of appointments
                            scheduled exclusively through the electronic
                            process.
                        (E) Outreach.--Not later than 90 days after the
                    date of the enactment of this Act, the Secretary shall
                    plan and carry out an outreach strategy to encourage
                    non-Department of Veterans Affairs health care
                    providers that participate in the Veterans Community
                    Care Program to participate in the electronic process
                    under such subsection. Such outreach shall--
                                (i) include contacting each such provider
                            during such 90 days;
                                (ii) include seeking to enter into an
                            agreement with each such provider under which
                            the provider shall participate in the
                            electronic process;
                                (iii) include collaborating with State
                            hospital associations and rural health
                            associations to promote such participation;
                                (iv) focus on providers in specialties or
                            underserved areas, as determined by the
                            Secretary; and
                                (v) include the publication, on a publicly
                            accessible website of the Department, of
                            information regarding--
                                        (I) details of the electronic
                                    process;
                                        (II) how a provider may elect to
                                    participate in the electronic process;
                                    and
                                        (III) a point of contact in the
                                    Department regarding the electronic
                                    process.
                        (F) Oversight.--The Secretary shall submit to the
                    Committees on Veterans' Affairs of the Senate and House
                    of Representatives, with regards to the electronic
                    process under such subsection, the following:
                                (i) Not later than 30 days after the
                            Secretary establishes guidelines under
                            subparagraph (B) of this paragraph, a copy of
                            such guidelines.
                                (ii) Not later than 30 days after the
                            Secretary formulates the plan under
                            subparagraph (E) of this paragraph, a briefing
                            on the outreach strategy under such paragraph.
                                (iii) Not later than 180 days after the
                            date of the enactment of this Act, the
                            benchmarks and metrics prescribed under
                            subparagraph (D).
                (3) Expansion.--Not later than 90 days after the date of
            the enactment of this Act, the Secretary shall submit to the
            Committees on Veterans' Affairs of the Senate and House of
            Representatives a plan to integrate the scheduling of
            appointments for health care furnished through health care
            providers of the Department of Veterans Affairs into the
            electronic process under subsection (d) of section 1703H of
            such title. Such plan shall include the following elements:
                        (A) A timeline to implement such plan.
                        (B) Estimated costs to carry out such plan.
                        (C) Changes to policies and procedures of the
                    Department the Secretary determines necessary to
                    implement such plan.
                (4) Codification.--
                        (A) In general.--Section 3101 of such Act, as
                    amended by paragraph (1), is transferred to subchapter
                    I of chapter 17 of title 38, United States Code,
                    inserted after section 1703G, and redesignated as
                    section 1703H.
                        (B) Conforming amendments.--Section 1703H of such
                    title, as transferred and redesignated by this
                    subsection, is amended--
                                (i) by striking any heading that is not a
                            section heading or subsection heading and
                            conforming the margins accordingly;
                                (ii) by striking ``of title 38, United
                            States Code'' both places it appears and
                            inserting ``of this title'';
                                (iii) in subsection (b)(1), by striking
                            ``Not later than one year after the date of the
                            enactment of this Act, the Secretary'' and
                            inserting ``The Secretary'';
                                (iv) in subsection (c)--
                                        (I) in paragraph (1), in the matter
                                    preceding subparagraph (A), by striking
                                    ``Not later than 180 days after the
                                    date of the enactment of this Act, the
                                    Secretary'' and inserting ``The
                                    Secretary''; and
                                        (II) in paragraph (2), by striking
                                    subparagraphs (A) and (B) and inserting
                                    ``The Secretary shall require each
                                    medical facility of the Department to
                                    use the method or tool described in
                                    paragraph (1).'';
                                (v) in the section enumerator, by striking
                            ``sec.'' and inserting ``Sec. ''; and
                                (vi) in the section heading--
                                        (I) by striking ``process and
                                    requirements for scheduling
                                    appointments for health care from
                                    department of veterans affairs and non-
                                    department health care.'' and inserting
                                    ``scheduling of appointments''; and
                                        (II) by conforming the typeface and
                                    typestyle, including capitalization, to
                                    the typeface and typestyle used in the
                                    section heading of section 1703G of
                                    such title.
                        (C) Table of sections.--The table of sections at
                    the beginning of such chapter is amended by inserting,
                    after the item relating to section 1703G, the following
                    new item:

    ``1703H. Scheduling of appointments.''.

                           TITLE V--MEMORIAL AFFAIRS

    SEC. 501. EXPANSION OF ELIGIBILITY FOR DEPARTMENT OF VETERANS AFFAIRS
                  MEMORIAL HEADSTONE OR MARKER FOR CERTAIN INDIVIDUALS.

        Section 2306(b)(2) of title 38, United States Code, is amended in
    subparagraphs (B) and (C) by striking ``who dies on or after November
    11, 1998,'' each place it appears.

    SEC. 502. DEPARTMENT OF VETERANS AFFAIRS PROVISION OF ADDITIONAL BURIAL
                  BENEFITS WHEN AN URN OR COMMEMORATIVE PLAQUE IS
                  FURNISHED.

        (a) In General.--Paragraph (2) of section 2306(h) of title 38,
    United States Code, is amended to read as follows:
        ``(2) If the Secretary furnishes an urn or commemorative plaque for
    an individual under paragraph (1), the Secretary may not provide for
    such individual a headstone or marker under this section, or any
    interment benefit under section 2402 of this title, unless--
                ``(A) in the case of a request for a headstone or marker
            under this section--
                        ``(i) such request is made at the same time as a
                    request for placement of a headstone or marker for
                    another individual who is eligible to have such a
                    headstone or marker placed in a national cemetery, a
                    veterans' cemetery in receipt of a grant made under
                    section 2408 of this title, or a post cemetery; and
                        ``(ii) the Secretary furnishes one headstone or
                    marker inscribed for both individuals; or
                ``(B) in the case of a request for interment, the
            individual is interred at the same time and in the same
            gravesite as the interment of another individual eligible for
            interment in a national cemetery under section 2402(a) of this
            title.''.
        (b) Applicability.--The amendment made by subsection (a) shall
    apply with respect to an individual who dies on or after January 5,
    2021.

    SEC. 503. FALLEN SERVICEMEMBERS RELIGIOUS HERITAGE RESTORATION PROGRAM.

        (a) Findings.--Congress finds the following:
                (1) An estimated 900 American-Jewish servicemembers of the
            Armed Forces, killed in World War I and World War II and buried
            overseas in United States military cemeteries were, for various
            reasons, mistakenly buried under Latin Crosses. In most
            instances, those mistakes were made inadvertently.
                (2) In 2022, more than 2,000,000 people visited the United
            States World War I and World War II cemeteries in foreign
            countries.
                (3) American-Jewish servicemembers played a vital role in
            the Allied victories in World War I and World War II.
                (4) American-Jewish servicemembers who fought and died for
            the United States must have their heritage properly recognized
            and honored.
                (5) The United States Government has a solemn
            responsibility to ensure that every American servicemember
            killed in action and buried overseas is properly honored.
                (6) The work of properly identifying American-Jewish
            servicemembers buried overseas is vital and integral to the
            responsibility of the American Battle Monuments Commission to
            ensure that past mistakes in honoring those servicemembers who
            died in the line of duty are corrected.
        (b) Fallen Servicemembers Religious Heritage Restoration Program.--
                (1) Establishment.--The American Battle Monuments
            Commission shall establish a program to identify covered
            members and to contact survivors and descendants of such
            covered members. Such program shall be known as the ``Fallen
            Servicemembers Religious Heritage Restoration Program''.
                (2) Duration.--The Commission shall carry out the Fallen
            Servicemembers Religious Heritage Restoration Program during
            the first five fiscal years that begin after the date of the
            enactment of this Act.
                (3) Contracts.--
                        (A) Authority.--During each fiscal year described
                    in subsection (b), the Commission shall seek to enter
                    into a contract with a nonprofit organization under
                    which such nonprofit organization shall carry out the
                    purpose described in subsection (a).
                        (B) Term; amount.--Each contract under this
                    subsection shall be for one year and in the amount of
                    $500,000 to the nonprofit organization.
                        (C) Priority.--In awarding a contract under this
                    subsection, the Commission shall give priority to a
                    nonprofit organization that has demonstrated capability
                    and expertise in carrying out the purpose described in
                    subsection (a).
                (4) Definitions.--In this section:
                        (A) The term ``covered member'' means a deceased
                    member of the Armed Forces who was Jewish and buried--
                                (i) in a United States military cemetery
                            located outside the United States; and
                                (ii) under a marker that indicates such
                            member was not Jewish.
                        (B) The term ``nonprofit organization'' means an
                    organization described in section 501(c)(3) of the
                    Internal Revenue Code of 1986 and exempt from taxation
                    under section 501(a) of such Code.

       TITLE VI--VETERANS' ASSURING CRITICAL CARE EXPANSIONS TO SUPPORT
                                 SERVICEMEMBERS

           Subtitle A--Improvement of Veterans Community Care Program

    SEC. 601. CODIFICATION OF REQUIREMENTS FOR ELIGIBILITY STANDARDS FOR
                  ACCESS TO COMMUNITY CARE FROM DEPARTMENT OF VETERANS
                  AFFAIRS.

        (a) Eligibility Access Standards.--Section 1703B of title 38,
    United States Code, is amended--
                (1) by striking subsections (a) through (e) and inserting
            the following:
        ``(a) Access Standards for Community Care.--(1) For purposes of
    section 1703(d)(1)(D) of this title, the eligibility access standards
    for hospital care, medical services, or non-institutional extended care
    services, are as follows:
                ``(A) With respect to primary care, mental health care, or
            non-institutional extended care services, the Secretary must
            schedule an appointment for the covered veteran with a health
            care provider of the Department who can provide the needed
            service--
                        ``(i) within 30 minutes average driving time from
                    the residence of the veteran unless a longer average
                    driving time has been agreed to by the veteran in
                    consultation with a health care provider of the
                    veteran; and
                        ``(ii) within 20 days of either the date of request
                    for such an appointment or a later date agreed to by
                    the veteran in consultation with a health care provider
                    of the veteran.
                ``(B) With respect to specialty care, the Secretary must
            schedule an appointment for the covered veteran with a health
            care provider of the Department who can provide the needed
            service--
                        ``(i) within 60 minutes average driving time from
                    the residence of the veteran unless a longer average
                    driving time has been agreed to by the veteran in
                    consultation with a health care provider of the
                    veteran; and
                        ``(ii) within 28 days of either the date of request
                    for such an appointment or a later date agreed to by
                    the veteran in consultation with a health care provider
                    of the veteran.
                ``(C) With respect to a covered treatment program, the
            Secretary must--
                        ``(i) provide to a covered veteran a screening not
                    later than 48 hours after the date on which the
                    veteran, or a relevant health care provider, makes a
                    documented request for the veteran to be admitted to a
                    covered treatment program; and
                        ``(ii) if the veteran is determined eligible for
                    priority admission to a covered treatment program--
                                ``(I) admit the veteran to a covered
                            treatment program not later than 48 hours after
                            the date of such determination or give the
                            veteran the option of seeking care at a non-
                            Department facility pursuant to section 1792(e)
                            of this title; or
                                ``(II) give the veteran the option of
                            seeking care at a non-Department facility
                            pursuant to section 1792(e) of this title.
        ``(2) For the purposes of determining the ability of the Secretary
    to schedule an appointment for a covered veteran with a health care
    provider of the Department under paragraph (1), the Secretary shall not
    take into consideration the availability of telehealth appointments
    from the Department.
        ``(3) In the case of a covered veteran who has had an appointment
    with a health care provider of the Department canceled by the
    Department for a reason other than either the request of the veteran or
    the failure of the veteran to appear as scheduled, in calculating a
    wait time for a subsequent appointment under the eligibility access
    standards established under paragraph (1), the Secretary shall
    calculate such wait time from the date of the request for the original,
    canceled appointment.
        ``(4) If a veteran agrees to a longer average drive time or a later
    date under paragraph (1), the Secretary shall document the agreement to
    such longer average drive time or later date in the electronic health
    record of the veteran and provide the veteran a copy of such
    documentation. Such copy may be provided electronically.
        ``(5) Paragraph (1)(C) shall not be construed to affect a covered
    veteran in a covered treatment program pursuant to a determination made
    on or before the date of the enactment of the Take Care of America's
    Veterans Act.
        ``(6)(A) Subject to the provisions of this paragraph, subparagraphs
    (A) and (B) of paragraph (1) shall terminate on the date that is eight
    years after the date of the enactment of the Take Care of America's
    Veterans Act.
        ``(B) Not later than seven years after the date of the enactment of
    the Take Care of America's Veterans 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 containing--
                ``(i) an assessment of the effects of the codification of
            eligibility access standards for primary care, mental health
            care, non-institutional extended care services, and specialty
            care under this subsection on the management and oversight of
            the Veterans Community Care Program under section 1703 of this
            title; and
                ``(ii) the recommendation of the Secretary for continued
            codification of such standards along with a justification for
            such recommendation.
        ``(C) On and after the date that is eight years after the date of
    the enactment of the Take Care of America's Veterans Act, the Secretary
    may not establish access standards for care and services described in
    subparagraph (A) or (B) of paragraph (1) that are different from the
    standards set forth in those subparagraphs unless, not later than 180
    days before establishing such different standards--
                ``(i) the Secretary submits to the Committee on Veterans'
            Affairs of the Senate and the Committee on Veterans' Affairs of
            the House of Representatives notification of the intent of the
            Secretary to establish such different standards, including a
            description of the changes the Secretary intends to make and
            the justification for such changes; and
                ``(ii) a joint resolution of approval is enacted that
            approves such different standards.
        ``(D) For purposes of this subsection, the term `joint resolution
    of approval' means only a joint resolution the matter after the
    resolving clause of which is as follows: `That Congress approves the
    access standards established by the Secretary submitted on __ relating
    to __.', with the first blank space filled by the appropriate date and
    the second blank space filled with a description of the access
    standards.
        ``(E) A joint resolution of approval shall be considered under the
    expedited procedures outlined in section 802 of title 5 to the same
    extent as a joint resolution described in subsection (a) of that
    section is considered.
        ``(b) Application.--The Secretary shall ensure that the eligibility
    access standards established under subsection (a) apply--
                ``(1) to all care and services within the medical benefits
            package of the Department to which a covered veteran is
            eligible under section 1703 of this title; and
                ``(2) to all covered veterans, regardless of whether a
            veteran is a new or established patient.
        ``(c) Periodic Review of Access Standards.--(1) Not later than
    three years after the date of the enactment of the Take Care of
    America's Veterans Act, and not less frequently than once every three
    years thereafter, the Secretary shall--
                ``(A) conduct a review of the eligibility access standards
            under subsection (a) in consultation with--
                        ``(i) such Federal entities as the Secretary
                    considers appropriate, including the Department of
                    Defense, the Department of Health and Human Services,
                    and the Centers for Medicare & Medicaid Services;
                        ``(ii) entities and individuals in the private
                    sector, including--
                                ``(I) veteran patients;
                                ``(II) representatives of veterans,
                            including individual veterans and participants
                            from veteran stakeholder organizations selected
                            through an open and transparent process; and
                                ``(III) health care providers participating
                            in the Veterans Community Care Program under
                            section 1703 of this title; and
                        ``(iii) other entities that are not part of the
                    Federal Government; and
                ``(B) submit to the appropriate committees of Congress a
            report on--
                        ``(i) the findings of the Secretary with respect to
                    the review conducted under paragraph (1); and
                        ``(ii) such recommendations as the Secretary may
                    have with respect to the eligibility access standards
                    under subsection (a).
        ``(2) Chapter 10 of title 5 shall not apply to the consultation
    required by paragraph (1)(A).'';
                (2) by striking subsection (g);
                (3) by redesignating subsections (f), (h), and (i) as
            subsections (d), (e), and (f), respectively;
                (4) in subsection (d), as redesignated by paragraph (3)--
                        (A) by striking ``established'' each place it
                    appears; and
                        (B) in paragraph (1), by striking ``(1) Subject
                    to'' and inserting ``Compliance by Community Care
                    Providers With Access Standards.--(1) Subject to'';
                (5) in subsection (e), as so redesignated--
                        (A) in paragraph (1)--
                                (i) by striking ``(1) Consistent with'' and
                            inserting ``Determination Regarding
                            Eligibility.--(1) Consistent with''; and
                                (ii) by striking ``designated access
                            standards established under this section'' and
                            inserting ``eligibility access standards under
                            subsection (a)''; and
                        (B) in paragraph (2)(B), by striking ``designated
                    access standards established under this section'' and
                    inserting ``eligibility access standards under
                    subsection (a)''; and
                (6) in subsection (f), as redesignated by paragraph (2)--
                        (A) in the matter preceding paragraph (1), by
                    striking ``In this section'' and inserting
                    ``Definitions.--In this section''; and
                        (B) in paragraph (2)--
                                (i) by striking ``covered veterans'' and
                            inserting ``covered veteran'';
                                (ii) by striking ``veterans described'' and
                            inserting ``a veteran described'';
                                (iii) by redesignating paragraphs (3) and
                            (4) as paragraphs (4) and (5), respectively;
                            and
                                (iv) by inserting after paragraph (2) the
                            following new paragraph (3):
                ``(3) The term `covered treatment program' has the meaning
            given such term in section 1791 of this title.''.
        (b) Conforming Amendments.--Section 1703(d) of such title is
    amended--
                (1) in paragraph (1)(D), by striking ``designated access
            standards developed by the Secretary under section 1703B of
            this title'' and inserting ``eligibility access standards under
            section 1703B(a) of this title'';
                (2) in paragraph (3), by striking ``designated access
            standards developed by the Secretary under section 1703B of
            this title'' and inserting ``eligibility access standards under
            section 1703B(a) of this title''; and
                (3) in paragraph (4), by striking ``designated access
            standards developed by the Secretary under section 1703B of
            this title'' and inserting ``eligibility access standards under
            section 1703B(a) of this title''.

    SEC. 602. REQUIREMENT THAT SECRETARY NOTIFY VETERANS OF ELIGIBILITY FOR
                  CARE OR DENIAL OF REQUEST FOR CARE UNDER VETERANS
                  COMMUNITY CARE PROGRAM.

        (a) In General.--Section 1703(a) of title 38, United States Code,
    is amended by adding at the end the following new paragraph:
        ``(5)(A)(i) Except as provided in clause (iii), the Secretary shall
    notify each covered veteran in writing of the eligibility of such
    veteran for care or services under this section as soon as possible but
    not later than five days after the date on which the Secretary is aware
    that the veteran is seeking care or services and is eligible for such
    care or services under this section.
        ``(ii) The Secretary is required to notify a covered veteran under
    clause (i) only at the start of an episode of care for such veteran.
        ``(iii) The Secretary shall allow a covered veteran to opt out of
    receiving notification under clause (i).
        ``(B) With respect to each covered veteran eligible for care or
    services under subsection (d), and consistent with subparagraph (A),
    the Secretary shall provide such veteran periodic reminders, as
    applicable and as the Secretary determines appropriate, of their
    ongoing eligibility under such subsection.
        ``(C) Any notification or reminder under this paragraph may be
    provided electronically.
        ``(6)(A) If a request by a veteran for the Secretary to authorize
    care or services under this section is denied, except as provided in
    subparagraph (C), the Secretary shall notify the veteran in writing as
    soon as possible but not later than five days after the denial is
    made--
                ``(i) of the reason for the denial; and
                ``(ii) with instructions on how to appeal such denial using
            the clinical appeals process of the Veterans Health
            Administration.
        ``(B) If a denial under subparagraph (A) is due to the Secretary
    meeting the eligibility access standards under section 1703B(a) of this
    title, notice under such subparagraph shall include an explanation of
    how the Secretary met such standards.
        ``(C) The Secretary shall allow a covered veteran to opt out of
    receiving notification under subparagraph (A).
        ``(D) Any notification under this paragraph may be provided
    electronically.''.
        (b) Reports to Congress.-- Not later than one year after the date
    of the enactment of this Act, and not less frequently than annually
    thereafter for a period of five years, the Secretary of Veterans
    Affairs shall submit to the Committee on Veterans' Affairs of the
    Senate and the Committee on Veterans' Affairs of the House of
    Representatives a report on the implementation of the amendments made
    by subsection (a), including--
                (1) an assessment of the timeliness of the notifications
            required by those amendments;
                (2) a description of barriers to increasing the timeliness
            of those notifications; and
                (3) the number of veterans who opt out of receiving those
            notifications.

    SEC. 603. CONSIDERATION UNDER VETERANS COMMUNITY CARE PROGRAM OF
                  CONTINUITY OF CARE AND NEED FOR CAREGIVER OR ATTENDANT.

        Section 1703(d) of title 38, United States Code, is amended--
                (1) in paragraph (2), by adding at the end the following
            new subparagraphs:
                ``(F) The potential for improved continuity of care,
            including if a veteran has an established relationship with a
            non-Department provider and the likelihood of the covered
            veteran to seek and complete recommended care, including if the
            veteran would abstain from seeking such care if required to
            seek such care at a facility of the Department.
                ``(G) Whether the covered veteran needs an attendant to
            provide required aid or assistance to the veteran, including
            for the veteran to travel to a facility of the Department.'';
            and
                (2) by adding at the end the following new paragraph:
        ``(5) The Secretary shall ensure that consideration of the factors
    specified in paragraph (2) includes consideration of all relevant
    factors, is driven by clinical need, and that no single factor is
    required to be determinative when considering the best medical interest
    of a covered veteran.''.

    SEC. 604. DISCUSSION OF TELEHEALTH OPTIONS UNDER VETERANS COMMUNITY
                  CARE PROGRAM.

        Section 1703 of title 38, United States Code, is amended--
                (1) by redesignating subsection (q) as subsection (r); and
                (2) by inserting after subsection (p) the following new
            subsection (q):
        ``(q) Discussion of Options for Telehealth.--(1) When discussing
    options for care or services for a covered veteran under this section,
    the Secretary shall ensure that the veteran is informed of the ability
    of the veteran to seek care or services via telehealth, either through
    a medical facility of the Department or through a non-Department
    provider, if--
                ``(A) telehealth is--
                        ``(i) available to the veteran;
                        ``(ii) appropriate for the type of care or services
                    the veteran is seeking, as determined by the Secretary;
                    and
                        ``(iii) is acceptable to the veteran; or
                ``(B) the care or services the veteran is seeking is only
            or primarily available through telehealth.
        ``(2) Nothing in paragraph (1) shall be construed to prohibit a
    health care provider specified in subsection (c) from furnishing
    hospital care, medical services, or extended care services under this
    section via telehealth.''.

    SEC. 605. EXTENSION OF DEADLINE FOR SUBMITTAL OF CLAIMS BY HEALTH CARE
                  ENTITIES AND PROVIDERS UNDER PROMPT PAYMENT STANDARD.

        Section 1703D of title 38, United States Code, is amended--
                (1) in subsection (a)(2), by striking ``the reason for
            denying the claim and what, if any, additional information is
            required to process the claim'' and inserting ``the reason for
            denying the claim and request additional missing information,
            if any, that is required to process the claim'';
                (2) by amending subsection (b) to read as follows:
        ``(b) Submittal of Claims by Health Care Entities and Providers.--
    (1) A health care entity or provider that furnishes hospital care, a
    medical service, or an extended care services under this chapter
    pursuant to a contract, agreement, or other arrangement shall submit to
    the Secretary a claim for payment for furnishing the hospital care,
    medical service, or extended care service not later than one year after
    the date on which the entity or provider furnished the hospital care,
    medical service, or extended care service.
        ``(2) No health care entity or provider may seek payment from a
    patient if the health care entity or provider failed to comply with the
    timely filing requirement set forth in paragraph (1).''; and
                (3) in subsection (c), by adding at the end the following
            new paragraph:
        ``(3)(A) If the Secretary determines, based on reliable evidence,
    that a health care entity or provider has submitted or caused to be
    submitted a fraudulent claim for payment under this chapter, the
    Secretary may suspend such entity or provider from furnishing hospital
    care, medical services, or extended care services under this chapter.
        ``(B) Before imposing a suspension under subparagraph (A) with
    respect to an entity or provider, the Secretary shall--
                ``(i) provide written notice to the entity or provider
            identifying the basis for the proposed suspension;
                ``(ii) afford the entity or provider an opportunity to
            respond within a period of 30 days; and
                ``(iii) consider any evidence or explanation submitted by
            the entity or provider.
        ``(C)(i) The Secretary shall take all necessary actions to resolve
    a suspension under subparagraph (A) as soon as possible but not longer
    than within one year of the date of the beginning of the suspension,
    unless the Secretary determines and provides a written determination
    that an extension beyond one year is strictly necessary to protect the
    interests of veterans and taxpayers and to preserve the integrity of
    the health care delivery system of the Department.
        ``(ii) Any extension under clause (i) of a suspension shall--
                ``(I) be for an additional period of not longer than one
            year; and
                ``(II) shall be reported to the Committee on Veterans'
            Affairs of the Senate and the Committee on Veterans' Affairs of
            the House of Representatives.
        ``(D) The Secretary shall establish procedures for reinstatement of
    an entity or provider suspended under subparagraph (A) following the
    resolution of any fraud-related investigation or proceeding.
        ``(E) The Secretary shall coordinate actions under this paragraph
    with the Office of Inspector General of the Department.
        ``(F) The Secretary shall prescribe regulations to carry out this
    paragraph, including standards of evidence, notice, and appeal
    procedures.
        ``(G)(i) Not less frequently than quarterly, 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
    written notification of the suspensions entered into, if any, during
    the preceding quarter that includes--
                ``(I) the identity of the suspended entity or provider;
                ``(II) the statutory or regulatory basis for the
            suspension;
                ``(III) a summary of the factual findings or evidence
            supporting the action; and
                ``(IV) the status of any related investigation of or
            referral to the Office of Inspector General of the Department
            or any other appropriate Federal agency.
        ``(ii) The Secretary shall provide to the Committee on Veterans'
    Affairs of the Senate and the Committee on Veterans' Affairs of the
    House of Representatives, upon request, all records, memoranda, and
    communications relevant to any suspension or reinstatement action taken
    under this paragraph, in accordance with applicable laws related to
    privacy, ongoing investigations, or sensitive law enforcement
    information.
        ``(iii) Failure by the Secretary to provide notice under clause (i)
    shall be treated as a failure to comply with a statutory reporting
    requirement.''.

    SEC. 606. AUDIT OF REPRESENTATIVE SAMPLE OF VETERANS RECEIVING CARE AND
                  SERVICES UNDER VETERANS COMMUNITY CARE PROGRAM.

        Not later than one year after the date of the enactment of this
    Act, and not less frequently than annually thereafter for the following
    five years, the Secretary of Veterans Affairs shall--
                (1) conduct an audit, for the one-year period preceding the
            audit, of--
                        (A) the number of veterans eligible for care or
                    services under section 1703 of title 38, United States
                    Code, and the reasons for such eligibility, including
                    multiple such reasons for veterans eligible under more
                    than one eligibility criteria;
                        (B) of those veterans eligible for care or services
                    under section 1703 of title 38, United States Code, the
                    number of veterans who are informed of such
                    eligibility;
                        (C) the number of veterans who opt to seek care or
                    services under such section;
                        (D) the number of veterans who do not opt to seek
                    care or services under such section;
                        (E) the timeliness of referrals for care or
                    services under such section and the timeliness of
                    receipt of such care or services, including whether
                    care or services received by the veteran through a non-
                    Department of Veterans Affairs provider had a shorter
                    wait time than the average wait time for such care or
                    services at a facility of the Department;
                        (F) the number of requests for an appeal of a
                    denial of care or services under such section using the
                    clinical appeals process of the Veterans Health
                    Administration;
                        (G) the timeliness of each such appeal; and
                        (H) the outcome of each such appeal; and
                (2) 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 audit conducted under paragraph
            (1).

    SEC. 607. INFORMATION ON WAIT TIME AND DRIVE TIME OPTIONS FOR RECEIPT
                  OF CARE BY VETERANS.

        (a) In General.--To the greatest extent practicable, the Secretary
    of Veterans Affairs shall ensure that veterans are informed in writing,
    for each episode of care provided under the laws administered by the
    Secretary, of current wait time and average drive time options for such
    episode of care disaggregated by care provided--
                (1) in person at a facility of the Department of Veterans
            Affairs;
                (2) via telehealth through a provider of the Department.
                (3) in person through the nearest suitable non-Department
            facility with which the Department has a provider agreement or
            other arrangement for non-Department care pursuant to section
            1703 of title 38, United States Code; and
                (4) via telehealth through a non-Department provider with
            which the Department has a provider agreement or other
            arrangement for non-Department care pursuant to such section
            with the shortest wait time.
        (b) Form of Information.--Information provided under subsection
    (a)--
                (1) may be provided electronically; and
                (2) shall be documented in the health record of the
            veteran.
        (c) Opt Out.--The Secretary shall permit a veteran to opt out of
    receiving information under subsection (a).

    SEC. 608. ESTABLISHMENT OF PERIOD DURING WHICH A REFERRAL UNDER
                  VETERANS COMMUNITY CARE PROGRAM REMAINS VALID.

        Section 1703(a) of title 38, United States Code, as amended by
    section 602(a), is further amended by adding at the end the following
    new paragraph:
        ``(7) When authorizing care or services under this section, the
    Secretary shall ensure that the period during which such care or
    services may be performed by a health care provider specified in
    subsection (c) begins on the date that the covered veteran has the
    first appointment with such provider.''.

    SEC. 609. UPDATES TO CONTRACTING REQUIREMENTS UNDER VETERANS COMMUNITY
                  CARE PROGRAM.

        Section 1703(h) of title 38, United States Code, is amended--
                (1) in paragraph (3)--
                        (A) by amending subparagraph (A) to read as
                    follows:
        ``(A) The Secretary may terminate a contract with an entity entered
    into under paragraph (1) at such time and upon such notice to the
    entity as the Secretary may specify for purposes of this section, if
    the Secretary notifies the appropriate committees of Congress that, at
    a minimum--
                ``(i) the entity failed to comply substantially with the
            provisions of the contract or with the provisions of this
            section and the regulations prescribed under this section,
            including with respect to access, quality, training, and
            medical documentation;
                ``(ii) it is reasonable to terminate the contract based on
            the health care needs of veterans; or
                ``(iii) it is reasonable to terminate the contract based on
            coverage provided by contracts or sharing agreements entered
            into under authorities other than this section.'';
                        (B) by redesignating subparagraph (B) as
                    subparagraph (D);
                        (C) by inserting after subparagraph (A) the
                    following new subparagraphs:
        ``(B)(i) The Secretary shall terminate a contract with an entity
    entered into under paragraph (1) at such a time and upon such notice to
    the entity as the Secretary may specify for the purposes of this
    section, if the entity--
                ``(I) is excluded from participation in a Federal health
            care program (as defined in section 1128B(f) of the Social
            Security Act (42 U.S.C. 1320a-7b(f))) under section 1128 or
            1128A of the Social Security Act (42 U.S.C. 1320a-7 and 1320a-
            7a);
                ``(II) has been convicted of a felony or other serious
            offense under Federal or State law and the continued
            participation of the entity would be detrimental to the best
            interests of veterans or the Department; or
                ``(III) is identified as an excluded source on the list
            maintained in the System for Award Management, or any successor
            system.
        ``(ii) The Secretary may issue a waiver for entities subject to
    clause (i) for a one-year period, and such a waiver shall be reported
    to Congress not later than 30 days after such waiver is issued.
        ``(C) Any entities ineligible to enter into contracts with the
    Department due to one or more reasons specified in this paragraph may
    be listed on a publicly available website of the Department or
    appropriate third party administrator.'';
                        (D) in subparagraph (D), as redesignated by
                    subparagraph (B) of this paragraph, by striking ``in
                    subparagraph (A)'' and inserting ``in this paragraph'';
                    and
                (2) by adding at the end the following new paragraph:
        ``(7) Any contract or agreement between the Department and a third
    party administrator or between a third party administrator and a health
    care provider specified in subsection (c) that is made with respect to
    care or services provided under this section shall include--
                ``(A) notice of obligations to comply with Federal laws and
            the consequences for failure to comply with those laws,
            including specific information regarding claims for payment and
            consequences for any false claims, statements, or documents, or
            concealment of a material fact;
                ``(B) confirmation by the health care provider that they
            are accredited to provide any specialized services subject to
            the contract or agreement and that they will only use qualified
            staff to provide those services; and
                ``(C) confirmation that the health care provider will
            identify any individuals providing specialized services or
            treatments included in the contract or agreement and provide
            proof of the licensure of those individuals to the
            Department.''.

    SEC. 610. PUBLICATION OF COMMUNITY CARE NETWORK SUFFICIENCY AND PAYMENT
                  WAIVER REQUESTS AND APPROVALS.

        Not later than one year after the date of the enactment of this
    Act, and not less frequently than annually thereafter, the Secretary of
    Veterans Affairs shall publish on a publicly available and user-
    friendly website--
                (1) the information contained in the most recent report
            required by section 1703(p) of title 38, United States Code;
            and
                (2) an overview, disaggregated by region, of the waivers
            requested, approved, and denied under section 1703B(f)(3) of
            such title.

    SEC. 611. REQUIREMENTS RELATING TO QUALITY OF COMMUNITY CARE PROVIDERS.

        (a) Monthly Checks Against List of Excluded Individuals or
    Entities.--The Secretary of Veterans Affairs shall ensure that third
    party administrators under the Veterans Community Care Program perform
    automated monthly checks for all community care providers against the
    list of excluded individuals or entities set forth by the Office of
    Inspector General of the Department of Health and Human Services using
    national provider identifier records or other unique identifiers.
        (b) Revision of Provider Exclusion Standard Operating Procedures.--
    Not later than 90 days after the date of the enactment of this Act, the
    Secretary shall ensure that the Office of Integrated Veteran Care or
    successor office revises its provider exclusion standard operating
    procedures to require automated matching of community care providers in
    the provider profile management system of the Department of Veterans
    Affairs to the system for award management exclusions of the General
    Services Administration using both taxpayer identification number and
    national provider identifier as identifiers.
        (c) Process to Identify Department Providers Terminated or
    Resigning From Employment.--Not later than 90 days after the date of
    the enactment of this Act, the Secretary shall ensure that the Under
    Secretary for Health of the Department of Veterans Affairs develops a
    process to identify health care providers that are terminated, retire,
    or resign from employment with the Department for quality of care
    concerns or while under investigation for quality of care concerns so
    those health care providers can be prevented from participating in the
    Veterans Community Care Program.
        (d) Update of Information on Providers.--Not later than one year
    after the date of the enactment of this Act, the Secretary, through the
    Office of Integrated Veteran Care or successor office, shall develop a
    process to ensure that third party administrators regularly, not less
    frequently than quarterly--
                (1) update their lists of community care providers to
            reflect accurate provider contact information;
                (2) annotate providers that are not currently accepting
            patients under the Veterans Community Care Program; and
                (3) remove providers from the provider profile management
            system that--
                        (A) are on the list of excluded individuals or
                    entities set forth by the Office of Inspector General
                    of the Department of Health and Human Services;
                        (B) are in the system for award management
                    exclusions of the General Services Administration; or
                        (C) have been terminated from employment with the
                    Department of Veterans Affairs due to quality of care
                    concerns or left such employment voluntarily, through
                    resignation, or through retirement, while under
                    investigation for quality of care concerns.
        (e) Definitions.--In this section:
                (1) Community care provider.--The term ``community care
            provider'' means a health care provider specified under section
            1703(c) of title 38, United States Code.
                (2) Veterans community care program.--The term ``Veterans
            Community Care Program'' means the Veterans Community Care
            Program under section 1703 of title 38, United States Code.

    SEC. 612. PROVIDER TRAINING.

        (a) Development of Plan.--Not later than 180 days after the date of
    the enactment of this Act, the Secretary of Veterans Affairs shall
    develop a comprehensive plan to better align training and incentive
    requirements applicable to community care providers participating in
    the Veterans Community Care Program and health care providers,
    residents, and trainees of the Department of Veterans Affairs.
        (b) Elements.--The plan required under subsection (a) shall--
                (1) identify existing training requirements or incentives
            applicable to health care providers of the Department;
                (2) identify existing training requirements or incentives
            applicable to health care trainees or residents of the
            Department;
                (3) identify existing training requirements or incentives
            applicable to community care providers;
                (4) assess gaps between training requirements and
            incentives for health care providers of the Department,
            trainees or residents of the Department, and community care
            providers;
                (5) establish standardized baseline training requirements
            to ensure consistency in the quality of care furnished through
            the Department from health care providers of the Department,
            trainees or residents of the Department, and community care
            providers; and
                (6) provide a strategy, assessment of barriers, and
            timeline for implementing such baseline training requirements,
            including--
                        (A) through online modules and continuing medical
                    education programs; and
                        (B) within such strategy--
                                (i) metrics to measure the effectiveness of
                            baseline training requirements in improving
                            clinical quality, satisfaction of veterans, and
                            health outcomes for veterans;
                                (ii) a mechanism to account for non-
                            Department training that is equivalent or
                            substantially similar to the Department
                            training in length, scope, and content, as
                            determined by the Secretary;
                                (iii) a mechanism to regularly communicate,
                            including through direct outreach and
                            publication online and in provider handbooks of
                            third party administrators under the Veterans
                            Community Care Program, requirements and
                            expectations with respect to training;
                                (iv) a mechanism to track, report, and
                            address non-compliance, to include corrective
                            actions, which may include suspending or
                            barring providers who are routinely non-
                            compliant; and
                                (v) a mechanism to designate community care
                            providers who routinely meet or exceed baseline
                            training requirements as preferred providers or
                            part of the high performing provider program of
                            the Department, as the Secretary considers
                            appropriate.
        (c) Implementation.--Not later than one year after submission of
    the report required under subsection (d), the Secretary shall begin
    implementing the plan required under subsection (a).
        (d) Report to Congress.--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 containing--
                (1) the plan required under subsection (a);
                (2) a description of identified gaps between training or
            incentives for providers of the Department, trainees or
            residents of the Department, and community care providers;
                (3) the estimated costs associated with implementation of
            the plan; and
                (4) a description of any legislative or regulatory changes
            necessary to carry out the plan.
        (e) Annual Updates.--Not later than one year after the submission
    of the report required by subsection (d), and annually thereafter for
    the following two years, the Secretary shall submit to the Committee on
    Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
    of the House of Representatives an update--
                (1) describing progress in implementing the plan required
            under subsection (a);
                (2) assessing any measurable impacts of such implementation
            on quality of care; and
                (3) assessing any improvements in rates of compliance with
            training requirements among health care providers, trainees,
            and residents of the Department and community care providers.
        (f) Definitions.--In this section:
                (1) Community care provider.--The term ``community care
            provider'' means a health care provider specified under section
            1703(c) of title 38, United States Code.
                (2) Training.--The term ``training'' includes training
            relating to--
                        (A) veteran-specific cultural competency;
                        (B) health conditions related to military service,
                    including toxic exposures, post-traumatic stress
                    disorder, traumatic brain injury, and military sexual
                    trauma;
                        (C) suicide prevention;
                        (D) pain management and opioid safety; and
                        (E) any other matter the Secretary determines
                    appropriate.
                (3) Veterans community care program.--The term ``Veterans
            Community Care Program'' means the Veterans Community Care
            Program under section 1703 of title 38, United States Code.

    SEC. 613. OVERSIGHT AUTHORITY OVER COMMUNITY CARE.

        (a) In General.--The Secretary of Veterans Affairs shall include in
    each contract or agreement used to provide care or services through the
    Veterans Community Care Program provisions requiring the contractor and
    any subcontractor or participating provider to provide government
    officials, including the Office of the Inspector General of the
    Department of Veterans Affairs, access, within a reasonable time and
    manner, to records, materials, documents, data, and personnel necessary
    to conduct audits, inspections, evaluations, or investigations related
    to such care or services.
        (b) Third Party Administrators.--
                (1) Requirement.--The Secretary shall require third party
            administrators under the Veterans Community Care Program to
            include provisions in agreements with participating providers
            that are equivalent to the provisions required under subsection
            (a).
                (2) Notification.--Notification of the requirements under
            this section and any other related information as the Secretary
            determines appropriate shall be included in the provider
            handbooks of third party administrators under the Veterans
            Community Care Program.
        (c) Standard Contract Language.--The Secretary shall establish
    standard contract language under this section in consultation with the
    Inspector General of the Department of Veterans Affairs.
        (d) Veterans Community Care Program Defined.--In this section, the
    term ``Veterans Community Care Program'' means the Veterans Community
    Care Program under section 1703 of title 38, United States Code.

                  Subtitle B--Mental Health Treatment Programs

    SEC. 621. VETERAN PARTICIPATION IN CERTAIN MENTAL HEALTH PROGRAMS.

        (a) Establishment.--Chapter 17 of title 38, United States Code, is
    amended by adding at the end the following new subchapter:

      ``SUBCHAPTER IX--PARTICIPATION BY VETERANS IN CERTAIN MENTAL HEALTH
                               TREATMENT PROGRAMS

    ``Sec. 1791. Definitions
        ``In this subchapter:
                ``(1) Activities of daily living.--The term `activities of
            daily living' means specific personal care activities that are
            required for basic daily maintenance and sustenance, to include
            eating, toileting, bathing, grooming, dressing and undressing,
            and mobility.
                ``(2) Covered treatment program.--
                        ``(A) In general.--The term `covered treatment
                    program'--
                                ``(i) means--
                                        ``(I) a mental health residential
                                    rehabilitation treatment program of the
                                    Department; or
                                        ``(II) a program of the Department
                                    for residential care for mental health
                                    and substance use disorders;
                                ``(ii) includes--
                                        ``(I) the programs designated as of
                                    the date of the enactment of the Take
                                    Care of America's Veterans Act as
                                    domiciliary residential rehabilitation
                                    treatment programs; and
                                        ``(II) any programs designated as
                                    domiciliary residential rehabilitation
                                    treatment programs on or after such
                                    date of enactment; and
                                ``(iii) does not include--
                                        ``(I) Compensated Work Therapy
                                    Transition Residence programs of the
                                    Department; or
                                        ``(II) Department or non-Department
                                    programs in which more than 20 percent
                                    of the care provided is provided
                                    through telehealth.
                        ``(B) Accreditation.--A program described in
                    subparagraph (A) must maintain accreditation by the
                    Commission on Accreditation of Rehabilitation
                    Facilities and the Joint Commission.
                ``(3) Covered veteran.--The term `covered veteran' means a
            veteran described in section 1703(b) of this title.
                ``(4) Evidence-based treatment.--The term `evidence-based
            treatment' means treatment provided in accordance with the
            Department of Veterans Affairs/Department of Defense Clinical
            Practice Guidelines for Mental Health and Substance Use
            Disorder, or any successor similar guidelines.
                ``(5) Social support systems.--The term `social support
            systems', with respect to a covered veteran--
                        ``(A) means--
                                ``(i) a member of the family of the covered
                            veteran, including a parent, spouse, child,
                            step-family member, or extended family member;
                            or
                                ``(ii) an individual who lives with the
                            veteran but is not a member of the family of
                            the veteran; and
                        ``(B) does not include a facility-organized peer
                    support program.
    ``Sec. 1792. Standardized process to determine eligibility of covered
                  veterans for participation in certain mental health
                  treatment programs
        ``(a) Standardized Screening Process.--Not later than one year
    after the date of the enactment of the Take Care of America's Veterans
    Act, the Secretary shall establish a standardized screening process to
    determine, based on clinical need, whether a covered veteran satisfies
    criteria for priority or routine admission to a covered treatment
    program.
        ``(b) Eligibility Criteria for Priority Admission.--
                ``(1) In general.--Under the standardized screening process
            required by subsection (a), a covered veteran shall be eligible
            for priority admission to a covered treatment program if the
            covered veteran meets criteria established by the Secretary
            that include any of the following:
                        ``(A) A clinical assessment of the symptoms of the
                    veteran, including symptoms that--
                                ``(i) significantly affect activities of
                            daily life; and
                                ``(ii) increase the risk of adverse
                            outcomes, such as overdose, suicide, self-harm,
                            or an unsafe living situation.
                        ``(B) The lack of availability and applicability of
                    other treatment options.
                        ``(C) Whether the veteran has a recent suicide or
                    overdose attempt.
                        ``(D) Whether the veteran is determined to be a
                    high risk for suicide or overdose.
                        ``(E) Whether the veteran has a demonstrated
                    history of non-responsiveness, relapse, or inability to
                    find recovery from two other completed courses of
                    treatment, such as outpatient or intensive outpatient
                    treatment, through a program that--
                                ``(i) is licensed by a State;
                                ``(ii) is accredited by the Commission on
                            Accreditation of Rehabilitation Facilities or
                            the Joint Commission; and
                                ``(iii) provides evidence-based treatment.
                        ``(F) Such other criteria as the Secretary
                    determines appropriate, in consultation with Congress.
                ``(2) Consideration.--In making a determination that a
            covered veteran meets criteria established by the Secretary
            under paragraph (1) for priority admission to a covered
            treatment program, the Secretary shall--
                        ``(A) consider any referral of a health care
                    provider of a covered veteran; and
                        ``(B) ensure that consideration of such criteria
                    includes consideration of all relevant factors, is
                    driven by clinical need, and that no single factor is
                    required to be determinative when considering the best
                    medical interest of a covered veteran.
                ``(3) Provision of higher-level care.--The Secretary shall
            provide immediate and clinically necessary care under other
            authorities available to the Secretary to any covered veteran
            who is not clinically recommended for admission to a covered
            treatment program based on the need for a higher level of care,
            such as being at a high acute risk for suicide.
        ``(c) Screening for Traumatic Brain Injury.--Under the standardized
    screening process required by subsection (a), the Secretary shall
    ensure a covered veteran is screened at an appropriate time for
    potential mild, moderate, or severe traumatic brain injury.
        ``(d) Considerations.--In making placement decisions in a covered
    treatment program for veterans who meet criteria for priority or
    routine admission, the Secretary shall--
                ``(1) consider the input of the covered veteran with
            respect to the--
                        ``(A) program specialty, subtype, and treatment
                    track offered to the covered veteran; and
                        ``(B) geographic placement of the covered veteran,
                    including proximity to the current residence, time
                    zone, or geographic region of the covered veteran;
                ``(2) maximize the proximity of the covered veteran to
            social support systems; and
                ``(3) to the greatest extent practicable, place the veteran
            in a covered treatment program located within the same time
            zone and geographic region as the residence of the veteran at
            the time of admission.
        ``(e) Conditions Under Which Care Shall Be Furnished Through Non-
    Department Providers.--
                ``(1) Priority admission.--If the Secretary determines a
            covered veteran is eligible for priority admission to a covered
            treatment program pursuant to the standardized screening
            process required by subsection (a) and the Secretary is unable
            to admit such covered veteran to a covered treatment program at
            a facility of the Department in a manner that complies with the
            requirements under subsection (d) and section 1703B(a)(1)(C) of
            this title, the Secretary shall offer the covered veteran the
            option to receive care at a non-Department facility that--
                        ``(A) can admit the covered veteran within the
                    period required by section 1703B(a)(1)(C)(ii)(I) of
                    this title;
                        ``(B) is party to a contract or agreement with the
                    Department or enters into such a contract or agreement
                    under which the Department furnishes a program that is
                    equivalent to a covered treatment program to a veteran
                    through such non-Department facility;
                        ``(C) is licensed by a State;
                        ``(D) is accredited by the Commission on
                    Accreditation of Rehabilitation Facilities or the Joint
                    Commission; and
                        ``(E) provides evidence-based treatment.
                ``(2) Routine admission.--If the Secretary determines a
            covered veteran is eligible for routine admission to a covered
            treatment program pursuant to the standardized screening
            process required by subsection (a) and the Secretary is unable
            to admit such covered veteran to a covered treatment program at
            a facility of the Department in a manner that complies with the
            requirements under section 1703B(a)(1)(C) of this title with
            respect to routine admission, the Secretary shall offer the
            covered veteran the option to receive care at a non-Department
            facility that--
                        ``(A) is party to a contract or agreement with the
                    Department or enters into such a contract or agreement
                    under which the Department furnishes a program that is
                    equivalent to a covered treatment program to a veteran
                    through such non-Department facility;
                        ``(B) is licensed by a State;
                        ``(C) is accredited by the Commission on
                    Accreditation of Rehabilitation Facilities or the Joint
                    Commission; and
                        ``(D) provides evidence-based treatment.
                ``(3) Rule of construction.--This subsection shall not be
            construed to affect a covered veteran in a covered treatment
            program pursuant to a determination made on or before the date
            of the Take Care of America's Veterans Act.
    ``Sec. 1793. Improvements to Department of Veterans Affairs mental
                  health residential rehabilitation treatment program
        ``(a) Performance Metrics.--
                ``(1) In general.--The Secretary shall develop metrics to
            track, and shall subsequently track, the performance of medical
            facilities of the Department, Veterans Integrated Service
            Networks, and non-Department facilities in meeting the
            requirements for--
                        ``(A) screening, under section 1792 of this title,
                    for a covered treatment program;
                        ``(B) timely admission, under section 1792 of this
                    title, to a covered treatment program pursuant to such
                    screening; and
                        ``(C) adherence to evidence-based treatment
                    standards developed by the Secretary in consultation
                    with appropriate governmental and non-governmental
                    professional organizations with a demonstrated history
                    of providing or accrediting programs that are
                    substantially similar to covered treatment programs, or
                    made of professionals who provide for such programs,
                    including by--
                                ``(i) using placement criteria established
                            by the American Society of Addiction Medicine;
                            and
                                ``(ii) maintaining standards to meet
                            accreditation by the Commission on
                            Accreditation of Rehabilitation Facilities or
                            the Joint Commission.
                ``(2) Elements.--The metrics developed under paragraph (1)
            shall include metrics for tracking the performance of medical
            facilities of the Department, Veterans Integrated Service
            Networks, and non-Department facilities with respect to routine
            and priority admission under a covered treatment program as
            well as adherence to evidence-based treatment standards.
                ``(3) Consultation.--In developing metrics under paragraph
            (1), the Secretary shall consult with mental health and
            substance use disorder providers, including providers employed
            by the Department and those employed by non-Department
            entities, and ensure adherence to industry standards.
                ``(4) Report.--Not later than one year after the date of
            the enactment of the Take Care of America's Veterans Act, the
            Secretary shall submit to the Committee on Veterans' Affairs of
            the Senate and the Committee on Veterans' Affairs of the House
            a report describing the consultation and performance metrics
            required under this subsection.
        ``(b) Oversight.--
                ``(1) In general.--The Secretary shall develop a process
            for systematically assessing at the facility, network, and
            regional level, as the Secretary considers appropriate, the
            quality of care delivered by facilities of the Department and
            non-Department facilities treating covered veterans under this
            section as well as a process for rectifying any identified
            concerns.
                ``(2) Elements.--The processes required under paragraph (1)
            shall include assessments of--
                        ``(A) the extent to which providers at the facility
                    deliver evidence-based treatments to covered veterans;
                        ``(B) clinical outcomes for covered veterans,
                    including those outcomes assessment pursuant to a
                    subsequent clinical screening under subsection
                    (g)(3)(E);
                        ``(C) the ratio of licensed independent
                    practitioners per resident;
                        ``(D) the rate of completion of training under
                    section 1795 of this title by licensed independent
                    practitioners;
                        ``(E) whether non-Department facilities and
                    providers generally meet the criteria outlined in
                    section 1792(e) of this title;
                        ``(F) the timeliness, completeness, and rate of
                    transmission, if applicable, of medical records during
                    and following treatment of covered veterans; and
                        ``(G) potentially wasteful, fraudulent, or
                    inappropriate referral or billing practices.
                ``(3) Consultation.--In developing the processes required
            under paragraph (1), the Secretary shall consult with relevant
            stakeholders, including mental health and substance use
            disorder providers employed by the Department and those
            employed by non-Department entities, and ensure adherence to
            industry standards.
                ``(4) Report.--Not later than one year after the date of
            the enactment of the Take Care of America's Veterans Act, the
            Secretary shall submit to the Committee on Veterans' Affairs of
            the Senate and the Committee on Veterans' Affairs of the House
            a report describing the consultation and oversight processes
            required by this subsection.
        ``(c) Placement; Transportation.--
                ``(1) Locations.--If the Secretary determines that a
            covered veteran is in need of residential care under a covered
            treatment program, the Secretary shall provide to the covered
            veteran a list of locations at which such covered veteran can
            receive such residential care that meets--
                        ``(A) the standards for screening under section
                    1792 of this title; and
                        ``(B) the care needs of the covered veteran,
                    including applicable treatment tracks.
                ``(2) Transportation coverage.--
                        ``(A) In general.--Notwithstanding any other
                    provision of law regarding the transportation of
                    individuals under this title, or any other law
                    administered by the Secretary, and except as provided
                    in subparagraph (B), the Secretary shall provide
                    transportation, pay for, or reimburse the costs of
                    transportation for any covered veteran who is admitted
                    into a covered treatment program and needs
                    transportation assistance--
                                ``(i) from the residence of the covered
                            veteran or a facility of the Department or
                            authorized non-Department facility that does
                            not provide such care to another Department or
                            non-Department facility that provides
                            residential care covered under a covered
                            treatment program; and
                                ``(ii) back to the residence of the covered
                            veteran or to a facility of the Department or
                            an authorized non-Department facility after the
                            conclusion of a covered treatment program, if
                            applicable.
                        ``(B) Limitations.--
                                ``(i) Costs incurred by veterans.--The
                            Secretary shall provide reimbursement under
                            subparagraph (A) directly to a covered veteran
                            only for costs directly incurred by the covered
                            veteran and pre-approved by the Department.
                                ``(ii) No coverage of transportation
                            provided by covered treatment program.--The
                            Secretary shall not reimburse a covered veteran
                            for transportation provided to the covered
                            veteran by a covered treatment program, unless
                            for a purpose and amount approved by the
                            Secretary.
        ``(d) Appeals.--
                ``(1) In general.--The Secretary shall develop a national
            policy and associated procedures, in accordance with the
            existing clinical appeals process of the Veterans Health
            Administration, under which a covered veteran, a representative
            of a covered veteran, or a provider who requests a covered
            veteran be admitted to a covered treatment program, including a
            provider of the Department or a non-Department provider, may
            file a clinical appeal pursuant to this subsection if the
            covered veteran is--
                        ``(A) denied admission into a covered treatment
                    program; or
                        ``(B) accepted into a covered treatment program but
                    is not offered bed placement in a timely manner.
                ``(2) Timeliness standards for review.--
                        ``(A) In general.--The national policy and
                    procedures developed under paragraph (1) for appeals
                    described in such paragraph shall include timeliness
                    standards for the Department to review and make a
                    decision on such an appeal.
                        ``(B) Decision.--The Secretary shall review and
                    respond to any appeal under paragraph (1) not later
                    than 72 hours after the Secretary receives such appeal.
                ``(3) Public guidance.--The Secretary shall develop, and
            make available to the public, guidance on how a covered
            veteran, a representative of the covered veteran, or a provider
            of the covered veteran can file a clinical appeal pursuant to
            this subsection--
                        ``(A) if the covered veteran is denied admission
                    into a covered treatment program;
                        ``(B) if the first date on which the covered
                    veteran may enter a covered treatment program does not
                    comply with the eligibility access standards under
                    section 1703B(a) of this title for care at a covered
                    treatment program; or
                        ``(C) with respect to such other factors as the
                    Secretary may specify.
                ``(4) Rule of construction.--Nothing in this subsection may
            be construed as granting a covered veteran, a representative of
            a covered veteran, or a provider who requests a covered veteran
            be admitted to a covered treatment program, including a
            provider of the Department or a non-Department provider, the
            right to appeal a decision of the Secretary with respect to
            admission to a covered treatment program to the Board of
            Veterans' Appeals under chapter 71 of this title.
        ``(e) Tracking of Availability and Wait Times.--
                ``(1) In general.--The Secretary, to the extent
            practicable, shall create a method for tracking availability
            and wait times under a covered treatment program across all
            facilities of the Department, Veterans Integrated Service
            Networks, and non-Department providers throughout the United
            States.
                ``(2) Availability of information.--The Secretary shall
            make the information tracked under paragraph (1) available, in
            real time to--
                        ``(A) the mental health treatment coordinators at
                    each facility of the Department;
                        ``(B) the leadership of each medical center of the
                    Department;
                        ``(C) the leadership of each Veterans Integrated
                    Service Network; and
                        ``(D) the Office of the Under Secretary for Health
                    of the Department.
                ``(3) Publication of information.--Not less frequently than
            monthly, the Secretary shall publish the information tracked
            under paragraph (1) on a publicly accessible website of the
            Department.
        ``(f) Staffing Matters.--
                ``(1) Training.--
                        ``(A) In general.--The Secretary shall update and
                    implement training for staff of the Department directly
                    involved in a covered treatment program regarding
                    referrals, screening, admission, placement decisions,
                    and appeals for such program, including all changes to
                    processes and guidance under such program required by
                    this section and section 1792.
                        ``(B) Covered veterans awaiting admission.--The
                    training under subparagraph (A) shall include
                    procedures for the care of covered veterans awaiting
                    admission into a covered treatment program and
                    communication with such covered veterans and the
                    providers of such covered veterans.
                        ``(C) Timing of training.--
                                ``(i) In general.--The Secretary shall
                            require the training under subparagraph (A) to
                            be completed by staff required to complete such
                            training--
                                        ``(I) not later than 60 days after
                                    beginning employment at the Department
                                    in a position that includes work
                                    directly involving a covered treatment
                                    program; and
                                        ``(II) not less frequently than
                                    annually.
                                ``(ii) Tracking.--The Secretary shall track
                            completion of training required under clause
                            (i) by staff required to complete such
                            training.
                ``(2) Oversight standards.--The Secretary shall review and
            revise oversight standards for the leadership of the Veterans
            Integrated Service Networks and the Veterans Health
            Administration to ensure that facilities and staff of the
            Department are adhering to the policy on access to care of each
            covered treatment program.
                ``(3) Staff coverage.--The Secretary shall not require
            staff of a covered treatment program to act as coverage for any
            other team, service, or project unrelated to the covered
            treatment program for a period of greater than three days per
            month unless such coverage is for purposes of the fourth
            mission of the Department or under an emergency declaration.
        ``(g) Care Coordination and Follow-up Care.--
                ``(1) Continuity of care.--The Secretary shall ensure each
            covered veteran who is screened for admission to a covered
            treatment program is offered, and provided if agreed upon, care
            options during the period between screening of the covered
            veteran and admission of the covered veteran to such program to
            ensure the covered veteran does not experience any lapse in
            care.
                ``(2) Care coordination for substance use disorder.--For a
            covered veteran being treated for substance use disorder, the
            Secretary shall--
                        ``(A) ensure there is a care plan in place during
                    the period between any detoxification services or
                    inpatient care received by the covered veteran and
                    admission of the covered veteran to a covered treatment
                    program; and
                        ``(B) communicate that care plan to the covered
                    veteran, the primary care provider of the covered
                    veteran, and the facility where the covered veteran is
                    or will be residing under such program.
                ``(3) Care planning and clinical screening.--
                        ``(A) In general.--A covered treatment program, in
                    consultation with the covered veteran and the treating
                    providers of the covered veteran in the covered
                    treatment program, shall ensure the completion of a
                    care plan and a clinical screening upon admittance to
                    the covered treatment program and prior to discharge
                    from the covered treatment program, which shall include
                    an assessment of, with respect to the covered veteran--
                                ``(i) overall mental health;
                                ``(ii) risk for suicide;
                                ``(iii) risk for overdose;
                                ``(iv) housing insecurity;
                                ``(v) food insecurity;
                                ``(vi) employment;
                                ``(vii) complex medical needs and
                            diagnoses; and
                                ``(viii) any other factors the Secretary
                            determines necessary.
                        ``(B) Matters to be included.--The care plan
                    required under subparagraph (A) for a covered veteran
                    shall include details on the course of treatment for
                    the covered veteran following completion of treatment
                    under the covered treatment program, including
                    recommended length of stay and any necessary follow-up
                    care and the results of any screening conducted under
                    such subparagraph.
                        ``(C) Length of stay.--
                                ``(i) In general.--Covered treatment
                            programs at non-Department facilities shall
                            submit the care plan under subparagraph (A) for
                            a covered veteran, including the requested or
                            recommended length of stay for the covered
                            veteran, to the Department not later than 72
                            hours after the veteran is admitted to the
                            covered treatment program.
                                ``(ii) Approval required.--Any length of
                            stay of a covered veteran at a covered
                            treatment program longer than 30 days or
                            extensions of length of stay greater than a
                            total of 30 days shall require approval by the
                            Secretary. The Secretary shall respond to any
                            such requests for approval within 72 hours. Any
                            such requests that have not received a response
                            within 72 hours shall be automatically approved
                            on a daily basis until the Secretary responds.
                        ``(D) Sharing of care plan.--The care plan required
                    under subparagraph (A) shall be shared with the covered
                    veteran, the primary care provider of the covered
                    veteran, and any other providers with which the covered
                    veteran consents to sharing the plan.
                        ``(E) Discharge from non-department facility.--Upon
                    discharge of a covered veteran under a covered
                    treatment program from a non-Department facility, and
                    not later than 30 days after discharge, the facility
                    shall share with the Department all care records
                    maintained by the facility with respect to the covered
                    veteran and shall work in consultation with the
                    Department on the care plan of the covered veteran
                    required under subparagraph (A).
                        ``(F) Subsequent clinical screening.--Not later
                    than 180 days after the end of treatment of a covered
                    veteran in a covered treatment program, the covered
                    treatment program or a Department or non-Department
                    provider shall conduct a subsequent clinical screening,
                    which shall include an assessment of the factors
                    specified in clauses (i) through (viii) of subparagraph
                    (A) and recommendations for follow-up care as the
                    Secretary considers appropriate.
                        ``(G) Complex medical needs.--Before, during, and
                    after treatment in a covered treatment program, the
                    Secretary shall provide greater engagement,
                    coordination, and monitoring of care for covered
                    veterans with--
                                ``(i) complex medical diagnoses, including
                            diagnoses of dementia, spinal cord injury or
                            disorder, epilepsy, Parkinson's, anemia, severe
                            mental illness, multiple sclerosis,
                            incontinence of the bladder or bowel, mobility
                            limitations, or impaired vision; or
                                ``(ii) complex medical needs, including
                            chemotherapy or other oncology care, dialysis,
                            recurring blood transfusions, or physical or
                            occupational therapy.
        ``(h) Data Collection.--The Secretary shall consult with the Office
    of Research and Development of the Department, or any successor office,
    regarding any data the Department should consider requesting or
    requiring from non-Department facilities to assist with research
    studies and projects in which the Department is participating relating
    to mental health residential rehabilitation treatment programs.
        ``(i) Reports to Congress.--
                ``(1) Report on modifications to programs.--
                        ``(A) In general.--Not later than two years after
                    the date of the enactment of the Take Care of America's
                    Veterans Act, the Secretary shall submit to the
                    Committee on Veterans' Affairs of the Senate and the
                    Committee on Veterans' Affairs of the House of
                    Representatives a report on modifications made to the
                    guidance, operation, and oversight of covered treatment
                    programs to fulfill the requirements of this section.
                        ``(B) Elements.--The report required by
                    subparagraph (A) shall include--
                                ``(i) an assessment of whether costs of
                            covered treatment programs, including for
                            residential care provided through facilities of
                            the Department and non-Department facilities,
                            serve as a disincentive to placement in the
                            such a program;
                                ``(ii) a description of actions taken by
                            the Department to address the findings and
                            recommendations by the Secretary contained in
                            the report under section 503(c) of the STRONG
                            Veterans Act of 2022 (division V of Public Law
                            117-328; 136 Stat. 5515), including--
                                        ``(I) such actions with respect
                                    to--
                                                ``(aa) any new locations
                                            added for covered treatment
                                            programs;
                                                ``(bb) any beds added at
                                            existing facilities of such
                                            programs; and
                                                ``(cc) any additional
                                            treatment tracks or sex-
                                            specific programs created or
                                            added at facilities of the
                                            Department; and
                                        ``(II) a breakdown of the number
                                    and percentage of covered veterans who
                                    are determined eligible for priority
                                    placement into a covered treatment
                                    program and the number and percentage
                                    of covered veterans who are determined
                                    eligible for routine placement into a
                                    covered treatment program; and
                                ``(iii) such recommendations as the
                            Secretary may have for legislative or
                            administrative action to address any funding
                            constraints or disincentives for use of a
                            covered treatment program.
                ``(2) Annual report on operation of programs.--
                        ``(A) In general.--Not later than one year after
                    the submission of the report under paragraph (1), and
                    not less frequently than annually thereafter for the
                    following five years, 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 operation of covered
                    treatment programs.
                        ``(B) Elements.--Subject to subparagraph (C), each
                    report required by subparagraph (A) shall include the
                    following:
                                ``(i) The number of covered veterans served
                            by a covered treatment program, disaggregated
                            by--
                                        ``(I) Veterans Integrated Service
                                    Network in which the covered veteran
                                    receives care;
                                        ``(II) facility, including
                                    facilities of the Department and non-
                                    Department facilities, at which the
                                    covered veteran receives care;
                                        ``(III) type of residential
                                    rehabilitation treatment care received
                                    by the covered veteran under such
                                    program;
                                        ``(IV) sex of the covered veteran;
                                    and
                                        ``(V) race or ethnicity of the
                                    covered veteran.
                                ``(ii) Wait times under a covered treatment
                            program for the most recent year data is
                            available, disaggregated by--
                                        ``(I) treatment track or
                                    specificity of residential
                                    rehabilitation treatment care sought by
                                    the covered veteran;
                                        ``(II) sex of the covered veteran;
                                        ``(III) State or territory in which
                                    the covered veteran is located;
                                        ``(IV) Veterans Integrated Service
                                    Network in which the covered veteran is
                                    located; and
                                        ``(V) facility of the Department at
                                    which the covered veteran seeks care.
                                ``(iii) A list of all locations of a
                            covered treatment program and number of bed
                            spaces at each such location, disaggregated by
                            residential rehabilitation treatment care or
                            treatment track provided under such program at
                            such location.
                                ``(iv) A list of any new locations of
                            covered treatment programs added or removed and
                            any bed spaces added or removed during the one-
                            year period preceding the date of the report.
                                ``(v) Average cost of a stay under a
                            covered treatment program, including total stay
                            average and daily average, at facilities of the
                            Department compared to non-Department
                            facilities.
                                ``(vi) A review of staffing needs and gaps
                            with respect to covered treatment programs that
                            is data-driven and aligned with industry
                            benchmarks and standards, including--
                                        ``(I) a list of facilities that had
                                    unstaffed beds or closed beds due to
                                    lack of staffing at any point in the
                                    previous year;
                                        ``(II) the number of additional
                                    staff needed to staff those beds;
                                        ``(III) the number of beds at each
                                    facility;
                                        ``(IV) the average wait-times for
                                    the covered treatment program,
                                    disaggregated by month, during the
                                    periods of bed closures; and
                                        ``(V) a list of facilities that
                                    required staff of covered treatment
                                    programs to perform duties unrelated to
                                    covered treatment programs for a period
                                    of greater than three days.
                                ``(vii) An overview of data collected
                            pursuant to a subsequent clinical screening
                            under subsection (g)(3)(F).
                                ``(viii) A list of health care systems
                            without a covered treatment program and an
                            assessment of the feasibility and advisability
                            of opening a covered treatment program at such
                            health care system that is aligned and
                            justified by patient demand and market factors.
                                ``(ix) A list of health care systems that
                            offer a covered treatment program aligned with
                            patient demand and market factors and that have
                            an average wait time of more than 20 days and
                            an assessment of the feasibility and
                            advisability of expanding such covered
                            treatment program to lower such average wait
                            time.
                                ``(x) Any recommendations for changes to
                            the operation of covered treatment programs,
                            including any policy changes, guidance changes,
                            training changes, or other changes.
                        ``(C) Anonymity.--To ensure that the data provided
                    under this paragraph, or some portion of that data,
                    will not undermine the anonymity of a veteran, the
                    Secretary shall provide such data pursuant to
                    applicable Federal law and in a manner that is wholly
                    consistent with applicable Federal privacy and
                    confidentiality laws, including--
                                ``(i) section 552a of title 5 (commonly
                            known as the `Privacy Act of 1974');
                                ``(ii) the Health Insurance Portability and
                            Accountability Act of 1996 (Public Law 104-
                            191);
                                ``(iii) parts 160 and 164 of title 45, Code
                            of Federal Regulations, or successor
                            regulations; and
                                ``(iv) sections 5701, 5705, and 7332 of
                            this title.
                ``(3) Notification to congress of beds not available due to
            lack of staffing.--The Secretary shall notify Congress of any
            covered treatment programs of the Department with more than
            five beds or more than ten percent of beds unavailable, closed,
            or reassigned due to lack of staffing, including--
                        ``(A) information on the staff needed to reopen
                    beds that are closed;
                        ``(B) plans to recruit and retain staff;
                        ``(C) the total number of beds closed or expected
                    to be closed;
                        ``(D) the estimated length of time until those
                    closed beds are made available; and
                        ``(E) the current wait time for access to those
                    beds.
        ``(j) Third-party Assessment.--
                ``(1) In general.--Not later than two years after the date
            of the enactment of the Take Care of America's Veterans Act,
            the Secretary shall seek to enter into a contract with an
            appropriate entity to conduct a study of the care provided
            under covered treatment programs through facilities of the
            Department and non-Department facilities.
                ``(2) Elements.--The study required under paragraph (1)
            shall include a review of--
                        ``(A) whether facilities are meeting requirements
                    of the Department pursuant to law, regulation, or
                    policy;
                        ``(B) staffing models used by facilities and level
                    of adherence to those models;
                        ``(C) success rates of covered treatment programs
                    in preventing readmittance to a covered treatment
                    program or death by suicide or overdose within a year
                    of discharge from the program;
                        ``(D) adherence of non-Department facilities to
                    timelines for claim submission and record returns to
                    the Department; and
                        ``(E) any other factors the Secretary or the
                    appropriate entity determines relevant or appropriate
                    to include.
                ``(3) Completion of study.--The contract sought under
            paragraph (1) shall include a requirement that the appropriate
            entity, not later than four years after the date of the
            enactment of the Take Care of America's Veterans Act, complete
            the study required under such paragraph and submit to the
            Secretary a report on the study.
                ``(4) Action plan and commentary.--Not later than five
            years after the date of the enactment of the Take Care of
            America's Veterans 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, and
            publish on a publicly accessible website of the Department, a
            report containing--
                        ``(A) the results of the study required under
                    paragraph (1);
                        ``(B) action plans for improvement based on the
                    results of the study; and
                        ``(C) general commentary and feedback on the
                    results of the study.
                ``(5) Appropriate entity defined.--In this subsection, the
            term `appropriate entity' means--
                        ``(A) a nongovernmental entity with experience in
                    assessing programs that deliver services provided under
                    covered treatment programs on a large scale; or
                        ``(B) a federally funded research and development
                    center.
        ``(k) Revision of Guidance.--The Secretary shall update the
    guidance of the Department on the operation of covered treatment
    programs to reflect each of the requirements under this section.
        ``(l) Deadline.--Unless otherwise specified, the Secretary shall
    carry out each requirement under this section by not later than one
    year after the date of the enactment of the Take Care of America's
    Veterans Act.
        ``(m) Comptroller General Review.--
                ``(1) In general.--Not later than two years after the date
            of the enactment of the Take Care of America's Veterans Act,
            the Comptroller General of the United States shall review
            access to care under a covered treatment program for covered
            veterans in need of residential mental health care and
            substance use disorder care.
                ``(2) Elements.--The review required by paragraph (1) shall
            include the following:
                        ``(A) A review of wait times for covered veterans
                    under a covered treatment program, disaggregated by--
                                ``(i) treatment track or specificity of
                            residential rehabilitation treatment care
                            needed;
                                ``(ii) sex of the covered veteran;
                                ``(iii) home State of the covered veteran;
                                ``(iv) home Veterans Integrated Service
                            Network of the covered veteran; and
                                ``(v) wait times for--
                                        ``(I) facilities of the Department;
                                    and
                                        ``(II) non-Department facilities.
                        ``(B) A review of policy and training of the
                    Department on screening, admission, and placement under
                    a covered treatment program.
                        ``(C) A review of the rights of covered veterans
                    and providers to appeal admission decisions under a
                    covered treatment program and how the Department
                    adjudicates appeals.
                        ``(D) When determining the facility at which a
                    covered veteran admitted to a covered treatment program
                    will be placed in such program, a review of how the
                    input of the covered veteran is taken into
                    consideration with respect to--
                                ``(i) program specialty, subtype, or
                            treatment track offered to the covered veteran;
                            and
                                ``(ii) the geographic placement of the
                            covered veteran, including family- or
                            occupation-related preferences or
                            circumstances.
                        ``(E) A review of staffing and staffing needs and
                    gaps of covered treatment programs, including with
                    respect to--
                                ``(i) mental health providers and
                            coordinators at the facility level;
                                ``(ii) staff of facilities of such
                            programs;
                                ``(iii) staff of Veterans Integrated
                            Service Networks; and
                                ``(iv) overall administration of such
                            programs at the national level.
                        ``(F) A review of outcomes from Department and non-
                    Department covered treatment programs based at least in
                    part on the subsequent clinical screenings required
                    under subsection (g)(3)(E).
                        ``(G) Recommendations for improvement of access by
                    covered veterans to care under a covered treatment
                    program, including with respect to--
                                ``(i) any new sites or types of programs
                            needed or in development;
                                ``(ii) changes in training or policy;
                                ``(iii) changes in communications with
                            covered veterans; and
                                ``(iv) oversight of covered treatment
                            programs by the Department.
    ``Sec. 1794. Fee schedule
        ``(a) In General.--Not later than 180 days after the date of the
    enactment of the Take Care of America's Veterans Act, the Secretary
    shall make publicly available on an appropriate website of the
    Department a fee schedule for each covered treatment program provided
    by a non-Department provider through which the Secretary furnishes care
    and services under section 1710 of this title.
        ``(b) Elements.--The fee schedule required under subsection (a) for
    a covered treatment program shall--
                ``(1) reflect reasonable charges for the services provided;
                ``(2) be based on the amounts customarily paid for similar
            services under the Medicaid program under title XIX of the
            Social Security Act (42 U.S.C. 1396 et seq.) and by commercial
            health insurance providers;
                ``(3) to the greatest extent practicable, be consistent
            with payment rates under section 1703(i) of this title;
                ``(4) be comprehensive to include a variety of possible
            types of care, services, and charges; and
                ``(5) be sufficient to ensure a robust network of qualified
            community providers able to provide services under a covered
            treatment program to covered veterans.
        ``(c) Coordination of Payment Rates.--After the date of the initial
    publication of the fee schedule under subsection (a), the rate paid by
    the Department for residential substance use disorder treatment shall
    be the rate provided in the fee schedule required under such
    subsection.
        ``(d) Recoupment of Amounts.--
                ``(1) In general.--The Secretary shall recoup from a non-
            Department entity, including a third party administrator, any
            amount paid to such entity that exceeds the amount specified
            under the fee schedule under subsection (a) for the care or
            services provided.
                ``(2) Limitation.--A non-Department entity shall not bill a
            veteran for any charges recouped under paragraph (1).
    ``Sec. 1795. Training
        ``(a) In General.--Not later than one year after the date of the
    enactment of the Take Care of America's Veterans Act, the Secretary
    shall--
                ``(1) develop and implement a plan to ensure that health
            care providers caring for veterans under covered treatment
            programs receive and complete relevant training aligned with
            industry standards and practices; and
                ``(2) submit that plan to the Committee on Veterans'
            Affairs of the Senate and the Committee on Veterans' Affairs of
            the House of Representatives.
        ``(b) Elements of Training.--Training required under subsection (a)
    shall--
                ``(1) be easily accessible, no-cost, and offered in such a
            manner as to qualify for or fulfill continuing education
            requirements for health care professionals;
                ``(2) include course modules related to military culture,
            post-traumatic stress disorder, the evaluation and management
            of suicide, traumatic brain injury, and opioid safety, or
            comparable course modules, as determined by the Secretary; and
                ``(3) be offered through Department and non-Department
            entities or organizations.
        ``(c) Elements of Plan.--The plan required under subsection (a)
    shall--
                ``(1) allow for Department or non-Department providers to
            receive credit for non-Department training that is equivalent
            or substantially similar to training required under subsection
            (a); and
                ``(2) include details regarding consequences for non-
            compliance with training required under such plan, which may
            include removal from a network of providers under the Veterans
            Community Care Program under section 1703 of this title for a
            specified period of time.
        ``(d) Consultation.--The Secretary shall consult with relevant
    professional organizations with respect to the content of relevant
    training required under subsection (a).''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    such chapter is amended by adding at the end the following new items:

      ``subchapter ix--participation by veterans in certain mental health
                               treatment programs

    ``1791. Definitions.
    ``1792. Standardized process to determine eligibility of covered
                                veterans for participation in certain
                                mental health treatment programs.
    ``1793. Improvements to Department of Veterans Affairs mental health
                                residential rehabilitation treatment
                                program.
    ``1794. Fee schedule.
    ``1795. Training.''.

    SEC. 622. ACCESS TO MENTAL HEALTH RESIDENTIAL REHABILITATION TREATMENT
                  PROGRAMS FOR VETERANS WITH SPINAL CORD INJURY OR
                  DISORDER.

        (a) Plan.--
                (1) In general.--Not later than 90 days after the date of
            the enactment of this Act, the Secretary of Veterans Affairs
            shall submit to the Committee on Veterans' Affairs of the
            Senate and the Committee on Veterans' Affairs of the House of
            Representatives a plan to ensure access to mental health
            residential treatment programs for veterans with a spinal cord
            injury or disorder.
                (2) Elements.--The plan required under paragraph (1) shall
            include--
                        (A) a staffing plan, which shall include a plan for
                    how the Department will--
                                (i) incorporate staff from other facilities
                            to support the pilot program required under
                            subsection (b); and
                                (ii) ensure adequate staffing to support
                            the needs of veterans with a spinal cord injury
                            or disorder;
                        (B) an assessment of medical equipment needs; and
                        (C) an assessment of the best location to deliver
                    treatment and health care under mental health
                    residential treatment programs, including through the
                    use of spinal cord injury or disorder centers, spinal
                    cord injury or disorder spokes, and community care
                    providers.
        (b) Pilot Program.--
                (1) In general.--Commencing not later than 120 days after
            the date of the enactment of this Act, the Secretary shall
            carry out a pilot program to provide improved access to mental
            health residential treatment programs of the Department of
            Veterans Affairs for veterans with a spinal cord injury or
            disorder at not fewer than three medical facilities of the
            Department.
                (2) Selection of locations.--In selecting sites for the
            pilot program under paragraph (1), the Secretary shall
            prioritize sites in the following areas:
                        (A) Areas with geographic diversity, including
                    areas that serve veterans residing in rural or highly
                    rural areas.
                        (B) Areas with a significant number of veterans
                    with spinal cord injury or disorder.
        (c) Report.--Not later than one year after the date of the
    enactment of this Act, the Secretary shall submit to the Committee on
    Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
    of the House of Representatives a report on--
                (1) the implementation of the plan required under
            subsection (a);
                (2) the initial results from the pilot program under
            subsection (b), including the number of unique veterans who
            participated in the pilot program, the cost of the pilot
            program, and an assessment of the effectiveness of the pilot
            program in increasing access to, and improving outcomes for,
            participants in the pilot program;
                (3) plans, if any, to expand or extend the pilot program to
            address demand for the highly specialized treatment provided
            under the mental health residential treatment programs of the
            Department for veterans with a spinal cord injury or disorder;
            and
                (4) Such other matters as the Secretary considers
            appropriate.

                          Subtitle C--Staffing Matters

    SEC. 631. 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. 632. MENTORSHIP PROGRAM FOR EXECUTIVE LEADERSHIP TEAMS AT MEDICAL
                  CENTERS OF THE DEPARTMENT OF VETERANS AFFAIRS.

        (a) In General.--The Secretary of Veterans Affairs may establish a
    program to connect covered individuals (in this section referred to as
    ``mentees'') with peer mentors to facilitate sharing of best practices
    and leadership experiences and to foster opportunities to develop
    knowledge and skills required to lead successfully at medical
    facilities of the Department (in this section referred to as the
    ``mentorship program'').
        (b) Covered Individual Defined.--In this section, the term
    ``covered individual'' means--
                (1) an individual in the position of Facility Director,
            Chief of Staff, Associate Director of Patient Care Services,
            Associate Director, Assistant Director, or Deputy Director at a
            medical center of the Department; or
                (2) any other employee of the Department who is determined
            by the Secretary to be an executive leader at a medical center
            of the Department.
        (c) Eligibility.--The following employees of the Department are
    eligible for participation as mentees in the mentorship program:
                (1) An employee appointed to a position as a covered
            individual who has been in that position for less than one
            year.
                (2) A covered individual employed at a medical center of
            the Department (regardless of appointment commencement date)
            that meets one or more of the following criteria:
                        (A) Reports poor performance, as defined by the
                    Secretary, on the Strategic Analytics for Improvement
                    and Learning Value Model of the Department, or
                    successor similar model.
                        (B) Reports data under section 1703C(a)(3) of title
                    38, United States Code, as published on the Access to
                    Care website of the Department, or successor similar
                    website, that--
                                (i) does not consistently meet the level
                            reported in the community surrounding such
                            medical center, as determined by the Secretary;
                            or
                                (ii) does not meet a threshold level
                            determined by the Secretary.
                        (C) Has one or more recommendations from a report
                    by the Office of Inspector General of the Department of
                    Veterans Affairs that is still open more than one year
                    after the report was published.
                (3) A covered individual employed at a medical center of
            the Department (regardless of appointment commencement date)
            who is recommended by the regional leadership overseeing such
            medical center.
        (d) Criteria for Peer Mentors.--Each peer mentor to be paired with
    a mentee under subsection (a) shall meet each of the following
    criteria:
                (1) Previous or current employment in the same position
            title as the mentee.
                (2) Employment in that position for not less than two
            years.
                (3) Employment at a medical center of the Department that
            reports--
                        (A) above average performance, as defined by the
                    Secretary, on the Strategic Analytics for Improvement
                    and Learning Value Model of the Department, or
                    successor similar model; and
                        (B) data under section 1703C(a)(3) of title 38,
                    United States Code, as published on the Access to Care
                    website of the Department, or successor similar
                    website, that exceeds the level reported in the
                    community surrounding such medical center, as
                    determined by the Secretary.
        (e) Report.--Not later than one year after the date of the
    enactment of this Act, and annually thereafter for an additional three
    years, 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 mentorship program, including--
                (1) the number of mentees and peer mentors participating in
            the mentorship program, disaggregated by medical center of the
            Department;
                (2) the number of mentor-mentee pairings initiated under
            each of the eligibility criteria outlined in paragraphs (1),
            (2), and (3) of subsection (c), including information on any
            circumstances in which multiple criteria under such paragraphs
            were met;
                (3) a description of the actions taken by the Department to
            encourage communication between mentees and peer mentors;
                (4) aggregated feedback from participants in the mentorship
            program; and
                (5) the turnover rate for mentee participants in the
            mentorship program.
        (f) Termination.--The authority under this section shall terminate
    on September 30, 2030.

    SEC. 633. REQUIREMENT FOR EQUIVALENT ROLE POSTINGS FOR VACANT POSITIONS
                  AT DEPARTMENT OF VETERANS AFFAIRS.

        (a) In General.--Whenever possible and practicable, if the
    Secretary of Veterans Affairs is issuing a posting for vacant positions
    at the Department of Veterans Affairs that may be filled by more than
    one type of professional or clinician, the Secretary shall issue
    postings for all possible clinicians or professionals who could fill
    the position.
        (b) Application to Certain Positions.--The Secretary shall consider
    the requirement under subsection (a) in particular with respect to
    hard-to-recruit, hard-to-retain, primary care, and mental health care
    positions.

    SEC. 634. IMPROVEMENTS TO DEPARTMENT OF VETERANS AFFAIRS HIRING
                  PROCESSES.

        (a) In General.--Subchapter I of chapter 7 of title 38, United
    States Code, is amended by inserting after section 701 the following
    new section:
    ``Sec. 702. Hiring processes
        ``(a) Standardized Approval Process for Filling Vacant Positions.--
                ``(1) Process required.--
                        ``(A) In general.--The Secretary shall establish a
                    standardized, nationwide approval process for filling
                    vacant employment positions within the Department.
                        ``(B) Variability.--The process required by
                    subparagraph (A) may be different for each type of
                    employment position in the Department.
                        ``(C) Approval windows.--The process required by
                    subparagraph (A) shall include a standardized approval
                    window for each approval step.
                ``(2) Delegation.--If the approval authority for a step in
            the hiring process established under paragraph (1) is vacant,
            on leave, or otherwise unable to respond to requests for
            approval in an appropriate timeframe, such authority for
            approval shall be delegated to the extent practicable to the
            supervisor of such approval authority or such other designee as
            may be specified in the chain of command.
                ``(3) Time to fill goal.--Each window of time allotted for
            each approval step under paragraph (1)(C) when added together
            shall not exceed the goal of the Department to fill window for
            that employment position.
        ``(b) Process for Tentative Offers of Employment.--The Secretary
    shall develop a standardized process for issuing tentative offers of
    employment with the Department and such process shall require that each
    such offer includes a specified rate of basic pay when possible and
    practicable.
        ``(c) Third-party Contracts.--The Secretary may conduct laboratory
    testing, background clearances, and other candidate approval and
    vetting procedures through a contract with a third party if the
    Secretary determines that the contract would ensure equal or better
    quality or timeliness.
        ``(d) Electronic Signatures.--
                ``(1) Authority.--The Secretary shall allow electronic
            signatures on any hiring, recruitment, retention, or other
            employment documents once a standardized process for such
            signatures is developed and implemented under paragraph (2).
                ``(2) Standardized process.--The Secretary shall develop a
            standardized process for use of electronic signatures as
            described in paragraph (1), which shall include exceptions and
            limitations as the Secretary considers appropriate and that
            allows for use of electronic signatures for employment
            documents, including SF 1152 and related successor forms, SF
            2823 and related successor forms, and SF 3102-FERS and related
            successor forms.
        ``(e) Employee Community Building Program.--The Secretary shall, to
    the extent practicable, establish an employee community building
    program that connects employees in similar positions, offices, and
    programs to connect with each other nationwide.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 7 of such title is amended by inserting after the item relating
    to section 701 the following new item:

    ``702. Hiring processes.''.

    SEC. 635. DEPARTMENT OF VETERANS AFFAIRS TELEWORK POLICY.

        (a) Policy Required.--Not later than 180 days after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall, in
    accordance with the requirements of this section and the requirements
    of section 6502 of title 5, United States Code, establish a policy for
    the use of telework within the Department of Veterans Affairs.
        (b) Locations.--The policy established under subsection (a) may be
    different for different locations, specialties, and categories of
    employees, as determined appropriate by the Secretary.
        (c) Assessment.--In developing the policy required by subsection
    (a), the Secretary shall assess the following for each category of
    employees at the Department--
                (1) staffing levels and trends over the last 5 years;
                (2) exit survey data related to telework;
                (3) the availability of dedicated work space at facilities
            of the Department to enable onsite work at a duty station;
                (4) a comparison of productivity levels when duties are
            performed on site or through telework;
                (5) telework flexibilities for comparable categories of
            employees in the private sector and in other Federal agencies;
            and
                (6) particular duties that necessitate on site work.
        (d) Notice and Reporting.--
                (1) In general.--For any change made to the policy
            established pursuant to subsection (a), the Secretary shall--
                        (A) notify all affected employees of the Department
                    of the changes; and
                        (B) 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 changes.
                (2) Report contents.--For each report submitted to Congress
            under paragraph (1)(B), the Secretary shall include the
            analyses for each category conducted in subsection (c) and the
            role of those analyses in the telework policy for each
            category.
                (3) Deadline.--A report submitted under paragraph (1)(B)
            regarding a change to the policy established under subsection
            (a) shall be made not fewer than 90 days before the change goes
            into effect.
        (e) Report on Budgetary Impact.--Not later than 1 year after the
    date on which the policy established pursuant to subsection (a) goes
    into effect, the Secretary shall submit to the Committee on Veterans'
    Affairs and the Committee on Appropriations of the Senate and the
    Committee on Veterans' Affairs and the Committee on Appropriations of
    the House of Representatives a report on the annual budgetary impact of
    such policy.
        (f) Effective Date and Changes.--
                (1) Effective date of initial policy.--The initial policy
            established by pursuant to subsection (a) shall go into effect
            not later than 180 days after the date on which the policy is
            established.
                (2) Effective date of subsequent changes.--Any change made
            to the policy established pursuant to subsection (a) after the
            effective date set forth in paragraph (1) shall take effect not
            less than 90 days after the date on which the change is made.
                (3) Notice.--For any change made to the policy established
            pursuant to subsection (a) after the effective date set forth
            in paragraph (1), the Secretary shall--
                        (A) notify all affected employees of the Department
                    of the changes; and
                        (B) 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 changes.

    SEC. 636. EXPANSION OF REIMBURSEMENT OF CONTINUING PROFESSIONAL
                  EDUCATION EXPENSES.

        (a) In General.--Section 7411 of title 38, United States Code, is
    amended to read as follows:
    ``Sec. 7411. Reimbursement of continuing professional education
                  expenses
        ``(a) Required Reimbursement.--The Secretary shall reimburse any
    full-time physician, dentist, podiatrist, chiropractor, optometrist,
    psychologist, registered nurse (including any advanced practice
    registered nurse), or physician assistant appointed under section
    7401(1) of this title not more than $1,000 per year for each such
    individual for expenses incurred for continuing professional education
    directly related to the duties and responsibilities of the position of
    the employee or related to the duties and responsibilities of the
    position or positions of the employees overseen by the employee.
        ``(b) Authorized Reimbursement.--The Secretary may reimburse any
    full-time licensed practical or vocational nurse (including any nurse
    practitioner), medical technologist, pharmacist, pharmacy technician,
    diagnostic radiologic technologist, or social worker appointed under
    section 7401(3) of this title, not more than $1,000 per year for each
    such individual for expenses incurred for continuing professional
    education directly related to the duties and responsibilities of the
    position of the employee or related to the duties and responsibilities
    of the position or positions of the employees overseen by the employee.
        ``(c) Maximum Number of Individuals Reimbursed.--The total number
    of individuals who may be reimbursed under this section may not exceed
    50,000 per year.
        ``(d) Priority Reimbursements.--In providing reimbursement under
    subsection (a), the Secretary shall prioritize reimbursement for
    individuals providing direct patient care or individuals who are
    decision-makers for direct patient care.
        ``(e) Report Required.--
                ``(1) In general.--Not less frequently than annually after
            the end of the first fiscal year following the date of the
            enactment of the Take Care of America's Veterans 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 information on utilization of reimbursement
            under this section, including--
                        ``(A) locations at which reimbursement is claimed;
                        ``(B) position title and specialty of the
                    individual claiming reimbursement;
                        ``(C) average amount claimed per position and
                    specialty; and
                        ``(D) percent utilization by each position and
                    specialty overall.
                ``(2) Authority to include in existing report.--The
            information required under paragraph (1) may be submitted
            independently or included in another annual report to
            Congress.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    subchapter I of chapter 74 of title 38, United States Code, is amended
    by striking the item relating to section 7411 and inserting the
    following new item:

    ``7411. Reimbursement of continuing professional education expenses.''.

    SEC. 637. DEPARTMENT OF VETERANS AFFAIRS PERSONNEL TRANSPARENCY.

        (a) In General.--Section 505 of the John S. McCain III, Daniel K.
    Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and
    Strengthening Integrated Outside Networks Act of 2018 (Public Law 115-
    182; 38 U.S.C. 301 note) is amended--
                (1) in subsection (a)--
                        (A) in paragraph (1)--
                                (i) in the matter before subparagraph (A),
                            by striking ``information,'' and all that
                            follows through ``facility:'' and inserting
                            ``information:'';
                                (ii) in subparagraph (B)--
                                        (I) by inserting ``(i)'' before
                                    ``The number''; and
                                        (II) by adding at the end the
                                    following new clause:
                        ``(ii) Information made available under this
                    subparagraph shall be updated not less frequently than
                    once each quarter to account for delays in data
                    processing and shall reflect the most recently
                    available data.'';
                                (iii) in subparagraph (C), by striking
                            ``vacancies, by occupation.'' and inserting
                            ``positions currently undergoing a recruitment
                            action, disaggregated by occupation and by
                            stage of recruitment.'';
                                (iv) in subparagraph (E)(iii), by striking
                            ``potential hires or''; and
                                (v) by adding at the end the following new
                            subparagraph:
                        ``(F) The number of positions vacated during the
                    quarter for which the Department has not initiated a
                    recruitment action or is not planning to initiate a
                    recruitment action.'';
                        (B) by redesignating paragraph (5) as paragraph
                    (6);
                        (C) by inserting after paragraph (4) the following
                    new paragraph (5):
                ``(5) Display of information.--The display of information
            made publicly available on a website of the Department pursuant
            to paragraph (1) shall be disaggregated--
                        ``(A) by departmental component;
                        ``(B) in the case of information relating to
                    Veterans Health Administration positions, by medical
                    facility; and
                        ``(C) in the case of information relating to
                    Veterans Benefits Administration positions, by regional
                    office.''; and
                        (D) in paragraph (6), as redesignated by
                    subparagraph (B), by striking ``shall'' and all that
                    follows and inserting the following: ``shall--
                        ``(A) review the administration of the website
                    required under paragraph (1);
                        ``(B) develop recommendations relating to the
                    improvement of such administration; and
                        ``(C) submit to the Committee on Veterans' Affairs
                    of the Senate and the Committee on Veterans' Affairs of
                    the House of Representatives a report containing--
                                ``(i) the findings of the Inspector General
                            with respect to the most recent review
                            conducted under subparagraph (A); and
                                ``(ii) the recommendations most recently
                            developed under subparagraph (B).''; and
                (2) by amending subsection (b) to read as follows:
        ``(b) Annual Report.--Each year, the Secretary shall submit to
    Congress an annual report that includes the following:
                ``(1) A description of the steps the Department is taking
            to achieve full staffing capacity.
                ``(2) A description of the actions the Department is taking
            to improve the onboard timeline for facilities of the
            Department, including--
                        ``(A) in the case of facilities of the Veterans
                    Health Administration, for facilities for which the
                    duration of the onboarding process exceeds the metrics
                    laid out in the Time to Hire Model of the Veterans
                    Health Administration, or successor model; and
                        ``(B) in the case of the Veterans Benefits
                    Administration, for regional offices that exceed the
                    time-to-hire target of the Office of Personnel
                    Management.
                ``(3) The amount of additional funds necessary to enable
            the Department to reach full staffing capacity.
                ``(4) Such recommendations for legislative or
            administrative action as the Secretary may have in order to
            achieve full staffing capacity at the Department.''.
        (b) Effective Date.--The amendments made by subsection (a) shall
    take effect on the date of the enactment of this Act and shall apply
    with respect to the second update under section 505(a)(3) of such Act
    beginning after the date of the enactment of this Act and each update
    thereafter.

    SEC. 638. MODIFICATION OF AUTHORITY OF LICENSURE OF HEALTH CARE
                  PROFESSIONALS PROVIDING TREATMENT VIA TELEMEDICINE.

        Section 1730C of title 38, United States Code, is amended--
                (1) by amending subsection (a) to read as follows:
        ``(a) In General.--Notwithstanding any provision of law regarding
    the licensure of health care professionals or the prescribing of
    controlled substances, a covered health care professional may practice
    the health care profession of the health care professional and
    prescribe controlled substances at any location in any State or any of
    the Freely Associated States (as defined in section 1724(f) of this
    title), regardless of where the covered health care professional or the
    patient is located, if the covered health care professional is using
    telemedicine to provide treatment or prescribe controlled substances to
    an individual under this chapter.'';
                (2) in subsection (b), by adding at the end the following
            new paragraph:
                ``(4) A health care professional who is a contractor of the
            Department acting in the scope of a contract with the
            Department to furnish care in a facility or clinic of the
            Department and who has an active, current, full, and
            unrestricted license, registration, or certification in a State
            to practice the health care profession of the health care
            professional, excluding the following:
                        ``(A) A health care professional located outside a
                    facility or clinic of the Department providing care
                    through the Veterans Community Care Program under
                    section 1703 of this title or a similar authority under
                    the laws administered by the Secretary.
                        ``(B) A health care professional conducting
                    disability compensation evaluations pursuant to a
                    contract with the Department.'';
                (3) in subsection (d)--
                        (A) by redesignating paragraph (2) as paragraph
                    (3); and
                        (B) by inserting after paragraph (1) the following
                    new paragraph (2):
        ``(2) State laws that may be inconsistent under paragraph (1)
    include--
                ``(A) the laws of--
                        ``(i) the State of licensure, certification, or
                    registration of the covered health care professional;
                        ``(ii) the State of practice of the covered health
                    care professional;
                        ``(iii) the State in which the patient is located;
                    or
                        ``(iv) the State of residence of the patient; and
                ``(B) such laws specified under subparagraph (A) as
            incorporated by the Controlled Substances Act (21 U.S.C. 801 et
            seq.).''; and
                (4) in subsection (e), striking ``Nothing'' and inserting
            ``Except as provided in subsections (a) and (d), nothing.''.

    SEC. 639. PROVISION OF DATA ON EDUCATIONAL ASSISTANCE PROGRAMS OF
                  VETERANS HEALTH ADMINISTRATION.

        (a) In General.--Beginning not later than 180 days after the date
    of the enactment of this Act, the Secretary of Veterans Affairs shall
    provide to the Committee on Veterans' Affairs of the Senate and the
    Committee on Veterans' Affairs of the House of Representatives data on
    graduate medical education programs, health profession scholarship
    programs, and any other educational assistance programs within the
    Veterans Health Administration.
        (b) Elements.--The data required to be provided under subsection
    (a) shall include, for each program, the following:
                (1) The number of active participants, broken down by
            position or expected future position or licensure.
                (2) The amount of funds spent each fiscal year.
                (3) The number of participants who have completed their
            education and are currently completing their service
            requirements at the Department of Veterans Affairs.
                (4) The number of participants who were previously active
            in the program but left the program before completing their
            education or service requirement during the year preceding the
            date on which the data is provided.
                (5) An overview of outreach by the Department to
            prospective participants in the program.
                (6) Such other information as the Secretary considers
            appropriate.
        (c) Update and Submittal of Data.--The data required to be provided
    under subsection (a)--
                (1) shall be updated not less frequently than annually; and
                (2) may be submitted to the Committee on Veterans' Affairs
            of the Senate and the Committee on Veterans' Affairs of the
            House of Representatives as part of another report required by
            law.
        (d) Initial Data.--With the first iteration of data provided under
    subsection (a), the Secretary shall provide to the Committee on
    Veterans' Affairs of the Senate and the Committee on Veterans' Affairs
    of the House of Representatives a report on the implementation of the
    pilot program under section 246 of the Military Construction, Veterans
    Affairs, and Related Agencies Appropriations Act, 2018 (division J of
    Public Law 115-141; 38 U.S.C. 7601 note), including the current status
    of the pilot program and a timeline of the status of the pilot program
    since its initial implementation.

                     Subtitle D--Optimization of Workforce

    SEC. 641. DEPARTMENT OF VETERANS AFFAIRS STRATEGIC HUMAN CAPITAL PLAN.

        (a) In General.--Subchapter I of chapter 7 of title 38, United
    States Code, is amended by adding at the end the following new section:
    ``Sec. 729. Strategic human capital plan
        ``(a) Plan Development.--(1) Not later than September 30, 2027, the
    Secretary shall develop and submit to the appropriate committees of
    Congress a five-year strategic human capital plan to support the
    mission and responsibilities of the Department, disaggregated by the
    Veterans Health Administration, the Veterans Benefits Administration,
    the National Cemetery Administration, and such other administrative
    components of the Department as the Secretary considers necessary to
    carry out the mission of the Department.
        ``(2) Not later than September 30, 2028, and each September 30
    thereafter, the Secretary shall update the plan developed pursuant to
    paragraph (1) and extend the plan so that it covers the next period of
    five fiscal years commencing immediately after the date of the update.
        ``(b) Requirements.--(1) In developing the plan required by
    subsection (a), the Secretary shall take into account and document
    current and future projected demand for benefits and services
    administered by the Department, disaggregated for each component by
    facility location, facility type, region, administration, program
    office, the type of benefit or service, and such other categories as
    the Secretary determines appropriate.
        ``(2) The Secretary shall develop and update the plan under
    subsection (a) in consultation with veterans service organizations and
    such other stakeholders as the Secretary considers appropriate.
        ``(c) Contents.--The strategic human capital plan required by
    subsection (a) shall incorporate leading practices, including the
    following:
                ``(1) A workforce gap analysis, including an assessment
            of--
                        ``(A) the staffing levels of each employee position
                    needed to deliver high quality, accessible, and timely
                    health care, benefits, and other services the Secretary
                    considers appropriate, disaggregated by employee
                    position, facility location, facility type, region,
                    administration, program office, the type of benefit or
                    service, and such other categories as the Secretary
                    determines appropriate;
                        ``(B) how the staffing levels described in
                    subparagraph (A) align with industry best practices in
                    each employee position for the anticipated demand for
                    health care, benefits, and other services described in
                    subsection (b); and
                        ``(C) core competencies, as defined by the
                    Secretary, and the staffing levels needed in each of
                    these core competencies, disaggregated by employee
                    position, facility location, facility type, region,
                    administration, program office, the type of benefit or
                    service and such other categories as the Secretary
                    considers appropriate.
                ``(2) An implementation plan that includes the following:
                        ``(A) Specific recruitment and retention goals to
                    fulfill the staffing needs identified in the strategic
                    human capital plan and the strategy of the Department
                    to achieve such goals.
                        ``(B) Specific strategies--
                                ``(i) to improve workforce productivity
                            using technological, organizational,
                            behavioral, and such other approaches as the
                            Secretary determines appropriate and
                            productivity measures that are specific to
                            employee positions and the benefits or services
                            they provide; and
                                ``(ii) that are informed by applicable
                            industry best practices.
                        ``(C) Specific strategies for recruiting and
                    retaining veterans, spouses of veterans and members of
                    the Armed Forces, family members of veterans and
                    members of the Armed Forces, caregivers of veterans,
                    and survivors of members of the Armed Forces as
                    employees of the Department.
                        ``(D) Specific goals to reduce the time to hire and
                    onboard employees of the Department and a strategy to
                    achieve such goals, including draft legislative
                    language for any legislative action necessary to
                    achieve such goals, without degradation of--
                                ``(i) necessary background checks; and
                                ``(ii) measures to protect Department
                            customer and employee safety.
        ``(d) Annual Updates.--Not later than September 30, 2028, and
    September 30 of each of year thereafter, the Secretary shall submit to
    the appropriate committees of Congress an update on the implementation
    of the strategic human capital plan developed pursuant to subsection
    (a), including an assessment by the Secretary of--
                ``(1) the progress of the Department in implementing the
            strategic human capital plan;
                ``(2) the progress of the Department in improving outcomes
            for veterans and their spouses, dependents, and caregivers
            through the delivery of high quality, accessible, and timely
            health care, benefits, and other services the Secretary
            considers appropriate using results based performance measures;
                ``(3) changes to projected demand for benefits and services
            based on new legislative action or other factors, disaggregated
            for each component by facility location, facility type, region,
            administration, program office and the type of benefit or
            service;
                ``(4) changes to the staffing levels included in the
            strategic human capital plan, including justifications for such
            changes, disaggregated by employee position, facility location,
            facility type, region, administration, program office, the type
            of benefit or service and such other categories as the
            Secretary determines appropriate;
                ``(5) any differentiation between the staffing levels
            included in the strategic human capital plan and those included
            in the budget justification materials most recently submitted
            to Congress in support of the budget of the Department (as
            submitted with the budget of the President under section
            1105(a) of title 31); and
                ``(6) any differentiation from the Quadrennial Veterans
            Health Administration review required by section 7330C of this
            title.
        ``(e) Comptroller General of the United States Biennial Reviews.--
    Not later than 180 days after the date on which the human capital plan
    is submitted to the appropriate committees of Congress pursuant to
    subsection (a), and not less frequently than once every 2 years
    thereafter, the Comptroller General of the United States shall--
                ``(1) review the strategic human capital plan developed
            pursuant to subsection (a) and updated pursuant to subsection
            (d), as the case may be, particularly with respect to the
            adequacy of the plan to fulfill the mission and
            responsibilities of the Department; and
                ``(2) submit to Congress the findings of the Comptroller
            General with respect to the review conducted pursuant to
            paragraph (1).
        ``(f) Definitions.--In this section:
                ``(1) 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.
                ``(2) The term `veterans service organization' means any
            organization recognized by the Secretary under section 5902 of
            this title.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 7 of such title is amended by inserting after the item relating
    to section 728 the following new item:

    ``729. Strategic human capital plan.''.

    SEC. 642. DEPARTMENT OF VETERANS AFFAIRS REDUCTION IN FORCE NOTICE
                  REQUIREMENT.

        (a) In General.--Subchapter I of chapter 7 of title 38, United
    States Code, as amended by section 2(a), is further amended by
    inserting after section 729 the following new section:
    ``Sec. 729A. Reductions in force
        ``(a) Notice Required.--In any case in which the Secretary plans to
    carry out a reduction in force, the Secretary shall, not later than the
    date that is 60 days before the date on which the Secretary commences
    carrying out such reduction in force, submit to the appropriate
    committees of Congress and the employees of the Department who will be
    affected by the reduction in force notice of the intention of the
    Secretary to carry out such reduction in force.
        ``(b) Limitation.--Notwithstanding any other provision of law, the
    Secretary may not carry out any reduction in force with respect to any
    employee who has not received the notice required under subsection (a)
    in the manner and within the time required by such subsection.
        ``(c) Contents.--Notice regarding plans to carry out a reduction in
    force submitted pursuant to subsection (a) shall include the following:
                ``(1) The total number of employees of the Department who
            will be affected by the reduction.
                ``(2) The offices of the Department that will be affected
            by the reduction, including, for each such office, the
            following:
                        ``(A) The location of the office.
                        ``(B) The program of the Department carried out by
                    the office.
                        ``(C) The total number of employees of the office
                    before and after the reduction in force.
                        ``(D) The services provided by the office.
                ``(3) A justification for the reduction in force, including
            how--
                        ``(A) the new staffing levels resulting from the
                    reduction in force align with the current and future
                    projected demand for benefits and services administered
                    by the Department, disaggregated for each component by
                    facility location, facility type, region,
                    administration, program office, the type of benefit or
                    service, and such other categories as the Secretary
                    determines appropriate; and
                        ``(B) the reduction in force aligns with the
                    strategic human capital plan required by section 729 of
                    this title.
                ``(4) Budgetary effects of the reduction in force.
                ``(5) An assessment of the anticipated impact of the
            reduction in force on the delivery of benefits and services
            furnished by the Department and the actions the Secretary plans
            to take to mitigate any adverse impacts.
        ``(d) Equal Content.--A notice regarding a reduction in force sent
    to an employee pursuant to subsection (a) shall be the same as the
    notice submitted under such subsection to Congress for the same
    reduction in force.
        ``(e) Administrative Remedy.--Effect of Noncompliance. A reduction
    in force carried out with respect to an employee in violation of
    subsection (b) shall have no force or effect with respect to such
    employee until the Secretary complies with subsection (a).
        ``(f) Definitions.--In this section:
                ``(1) 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.
                ``(2) The term `reduction in force' means any action that
            would have required notice under part 351 of title 5, Code of
            Federal Regulations, as in effect on January 1,2026.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 7 of such title, as amended by section 2(b), is further amended
    by inserting after the item relating to section 729 the following new
    item:

    ``729A. Reductions in force.''.

    SEC. 643. DETAILED PLANS AND JUSTIFICATIONS FOR REORGANIZATION OF
                  OFFICES.

        Section 510 of title 38, United States Code, is amended--
                (1) in subsection (f)(2)--
                        (A) in subparagraph (D), by inserting ``in
                    improving outcomes for veterans and their spouses,
                    dependents, and caregivers through the delivery of high
                    quality, accessible, and timely health care, benefits,
                    and other services the Secretary considers
                    appropriate'' before the period at the end; and
                        (B) by adding at the end the following new
                    subparagraphs:
                        ``(G) A description of how the Secretary will
                    analyze success of the reorganization using results
                    based performance metrics that are derived from the
                    justification for the reorganization.
                        ``(H) A risk mitigation plan identifying
                    significant operational, workforce, financial,
                    information technology, patient care, and service-
                    delivery risks reasonably anticipated by the Secretary
                    and the actions planned to mitigate such risks.'';
                (2) by redesignating subsections (e) and (f) as subsections
            (f) and (g), respectively; and
                (3) by inserting after subsection (d) the following new
            subsection (e):
        ``(e) Not later than 180 days after the date on which the Secretary
    completes an administrative reorganization for which the Secretary
    submitted under subsection (b) a report containing a detailed plan and
    justification for the administrative reorganization, and not less
    frequently than once every 180 days thereafter until the date that is
    two years after the date of the completion of such administrative
    reorganization, 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 assessing the administrative
    reorganization using the performance metrics described in the detailed
    plan and justification pursuant to subsection (g)(2)(G).''.

    SEC. 644. RULE OF CONSTRUCTION.

        Nothing in this subtitle or an amendment made by this subtitle
    shall be construed to have any effect on any provision of law in effect
    before the date of the enactment of this Act.

             Subtitle E--Veterans Infrastructure and Transformation

    SEC. 651. SHORT TITLE.

        This subtitle may be cited as the ``Veterans Infrastructure and
    Transformation Act of 2026'' or the ``VITAL Act of 2026''.

    SEC. 652. MODIFICATION OF AUTHORITY FOR SHARING OF HEALTH-CARE
                  RESOURCES OF DEPARTMENT OF VETERANS AFFAIRS TO INCLUDE
                  FLEXIBLE SPACE UTILIZATION AND STREAMLINED SERVICE
                  AGREEMENTS.

         Section 8153 of title 38, United States Code, is amended--
                (1) in subsection (a)(3)--
                        (A) in subparagraph (A), by inserting ``physical''
                    before ``space'';
                        (B) in subparagraph (B)(i), by inserting
                    ``physical'' before ``space'';
                        (C) by striking subparagraph (E);
                        (D) by redesignating subparagraphs (C) and (D) as
                    subparagraphs (D) and (E), respectively;
                        (E) by inserting after subparagraph (B) the
                    following new subparagraph (C):
                ``(C) If the health-care resource required is physical
            space or common services with respect to existing buildings and
            is to be acquired from an institution affiliated with the
            Department in accordance with section 7302 of this title or
            another entity, the Secretary may enter into contracts or
            agreements for the acquisition of the space or service--
                        ``(i) without regard to any law or regulation
                    (including any Executive order, circular, or other
                    administrative policy) that would otherwise require the
                    use of competitive procedures for acquiring the
                    resource; and
                        ``(ii) if all obligations are funded through
                    available appropriations or borne by the institution or
                    entity, without regard to any limitations applicable to
                    leases of the Department, if, in the case of a multi-
                    year space-sharing agreement, the agreement--
                                ``(I) requires that payments for each
                            fiscal year be made only from appropriated
                            funds and available that year; and
                                ``(II) includes a provision that the
                            Government's obligations for future years is
                            contingent upon availability of
                            appropriations.'';
                        (F) in subparagraph (D), as redesignated by
                    subparagraph (D) of this paragraph, by striking
                    ``subparagraph (A) or (B)'' and inserting
                    ``subparagraph (A), (B), or (C)'';
                (2) by adding at the end the following:
        ``(h) In this section:
                ``(1) The term `commercial service' means a service that is
            offered and sold competitively in the commercial marketplace,
            is performed under standard commercial terms and conditions,
            and is procured using firm-fixed price contracts.
                ``(2) The term `common service' means a commercial service
            necessary to maintain or operate existing physical space,
            including maintenance, heating, ventilation, air conditioning,
            electricity, energy, water, wastewater, landscaping, security,
            laundry, or any other service as determined by the Secretary.
                ``(3) The term `physical space' means a portion of a
            building or parking facilities.''.

    SEC. 653. USE OF COMMERCIAL CONSTRUCTION AND FACILITIES CODE AND
                  STANDARDS.

        (a) In General.--The Secretary of Veterans Affairs may use
    commercial codes and standards instead of or in addition to Federal
    codes and standards in the construction or alteration of facilities of
    the Department of Veterans Affairs, where such commercial codes and
    standards do not conflict with statutory and regulatory requirements.
        (b) Pilot Projects.--The Secretary shall under take not fewer than
    three pilot projects during each of fiscal years 2027, 2028, 2029,
    2030, and 2031 utilizing commercial codes and standards instead of
    Federal codes and standards to lease or construct facilities of the
    Department for major construction, minor construction, or major lease
    projects.
        (c) Reports.--The Secretary shall submit a report to the Committee
    on Veterans' Affairs of the Senate and the Committee on Veterans'
    Affairs of the House of Representatives not later than 90 days after
    the end of each of fiscal years 2027, 2028, 2029, 2030, and 2031
    detailing the use by the Secretary of the authority provided by
    subsection (a) and conduct of each pilot project required by subsection
    (b) that was initiated, ongoing, or completed during the fiscal year.
        (d) Definitions.--In this section:
                (1) Commercial codes and standards.--The term ``commercial
            codes and standards'' means building codes or standards of the
            following:
                        (A) The National Fire Protection Association.
                        (B) The International Code Council.
                        (C) The American Society for Testing and Materials.
                        (D) The American Society of Civil Engineers.
                        (E) Any other building code or standard, other than
                    those described in (2), determined by the Secretary.
                (2) Federal codes and standards.--The term ``Federal codes
            and standards'' means the following:
                        (A) Building codes or standards specific to one or
                    more Federal agencies.
                        (B) Building codes or standards specific to the
                    Department, including the Technical Information
                    Library.
                        (C) Standards of the Federal Guidelines Institute.

    SEC. 654. FEASIBILITY STUDY FOR FULL-SERVICE HOSPITAL OF DEPARTMENT OF
                  VETERANS AFFAIRS IN CERTAIN STATES.

        (a) In General.--The Secretary of Veterans Affairs shall conduct a
    study on the feasibility of establishing a full-service hospital of the
    Department of Veterans Affairs in Alaska and Hawaii.
        (b) Publication.--Not later than one year after the date of the
    enactment of this title, the Secretary shall publish on a publicly
    available website of the Department the findings of the Secretary with
    respect to the study conducted under subsection (a).

    SEC. 655. REPORT ON STRATEGIC PLAN FOR INFRASTRUCTURE AND CAPITAL
                  ASSETS OF DEPARTMENT OF VETERANS AFFAIRS.

        (a) Report.--Not later than one year after the date of the
    enactment of this title, the Secretary of Veterans Affairs shall submit
    to the Committee on Veterans' Affairs of the Senate and the Committee
    on Veterans' Affairs of the House of Representatives a report on the
    strategic plan for infrastructure and capital assets of the Department
    of Veterans Affairs, which summarizes a facility lifecycle strategy
    targeting modernization of owned and leased facilities and
    infrastructure required to mitigate increasing systemic failures,
    veteran and staff safety, benefits delivery interruptions, and funding
    associated to address emergency repairs.
        (b) Elements.--The report required by subsection (a) shall cover
    known and projected requirements over a period of not less than 10
    years for the following:
                (1) Land acquisition.
                (2) Operations and maintenance of facilities of the
            existing capital asset portfolio of the Department.
                (3) Operations and maintenance of the planned future
            capital asset portfolio of the Department.
                (4) New construction, disaggregated by type of new
            construction, including the following types of construction:
                        (A) Major construction.
                        (B) Minor construction.
                        (C) Nonrecurring maintenance.
                (5) Leasing.
                (6) Alternative acquisition methods, such as partnerships
            and donations.
                (7) Activation of space.
                (8) Disposal, reuse, and remediation.
                (9) Facility lifecycle strategy process supporting the
            planning, programming delivery, management, and maintenance of
            the current and future capital asset portfolio of the
            Department.
                (10) A discussion of the negative effect of the lack of
            stable and predictable capital asset funding on the ability of
            the Department to plan, staff, and execute effective capital
            asset management.
                (11) Overview of the strategy being utilized in the
            approach of the Secretary to capital investment, across all the
            capital and leasing programs, including the approach of repair
            versus recapitalization, use of leasing, and other relevant
            strategies as deemed appropriate by the Secretary.
                (12) Such other matters as the Secretary considers
            appropriate, including with respect to legislative or
            administrative action, if such actions are subject to the
            availability of appropriated funds.
        (c) Rule of Construction.--Nothing in this section or a report
    submitted under this section shall be construed to create or imply any
    financial or operational obligation beyond the availability of
    appropriated funds.

    SEC. 656. PERMANENT EXTENSION OF PILOT PROGRAM ON ACCEPTANCE BY THE
                  DEPARTMENT OF VETERANS AFFAIRS OF DONATED FACILITIES AND
                  RELATED IMPROVEMENTS.

        (a) In General.--Section 2 of the Communities Helping Invest
    through Property and Improvements Needed for Veterans Act of 2016
    (Public Law 114-294; 38 U.S.C. 8103 note) is amended--
                (1) in the section heading, by striking ``pilot'';
                (2) in subsection (a), in the subsection heading, by
            striking ``Pilot'';
                (3) by striking ``pilot'' each place it appears;
                (4) by striking subsection (i); and
                (5) by redesignating subsection (j) as subsection (i).
        (b) Modification of Acceptance of Property.--Paragraph (1) of
    subsection (b) of such section is amended to read as follows:
                ``(1) the donation aligns with--
                        ``(A) a need identified in a Strategic Capital
                    Investment Planning process priority list, a five-year
                    development plan, a facility master plan, or an annual
                    capital needs inventory of the Department; or
                        ``(B) any component or phase of a need described in
                    paragraph (1); and''.

    SEC. 657. AUTHORITY TO ACCEPT DONATIONS OF CONSTRUCTION SERVICES, MINOR
                  CONSTRUCTION OR NONRECURRING MAINTENANCE PROJECTS, AND
                  TARGETED CONTRIBUTIONS.

        (a) Authority.--Notwithstanding any other provision of law, the
    Secretary of Veterans Affairs may accept donations comprising the total
    cost or a portion of the cost of--
                (1) minor construction projects;
                (2) nonrecurring maintenance projects; or
                (3) construction services relating--
                        (A) to minor construction projects;
                        (B) to nonrecurring maintenance projects;
                        (C) to an existing facility of the Department; or
                        (D) to a new facility or portion thereof of the
                    Department.
        (b) Alignment to Needs.--The Secretary may accept a donation under
    this section only if--
                (1) the donation aligns with--
                        (A) a need identified in a Strategic Capital
                    Investment Planning process priority list, a five-year
                    development plan, a facility master plan, or an annual
                    capital needs inventory of the Department; or
                        (B) any component or phase of a need described in
                    subparagraph (A);
                (2) the donation is from an entity described in section
            2(a)(2) of the Communities Helping Invest through Property and
            Improvements Needed for Veterans Act of 2016 (Public Law 114-
            294; 38 U.S.C. 8103 note);
                (3) the Secretary determines such donation would--
                        (A) accelerate project completion;
                        (B) reduce the expense to the Department;
                        (C) improve facility condition; or
                        (D) otherwise benefit veterans;
                (4) the donor enters into a formal agreement with the
            Secretary that includes--
                        (A) provisions for the Department's oversight
                    during performance;
                        (B) compliance with applicable construction codes
                    and standards, and applicable laws and regulations;
                        (C) donor-provided insurance, warranties, and
                    liability protections;
                        (D) the amount of the donation and the amount of
                    the Department's funding contribution, if any;
                        (E) that the donation shall not increase the cost
                    to the Federal Government of completing such project
                    described in subsection (a) (excluding activation and
                    sustainment of such facility); and
                        (F) such other terms as the Secretary determines
                    necessary.
        (c) Streamlined Requirements.--For donations under this section
    that do not involve transfer of real property title--
                (1) the donor shall enter into an agreement with the
            Department that determines who is responsible to ensure
            environmental or historic preservation due diligence is
            completed;
                (2) the donor shall obtain all federally required
            construction and facility related permits; and
                (3) agreements may be simplified relative to those under
            section 2 of the Communities Helping Invest through Property
            and Improvements Needed for Veterans Act of 2016 (Public Law
            114-294; 38 U.S.C. 8103 note) to reflect the nature of services
            or targeted contributions.
        (d) Reporting.--The Secretary shall include information on
    donations accepted under this section in the reports required under
    section 2(g) of the Communities Helping Invest through Property and
    Improvements Needed for Veterans Act of 2016 (Public Law 114-294; 38
    U.S.C. 8103 note), with separate tracking for donations under this
    section.

    SEC. 658. REPORT ON USE OF ADDITIONAL AUTHORITIES RELATING TO
                  RECRUITMENT AND RETENTION OF PERSONNEL.

        (a) Report Required.--Not later than 90 days after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall submit
    to the appropriate committees of Congress a report detailing how the
    Secretary will use the authorities of section 706 of title 38, United
    States Code, to increase the size and performance of the acquisition
    workforce of the Department of Veterans Affairs.
        (b) Definitions.--In this section:
                (1) Acquisition workforce of the department.--The term
            ``acquisition workforce of the Department of Veterans Affairs''
            means personnel of the Department of Veterans Affairs occupying
            positions within occupational series, as defined by the
            Director of the Office of Personnel Management, responsible for
            acquisition functions, as determined by the Secretary.
                (2) Appropriate committees of congress.--The term
            ``appropriate committees of Congress'' means the Committee on
            Veterans' Affairs of the Senate and the Committee on Veterans'
            Affairs of the House of Representatives.

    SEC. 659. REPORTS ON KEY CAPITAL ASSET INVESTMENTS, ACTIVITIES, AND
                  PERFORMANCE OF DEPARTMENT OF VETERANS AFFAIRS.

        (a) In General.--Section 8120 of title 38, United States Code, is
    amended to read as follows:
    ``Sec. 8120. Reports on key capital asset investments, activities, and
                  performance
        ``(a) Capital Asset Investment, Activities, and Performance.--
                ``(1) In general.--Not later than 30 days after the end of
            each fiscal year, and every 60 days thereafter until the end of
            the subsequent fiscal year, the Secretary shall submit to the
            appropriate committees of Congress a report on key capital
            asset investments, activities, and performance of the
            Department.
                ``(2) Elements.--
                        ``(A) First report in each fiscal year.--The first
                    report under paragraph (1) in each fiscal year shall
                    include the following:
                                ``(i) A brief summary of work that was
                            completed on each capital asset project that
                            was completed in the previous fiscal year.
                                ``(ii) A brief summary of the
                            accomplishments, impediments, and challenges
                            experienced by the Department with respect to
                            capital asset projects in the previous fiscal
                            year and a description of efforts made to
                            address any such impediments and challenges.
                                ``(iii) With respect to each capital asset
                            project completed in such year, the following:
                                        ``(I) The type of project (major
                                    construction, minor construction,
                                    nonrecurring maintenance, leases, or
                                    other category, including disposals).
                                        ``(II) The estimated total cost and
                                    the actual total cost of the project.
                                        ``(III) A description of the
                                    project.
                                        ``(IV) The location and facility
                                    with respect to which the project was
                                    carried out.
                                        ``(V) The fiscal quarter the
                                    project was expected to begin, the
                                    fiscal quarter the project began, the
                                    month and year the project was
                                    completed, and the fiscal quarter the
                                    facility in connection to such project
                                    was in use by veterans, employees of
                                    the Department, or other relevant
                                    users, as the case may be.
                                ``(iv) In the case of any capital asset
                            project completed during the previous fiscal
                            year with respect to which the final cost of
                            the project (or any increment of the project)
                            was more than 10 percent greater than the
                            estimated cost of the project (or increment) or
                            the completion of such project (or increment)
                            was more than 180 days later than the planned
                            schedule for such project (or increment)--
                                        ``(I) the reason for any such
                                    overage or delay; and
                                        ``(II) actions being taken to
                                    prevent any such overage or delay in
                                    future projects.
                                ``(v) A list of any capital asset projects
                            cancelled during the previous fiscal year,
                            including any projects in the design phase and
                            including the reason for the cancellation.
                                ``(vi) A summary of total actual
                            obligations for capital asset projects for the
                            previous fiscal year, broken out by major
                            construction, minor construction, nonrecurring
                            maintenance, and leases from the medical
                            facilities appropriation account of the
                            Department.
                                ``(vii) A projected list of capital asset
                            projects, broken out by type of project under
                            subclause (I), that are expected to be
                            initiated during the current fiscal year and
                            those that are expected to be completed during
                            the current fiscal year, which shall include
                            the following:
                                        ``(I) The type of project (major
                                    construction, minor construction,
                                    nonrecurring maintenance, leases, or
                                    other category, including disposals).
                                        ``(II) The estimated total cost of
                                    the project.
                                        ``(III) A description of the
                                    project.
                                        ``(IV) The location and facility
                                    with respect to which the project was
                                    carried out or is expected to be
                                    carried out.
                                        ``(V) The fiscal quarter the
                                    project is expected to begin, the
                                    fiscal quarter the project is expected
                                    to be completed, and the fiscal quarter
                                    the facility in connection to such
                                    project is expected to be in use by
                                    veterans, employees of the Department,
                                    or other relevant users, as the case
                                    may be.
                                ``(viii) Projected total obligations for
                            capital asset projects for the current fiscal
                            year, broken out by major construction, minor
                            construction, nonrecurring maintenance, and
                            leases, from the medical facilities
                            appropriation account of the Department.
                                ``(ix) Such observations of best practices,
                            impediments, and accomplishments related to the
                            capital asset management and performance of the
                            Department, including any legislative or
                            administrative action, as the Secretary
                            considers appropriate with respect to such
                            practices, impediments, and accomplishments.
                                ``(x) Meaningful metrics that show the
                            progress of the Department toward meeting
                            relevant goals of the Department relating to
                            capital asset management.
                                ``(xi) Such other matters as the Secretary
                            considers appropriate.
                        ``(B) Subsequent reports.--Each report in a fiscal
                    year after the first report shall include, at a
                    minimum, relevant updates on any capital asset projects
                    that are ongoing during that fiscal year, including any
                    updates to information provided with respect to such
                    projects under subparagraph (A).
                ``(3) Matters relating to reporting costs.--In each report
            under paragraph (1), when reporting on costs for capital asset
            projects, the Secretary may include information regarding
            Federal requirements, including those specific to the
            Department, that may not exist in the non-Federal construction
            sector that may increase costs for capital asset projects.
        ``(b) Super Construction Projects.--
                ``(1) In general.--Not later than 30 days after the end of
            each fiscal year, and every 60 days thereafter until the end of
            that fiscal year, the Secretary shall submit to the appropriate
            committees of Congress a report on the super construction
            projects carried out by the appropriate non-Department Federal
            entity described in section 8103(e)(1) of this title during
            such year.
                ``(2) Elements.--Each report required under paragraph (1)
            shall include, for each project described in such paragraph--
                        ``(A) the budgetary and scheduling status of the
                    project, as of the last day of the most recent fiscal
                    quarter ending before the date on which the report is
                    required to be submitted; and
                        ``(B) the actual cost and schedule variances of the
                    project, as of such day, compared to the planned cost
                    and schedules for the project.
        ``(c) Definitions.--In this section:
                ``(1) Appropriate committees of congress.--The term
            `appropriate committees of Congress' means--
                        ``(A) the Committee on Appropriations and the
                    Committee on Veterans' Affairs of the Senate; and
                        ``(B) the Committee on Appropriations and the
                    Committee on Veterans' Affairs of the House of
                    Representatives.
                ``(2) Capital asset project.--The term `capital asset
            project' means a capital asset investment or activity of the
            Department.
                ``(3) Super construction project.--The term `super
            construction project' has the meaning given such term in
            section 8103(e)(3) of this title.''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    chapter 81 of title 38, United States Code, is amended by striking the
    item relating to section 8120 and inserting the following new item:

    ``8120. Reports on key capital asset investments, activities, and
                                performance.''.

    SEC. 660. DEVELOPMENT OF STREAMLINED PROCUREMENT MODEL; REPORT.

        Not later than 180 days after the date of enactment of this Act,
    the Secretary of Veterans Affairs, in consultation with the Comptroller
    General of the United States, the Director of the Office of Management
    and Budget, and private sector stakeholders, shall develop a revised
    process for the procurement of major medical facility leases under
    chapter 81 of title 38, United States Code, and submit to the
    Committees on Veterans' Affairs of the House of Representatives and the
    Senate a report that includes a description of such revised process.

    SEC. 661. SUBMISSION AND NOTIFICATION OF COST ESTIMATES FOR MEDICAL
                  FACILITY LEASES.

        (a) Submission of Cost Estimates for Major Medical Facility Leases
    With Presidential Budget Request.--Subchapter I of chapter 81 of title
    38, United States Code, is amended by inserting after section 8104 the
    following new section:
    ``Sec. 8104A. Submission of cost estimates for major medical facility
                  leases with president's budget request
        ``(a) In General.--For each major medical facility lease or
    prospectus-level lease for which the Secretary seeks authorization,
    appropriations, or prospectus approval, the Secretary shall include in
    the budget justification materials submitted to Congress in connection
    with the budget of the Department for the applicable fiscal year (as
    submitted with the budget of the President under section 1105(a) of
    title 31) a market-based cost estimate and full life-cycle cost
    estimate for such lease.
        ``(b) Market-based Cost Estimate.--Each market-based cost estimate
    required under subsection (a) shall include an evaluation of--
                ``(1) local land values;
                ``(2) applicable construction costs; and
                ``(3) other cost factors the Secretary determines relevant
            to build-to-suit facilities.
        ``(c) Standardized Methodology.--
                ``(1) In general.--The Secretary shall adopt and apply a
            standardized methodology for estimating under subsection (a)
            the full life-cycle cost of major medical facility leases and
            prospectus-level leases.
                ``(2) Required elements.--The methodology required under
            paragraph (1) shall include, at a minimum--
                        ``(A) base rent projections over the full lease
                    term;
                        ``(B) tenant improvement and buildout costs based
                    on current medical facility standards;
                        ``(C) estimated operating expenses, including
                    utilities, maintenance, and security;
                        ``(D) annual escalation factors tied to
                    construction cost indices, labor rates, and market
                    trends;
                        ``(E) cost assumptions for option periods or
                    potential renewal terms; and
                        ``(F) geographic adjustments using current regional
                    market data to reflect location-specific construction
                    and leasing conditions.
        ``(d) Annual Adjustment.--
                ``(1) In general.--To reflect inflation and market
            escalation, the Secretary shall annually adjust each cost
            estimate for a lease submitted to Congress for authorization,
            appropriations, or prospectus approval during the period
            beginning on the date on which the Secretary first includes
            such cost estimate in the budget justification materials
            described in subsection (a) and ending on the projected award
            date for the lease.
                ``(2) Indices.--In adjusting a cost estimate under
            paragraph (1), the Secretary shall use such medical
            construction or real estate indices as the Secretary determines
            appropriate.
        ``(e) Rules of Construction.--
                ``(1) Budgetary treatment.--Nothing in this section shall
            be construed to alter, supersede, waive, or otherwise affect
            the application of the scorekeeping guidelines, including the
            budgetary treatment of leases under Office of Management and
            Budget Circular A-11 or any successor guidance.
                ``(2) Preservation of existing budget authority
            requirements.--Nothing in this section shall be construed to
            authorize the Secretary to enter into a lease, incur an
            obligation, or make an expenditure except to the extent and in
            the amount provided in advance in appropriations Acts.
        ``(f) Definitions.--In this section, the term `major medical
    facility lease' has the meaning given that term in section
    8104(a)(3)(B) of this title.''.
        (b) Congressional Notification and Plan Required for Cost Estimates
    Exceeding Approved Prospectus Amounts.--Subchapter I of such chapter is
    further amended by inserting after section 8104A the following new
    section:
    ``Sec. 8104B. Congressional notification and plan required for cost
                  estimates exceeding approved prospectus amounts
        ``(a) Price Estimates Required During Solicitation Phase.--As part
    of the request for lease proposals (or equivalent formal solicitation)
    for a major medical facility lease, the Secretary shall require
    offerors to provide detailed price proposals, including the cost of
    land (if applicable), to enable evaluation against the authorized
    prospectus amount.
        ``(b) Notification Required.--If the lowest responsive offer for a
    major medical facility lease exceeds the unserviced shell rent
    authorized in the approved prospectus by more than 10 percent, the
    Secretary shall notify the Committee on Veterans' Affairs of the Senate
    and the Committee on Veterans' Affairs of the House of Representatives
    not later than 45 days after the date on which the Secretary determines
    that such offer exceeds such authorized amount.
        ``(c) Plan Required.--
                ``(1) In general.--Not later than 60 days after
            notification under subsection (b) with respect to a major
            medical facility lease, 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 the cost discrepancy for such lease, which may include
            scope adjustment, value engineering, requesting additional
            authority, or other appropriate measures.
                ``(2) Limitation on award.--The Secretary shall not award a
            major medical facility lease until the Committee on Veterans'
            Affairs of the Senate and the Committee on Veterans' Affairs of
            the House of Representatives have received the plan required
            under paragraph (1) with respect to such lease.
        ``(d) Limitation on Further Action.--If the Secretary is required
    to submit a notification under subsection (b), the Secretary may not
    issue a request for lease proposals for the applicable major medical
    facility lease until the date on which the Secretary submits the plan
    required under subsection (c).
        ``(e) Rule of Construction.--Nothing in this section shall be
    construed to authorize the Secretary to exceed any amount authorized in
    an approved prospectus or any amount provided in advance in an
    appropriations Act.''.
        (c) Clerical Amendment.--The table of sections at the beginning of
    such chapter is amended by inserting after the item relating to section
    8104 the following new items:

    ``8104A. Submission of cost estimates for major medical facility leases
                                with President's budget request
    ``8104B. Congressional notification and plan required for cost
                                estimates exceeding approved prospectus
                                amounts''.

    SEC. 662. REPORT ON CAPITAL ASSET AND INFORMATION TECHNOLOGY NEEDS OF
                  THE RESEARCH AND DEVELOPMENT PROGRAM OF DEPARTMENT OF
                  VETERANS AFFAIRS.

        (a) Report Required.--Not later than two years after the date of
    the enactment of this Act, the Secretary of Veterans Affairs shall
    submit to Congress a report on the capital asset and information
    technology needs of the research and development program of the
    Department of Veterans Affairs.
        (b) Contents.--
                (1) In general.--The report required by subsection (a)
            shall include the following:
                        (A) A comprehensive summary of new facilities,
                    renovations of existing facilities, leasing of
                    facilities, and any other such facilities or physical
                    infrastructure the Department requires to effectively
                    perform its research and development functions,
                    including projected functions.
                        (B) Detailed information on the information
                    technology resources, projects, equipment, and related
                    information technology needs, disaggregated by type of
                    information technology funding categories, such as
                    development or operations and maintenance, the
                    Department requires in order to make the research and
                    development program and activities of the Department
                    functional and high-performing in the short-, medium-,
                    and long-term, and those needed to enable employees of
                    the Department to perform their research and
                    development activities in an effective and efficient
                    manner.
                        (C) Such matters as the Secretary determines
                    relevant to maintain and further improve and advance
                    the research and development functions of the
                    Department through improved capital asset and
                    information technology support.
                (2) Requirements.--
                        (A) Facilities.--
                                (i) Summaries by project.--In providing
                            information under paragraph (1)(A), the
                            Secretary shall provide estimated summaries for
                            each project with cost data as well as a
                            realistic multi-year plan to design and deliver
                            the capital asset projects, assuming required
                            funding is provided.
                                (ii) Identification of projects.--The
                            Secretary shall identify each project under
                            paragraph (1)(A) by its project type, such as
                            major construction, minor construction,
                            nonrecurring maintenance, major lease, minor
                            lease, or such other category as the Secretary
                            determines may be appropriate.
                        (B) Information technology.--In providing
                    information under paragraph (1)(B), the Secretary shall
                    provide estimated summaries for each project or
                    investment with individual and total cost data as well
                    as a realistic multi-year plan to develop relevant
                    requirements and acquire and deploy the relevant
                    information technology services, projects, equipment,
                    and related matters.
                        (C) Scope.--The scope of the report submitted under
                    subsection (a) is on the capital asset, information
                    technology, and other related critical support
                    functions, excluding human capital related needs,
                    needed for the Department to perform research and
                    development in an effective and efficient manner.
        (c) Considerations.--In preparing the report required by subsection
    (a), the Secretary may consider the following:
                (1) The findings of the 2012 final report of the Research
            Infrastructure Program of the Department.
                (2) Current and updated data providing the most accurate
            and holistic presentation of the physical infrastructure,
            information technology, and other relevant support function
            needs of the research and development program of the
            Department.
                (3) Such other matters as the Secretary considers
            appropriate.

    SEC. 663. IMPROVING PREVENTION, DETECTION, AND REPORTING OF WASTE,
                  FRAUD, AND ABUSE IN DEPARTMENT OF VETERANS AFFAIRS
                  CAPITAL ASSET PROJECTS AND ACTIVITIES.

        (a) Report Required.--Not later than one year after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall submit
    to the appropriate committees of Congress a report on actions the
    Department of Veterans Affairs is taking or plans to take to enhance
    the ability of the Department to prevent, detect, and report waste,
    fraud, and abuse occurring in capital asset projects of the Department,
    whether by employees, contractors, or other relevant persons or
    entities involved with the Department.
        (b) Elements.--The report required by subsection (a) shall include
    the following:
                (1) An assessment of whether new training or enhancements
            to existing training should be undertaken to improve the
            prevention, detection, and reporting of waste, fraud, and
            abuse.
                (2) Recommendations for such legislative and administrative
            action as the Secretary determines appropriate to improve the
            prevention, detection, and reporting of waste, fraud, and
            abuse.
                (3) Such other matters as the Secretary considers
            appropriate.
        (c) Consultation.--In carrying out subsection (a), the Secretary--
                (1) shall consult with the Inspector General of the
            Department of Veterans Affairs and the Comptroller General of
            the United States on matters relating to best practices and
            strategies to improve detection and prevention by the
            Department of waste, fraud, and abuse in capital asset projects
            and management; and
                (2) may consult with such other persons and entities on
            such matters as the Secretary considers appropriate.

    SEC. 664. REPORT ON LONG-TERM CARE PHYSICAL INFRASTRUCTURE NEEDS OF
                  DEPARTMENT OF VETERANS AFFAIRS.

        (a) In General.--Not later than one year after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall submit
    to the appropriate committees of Congress a report, disaggregated by
    medical center or other relevant health care facility of the Department
    of Veterans Affairs, identifying the physical infrastructure needs of
    the Department to support current and future anticipated long-term care
    needs and models of care for veterans, including--
                (1) infrastructure needed to support the delivery of long-
            term care for women veterans, veterans with spinal cord
            injuries and diseases, veterans with traumatic brain injury,
            veterans with unique behavioral health needs, veterans with
            memory loss, and other population groups with unique needs or
            projected future needs;
                (2) information regarding the plans of the Department to
            provide such care as the Department builds internal capacity
            but space is not yet available to meet the demand for such
            care; and
                (3) with respect to any projects needed to provide the
            infrastructure specified under paragraph (1)--
                        (A) the estimated individual project cost and total
                    cost to accomplish those projects; and
                        (B) the estimated individual project timeline to
                    accomplish each such project upon receipt of
                    appropriate funding.
        (b) Inclusion of Information Regarding Prioritization of Certain
    Projects.--The Secretary shall include in the report required under
    subsection (a) information regarding how the infrastructure
    prioritization processes of the Department, such as the Strategic
    Capital Investment Planning process, or successor process, could be
    modified to include higher prioritization of projects that support the
    provision of a health care service that is not widely available, or is
    not available in compliance with appropriate quality or access
    standards, from non-Department providers.
        (c) Development of Report.--In developing the report required under
    subsection (a), the Secretary shall consult with relevant regional and
    national program offices of the Veterans Health Administration with
    responsibility for managing the various health care services covered by
    the report, including long-term care and care relating to spinal cord
    injuries and diseases, to ensure that the report contains a holistic,
    comprehensive, and integrated plan to address the capital asset and
    other space needs for the population of veterans who require those
    services.
        (d) Indication of Types of Projects.--In the report required under
    subsection (a), the Secretary shall indicate the projects that can be
    most efficiently and effectively accomplished through smaller
    individual infrastructure projects or through a larger medical facility
    replacement or new site of care, as determined by the Secretary.

                     Subtitle F--Other Health Care Matters

    SEC. 671. PRESCRIPTION, DELIVERY, DISTRIBUTION, AND DISPENSATION OF
                  CONTROLLED SUBSTANCE MEDICATIONS BY COVERED HEALTH CARE
                  PROFESSIONALS OF DEPARTMENT OF VETERANS AFFAIRS VIA
                  TELEMEDICINE.

        (a) In General.--Subchapter III of chapter 17 of title 38, United
    States Code, is amended by adding at the end the following new section:
    ``Sec. 1730D. Prescription, delivery, distribution, and dispensation of
                  controlled substance medications via telemedicine
        ``(a) In General.--Notwithstanding sections 102(54) and 309(e) of
    the Controlled Substances Act (21 U.S.C. 802(54) and 829(e)), a covered
    health care professional may prescribe, deliver, distribute, and
    dispense a controlled substance if the covered health care professional
    is using telemedicine through the use of an interactive
    telecommunications system, including an audio-only telecommunications
    system when necessary, to prescribe, deliver, distribute, or dispense
    to a patient eligible to receive hospital care or medical services
    under this chapter a controlled substance that is a prescription drug
    as determined under the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
    301 et seq.), regardless of whether such covered health care
    professional has conducted an in-person medical examination of such
    patient, if--
                ``(1) such covered health care professional--
                        ``(A) is acting in the usual course of professional
                    practice;
                        ``(B) is registered pursuant to section 303(g) of
                    the Controlled Substances Act (21 U.S.C. 823(g)) in any
                    State or is utilizing the registration of a facility of
                    the Department registered pursuant to section 303(f) of
                    such Act (21 U.S.C. 823(f));
                        ``(C) has access to medical documentation from an
                    in-person medical evaluation of such patient in the
                    past two years by--
                                ``(i) a covered health care professional;
                                ``(ii) a health care professional who
                            furnished care and services under the Veterans
                            Community Care Program under section 1703 of
                            this title; or
                                ``(iii) a health care professional of the
                            Department of Defense; and
                        ``(D) at the time of the telemedicine visit of the
                    patient--
                                ``(i) has reviewed the prescription data of
                            the individual from the electronic health
                            record database of the Department and data from
                            the prescription drug monitoring program for
                            the State in which the patient is located at
                            the time of the telemedicine encounter (if such
                            a program exists) for at least the one-year
                            period preceding the date of the visit or, if
                            less than one year of data is available, for
                            the entire period available; and
                                ``(ii) provides documentation of--
                                        ``(I) such review;
                                        ``(II) all successful attempts to
                                    access such databases and program; and
                                        ``(III) all unsuccessful attempts
                                    to access such databases and program
                                    that resulted in the prescription of a
                                    limited supply under subsection (b);
                                    and
                ``(2) such substance is delivered, distributed, or
            dispensed for a legitimate medical purpose.
        ``(b) Authority for Limited Supply.--
                ``(1) In general.--If the databases and program described
            in subsection (a)(1)(D) are unavailable or inaccessible at the
            time of a telemedicine encounter conducted by a covered health
            care professional, the covered health care professional may not
            prescribe, deliver, distribute, or dispense more than a seven-
            day supply of a controlled substance until the covered health
            care professional is able to review such databases and program.
                ``(2) Databases unavailable or inaccessible.--If a database
            or program required to be reviewed under subsection (a)(1)(D)
            is unavailable or inaccessible for an extended period, as
            determined by the Secretary, a covered health care professional
            may provide additional seven-day supplies of a controlled
            substance until such database or program is accessible.
        ``(c) Maximum Supply.--The authority under this section may be used
    to supply a controlled substance for not more than a six-month period.
        ``(d) Use of Authority.--The Secretary shall ensure that the
    authority under this section is used to prevent interruptions to
    patient care and not as a replacement for routine in-person patient
    care.
        ``(e) Regulations.--
                ``(1) In general.--The Secretary shall establish in
            regulations guidelines and a process for the prescription,
            delivery, distribution, and dispensation of a controlled
            substance pursuant to subsection (a).
                ``(2) Elements.--The Secretary shall ensure the guidelines
            and process described in paragraph (1)--
                        ``(A) do not restrict access of a patient to in-
                    person care; and
                        ``(B) provide for the collection and analysis of
                    data to determine if an individual has evidence of a
                    prior in-person medical evaluation by a health care
                    professional described in subsection (a)(1)(C) who
                    would reasonably be expected to have prescribing
                    authority based on their credential or organizational
                    role.
                ``(3) Initiating treatment.--
                        ``(A) In general.--The guidelines established by
                    paragraph (1) shall prohibit a covered health care
                    professional from initiating treatment with an opioid
                    medication listed in schedule II or III under section
                    202 of the Controlled Substances Act (21 U.S.C. 812)
                    unless the covered health care professional is
                    providing treatment--
                                ``(i) for opioid use disorder;
                                ``(ii) for a patient receiving palliative
                            care or enrolled in hospice care; or
                                ``(iii) for a patient who is physically
                            located in a medical facility where the patient
                            is receiving in-person care.
                        ``(B) Exception.--The prohibition under
                    subparagraph (A) shall not apply to renewal or
                    maintenance of a previously prescribed medication
                    described in such subparagraph.
        ``(f) Reporting.--
                ``(1) In general.--Not later than one year after the date
            of the enactment of the Take Care of America's Veterans Act,
            and not less frequently than annually thereafter until the
            termination date under subsection (g), 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 addresses the use of the
            authority under this section during the fiscal year preceding
            the date of submission of the report in each Veterans
            Integrated Service Network.
                ``(2) Elements.--Each report under paragraph (1) shall
            indicate, at a minimum--
                        ``(A) how many patients received prescriptions for
                    controlled substance medications through telemedicine
                    under this section;
                        ``(B) which controlled substances are being
                    prescribed under this section and how many
                    prescriptions were written for each such substance;
                        ``(C) the number of individuals who received a
                    controlled substance medication that was prescribed,
                    delivered, distributed, or dispensed under this section
                    without evidence of an in-person medical evaluation
                    within the previous two years by a health care
                    professional described in subsection (a)(1)(C); and
                        ``(D) the barriers that exist to reviewing
                    prescription drug monitoring programs of States and how
                    often those barriers occur.
        ``(g) Duration.--The authority under this section shall terminate
    on September 30, 2031.
        ``(h) Definitions.-- In this section:
                ``(1) The terms `controlled substance', `deliver',
            `dispense', and `distribute' have the meanings given those
            terms in section 102 of the Controlled Substances Act (21
            U.S.C. 802).
                ``(2) The term `covered health care professional' means--
                        ``(A) a health care professional who--
                                ``(i) is--
                                        ``(I) an employee of the Department
                                    appointed under section 7306, 7401,
                                    7405, 7406, or 7408 of this title or
                                    under title 5; or
                                        ``(II) operating from a facility of
                                    the Department, including a clinic of
                                    the Department;
                                ``(ii) is authorized by the Secretary to
                            provide health care under this chapter;
                                ``(iii) is required to adhere to all
                            standards for quality relating to the provision
                            of health care in accordance with applicable
                            policies of the Department;
                                ``(iv) has an active, current, full, and
                            unrestricted license, registration, or
                            certification or meets qualification standards
                            set forth by the Secretary within a specified
                            time frame; and
                                ``(v) with respect to a health care
                            profession listed under section 7402(b) of this
                            title, has the qualifications for such
                            profession as set forth by the Secretary; and
                        ``(B) a health professions trainee who--
                                ``(i) is appointed under section 7405 of
                            this title; and
                                ``(ii) is under the clinical supervision of
                            a health care professional described in
                            subparagraph (A).''.
        (b) Clerical Amendment.--The table of sections at the beginning of
    such chapter is amended by inserting after the item relating to section
    1730C the following new item:

    ``1730D. Prescription, delivery, distribution, and dispensation of
                                controlled substance medications via
                                telemedicine.''.

    SEC. 672. COPAYMENTS FOR LIMITED SUPPLIES OF MEDICATIONS.

        Paragraph (4) of section 1722A(a) of title 38, United States Code,
    is amended to read as follows:
        ``(4) Paragraph (1) does not apply--
                ``(A) to opioid antagonists furnished under this chapter to
            a veteran who is at high risk for overdose of a specific
            medication or substance in order to reverse the effect of such
            an overdose; and
                ``(B) to any limited supply prescription for medication, up
            to a 30-day supply of such medication, under section 1730D(b)
            of this title if the covered health care professional would
            have prescribed, delivered, distributed, or dispensed a supply
            for more than seven days if not for the restrictions under such
            section.''.

    SEC. 673. PLAN ON ESTABLISHMENT OF INTERACTIVE, ONLINE SELF-SERVICE
                  MODULE FOR CARE.

        (a) In General.--The Secretary of Veterans Affairs shall develop
    and implement a plan to establish, to the greatest extent practicable,
    an interactive, online self-service module--
                (1) to allow veterans enrolled in the system of annual
            patient enrollment of the Department of Veterans Affairs
            established and operated under section 1705(a) of title 38,
            United States Code--
                        (A) to request appointments, track referrals for
                    health care under the laws administered by the
                    Secretary, whether at a facility of the Department of
                    Veterans Affairs or through a non-Department provider,
                    and receive appointment reminders;
                        (B) to appeal and track decisions relating to--
                                (i) denials of requests for authorization
                            for care or services under section 1703 of
                            title 38, United States Code; or
                                (ii) denials of requests for care or
                            services at facilities of the Department,
                            including under section 1710 of such title;
                        (C) to compare the average wait times for
                    appointments for the type of care sought by the veteran
                    at facilities of the Department and with non-Department
                    facilities and providers through which the Secretary
                    furnishes care and services under section 1703 of such
                    title;
                        (D) to compare average driving times between their
                    residence and the nearest facility of the Department
                    that provides the care they are seeking and between
                    their residence and the closest non-Department provider
                    that provides the care they are seeking and through
                    which the Secretary furnishes care and services under
                    section 1703 of such title; and
                        (E) to view a provider directory, information
                    regarding pending medical claims, and explanations of
                    benefits; and
                (2) to implement such other matters as determined
            appropriate by the Secretary.
        (b) Submittal of Plan.--
                (1) Initial plan.--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 the plan
            developed under subsection (a).
                (2) Biannual update.--Not less frequently than once every
            180 days during the two-year period beginning on the submittal
            of the plan under paragraph (1), the Secretary shall brief the
            Committee on Veterans' Affairs of the Senate and the Committee
            on Veterans' Affairs of the House of Representatives on any
            updates on the implementation of such plan.

    SEC. 674. MODIFICATION OF REQUIREMENTS FOR CENTER FOR INNOVATION FOR
                  CARE AND PAYMENT OF THE DEPARTMENT OF VETERANS AFFAIRS
                  AND TRANSFER OF AUTHORITY.

        (a) In General.--Chapter 3 of title 38, United States Code, is
    amended by adding at the end the following new section:
    ``Sec. 326. Center for Innovation
        ``(a) Establishment.--There is established within the Department a
    Center for Innovation (in this section referred to as the `Center').
        ``(b) Purpose.--The purpose of the Center is to test innovative
    payment and service delivery models to reduce program expenditures of
    the Department under chapter 17 of this title while preserving or
    enhancing the quality of care furnished to veterans and other eligible
    individuals.
        ``(c) Identification and Testing of Models.--
                ``(1) In general.--The Center shall--
                        ``(A) identify and test health care payment and
                    service delivery models under this title, including
                    care from non-Department providers under subchapter I
                    of chapter 17 of this title, that have the potential
                    to--
                                ``(i) reduce program expenditures; and
                                ``(ii) preserve or enhance the quality of
                            care furnished to veterans;
                        ``(B) give preference to models that improve the
                    coordination, quality, and efficiency of health care
                    services furnished under this title; and
                        ``(C) evaluate the effect of applying such models
                    on program expenditures and quality outcomes under this
                    title.
                ``(2) Included models.--The models identified and tested
            under paragraph (1) may include the following:
                        ``(A) Bundled payment arrangements.
                        ``(B) Preventive care initiatives.
                        ``(C) Chronic care coordination models.
        ``(d) Selection of Models.--
                ``(1) In general.--The Secretary, acting through the
            Center, shall select models to be tested under subsection (b)
            from among those that--
                        ``(A) address a defined population for which there
                    are demonstrated deficits in care leading to poor
                    clinical outcomes or potentially avoidable
                    expenditures; and
                        ``(B) are expected to reduce program costs while
                    preserving or enhancing the quality of care furnished
                    to veterans.
                ``(2) Criteria.--In selecting models under paragraph (1),
            the Secretary shall apply criteria consistent with the model
            selection framework used in evidence-based criteria that the
            Secretary determines appropriate.
        ``(e) Testing and Evaluation.--
                ``(1) In general.--The Secretary shall design and test each
            model under this section in a manner that allows for the
            evaluation of--
                        ``(A) changes in program expenditures;
                        ``(B) changes in quality and outcomes of care for
                    veterans; and
                        ``(C) other factors the Secretary determines
                    relevant to care coordination, access, and equity.
                ``(2) Evaluation.--The Secretary shall evaluate each model
            under this section using scientifically valid methodologies,
            including control or comparison groups if practicable.
        ``(f) Reporting.--
                ``(1) Annual report.--Not less frequently than annually,
            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 models being tested
            under this section and their preliminary results, including--
                        ``(A) a brief narrative description of the model
                    explaining its intent and the proposed manner in which
                    it is supposed to reduce expenditures and increase
                    quality of or access to care for veterans;
                        ``(B) the number of veterans and providers
                    participating in the model, broken down by demographics
                    such as age, race or ethnicity, geographic location,
                    and other characteristics as chosen by the Secretary;
                        ``(C) gross and net savings or increases to the
                    medical services account of the Department, including
                    in comparison to baseline budgetary assumptions in the
                    absence of the model;
                        ``(D) an assessment of the utilization of the
                    model, including the proportion of providers choosing
                    to participate in the model and the proportion of
                    veterans choosing to participate in the model, as the
                    case may be;
                        ``(E) an assessment of quality of care and patient
                    outcome as measured by discrete objective metrics,
                    including changes to morbidity and mortality, changes
                    to admission rates, changes to readmission rates,
                    changes to population health metrics such as average
                    blood pressure, A1C levels, body mass index, or other
                    relevant health metrics, or other relevant clinical
                    outcome metrics;
                        ``(F) a description of provider, stakeholder, and
                    veteran experiences; and
                        ``(G) such other matters as the Secretary may
                    consider relevant.
                ``(2) Final report on models.--Not later than 180 days
            after completing each model 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 such model, including--
                        ``(A) findings from the evaluation of such model;
                        ``(B) updated findings under paragraph (1) with
                    respect to such model;
                        ``(C) an assessment of the fiscal impact of such
                    model; and
                        ``(D) recommendations for expansion or termination
                    of the use of such model.
        ``(g) Expansion of Successful Models.--
                ``(1) In general.--Except as provided in paragraph (2), the
            Secretary may, through rulemaking, expand the duration and
            scope of a model tested under this section to the extent that--
                        ``(A) the Secretary determines such expansion is
                    expected to--
                                ``(i) reduce program expenditures without
                            reducing quality of care; or
                                ``(ii) improve quality of care without
                            increasing program expenditures; and
                        ``(B) the Chief Financial Officer of the Department
                    certifies that such expansion will maintain budget
                    neutrality.
                ``(2) Limitation.--The Secretary shall not expand a model
            unless the results of the evaluation of the model under
            subsection (e) demonstrate that the requirements of paragraph
            (1) are satisfied.
        ``(h) Cost Neutrality and Funding.--
                ``(1) In general.--Implementation or expansion of any model
            under this section shall be conducted in a manner that is cost-
            neutral to the Department over the duration of the use of the
            model, including administrative costs.
                ``(2) Use of available amounts.--The Secretary shall ensure
            that expenditures under this section are made from amounts
            otherwise available to the Department for medical services,
            community care, or medical support and compliance.
        ``(i) Rule of Construction.--Nothing in this section shall be
    construed to authorize the Secretary to reduce the scope or amount of
    benefits under this title, or to impose additional eligibility
    requirements, except as may be necessary to carry out an approved model
    under this section.''.
        (b) Conforming and Clerical Amendments.--
                (1) Conforming repeal.--Section 1703E of title 38, United
            States Code, is repealed.
                (2) Conforming amendments.--
                        (A) Pilot program to improve administration of care
                    under veterans community care program.--Section 105(a)
                    of the Senator Elizabeth Dole 21st Century Veterans
                    Healthcare and Benefits Improvement Act (Public Law
                    118-210; 38 U.S.C. 1703 note) is amended, in the matter
                    preceding paragraph (1), by striking ``Pursuant to
                    section 1703E of title 38, United States Code, the
                    Secretary of Veterans Affairs, acting through the
                    Center for Innovation for Care and Payment'' and
                    inserting ``Pursuant to section 326 of title 38, United
                    States Code, the Secretary of Veterans Affairs, acting
                    through the Center for Innovation''.
                        (B) Pilot program on consolidating approval process
                    of department of veterans affairs for covered dental
                    care.--Section 106(a) of the Senator Elizabeth Dole
                    21st Century Veterans Healthcare and Benefits
                    Improvement Act (Public Law 118-210; 38 U.S.C. 1703
                    note) is amended, in the matter preceding paragraph
                    (1), by striking ``the Center for Innovation for Care
                    and Payment established under section 1703E of title
                    38, United States Code'' and inserting ``the Center for
                    Innovation established under section 326 of title 38,
                    United States Code''.
                        (C) Strategic plan on value-based health care
                    system for veterans health administration; pilot
                    program.--Section 107 of the Senator Elizabeth Dole
                    21st Century Veterans Healthcare and Benefits
                    Improvement Act (Public Law 118-210; 38 U.S.C. 1701
                    note) is amended--
                                (i) in subsection (a)(2)(A)(viii), by
                            striking ``the Center for Innovation for Care
                            and Payment of the Department under section
                            1703E of title 38, United States Code'' and
                            inserting ``the Center for Innovation under
                            section 326 of title 38, United States Code'';
                            and
                                (ii) in subsection (c)(1), by striking
                            ``the Center for Innovation for Care and
                            Payment established under section 1703E of
                            title 38, United States Code'' and inserting
                            ````the Center for Innovation under section 326
                            of title 38, United States Code''.
                (3) Clerical amendments.--
                        (A) Chapter 17.--The table of sections at the
                    beginning of chapter 17 of title 38, United States
                    Code, is amended by striking the item relating to
                    section 1703E.
                        (B) Chapter 3.--The table of sections at the
                    beginning of chapter 3 of such title is amended by
                    adding at the end the following new item:

    ``326. Center for Innovation.''.
        (c) Comptroller General Report.--Not later than 18 months after the
    date of the enactment of this Act, the Comptroller General of the
    United States shall submit to Congress a report--
                (1) on the efforts of the Center for Innovation of the
            Department of Veterans Affairs in fulfilling the objectives and
            requirements under section 326 of title 38, United States Code,
            as added by subsection (a); and
                (2) containing such recommendations as the Comptroller
            General considers appropriate.
        (d) Review of Veterans Community Care Program.--
                (1) In general.--Not later than one year after the date of
            the enactment of this Act, the Secretary of Veterans Affairs,
            acting through the Office of Management of the Department of
            Veterans Affairs, shall conduct a review of all aspects of the
            Veterans Community Care Program.
                (2) Elements.--The review required by paragraph (1) shall--
                        (A) identify proven management and payment best
                    practices of the Federal Government used under the
                    Medicare program under title XVIII of the Social
                    Security Act (42 U.S.C. 1395 et seq.), the Medicaid
                    program under title XIX of such Act (42 U.S.C. 1396 et
                    seq.), and the TRICARE program (as defined in section
                    1072 of title 10, United States Code);
                        (B) determine what best practices, if any,
                    identified under subparagraph (A) should be adopted and
                    implemented by the Secretary, including those practices
                    that would require legislative action before adoption
                    and implementation;
                        (C) determine how the Secretary can improve access
                    to care through the Veterans Community Care Program for
                    veterans eligible for such care;
                        (D) identify solutions to ease administrative,
                    legislative, and regulatory burdens and improve
                    efficiency in the Veterans Community Care Program;
                        (E) identify improvements to the Veterans Community
                    Care Program that can enhance the experience of
                    veterans and participating entities and providers
                    furnishing hospital care, medical services, and
                    extended care services under the Veterans Community
                    Care Program;
                        (F) review how the Secretary--
                                (i) identifies eligibility for and reviews,
                            processes, and approves referrals for care
                            under the Veterans Community Care Program;
                                (ii) authorizes the furnishing of services
                            under the Veterans Community Care Program; and
                                (iii) receives, reviews, processes, and
                            approves requests for payment from
                            participating entities and providers furnishing
                            services under the Veterans Community Care
                            Program.
                        (G) assess such other factors as determined
                    appropriate by the Secretary in consultation with
                    Congress.
                (3) Briefing and report.--
                        (A) Briefing.--Periodically throughout the duration
                    of the review required under paragraph (1), but not
                    less frequently than quarterly, the Secretary shall
                    brief the Committee on Veterans' Affairs of the Senate
                    and the Committee on Veterans' Affairs of the House of
                    Representatives on the status and preliminary findings
                    of such review.
                        (B) Report.--Not later than 30 days after the
                    conclusion of the review required 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
                    written report containing--
                                (i) a complete and unredacted list of all
                            findings and recommendations from the review;
                            and
                                (ii) any legislative, administrative,
                            regulatory, policy, or other changes sought by
                            the Secretary as a result of such findings.
                (4) Veterans community care program defined.--In this
            subsection, the term ``Veterans Community Care Program'' means
            the Veterans Community Care Program under section 1703 of title
            38, United States Code.
        (e) Pilot Programs.--
                (1) In general.--Not later than one year after the date of
            the enactment of this Act, the Secretary of Veterans Affairs
            shall commence carrying out the pilot programs described in
            paragraph (2) through the Center for Innovation established by
            section 326 of title 38, United States Code, as added by
            subsection (a), and the Office of Management of the Department
            of Veterans Affairs.
                (2) Pilot programs described.--The Secretary shall carry
            out the following pilot programs:
                        (A) A pilot program to test innovative payment
                    models for the furnishing of preventive health
                    services, as such term is defined in section 1701 of
                    title 38, United States Code.
                        (B) A pilot program to test innovative payment
                    models involving payment bundling for integrated care
                    during an episode of care authorized under the Veterans
                    Community Care Program under section 1703 of title 38,
                    United States Code, to improve the coordination,
                    quality, and efficiency of health care delivery under
                    such program.
        (f) Modification of Independent Assessments of Health Care Delivery
    Systems and Management Processes.--Subsection 1704A of title 38, United
    States Code, is amended--
                (1) in subsection (a)(2)(I), by adding at the end the
            following new clause:
                        ``(vi) To identify proven management and payment
                    best practices of the Federal Government used under the
                    Medicare program under title XVIII of the Social
                    Security Act (42 U.S.C. 1395 et seq.), the Medicaid
                    program under title XIX of such Act (42 U.S.C. 1396 et
                    seq.), and the TRICARE program (as defined in section
                    1072 of title 10).''; and
                (2) in subsection (d), by inserting ``or federally funded
            research and development center'' after ``private entity''.

    SEC. 675. REPORT ON IMPROVEMENTS TO CLINICAL APPEALS PROCESS.

        (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 veterans service organizations, veterans, caregivers
    of veterans, employees of the Department of Veterans Affairs, and other
    stakeholders as determined by 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 containing
    recommendations for legislative or administrative action to improve the
    clinical appeals process of the Department with respect to timeliness,
    transparency, objectivity, consistency, and fairness.
        (b) Inapplicability of Requirements Relating to Federal Advisory
    Committees.--Chapter 10 of title 5, United States Code, shall not apply
    to the consultation required by subsection (a).
        (c) Veterans Service Organization Defined.--In this section, the
    term ``veterans service organization'' means any organization
    recognized by the Secretary under section 5902 of title 38, United
    States Code.

    SEC. 676. PLAN ON INCREASING ACCESSIBILITY OF CARE FOR VETERANS WITH
                  SPINAL CORD INJURY OR DISORDER.

        (a) In General.--Not later than one year after the date of the
    enactment of this Act, the Secretary of Veterans Affairs shall submit
    to the Committee on Veterans' Affairs of the Senate and the Committee
    on Veterans' Affairs of the House of Representatives a plan on
    improving disability-related access to care from facilities of the
    Department and from non-Department facilities and providers through
    which the Secretary furnishes care and services under section 1703 of
    title 38, United States Code, for veterans with spinal cord injury or
    disorder.
        (b) Consultation.--In developing the plan required under subsection
    (a), the Secretary shall consult with relevant stakeholders, including
    veterans service organizations who serve veterans with spinal cord
    injury or disorder.
        (c) Elements.--The plan required under subsection (a) shall include
    an assessment of disability-related barriers to care at medical
    facilities of the Department of Veterans Affairs and through community
    care networks of non-Department providers for veterans with spinal cord
    injury or disorder and a description of the actions needed to overcome
    such barriers, including cost estimates, timelines for corrective
    action, and requests for legislative action, if any.
        (d) Veterans Service Organization Defined.--In this section, the
    term ``veterans service organization'' means any organization
    recognized by the Secretary under section 5902 of title 38, United
    States Code.
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