119 HR 9237 IH: Take Care of America’s Veterans Act
U.S. House of Representatives
2026-06-10
text/xml
EN
Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.
1.Short title; table of contents
(a)This Act may be cited as the Take Care of America’s Veterans Act
. (b)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.
<enum>I</enum><header>Compensation </header>
<section id="HE11CBB1733184D13909F7CE789A90BC6" section-type="subsequent-section"><enum>101.</enum><header>Major Richard Star Act</header>
<subsection id="H80D3D94A47A247909151215C495EAECC"><enum>(a)</enum><header>Concurrent receipt generally</header><text>Section 1414(b) of title 10, United States Code, is amended by striking paragraph (2) and inserting the following new paragraphs:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H395C2E6F153746E2A99EF36524DFF350"> <paragraph commented="no" display-inline="no-display-inline" id="H695881DF4549417F92FF2316CF91B6E9"><enum>(2)</enum><header>Combat-related disability retirees</header> <subparagraph commented="no" display-inline="no-display-inline" id="HD2C7EE1C8E7D4DF681ACA0A3CF65EB83"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H6BD139A573D749B5850BF9EA28A41E62"><enum>(B)</enum><header>Career retirees</header><text display-inline="yes-display-inline">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—</text> <clause commented="no" display-inline="no-display-inline" id="H4052993EA6D84C469745D1F8A31BBE27"><enum>(i)</enum><text display-inline="yes-display-inline">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 </text></clause>
<clause commented="no" display-inline="no-display-inline" id="HD2E289030CFD40B0994E487AE8F5E1C1"><enum>(ii)</enum><text display-inline="yes-display-inline">veterans’ disability compensation under title 38.</text></clause></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H712B4FAEF7B3443DAAA55C022BF7EE1B"><enum>(C)</enum><header>Disability retirees with less than 20 years of service</header><text display-inline="yes-display-inline">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—</text>
<clause commented="no" display-inline="no-display-inline" id="HD8195D55E05941BDA0880A10AE1D2229"><enum>(i)</enum><text display-inline="yes-display-inline">both—</text> <subclause commented="no" display-inline="no-display-inline" id="HDB084BA9EEE44B33A6611CE7420F2FF7"><enum>(I)</enum><text display-inline="yes-display-inline">the retired pay for which the member is eligible under chapter 61 of this title; and </text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="H1F36A1CB76A24562880F0F10AA7932F1"><enum>(II)</enum><text display-inline="yes-display-inline">veterans’ disability compensation under title 38; or</text></subclause></clause> <clause commented="no" display-inline="no-display-inline" id="HE8680AECF0744EBFA48C1CB13D5B4084"><enum>(ii)</enum><text display-inline="yes-display-inline">both—</text>
<subclause id="H871CA397357D48E99760FF11C9EC80CE"><enum>(I)</enum><text>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</text></subclause> <subclause id="H9936A7605C5F42F5806F6B193101BD89"><enum>(II)</enum><text>veterans’ disability compensation under title 38.</text></subclause></clause></subparagraph>
<subparagraph id="HA9ADE375CC8343478A4880D310030761"><enum>(D)</enum><header>Combat-related disability defined</header><text>In this paragraph, the term <term>combat-related disability</term> 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.</text></subparagraph></paragraph> <paragraph id="H4AF870073F374009AA0EFC2FCF00A676"><enum>(3)</enum><header>Exclusion of other retirees</header><text>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).</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H6F370EB5C86749E394C33C73250D891C"><enum>(b)</enum><header>Technical and conforming amendments</header>
<paragraph commented="no" display-inline="no-display-inline" id="H0BF38D07A7374A56A6A64523F1324A9B"><enum>(1)</enum><header display-inline="yes-display-inline">Coordination with combat-related special compensation program</header><text>Section 1414(d) of title 10, United States Code, is amended by striking <quote>qualified retiree under this section</quote> and inserting <quote>qualified retiree under subsection (a) or is entitled to a payment under subsection (b)(2)</quote>.</text></paragraph> <paragraph id="H1C39D4D523AE4A65A9A29162D9C4B53E"><enum>(2)</enum><header>Amendments reflecting end of concurrent receipt phase-in period</header><text display-inline="yes-display-inline">Section 1414 of title 10, United States Code, is further amended—</text>
<subparagraph id="H9AC63F556CB9459CBC2AE3B9A7DBA964"><enum>(A)</enum><text display-inline="yes-display-inline">in subsection (a)(1)—</text> <clause id="HE3EB08BD9839413E939E0AFA0600F62A"><enum>(i)</enum><text>by striking the second sentence; and</text></clause>
<clause id="H6D0C098642FF45339FD2FB38E2A0C03C"><enum>(ii)</enum><text>by striking subparagraphs (A) and (B);</text></clause></subparagraph> <subparagraph id="H86BB6BB89BA04911A2E25D04B44F45E0"><enum>(B)</enum><text>by striking subsection (c) and redesignating subsections (d) and (e) as subsections (c) and (d), respectively; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HB72396E76E144A34945F96D6C4614303"><enum>(C)</enum><text>in subsection (d), as redesignated, by striking paragraphs (3) and (4).</text></subparagraph></paragraph> <paragraph commented="no" id="H328A1B2112554931BDD9D5DD8CDD94D5"><enum>(3)</enum><header>Section heading</header><text display-inline="yes-display-inline">The heading of section 1414 of such title is amended to read as follows:</text>
<quoted-block style="USC" id="H8AC4DEF98160420BA3B55BC57A0680A2">
<section commented="no" id="H2D6D8CEBA039459C890FECE7D06A9809"><enum>1414.</enum><header>Members eligible for retired pay who are also eligible for veterans’ disability compensation: concurrent receipt</header></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph commented="no" id="H7356B09BD51E4042A8600F6FA67B519B"><enum>(4)</enum><header>Conforming amendment</header><text>Section 1413a(f) of such title is amended by striking <quote>Subsection (d)</quote> and inserting <quote>Subsection (c)</quote>.</text></paragraph></subsection> <subsection id="H1B2E8EF865094E84B9A28213A2D0B37A"><enum>(c)</enum><header>Effective date</header><text>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.</text></subsection></section>
<section id="HBBB51248A9504761ADCAE0F331CED2E3"><enum>102.</enum><header>Love Lives On Act</header>
<subsection id="H0D4DCB26A47F4FB89E9493BD8C0726D1"><enum>(a)</enum><header>Modification of entitlement to veterans dependency and indemnity compensation for surviving spouses who remarry</header><text>Section 103(d) of title 38, United States Code, is amended—</text> <paragraph id="H428B0EC003974C6FA01F892800827A54"><enum>(1)</enum><text>in paragraph (2)(B)—</text>
<subparagraph id="H277E51ECCD444064A908AA2B27CDBEF9"><enum>(A)</enum><text>by inserting <quote>(i)</quote> before <quote>The remarriage</quote>;</text></subparagraph> <subparagraph id="HDCB38E0344724CB6AA799A9C8EB06BFA"><enum>(B)</enum><text>in clause (i), as designated by subparagraph (A), by striking <quote>Notwithstanding the previous sentence</quote> and inserting the following: </text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HD9702846782343CF89BDB79E00B7C5EE">
<clause id="H1D5594A5B44847F7B0B553CCFF67D000" indent="up3"><enum>(ii)</enum><text>Notwithstanding clause (i)</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H4ADBD68AB6914E34B5E2598714AD07D0"><enum>(C)</enum><text>by adding at the end the following new clause:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H516B7029A8EE4C52B868FAC3AF290487">
<clause id="H9527BEA7A99A4A37B1D7CCAE1FCFED05" indent="up3"><enum>(iii)</enum><text>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.</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="HE0843C120539490FB9C8103E4DE801F6"><enum>(2)</enum><text>in paragraph (5)—</text>
<subparagraph id="HC7DF16D8C3374209AAF0C3367DBBD9A0"><enum>(A)</enum><text>by striking subparagraph (A); and</text></subparagraph> <subparagraph id="H2E2964E8FA47494F9438A1C9A24DF924"><enum>(B)</enum><text>by renumbering subparagraphs (B) through (E) as subparagraphs (A) through (D), respectively.</text></subparagraph></paragraph></subsection>
<subsection id="H4A67D017E98E4579BB61FEAF6B533783"><enum>(b)</enum><header>Continued eligibility for survivor benefit plan for certain surviving spouses who remarry</header><text>Section 1450(b)(2) of title 10, United States Code, is amended—</text> <paragraph id="H8BFFB3F8E63C4EBB82F257DF9F04A78D"><enum>(1)</enum><text>by striking <quote>An annuity</quote> and inserting the following:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H53943C3E7BBB41AAACBEAC6BC778F4DE">
<subparagraph id="H3EAE1D2827ED4654AC20E85B46DC2E33"><enum>(A)</enum><header>In general</header><text>(A) Subject to subparagraph (B), an annuity</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph> <paragraph id="H76A96154AA294458A733B9CA8EBDF37A"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H073BBB36A4DA42EAA7FC3307C70D4F84">
<subparagraph id="HCBC014BD6B2943D287C891EA8F0A5019"><enum>(B)</enum><header>Treatment of survivors of members who die on active duty</header><text>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 <short-title>Take Care of America’s Veterans Act</short-title>, the Secretary shall resume payment of the annuity to that surviving spouse—</text> <clause id="H7C2EB7C76B3948B8B4A670985DAF5889"><enum>(i)</enum><text>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</text></clause>
<clause id="HE3E74C42F37447BCB1C87DC652BC11C4"><enum>(ii)</enum><text>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.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="HE4B0035F1B0C4FFC9727DA422D7ABEFC"><enum>(c)</enum><header>Expansion of definition of dependent under TRICARE program to include a remarried widow or widower whose subsequent marriage has ended</header><text>Section 1072(2) of title 10, United States Code, is amended—</text>
<paragraph id="H56E3A2B8340146E585400AF86BBD0914"><enum>(1)</enum><text>in subparagraph (H), by striking <quote>; and</quote> and inserting a semicolon;</text></paragraph> <paragraph id="HD6A285B6CB704898A05153EECCC722D0"><enum>(2)</enum><text>in subparagraph (I)(v), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph>
<paragraph id="HE5F09C32A7214CC4AC183ADFCBDB3A57"><enum>(3)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H81875137845246C8B186FDB586048B14"> <subparagraph id="H7E9345F93D014F07856DFBBA2C56134F"><enum>(J)</enum><text>a remarried widow or widower whose subsequent marriage has ended due to death, divorce, or annulment.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section>
<section section-type="subsequent-section" id="H91E28416445E4584BA87D6307B808758"><enum>103.</enum><header>Extension of increased dependency and indemnity compensation to surviving spouses of veterans who die from amyotrophic lateral sclerosis</header>
<subsection id="H6FE0599B12EE4066929B67322454EB4E"><enum>(a)</enum><header>Extension</header><text>Section 1311(a)(2) of title 38, United States Code, is amended—</text> <paragraph id="H49A3858DC6854DABAE3888B666A5B02C"><enum>(1)</enum><text display-inline="yes-display-inline">by inserting <quote><header-in-text level="subparagraph" style="USC"><enum-in-header>(A)</enum-in-header></header-in-text></quote> before <quote>The rate</quote>; and</text></paragraph>
<paragraph id="H7F152182AC4A412A89D0618CE103F1D0"><enum>(2)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="USC" display-inline="no-display-inline" id="H6D09AEABC41F49DE8F88263987C9496F"> <subparagraph id="H3920C42FB84849A5913E26DFFFE96F00" indent="up2"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection commented="no" id="HB5F24055BB8C411193A6CBC0EDC9D814"><enum>(b)</enum><header>Applicability</header><text display-inline="yes-display-inline">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.</text></subsection></section> <section id="H9D70513BFD1144EB9C47B561C43FC6BF"><enum>104.</enum><header>Sharri Briley and Eric Edmundson Veterans Benefits Expansion Act of 2026</header> <subsection id="H96C129B665F441988B09E55D387AD262"><enum>(a)</enum><header>Increase in rates of certain disability compensation and dependency and indemnity compensation under laws administered by Secretary of Veterans Affairs</header> <paragraph id="HE9CB6FEE5AAD408B85DDE9A8D1D23666"><enum>(1)</enum><header>Increase to rates of wartime disability compensation</header> <subparagraph id="H7B43291B06E64B1F8FED5D54EC4FBEC9"><enum>(A)</enum><header>In general</header><text>Section 1114 of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block style="USC" id="H13BDBF33EF60495BA45A54CB4A9A5949" display-inline="no-display-inline">
<subsection id="HE80C35B3CFAB4B9D91CC355A7949F8CB"><enum>(u)</enum><text display-inline="yes-display-inline">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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H62B0335BD77C42DEB682C3282CD15097"><enum>(B)</enum><header>Effective date; applicability</header><text>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.</text></subparagraph></paragraph>
<paragraph id="H2BD90FA4285444CDB2388A2D3F59CB84"><enum>(2)</enum><header>Increase to rates of dependency and indemnity compensation</header><text>Section 5312 of such title is amended by adding at the end the following new subsection:</text> <quoted-block id="H48BF0FA5907D4E20B74D8CCCDD233365" style="OLC"> <subsection id="H313357A19B244104A2757ACEC5ABCFEF"><enum>(d)</enum> <paragraph commented="no" display-inline="yes-display-inline" id="H8BA98013168940B2B13EBA3B4F7E3FDD"><enum>(1)</enum><text display-inline="yes-display-inline">Whenever there is an increase in benefit amounts payable under title II of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/401">42 U.S.C. 401 et seq.</external-xref>) as a result of a determination made under section 215(i) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/415">42 U.S.C. 415(i)</external-xref>), 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—</text>
<subparagraph id="H89243D3E555F482491595628E3AB01D2" indent="up1"><enum>(A)</enum><text>the percentage by which such benefit amounts are increased; and</text></subparagraph> <subparagraph id="H6455726C1AAE43B899C65CFB684C8F14" indent="up1" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">one percent.</text></subparagraph></paragraph>
<paragraph id="H27620183040E448D95B05079CAB61E8F" indent="up1" commented="no"><enum>(2)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/415">42 U.S.C. 415(i)(2)(D)</external-xref>) is published by reason of a determination under section 215(i) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/415">42 U.S.C. 415(i)</external-xref>).</text></paragraph> <paragraph id="H7B6D8201C6C348EF8F6B1896A02DD9AD" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="HE7EC862C39924DD5A94929D692276237"><enum>(A)</enum><text>take effect on December 1, 2026, and shall apply with respect to months beginning on or after such date; and</text></subparagraph> <subparagraph id="H7E1AA6328C144B62943BEFE5D0ECC783"><enum>(B)</enum><text>terminate after the date on which the third increase to such amounts pursuant to such paragraph occurs.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H4DF1E94F268C4B8091909FE366943FFD"><enum>(b)</enum><header>Modification of waivers of fees collected for housing loans guaranteed, insured, or made by the Secretary of Veterans Affairs</header><text>Section 3729(b)(2) of such title is amended, in the loan fee table—</text> <paragraph id="HEB49619DB07444FB9A9F12537D5E7842"><enum>(1)</enum><text>in subparagraph (E), by striking <quote>0.50</quote> both places it appears and inserting <quote>1.42</quote>; and</text></paragraph>
<paragraph id="H1576371F0EAD42029951D39718FE444E"><enum>(2)</enum><text>in subparagraph (I), by striking <quote>0.50</quote> each place it appears and inserting <quote>1.0</quote>.</text></paragraph></subsection> <subsection id="H04696B894C7E462291A83A4871EE8770"><enum>(c)</enum><header>Home affordability for Guard and Reserve</header> <paragraph id="H2B19084ECB13469FB560DB6F1B040E71"><enum>(1)</enum><header>Eligibility of certain members of the reserve components and the National Guard for guaranteed housing loans</header> <subparagraph id="H4C61785F1B8347FCBD0B2A049F6F3FD6"><enum>(A)</enum><header>Expanded definition of <quote>active duty</quote> for purposes of housing loans</header><text>Section 3701(b) of title 38, United States Code, is amended by adding at the end the following new paragraph:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="H9576280D6B544A08893B6EC91083E46F">
<paragraph id="H3B93B8FB9B6C475A9D1C87D4012804A2"><enum>(9)</enum><text display-inline="yes-display-inline">The term <quote>active duty</quote> has the meanings as follows:</text> <subparagraph id="HBED10B90C73D4580A80551763B51175D"><enum>(A)</enum><text display-inline="yes-display-inline">In the case of members of the regular components of the Armed Forces, the meaning given such term in section 101(21)(A). </text></subparagraph>
<subparagraph id="H28D9ED5CF83D47CEA6404EEAC9240ACE"><enum>(B)</enum><text>In the case of members of the reserve components of the Armed Forces—</text> <clause id="HC97B725B4E8E46F18392D4C6E88C2E36"><enum>(i)</enum><text>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</text></clause>
<clause id="HEC402072373A499C82307051CE4EA74A"><enum>(ii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="H4B57B134313542C5BA36B5CED284BB07" display-inline="no-display-inline"><enum>(C)</enum><text>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—</text>
<clause id="HE49560DF010A4ACB95E104D42B0329DD"><enum>(i)</enum><text>in the National Guard of a State for the purpose of organizing, administering, recruiting, instructing, or training the National Guard; </text></clause> <clause id="HDF638EEE933E4E8DB1BFCB3F8BFB41D4"><enum>(ii)</enum><text>in the National Guard when performing full-time National Guard duty (as defined in section 101 of title 32); or</text></clause>
<clause id="HCC31D2667AD244639F9E19072A33AE2A"><enum>(iii)</enum><text>in the National Guard when performing active duty (as defined in section 101 of title 32).</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H642511C5A99441008542F39F1A9F6962"><enum>(B)</enum><header>Retroactive applicability to service performed</header><text>The amendments made by this subsection shall apply with respect to any service performed on or after September 11, 2001.</text></subparagraph></paragraph>
<paragraph id="H8F73ED49E1504590A01AF9EBA630E0BC"><enum>(2)</enum><header>Expansion of eligibility for guaranteed housing loans to certain additional personnel upon payment of additional loan fee</header>
<subparagraph id="HB90476B5D8524C639F72EDD691E452A3"><enum>(A)</enum><header>Expansion to individuals with at least 14 days of service</header><text>Section 3701(b) of title 38, United States Code, is amended by inserting after paragraph (7) the following new paragraph:</text> <quoted-block style="USC" display-inline="no-display-inline" id="H7A25D3D5E41D4AA08340A42EEE53C08D"> <paragraph id="HE23FFF7452644911AA78992CE9FDCD9D"><enum>(8)</enum><text display-inline="yes-display-inline">The term <quote>veteran</quote> 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—</text>
<subparagraph id="HEFCC693B2E804B8D97076658A7249D6F"><enum>(A)</enum><text>is not otherwise eligible for the benefits of this chapter;</text></subparagraph> <subparagraph id="H0C3C54343923467AA8423D46FF6F99D4"><enum>(B)</enum><text>has completed a total service of at least 14 days on active duty under paragraph (B) or (C) of paragraph (9); and</text></subparagraph>
<subparagraph id="H4C330797878F4D019A7B355CE09D6AC2"><enum>(C)</enum><text display-inline="yes-display-inline">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).</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H0F59B9B7E79743C395C95899121D925F"><enum>(B)</enum><header>Basic entitlement</header><text>Section 3702(a)(2) of title 38, United States Code, is amended by adding at the end the following:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H5BC808EBB8EE4A3D89FAC89527615844">
<subparagraph id="H9040D94C9C774FA7B5D25F48A5D925F3" indent="up1"><enum>(H)</enum><text display-inline="yes-display-inline">Each individual described in section 3701(b)(8) of this title.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H8C3EF019CC8C4CD39D28057456BB8A3D"><enum>(C)</enum><header>Additional loan fee for such individuals</header><text>Section 3729(b)(4) of title 38, United States Code, is amended by adding at the end the following new subparagraph:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="H935F72D11674449784510A173E81408A">
<subparagraph id="HB7E35713764540438CC9EF81F09A4341" indent="up1"><enum>(J)</enum><text>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.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H62F4E485D79A4BEF91BA918546EB9114"><enum>(D)</enum><header>Notification to personnel</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection></section>
<section id="HBE42B1CF80A948D1A58EEF18695F5FD8" section-type="subsequent-section"><enum>105.</enum><header>Claims: prohibition on denial solely for certain reason; improved efficiency of adjudications and appeals</header>
<subsection id="H023B4B4A99DE4107A59EF652085412C7"><enum>(a)</enum><header>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</header><text>Subsection (d) of section 5103A of title 38, United States Code, is amended—</text> <paragraph id="HAC88B5497A25487C86892271B45D8348"><enum>(1)</enum><text>in the heading, by striking <quote><header-in-text level="subsection" style="USC">compensation claims</header-in-text></quote> and inserting <quote><header-in-text level="subsection" style="USC">claims for benefits</header-in-text></quote>;</text></paragraph>
<paragraph id="H6532A2ACB3FD429685C44C2252718806"><enum>(2)</enum><text>in paragraph (2), by striking <quote>treat an examination or opinion as being necessary to make a decision on a claim for purposes of </quote> and inserting <quote>provide for a medical examination or obtain a medical opinion under</quote>; and</text></paragraph> <paragraph id="HF6CDDB1D6D3A40CFA5A4D65A1DAFB513"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block style="USC" id="H9B34EA59BAEE4CB0BE7D9DE808B4711A" display-inline="no-display-inline">
<paragraph id="H28F4A3B90802483E824FDE4C53D1ADD8" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="HBBA3BC34703045A7B0B576E07E26316D"><enum>(b)</enum><header>Improvements to efficiency of adjudications and appeals of claims for benefits under laws administered by Secretary of Veterans Affairs</header> <paragraph id="HEF1A405731AF436F92689C69C71BEF89"><enum>(1)</enum><header>Annual report on length of adjudications</header> <subparagraph id="H590D83019C604D998FAEA2CD18EFCC1A"><enum>(A)</enum><header>In general</header><text>Section 5109B of title 38, United States Code, is amended—</text>
<clause id="H0D7118F9005F4F64B78B47495725A821"><enum>(i)</enum><text>by striking <quote>The Secretary</quote> and inserting <quote>(a) <header-in-text level="subsection" style="USC">In general.—</header-in-text>The Secretary</quote>; and</text></clause> <clause id="H945CE8EA4C60425788E787FCCA225765"><enum>(ii)</enum><text>by adding at the end the following new subsection:</text>
<quoted-block style="USC" id="H8E8516E8F0EA4D98B9D62A14F4268930" display-inline="no-display-inline">
<subsection id="H97E97DAC2E8448FF82EDD5EBE9026C4E"><enum>(b)</enum><header>Annual report</header><text display-inline="yes-display-inline">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—</text> <paragraph id="H610A077C39884646A4C593515E3B3F59"><enum>(1)</enum><text>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;</text></paragraph>
<paragraph id="HC0D020FF104040C79549728B71F2316D"><enum>(2)</enum><text display-inline="yes-display-inline">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—</text> <subparagraph id="H357A78806A8241F2886132DACE8D148E"><enum>(A)</enum><text>whether a motion was granted or denied; and</text></subparagraph>
<subparagraph id="H2BCC4473163346F6A454981F554FB8B8"><enum>(B)</enum><text>the reason provided for the motion; and</text></subparagraph></paragraph> <paragraph id="HE451EA79D9324AB48E9E0392FD846ECE"><enum>(3)</enum><text>the number of appeals dismissed by the Board, disaggregated by—</text>
<subparagraph id="HC0F35FBAC14D4CDA829A93C7220BDB9D"><enum>(A)</enum><text>whether or not the dismissal was by reason of the death of the appellant; and</text></subparagraph> <subparagraph id="HFFFF4D29BB18444DB1C8F9016B059020"><enum>(B)</enum><text>in the case of a dismissal by reason of the death of the appellant, whether or not such death was a result of suicide. </text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph>
<subparagraph id="H878E959A10AD4F3F91B2C214146FDC90"><enum>(B)</enum><header>Deadline</header><text>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.</text></subparagraph></paragraph> <paragraph id="H299D9E9543E247DE9B31EE897BCF8E74"><enum>(2)</enum><header>Guidelines for advancement of cases on docket of Board</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, 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.</text></paragraph>
<paragraph id="H7DE8CD23B7A34C0E9BD1A73D653A335F"><enum>(3)</enum><header>Requirement To track certain claims for benefits</header>
<subparagraph id="H702B10A509994B76A7398F35B07EAEE0"><enum>(A)</enum><header>In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/51">Chapter 51</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/5109B">section 5109B</external-xref> the following new section:</text> <quoted-block style="USC" id="H351FDC1401F74355B30045FFA11E22F8" display-inline="no-display-inline"> <section id="HA005F209D63F4241B2339E253AD033BB"><enum>5109C.</enum><header>Requirement to track and maintain information on certain claims for benefits; notice of certain assignments</header> <subsection id="H58DA7AB5C61E4E5E94042FEF03304EB7"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall use technology to track and maintain information (including information with respect to timeliness) on—</text>
<paragraph id="H28EE81F5EED64841BC81F4C589411885"><enum>(1)</enum><text>claims for benefits under the laws administered by the Secretary (including issues within such claims) that are—</text> <subparagraph id="HF8D827A5FDB144FAA66494538D9C09EA"><enum>(A)</enum><text>continuously pursued in accordance with—</text>
<clause id="HCBB5CF908F834E20ACDAA99381738845"><enum>(i)</enum><text>sections 5104C(a) and 5110(a)(2) of this title; or</text></clause> <clause id="H33AE46C49C134C068C6253582C4C58F5"><enum>(ii)</enum><text>any other policy established by the Secretary;</text></clause></subparagraph>
<subparagraph id="H3508C16225BF4CD88475A15F2743510F"><enum>(B)</enum><text>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;</text></subparagraph> <subparagraph id="HEA50A4E6719A440CA865217260A0E5FF"><enum>(C)</enum><text display-inline="yes-display-inline">afforded expeditious treatment by the Veterans Benefits Administration pursuant to section 5109B of this title or any other policy established by the Secretary;</text></subparagraph>
<subparagraph id="H7B1EA3FFFC0F47C789686200500ABB30"><enum>(D)</enum><text display-inline="yes-display-inline">remanded by the Board of Veterans’ Appeals to the Secretary pursuant to section 7104 of this title; or</text></subparagraph> <subparagraph id="HEB81703F994A445BB8B970845AA5D458"><enum>(E)</enum><text>pending a hearing by the Board of Veterans’ Appeals under section 7107 of this title;</text></subparagraph></paragraph>
<paragraph id="H75A8B6E005134525BE6D6D5F0F236C59"><enum>(2)</enum><text>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;</text></paragraph> <paragraph id="H1CBB5AF4AFBF45AD99FAE3698E957512"><enum>(3)</enum><text>supplemental claims under section 5108 of this title that are filed—</text>
<subparagraph id="H0D9C10F6277B497CA59C1CF2533BE094"><enum>(A)</enum><text>in accordance with section 5104C(a) and section 5110(a)(2) of this title; and</text></subparagraph> <subparagraph id="H3168975D14D84293BB42FF164EA33DE2"><enum>(B)</enum><text>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</text></subparagraph></paragraph>
<paragraph id="HE6CBD64392504DECB23542312CE7B472"><enum>(4)</enum><text>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—</text> <subparagraph id="H1CDDC0282D8348A581C00EF9B107A109"><enum>(A)</enum><text>assigned a fiduciary; and</text></subparagraph>
<subparagraph id="HC30222B6065846CF8BF78AA1344C9F20"><enum>(B)</enum><text>not assigned a fiduciary.</text></subparagraph></paragraph></subsection> <subsection id="H901A813B3F814376ACDA504BF29C0704"><enum>(b)</enum><header>Annual report</header> <paragraph commented="no" display-inline="yes-display-inline" id="HA0832A1F75984B65803D740B8C4E1D37"><enum>(1)</enum><text>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).</text></paragraph>
<paragraph id="H11D3BBC149D14D47AEDBD120E7B88B94" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">The first report required by paragraph (1) shall be submitted by not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H069D6F21E53949C599CDA990811B3E0B" commented="no"><enum>(B)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 5109B the following new item:</text>
<quoted-block style="USC" id="HE4F0E61A4ADF4EBC97FE2AC8513D80F2" display-inline="no-display-inline">
<toc regeneration="no-regeneration">
<toc-entry level="section">5109C. Requirement to track and maintain information on certain claims for benefits; notice of certain assignments.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H859D6AB2D5874814A43669A37C3F7596"><enum>(4)</enum><header>Improvements to Board of Veterans’ Appeals</header>
<subparagraph id="H1CEABF9D5CEF4A37A37B201B4B3948B3"><enum>(A)</enum><header>Authority to aggregate certain claims</header>
<clause id="HAF8585229F134DB28D8D5CCD9DEE0A7E"><enum>(i)</enum><header>In general</header><text>Section 7104(a) of such title is amended by inserting after the second sentence the following new sentence: <quote>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.</quote>.</text></clause> <clause id="HD0735728D9354C1D929DB078392CD3D2" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><header>Effective date</header><text display-inline="yes-display-inline">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).</text></clause>
<clause id="HF62F8D1A38E34219888E20278AD99FBF" commented="no"><enum>(iii)</enum><header>Sunset</header><text display-inline="yes-display-inline">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).</text></clause></subparagraph> <subparagraph id="H3C0AE5D1776E4FC1B0A5F376DFF8290C"><enum>(B)</enum><header>Requirement to ensure substantial compliance with certain decisions</header><text>Such section is further amended—</text>
<clause id="H0C78609B2D8E4EE196563E3BF271CF78"><enum>(i)</enum><text>by redesignating subsection (f) as subsection (g); and</text></clause> <clause id="H996BBF1553564E9B811A305FE9B68D8D"><enum>(ii)</enum><text>by inserting after subsection (e) the following new subsection (f):</text>
<quoted-block style="USC" id="H7337FF15D3264315BE5EC68B60102912" display-inline="no-display-inline">
<subsection id="H8121DFAE396744B597C322BAF655C293"><enum>(f)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="H9841C3251C5D4B7EB419D5618102BE39"><enum>(1)</enum><text>The Secretary, acting through a member of the Board, shall ensure substantial compliance with any decision of the Board to remand a claim.</text></paragraph> <paragraph id="HC2314FEC2E4F4DABBD6DC295C193CA9A" indent="up1" commented="no"><enum>(2)</enum><text>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—</text>
<subparagraph id="H8C17160C3D724E97A4284DDC64C1A35E" commented="no"><enum>(A)</enum><text>evidence added to the evidentiary record after the date of such decision is sufficient to resolve the issues underlying such decision; or</text></subparagraph> <subparagraph id="H3F58D138494A4512AA3C88ABEAA0EF03" commented="no"><enum>(B)</enum><text>such decision was unnecessary.</text></subparagraph></paragraph>
<paragraph id="H12F90445C6934F00AF979B2FB345E44D" indent="up1"><enum>(3)</enum><text>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. </text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="H80EA7F5C1BDC4A178566CB9BF27CD569"><enum>(C)</enum><header>Definition of aggregate; report</header><text>Such section is further amended by adding at the end the following new subsections:</text>
<quoted-block style="USC" id="H993B0C7561FA4C43812DA51E04DEAA86" display-inline="no-display-inline">
<subsection id="H03281AD9367246CF9B68FCAE4F22C9BF"><enum>(h)</enum><text display-inline="yes-display-inline">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—</text> <paragraph id="H7762BE441EF74B00A517D8B97C294911"><enum>(1)</enum><text>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;</text></paragraph>
<paragraph id="H62EA9A5D82254136B05B8E0D10AF07FE"><enum>(2)</enum><text>an assessment of whether the aggregation of appeals has contributed to improved efficiency at the Board with issuing decisions on appeals; and</text></paragraph> <paragraph id="H93ECC1DA37104421B91AB5D6E5B16881"><enum>(3)</enum><text>such other matters as the Secretary determines appropriate.</text></paragraph></subsection>
<subsection id="HC5B2DCD71174493182A652FF5EE4B277"><enum>(i)</enum><text>In this section, the term <quote>aggregate</quote>—</text> <paragraph id="HED798839F9C148FE8EC305E86661BEBC"><enum>(1)</enum><text>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</text></paragraph>
<paragraph id="HEFAE97905CE14CE5B4D7BFA030722D8D"><enum>(2)</enum><text>includes the use of joinder, consolidation, intervention, class actions, and any other multiparty proceedings.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="HD741C01E643045FF98CA4792D8303482"><enum>(5)</enum><header>Expansion of jurisdiction of Court of Appeals for Veterans Claims</header><text display-inline="yes-display-inline">Section 7252 of title 38, United States Code, is amended—</text>
<subparagraph id="H6742BBAE03184AB79CE2BE51875B8927"><enum>(A)</enum><text>by redesignating subsections (b) and (c) as subsections (d) and (e), respectively; and</text></subparagraph> <subparagraph id="H75796C45DE8240339753E0E83FE7E549"><enum>(B)</enum><text>by inserting after subsection (a) the following new subsections:</text>
<quoted-block style="USC" id="H6E0CB22E4AE142C190BE496D92A648FF" display-inline="no-display-inline">
<subsection id="H6255E8A2931944B4871F710C235EED41" commented="no"><enum>(b)</enum>
<paragraph id="HB6EB0F1A962447FD9393BD9C44302EB8" commented="no" display-inline="yes-display-inline"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text> <subparagraph id="H5EAC2E60B4D346BBA8A475B5B898CFB7" indent="up1"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph>
<subparagraph id="HE5580FDFE7BC4F21BF4BE735C017550D" indent="up1"><enum>(B)</enum><text>regarding which—</text> <clause id="H1B45A5312B134F2DBFD0BCA94F72D2A0"><enum>(i)</enum><text>the agency of original jurisdiction has issued a nonfinal decision; and</text></clause>
<clause id="H58D9F1104749440880B2557C77D0DC8F"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph> <paragraph id="H78CF3B17522D43ED870C68C5BB46A430" indent="up1" commented="no"><enum>(2)</enum><text>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:</text>
<subparagraph id="H41F79D71DB99457D96B963C27C720C2D" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">The date on which the Court issues a final decision with respect to such claim.</text></subparagraph> <subparagraph id="HBFC185518FF24174B5D79261AA7714A1" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">The date on which the Court issues a final decision with respect to such motion for class action review.</text></subparagraph></paragraph>
<paragraph id="H31592705170F4E26A2AC5B2C30A77FFA" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">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. </text></paragraph></subsection> <subsection id="HEC78B135466542C7B86A5633B012FF14" display-inline="no-display-inline"><enum>(c)</enum> <paragraph commented="no" display-inline="yes-display-inline" id="HBCC0B3C5031949F5A4B074166CCE725F"><enum>(1)</enum><text>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—</text>
<subparagraph id="HBB5DC7FB9AA5409D8AE47FF44673D853" indent="up1"><enum>(A)</enum><text>address, in the relevant decision of the Board, an issue that—</text> <clause id="H1F1A8C957B77434DBD38460DEE282245"><enum>(i)</enum><text>the claimant or the representative of the claimant raised; or</text></clause>
<clause id="H4FE74DA250EA4CD28E38E81DEEFD5635"><enum>(ii)</enum><text>was reasonably raised by the evidentiary record of the claim; or</text></clause></subparagraph> <subparagraph id="HA952927B8138496388C0CF0622DF64C1" indent="up1"><enum>(B)</enum><text>provide adequate reasons or bases for the decision of the Board with respect to such question.</text></subparagraph></paragraph>
<paragraph id="HE065039ACC3045E8BA97426F5B4C7CB3" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">The Court shall issue Rules that provide for each of the following:</text> <subparagraph id="H1B68CE8C7FD54F14ACBC30580F93ED53"><enum>(A)</enum><text>When and how a party to an appeal (either the appellant or the Secretary) may request that the Court issue a limited remand.</text></subparagraph>
<subparagraph id="H0B72373D715F4BF38AE6A3307B56A943"><enum>(B)</enum><text>The period of time within which the Board is required to issue a decision on the relevant question identified in a limited remand.</text></subparagraph> <subparagraph id="HF6B4384466244247BE4F46056925A914"><enum>(C)</enum><text>Guidelines for when the Court may grant a request for a limited remand.</text></subparagraph>
<subparagraph id="H8A0BD0C2202B4771B54C42BD0D7F8FC8"><enum>(D)</enum><text>Guidelines for when the Court may decide sua sponte to issue a limited remand without a request from any party.</text></subparagraph> <subparagraph id="H90B8E251097C402B811F95D11A85AEB4"><enum>(E)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="H0C764D08006B467EB37F6B6EDB0D3EF5" indent="up1"><enum>(3)</enum><text>With respect to any matter remanded to the Board pursuant to paragraph (1), the Court shall—</text> <subparagraph id="HBD988B9286DE42FC9ECEF120878D4394"><enum>(A)</enum><text>retain jurisdiction over such matter; and</text></subparagraph>
<subparagraph id="HB6194875B123496C81B7F91F1611ACF5"><enum>(B)</enum><text>stay the proceedings of the Court on such matter until the date on which the Board issues the decision required by such remand.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="HA6761E2370EF4EDE9D78A48242138F72"><enum>(6)</enum><header>Study and report on common questions of law or fact before Board of Veterans’ Appeals</header> <subparagraph id="HB0F6CE47C876453EA42D8FE69BB38752"><enum>(A)</enum><header>Study</header><text>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.</text></subparagraph>
<subparagraph id="H292CBD0C0C6942ED9355FBCACABC61EC"><enum>(B)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the 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).</text></subparagraph></paragraph> <paragraph id="HD6B0232964ED49FA9307648472FD2B6D"><enum>(7)</enum><header>Independent assessment of potential modifications to authority of Board of Veterans’ Appeals</header> <subparagraph id="HA5BD9A78205D48FD942574F7FC4BCC61"><enum>(A)</enum><header>Agreement</header><text display-inline="yes-display-inline">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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/71">chapter 71</external-xref> 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.</text></subparagraph>
<subparagraph id="H0371EF2AC85B443BA7589B26B85C1F9A"><enum>(B)</enum><header>Report; briefings</header><text display-inline="yes-display-inline">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—</text> <clause id="H1D2B60AA9260459789B8C741403CC33C"><enum>(i)</enum><text>submit to the Committees on Veterans’ Affairs of the House of Representatives and the Senate a report that includes—</text>
<subclause id="H8C822A43E7E8485B9CD70C5B5AD00642"><enum>(I)</enum><text>an explanation of the reasons the Secretary failed to satisfy such requirement; and</text></subclause> <subclause id="H75076532A4294A77A86997FB19A2B72C"><enum>(II)</enum><text>an estimate of the date on which the Secretary will finalize the agreement under subparagraph (A); and</text></subclause></clause>
<clause id="HC95433DDF1F84B4D8BFA8876AC79D7C3"><enum>(ii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="HEBC7106E79A14345B5A864BBCFAEB335"><enum>(C)</enum><header>Assessment</header><text display-inline="yes-display-inline">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:</text>
<clause id="HB38BB5297C6D4627B05D494EACB3B57D"><enum>(i)</enum><text display-inline="yes-display-inline">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.</text></clause> <clause id="H69EA80683DDE49CEB57AEB8167DF9E38"><enum>(ii)</enum><text display-inline="yes-display-inline">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).</text></clause>
<clause id="HAE3AE914361C46899D846D29F1916295" commented="no"><enum>(iii)</enum>
<subclause id="H0014F48F8D03417F88C8D01739500CF6" display-inline="yes-display-inline" commented="no"><enum>(I)</enum><text>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—</text> <item id="H8BAF2D0379744B0A9F8ADF27892E931B" commented="no" indent="up1"><enum>(aa)</enum><text display-inline="yes-display-inline">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;</text></item>
<item id="H7327F9FA8C14456AA7DF95FD1BE7F697" commented="no" indent="up1"><enum>(bb)</enum><text>whether aggregation described in clause (ii) is better carried out by one member, or a panel of members, of the Board;</text></item> <item id="H73AA40C68DB24B34AC25EE94B6C3D5E7" commented="no" indent="up1"><enum>(cc)</enum><text>whether such aggregation may be accomplished in accordance with section 7107 of title 38, United States Code; and</text></item>
<item id="HC41BA093533B422E858136700BED2634" commented="no" indent="up1"><enum>(dd)</enum><text display-inline="yes-display-inline">how an accredited representative, attorney, or authorized agent may be selected to represent a class before the Board.</text></item></subclause> <subclause id="HA2DF23B94749440C946FCAA950C6E8D5" commented="no" indent="up1"><enum>(II)</enum><text>The recommendations shall include, but not be limited to, the following:</text>
<item id="HB581026175824FD0925A53796075B2FA" commented="no"><enum>(aa)</enum><text>How the Board should provide notice to claimants of the Board’s intent to aggregate their claim.</text></item> <item id="H820D3D2BC5774FA19CD652A4C382D0C1" commented="no"><enum>(bb)</enum><text>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.</text></item>
<item id="H4E56332975BC47E496F80E4CBEE95E63" commented="no"><enum>(cc)</enum><text>The options the Board should provide to claimants to opt out of participation in aggregation of their claim.</text></item> <item id="H4B55B8068A6445CD9CC2A99CC83DC5E0" commented="no"><enum>(dd)</enum><text>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.</text></item>
<item id="HF02AD1689DB14324A3515F5720851704" commented="no"><enum>(ee)</enum><text>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.</text></item> <item id="HE56EC925FB8145209996A6B08028DC5D" commented="no"><enum>(ff)</enum><text>Recommendations regarding quality review procedures and oversight mechanisms to monitor the impact of aggregation on claim accuracy, consistency, timeliness, and claimant outcomes.</text></item></subclause></clause> </subparagraph>
<subparagraph id="HA8C8A32B0BDC44A6917295AA9E541BBD"><enum>(D)</enum><header>Report; implementation</header>
<clause id="H9BE9878616EC41EA88DD72EE7D78FF8C"><enum>(i)</enum><header>In general</header><text>Not later than 90 days after the Secretary receives the assessment under subparagraph (C), the Secretary shall—</text> <subclause id="HC8EB48AEFF914863AB33451CFC3A06DB"><enum>(I)</enum><text>submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a copy of such assessment; and</text></subclause>
<subclause id="H0DF605670A854F6E889CEA98948266E0"><enum>(II)</enum><text display-inline="yes-display-inline">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).</text></subclause></clause> <clause id="H8F33C64C36244A8FB73B5A6775BEB3E8"><enum>(ii)</enum><header>Deadline</header><text>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.</text></clause></subparagraph>
<subparagraph id="H583D1741B3184D44A08EB51DC4616460"><enum>(E)</enum><header>Definitions</header><text>In this paragraph:</text> <clause id="HFB05F4FAABDE4C04833DFEE9DE4F7878"><enum>(i)</enum><text display-inline="yes-display-inline">The term <quote>FFRDC</quote> means a federally funded research and development center.</text></clause>
<clause id="HEEE7290805B747CEA4E6B187E969D3FD"><enum>(ii)</enum><text display-inline="yes-display-inline">The term <quote>veterans service organization</quote> means an organization recognized by the Secretary for the representation of veterans under section 5902 of title 38, United States Code.</text></clause></subparagraph></paragraph></subsection> <subsection id="HB8E318B3B5CC4F1CB9CC9A7EC65A1B00"><enum>(c)</enum><header>Improvements to system for adjudication of claims for benefits under laws administered by Secretary of Veterans Affairs</header> <paragraph id="H2C35512795284C3BB853EAC71648DD18"><enum>(1)</enum><header>Program for quality assurance in decisions of Board of Veterans’ Appeals; performance reviews</header> <subparagraph id="H9198B21B8B554ED5B9BCE505D5B08079"><enum>(A)</enum><header>In general</header><text>Section 7101 of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block style="OLC" id="HF9998471F87840B0BE05C9F63555FB59" display-inline="no-display-inline">
<subsection id="H71FDD99D58614B25B20EAA4669030261"><enum>(f)</enum>
<paragraph id="HF00D2673D7FF455ABED84074125E8DDB" display-inline="yes-display-inline"><enum>(1)</enum><text>The Chairman shall carry out a program to ensure quality in the decisions of the Board. Under such program, the Chairman shall—</text> <subparagraph id="H51AD82A7E2ED4E9D98557DCD2D3655FD" indent="up1"><enum>(A)</enum><text>develop policies and procedures for—</text>
<clause id="H440A50E57D9A4562BE0FDA7E6721442E"><enum>(i)</enum><text>measuring quality in such decisions;</text></clause> <clause id="H8E61FC08805D42098DB36A0DDA1066B4"><enum>(ii)</enum><text>maintaining data and identifying trends with respect to—</text>
<subclause id="H4C8372F6FFCE4DB7ADC979D9DE90A257"><enum>(I)</enum><text>errors in such decisions;</text></subclause> <subclause id="HCB1367389DC047758D4C38661F3F8B3F" commented="no"><enum>(II)</enum><text>errors in decisions remanded or returned to the Board by the Court of Appeals for Veterans Claims; and</text></subclause>
<subclause id="HFBA2689259844B4DB9F8F31A9CDB1DA6" commented="no"><enum>(III)</enum><text>specific members of the Board that issued decisions that were subsequently vacated by the Court of Appeals for Veterans Claims; and</text></subclause></clause> <clause id="HC69F65FFBF15474CB9F2211A47CB81E1" commented="no"><enum>(iii)</enum><text>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;</text></clause></subparagraph>
<subparagraph id="H4DD671420C144C96B0F7927C054F2AC7" indent="up1"><enum>(B)</enum><text>with respect to a claim for such a benefit that is remanded to the Board by the Court of Appeals for Veterans Claims—</text> <clause id="HA5DF4742D59C4D6EB0FE605460652917"><enum>(i)</enum><text>inform any employee of the Board responsible for drafting the decision of the Board with respect to such claim that such decision was remanded;</text></clause>
<clause id="H1FC24B444C794A1092D54F14DCE178BC"><enum>(ii)</enum><text>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</text></clause> <clause id="H389B97E0727A46EF9A478399F0E3A342"><enum>(iii)</enum><text>provide incentives to such employees to review such relevant orders and joint motions for remand; and</text></clause></subparagraph>
<subparagraph id="H578BE4EC63794DB699E3C67D81E2F976" indent="up1"><enum>(C)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H6FB3383248BC4176BCBBF53B5D8AEAD6" indent="up1" commented="no"><enum>(2)</enum><text>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.</text></paragraph>
<paragraph id="HAA2F509EAA034C53B502CD3D44DFF0BB" indent="up1" commented="no"><enum>(3)</enum><text>The Chairman may use technology, including artificial intelligence, to maintain such data and identify such trends.</text></paragraph> <paragraph id="H4800347E825B4C23A2E8C4DB95374D2F" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="HECC026FBE8254F76AF36C2C59C7410F8"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="H7ADEDE24872C40CDA3EE1AB47E222E69"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="HF8BF4913B47D415893F1E435EACFB607"><enum>(B)</enum><header>Deadline</header><text>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.</text></subparagraph></paragraph> <paragraph id="HF410DCD05DC248A6B8ED21F5BDDD2BD3"><enum>(2)</enum><header>Training program for certain employees of Board of Veterans’ Appeals; performance reviews</header> <subparagraph id="HC6C457287C054F6D99E0CBFA38D7557F"><enum>(A)</enum><header>Training program</header> <clause id="HB5022B88120943C19ECD1777BCE0A1AC"><enum>(i)</enum><header>In general</header><text>Chapter 71 of such title (as amended by paragraph (1)) is further amended by inserting after section 7101A the following new section:</text>
<quoted-block style="USC" id="HED37A0F8562348DB80F9D105FEFD9178" display-inline="no-display-inline">
<section id="HEC91AEA1FDB3412A9D570802C9D1F36B"><enum>7101B.</enum><header>Training program for members of Board on timely and correct adjudication of appeals</header>
<subsection id="H8DEAD62A9A0248758047E0173F1D579E"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection id="HE5B94009BDA14E11B85055101E32F9D3"><enum>(b)</enum><header>Required considerations</header><text>In carrying out the program required by subsection (a), the Secretary shall consider the following:</text>
<paragraph id="HAF72DF8A35064FBB81E62BD79D133C07"><enum>(1)</enum><text>Feedback, if any, from members of the Board and covered employees with respect to such program.</text></paragraph> <paragraph id="H1CE0659F38A949DB91E2F849A002D939"><enum>(2)</enum><text>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.</text></paragraph>
<paragraph id="H381F1F6D7F214765B69EAFD11607B933"><enum>(3)</enum><text>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.</text></paragraph></subsection> <subsection id="H12360D1349574438B75788BB435FEABC" commented="no"><enum>(c)</enum><header>Assessments of effectiveness</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="HEF93B565AA6242ABB5FD64C6146B7A1A"><enum>(d)</enum><header>Report</header><text>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—</text> <paragraph id="HC18C66B810F24B5CB6E1B40434D22C30"><enum>(1)</enum><text>a statement of the topics of the training provided pursuant to this section, disaggregated by—</text>
<subparagraph id="HBE425737BD704245BDE5588A87F08650"><enum>(A)</enum><text>mandatory training; and</text></subparagraph> <subparagraph id="H8067F24E2F0E4C06B568326173862DA8"><enum>(B)</enum><text>non-mandatory training; and</text></subparagraph></paragraph>
<paragraph id="HC351E40B26F3475085511A601FDABB77"><enum>(2)</enum><text>the results of the assessment of the effectiveness of such program required under subsection (c).</text></paragraph></subsection> <subsection id="H0F0476D7740B4FCDB47CEB0BF735CE4B"><enum>(e)</enum><header>Covered employee defined</header><text>In this section, the term <quote>covered employee</quote> means an employee of the Board who is—</text>
<paragraph id="H211F14F54E894E6AB202EA4F5C45F7DA"><enum>(1)</enum><text>not a member of the Board; and</text></paragraph> <paragraph id="H60AA3F9F98014190BF85AA1794C45224"><enum>(2)</enum><text>responsible for drafting decisions of the Board.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></clause>
<clause id="HA24B9FEBCF56449BABD8A6407D97E30A"><enum>(ii)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 7101A the following new item:</text> <quoted-block style="USC" id="H82A713111EA842F79F3DC5993C6B797B" display-inline="no-display-inline"> <toc regeneration="no-regeneration"> <toc-entry level="item">7101B. Training program for Members of Board on timely and correct adjudication of appeals.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="H0003FFD0E8094BB29E22F1D0550AABD5" commented="no"><enum>(B)</enum><header>Performance reviews of members of the Board</header><text>Section 7101A of such title is amended—</text>
<clause id="H5654B69A6E5447029C7FD22DE47D0713" commented="no" display-inline="no-display-inline"><enum>(i)</enum><text>in subparagraph (B) of subsection (c)(1) by striking <quote>not less often than once every three years</quote> and inserting <quote>not less often than annually</quote>; and</text></clause> <clause id="H550DACAD980C4BEEB94550F228001924" commented="no"><enum>(ii)</enum><text>by adding at the end the following new subsection:</text>
<quoted-block style="USC" id="HB9BA25BB9E354DA3BE7D3BB8E82CBB45" display-inline="no-display-inline">
<subsection id="H882D29C7A0EE43699B0D0DDA8B846089" commented="no"><enum>(h)</enum>
<paragraph id="H78FBB29CBF0846A0A6DCE27C0AD55998" display-inline="yes-display-inline" commented="no"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="HB872C2D821164484B159C8449FC97146" indent="up1" commented="no"><enum>(2)</enum><text>In this subsection, the term <quote>covered employee</quote> has the meaning given such term in section 7101B of this title.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph></paragraph>
<paragraph id="H8185D599BDCC4F94B51DCF0F92A6064B" commented="no"><enum>(3)</enum><header>Decisions of Board to remand</header>
<subparagraph id="H94E099DF00DB44C8935294602F811BF5" commented="no"><enum>(A)</enum><header>Information relating to decisions to remand</header><text display-inline="yes-display-inline">Section 7104 of such title is amended in subsection (d)—</text> <clause id="H68F5C72E27C9486889843B4CBEEF09D3" commented="no"><enum>(i)</enum><text>by redesignating paragraphs (1) through (3) as paragraphs (2) through (4), respectively; and</text></clause>
<clause id="HB50AAA23FA4D4E2D9578C3199075F0B7" commented="no"><enum>(ii)</enum><text>by inserting before paragraph (2) (as so redesignated), the following new paragraph:</text> <quoted-block style="USC" display-inline="no-display-inline" id="H6085671009154E5B9FF984C63B12AF5E"> <paragraph id="HD4C98268BD274A03A7446D166DF947E5" commented="no"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="HFF7FC4E327484CB2AD4050F0CE1F8740" commented="no"><enum>(A)</enum><text>the Secretary’s duty to assist under section 5103A of this title; and</text></subparagraph> <subparagraph id="HB446A761488143ACB9E5A496B312A077" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">the Secretary’s duty to notify under section 5103 of this title;</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph>
<subparagraph id="HE8D877EA90F74643A7B483C73DA81F30" commented="no"><enum>(B)</enum><header>Notice of remanded decision for certain employees</header><text>Such section is further amended in—</text> <clause id="H37B7B1B3195D4404B8BB2F50023824F0"><enum>(i)</enum><text>subsection (e)—</text>
<subclause id="HB55B260AEECF431694D9F69BD9070E07"><enum>(I)</enum><text>by redesignating paragraphs (1) through (3) as subparagraphs (A) through (C), respectively;</text></subclause> <subclause id="H6CD2615689774651B33FB29B8F43759B"><enum>(II)</enum><text>by striking <quote>After</quote> and inserting <quote>(1) After</quote>; and</text></subclause>
<subclause id="H5E6732F1453C42EC9207277AD15B9C26"><enum>(III)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block style="USC" id="H7177ED0813564121966B675C5575406F" display-inline="no-display-inline"> <paragraph id="H5663A2AEF31A4E4EA63DCCEB38DA58D1" indent="subsection"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subclause></clause>
<clause id="HB42BF46A43094E37A57E03C9A560F897"><enum>(ii)</enum><text>in subsection (g), as redesignated by section 3(d)(2)(A), by striking <quote>under subsection (e)</quote> and inserting <quote>under paragraph (1) of subsection (e)</quote>.</text></clause></subparagraph></paragraph> <paragraph id="HF2453F7628C74736BF96940F70E7B920"><enum>(4)</enum><header>Annual reports for Board of Veterans’ Appeals</header> <subparagraph id="H55B266326FC24A4C946D0AA96FF19E3B"><enum>(A)</enum><header>In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/71">Chapter 71</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/7114">section 7114</external-xref> the following new section:</text>
<quoted-block style="USC" id="HA78F5AB221A140B086F79CE83498E7B9" display-inline="no-display-inline">
<section id="H2FBC4E73079E40969BDD6062BDF85D3C"><enum>7115.</enum><header>Annual report on Board of Veterans’ Appeals</header><text display-inline="no-display-inline">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—</text> <paragraph id="H0FE06BB1DC654F6FB15A87F064A25E8D"><enum>(1)</enum><text>claims with a rating decision dated on or after February 19, 2019; and</text></paragraph>
<paragraph id="H73164765EC884C7CA46FEAC9E0B57F95"><enum>(2)</enum><text>claims with a rating decision dated before such date.</text></paragraph></section><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="HB0928B4AC2824DD6B34A586D9503BFCF"><enum>(B)</enum><header>Deadlines</header><text>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.</text></subparagraph>
<subparagraph id="H895D7949B6844AD7B84EAB6E335446F8"><enum>(C)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 7114 the following new item:</text> <quoted-block style="USC" id="H081CC68E32924D56AB9CC874605D9120" display-inline="no-display-inline"> <toc regeneration="no-regeneration"> <toc-entry level="section">7115. Annual report on Board of Veterans’ Appeals</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H6E00256150194E1B89663F2DE6343321"><enum>(5)</enum><header>Plan for improvements to quality in decisions of Board</header> <subparagraph id="HC455DD2D3D314CC783DE10ECCF6C8D8C"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text>
<clause id="HF2F291FA10DD4F9EB5F3326DA647C117"><enum>(i)</enum><text>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</text></clause> <clause id="HF0B197E03DAC48BB908A6C18E0669836"><enum>(ii)</enum><text>mitigate the number of such decisions that are unnecessary under any applicable law or regulation.</text></clause></subparagraph>
<subparagraph id="HE0F682902571497598B4D2DAD8B72EC8" display-inline="no-display-inline"><enum>(B)</enum><header>Report</header><text>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.</text></subparagraph></paragraph></subsection> <subsection id="H68DEC4D55D604EBA9378EF313C6833E3"><enum>(d)</enum><header>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</header> <paragraph id="H333B453C0FA746BBA563446BC63298B8" commented="no"><enum>(1)</enum><header>Notice of avoidable deferrals</header><text>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.</text></paragraph>
<paragraph id="HA89C0F4D69204233B8DB76CD26EBE278"><enum>(2)</enum><header>Study and report on certain OGC opinions</header>
<subparagraph id="HCB4DE6A6E9984F3FAA9DE465CACCC48D" commented="no"><enum>(A)</enum><header>Study</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the 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—</text> <clause id="HDCD090368B4348BC87D74694C34667B0"><enum>(i)</enum><text>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</text></clause>
<clause id="H66721392ECDF4C40AD5280FA71D1E1C7"><enum>(ii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="HC088954CD8F04F2FB1B0BD07888E5086"><enum>(B)</enum><header>Report</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a report that includes—</text>
<clause id="H388C80A9F2BA49FE91A3AF06CFAC729B"><enum>(i)</enum><text>the findings of the study required by subparagraph (A);</text></clause> <clause id="H7B7877C3EE1D4A4E8BF8E9889CA1D7C3"><enum>(ii)</enum><text>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</text></clause>
<clause id="H5D28E7E86C8F4B07BA0AB982D5D9A02C"><enum>(iii)</enum><text>a timeline for the publication of any such opinion.</text></clause></subparagraph></paragraph></subsection> </section> <section id="H4027B614E4074FC6B4F6DE93A6729792"> <enum>106.</enum> <header>Annual report on causes of death among veterans</header> <subsection id="HD4801DCA08A740198B72A43641FE0712"> <enum>(a)</enum> <header>In general</header> <text display-inline="yes-display-inline">Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/5">chapter 5</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text>
<quoted-block style="USC" id="HA18A993F3B0F4B3685460DB623630A56" display-inline="no-display-inline">
<section id="H6B63754A8FB44345B436C7632BDBF924"> <enum>534.</enum> <header>Annual report on causes of death among veterans</header>
<subsection id="H900C5EBCBE8A46D494000599F75E6A46"> <enum>(a)</enum> <header>In general</header> <text display-inline="yes-display-inline">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.</text> </subsection> <subsection id="HBEB3B7D6BA694195ADD2A59ACB59EF96"> <enum>(b)</enum> <header>Elements</header> <text>Such report shall include—</text>
<paragraph id="H7909350C223F417E926D8E6C5D0A2EA9"> <enum>(1)</enum> <text>for each veteran that died during the period covered by the report an identification of—</text> <subparagraph id="H0C001C1785454B4B8CFE397D954169A1"> <enum>(A)</enum> <text>whether such veteran had a service-connected disability rated as total;</text> </subparagraph>
<subparagraph id="H9D9D5983B9A34E5AAA28B3CE32366369"> <enum>(B)</enum> <text>the primary cause of death;</text> </subparagraph> <subparagraph id="H5C723D22C5B04831855B886FC1EA97CE"> <enum>(C)</enum> <text>the secondary cause of death, if applicable; and</text> </subparagraph>
<subparagraph id="HF89C2B0F834E4FDCAE9D16701F7EF4AA"> <enum>(D)</enum> <text>the manner of death;</text> </subparagraph> </paragraph> <paragraph id="H3840052395B6447C95F450CE733AF8A4"> <enum>(2)</enum> <text>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</text> </paragraph>
<paragraph id="H7DB03F6400B14B8480268B0021CDF066"> <enum>(3)</enum> <text>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.</text> </paragraph> </subsection> <subsection id="H7C5800CA502C40EE8574D5C78BC1FC52"> <enum>(c)</enum> <header>Sunset</header> <text display-inline="yes-display-inline">This section shall terminate on the date that is five years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>.</text> </subsection> </section> <after-quoted-block>.</after-quoted-block> </quoted-block> </subsection>
<subsection id="HF8064843D97F4EE9B5AAC25E877B6A1B"> <enum>(b)</enum> <header>Clerical amendment</header> <text>The table of sections at the beginning of chapter 5 of such title is amended by inserting after the item relating to section 533 the following new item:</text> <quoted-block style="USC" id="H74DE123FBC6A4D97B0EE61B4DBCDDA29" display-inline="no-display-inline"> <toc regeneration="no-regeneration"> <toc-entry level="item">534. Annual report on causes of death among veterans</toc-entry> </toc> <after-quoted-block>.</after-quoted-block> </quoted-block> </subsection> </section> <section id="HF9D399DF34DE4052A64AE6DB0129A5F8"> <enum>107.</enum> <header>Plan for use of automation tools to process claims under laws administered by the Secretary of Veterans Affairs</header> <subsection id="H2190F0364D584C64B44B900D8E15F263"> <enum>(a)</enum> <header>In general</header> <text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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. </text> </subsection>
<subsection id="H20C4C7E54DBD45BAA8F3FEC11C35DBCC"> <enum>(b)</enum> <header>Automation tool described</header> <text display-inline="yes-display-inline">An automation tool described in this subsection is a technology developed for the Compensation Service of the Veterans Benefits Administration that—</text> <paragraph id="H7C04B003561B4074BA00FA6F8CFD3205"> <enum>(1)</enum> <text>automates the retrieval of the service record or health records of a veteran;</text> </paragraph>
<paragraph id="HB8107B66C9BE40E1B9CC142426DE2457"> <enum>(2)</enum> <text>compiles evidence relevant to the determination of a claim for benefits under laws administered by the Secretary;</text> </paragraph> <paragraph id="HB47E18D1D6554E4BADD18535B2358A77"> <enum>(3)</enum> <text>provides automated decision support relevant to such a determination;</text> </paragraph>
<paragraph id="H19E24AE5BE754BC780CF7398A91F4D7B"> <enum>(4)</enum> <text>automates information sharing between Federal agencies; and</text> </paragraph> <paragraph id="H3E939330CADF4473B1FA157B7E7DAE63"> <enum>(5)</enum> <text>assists in generating correspondence regarding such a claim.</text> </paragraph> </subsection>
<subsection id="HC034661C9A9D410A94F95390621D5C04"> <enum>(c)</enum> <header>Analysis</header> <text display-inline="yes-display-inline">In developing the plan required under subsection (a), the Secretary shall conduct an analysis of each of the following:</text> <paragraph id="H990671ADA91649C88B9A673957D3024A"> <enum>(1)</enum> <text display-inline="yes-display-inline">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.</text> </paragraph>
<paragraph id="H576F7F4CBF37428AA58947E629CB2A08"> <enum>(2)</enum> <text display-inline="yes-display-inline">Any modification to an existing automation tool that could render such tool usable for such purpose by such an element.</text> </paragraph> <paragraph id="H8A48BA12602544269E928AB955FFF501"> <enum>(3)</enum> <text>Any requirement of any such element pertaining to such purpose that cannot be addressed by using an automation tool.</text> </paragraph>
<paragraph id="H75973EC490D24147A28AF3AB007CF96D"> <enum>(4)</enum> <text>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.</text> </paragraph> <paragraph id="HEFC20097E9D6417BB0B0C94AD2A31367"> <enum>(5)</enum> <text display-inline="yes-display-inline">A timeline for modifying and implementing any automation tool for use by such elements for such purpose.</text> </paragraph> </subsection>
<subsection id="H579986B9C5414347AA247D972A36D89D"> <enum>(d)</enum> <header>Priority</header> <text display-inline="yes-display-inline">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:</text> <paragraph id="H7736E2F8E8D3499990456E7D09866D57"><enum>(1)</enum><text display-inline="yes-display-inline">The Compensation Service.</text> </paragraph>
<paragraph id="HC5EB2B5A75874525874859C7C5BA5C27"> <enum>(2)</enum> <text>The Pension and Fiduciary Service of the Veterans Benefits Administration.</text> </paragraph> <paragraph id="HC2BF47C3609B41699064DED32B93EE5B"> <enum>(3)</enum> <text>The Education Service of the Veterans Benefits Administration.</text> </paragraph>
<paragraph id="HB5DA1E613FA1496C9CA16679C61268D0"> <enum>(4)</enum> <text>Program offices of the Veterans Benefits Administration, as determined by the Secretary.</text> </paragraph> <paragraph id="H84391640E7754694AA1F1E5573120C53"> <enum>(5)</enum> <text>The Debt Management Center.</text> </paragraph>
<paragraph id="HE0F58AAD9BDA4108AF73CC0305B59330"> <enum>(6)</enum> <text>The Board of Veterans’ Appeals.</text> </paragraph> </subsection> <subsection id="HFF02C99C0F074E69B8F07EF91AD55DF2"> <enum>(e)</enum> <header>Other requirements relating to technology at Department of Veterans Affairs</header> <paragraph id="H30354DAD569F4442A48B925C9760B704"> <enum>(1)</enum> <header>Automatic notices regarding benefits for certain children of veterans</header> <subparagraph id="H28A751AF81A9405DAA38A26174A65BA4"> <enum>(A)</enum> <header>In general</header> <text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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.</text> </subparagraph>
<subparagraph id="H0C7E366885F2405B8A22EF42656B443B"> <enum>(B)</enum> <header>Definitions</header> <text>In this subsection:</text> <clause id="HB26C30D61D7242C3A0C37904800A00BB"> <enum>(i)</enum> <text>The term <quote>covered situation</quote> means—</text>
<subclause id="H47E14CDE85314E0FAAF9EE38F2A6FD9F"> <enum>(I)</enum> <text>any increase in the amount of dependency compensation paid to a beneficiary for a child under the laws administered by the Secretary; and</text> </subclause> <subclause id="HE13C03F08299485181A1060F5DAE3E62"> <enum>(II)</enum> <text>any educational assistance paid to the child of a veteran under the laws administered by the Secretary.</text> </subclause> </clause>
<clause id="H07BBB289D36647B4A750C4EFFA1B9118"> <enum>(ii)</enum> <text>The term <quote>child</quote> has the meaning given such term in section 101(4)(A)(iii) of title 38, United States Code.</text> </clause> </subparagraph> </paragraph> <paragraph id="HEDF1E555460A478AB62B8C57E621C8BD"> <enum>(2)</enum> <header>Correct labeling of documents</header> <text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary shall submit to the Committees on Veterans’ Affairs of the 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.</text> </paragraph> </subsection></section>
<section id="H34B4B2C4D63B41C0A30C5B92490C7B84"><enum>108.</enum><header>Reforms relating to Department of Veterans Affairs disability ratings</header>
<subsection commented="no" display-inline="no-display-inline" id="H76EADD97B5F24B3E88900404FB2B882D"><enum>(a)</enum><header display-inline="yes-display-inline">Ratings for sleep apnea</header>
<paragraph commented="no" display-inline="no-display-inline" id="H8701C75F3A6544319F63D09BBBF3721F"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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:</text> <subparagraph id="HF1EB9F264CE346E98D59DBEFCF95A85A"><enum>(A)</enum><text>A grade of disability of 0 percent shall be assigned for sleep apnea syndrome when the syndrome is asymptomatic, with or without treatment.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HCE7C3ACD219A43DBB3C14C4CCEE278FE"><enum>(B)</enum><text display-inline="yes-display-inline">A grade of disability of 10 percent shall be assigned for sleep apnea syndrome when treatment yields incomplete relief.</text></subparagraph> <subparagraph id="H99FF331FE0E749FCA6FD4A4D49B345B0"><enum>(C)</enum><text>A grade of disability of 50 percent shall be assigned for sleep apnea syndrome only if—</text>
<clause commented="no" display-inline="no-display-inline" id="HB13EFD4E51B24E62B7391380D78F584E"><enum>(i)</enum><text display-inline="yes-display-inline">treatment is either ineffective or the veteran is unable to use the prescribed treatment due to comorbid conditions; and</text></clause> <clause commented="no" display-inline="no-display-inline" id="H5C6F22D21ECE46ECAFE9E398BA65E337"><enum>(ii)</enum><text display-inline="yes-display-inline">there is no end-organ damage.</text></clause></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H27C21E312B1441E4BA5A9E1965CE0E40"><enum>(D)</enum><text display-inline="yes-display-inline">A grade of disability of 100 percent shall be assigned for sleep apnea syndrome only if there is also end-organ damage.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HC2DA2B1EF4B44F89BA8EC2430F746D29"><enum>(2)</enum><header>Qualifying comorbid conditions</header><text display-inline="yes-display-inline">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.</text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H24001006D9494790BC8C5CD95E846B25"><enum>(b)</enum><header>Ratings for tinnitus</header><text>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:</text> <paragraph id="H88CCDCC72BCC4601AF1C094A128D0650"><enum>(1)</enum><text>Except as provided in paragraph (2), tinnitus may not be assigned a separate compensable disability rating.</text></paragraph>
<paragraph id="H0A1C0860F66145E3957D9700B1045DE2"><enum>(2)</enum><text>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.</text></paragraph></subsection> <subsection commented="no" display-inline="no-display-inline" id="H0E8C5564653A48729332B3767688F1CA"><enum>(c)</enum><header>Applicability</header> <paragraph commented="no" display-inline="no-display-inline" id="HE942DF62EF414F82842C99F5A27D913D"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="HEF21E38D560C42ECB8AD765406790575"><enum>(2)</enum><header>Protection of existing ratings</header><text>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.</text></paragraph></subsection></section> <section id="H5538A5ED3E034C7486421D259F833AA2" section-type="subsequent-section" display-inline="no-display-inline"><enum>109.</enum><header>Improvements to temporary licensure requirements for contract health care professionals who perform medical disability examinations for the Department of Veterans Affairs</header> <subsection id="H85019DE36D90408AB347007B53421F46"><enum>(a)</enum><header>Expansion</header><text display-inline="yes-display-inline">Section 504 of the Veterans’ Benefits Improvements Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note), as amended by 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 (<external-xref legal-doc="public-law" parsable-cite="pl/116/315">Public Law 116–315</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> 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:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HCF17951BD75B491F9EF07E57E1FB1465">
<paragraph id="H02F08B20A0F048E49DD5DEFB8F2E788B"><enum>(2)</enum><header>Health care professional described</header><text>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—</text> <subparagraph id="HD00DABE7F86D4EE4BB5414F60A84C8FE"><enum>(A)</enum><text display-inline="yes-display-inline">has a current and unrestricted license to practice the health care profession for which they are licensed;</text></subparagraph>
<subparagraph id="HD27D75BDC03F486F936C6D76A2DAE2A9"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="HF7AB81ECDC464488946B1D0C3D486A41"><enum>(C)</enum><text>is performing authorized duties for the Department pursuant to a contract entered into under subsection (a).</text></subparagraph></paragraph>
<paragraph id="H9BAE0F9BA2BC420189EB495127FBC15B" commented="no"><enum>(3)</enum><header>Source of funds</header><text>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.</text></paragraph> <paragraph id="HB3EDFEA1085D4DD79184296B3CE0B5EF" commented="no"><enum>(4)</enum><header>Mechanism for transmittal of evidence introduced by applicants during examinations</header><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H3132379EE79B4E37BA274BA627B1B13F" display-inline="no-display-inline"><enum>(b)</enum><header>Delayed sunset of amendment</header><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/116/315">Public Law 116–315</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note) is amended by striking <quote>On the date that is five years after the date of the enactment of this Act</quote> and inserting <quote>On September 30, 2033</quote>.</text></subsection> <subsection id="H1730E48E535E4D57AE076B9C90755FAB" commented="no"><enum>(c)</enum><header>Conforming amendment</header><text display-inline="yes-display-inline">Paragraph (2) of such subsection is amended by striking <quote>physicians assistants, nurse practitioners, audiologists, and psychologists</quote> and inserting <quote>health care professionals</quote>.</text></subsection>
<subsection id="H61F96BA96CF84606B320072AF482D593"><enum>(d)</enum><header>Report</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="public-law" parsable-cite="pl/104/275">Public Law 104–275</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> note), as 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 (<external-xref legal-doc="public-law" parsable-cite="pl/116/315">Public Law 116–315</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/5101">38 U.S.C. 5101</external-xref> 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:</text> <paragraph id="H58854EE944C9465DB709D04433B2BA03"><enum>(1)</enum><text display-inline="yes-display-inline">The number of examinations conducted pursuant to a contract under such authority.</text></paragraph>
<paragraph id="HB17581BE3508448C9412DB555F70906A"><enum>(2)</enum><text display-inline="yes-display-inline">The cost, timeliness, and legal adequacy of such examinations, disaggregated by—</text> <subparagraph id="HBC4747D9D6534DB9BF8512D64D2CD848"><enum>(A)</enum><text>health care professional; and</text></subparagraph>
<subparagraph id="H6203C12A713E44A795DD5A7E19DE2360"><enum>(B)</enum><text>contract.</text></subparagraph></paragraph> <paragraph id="HE95D848969B94405B5E32926830C7214"><enum>(3)</enum><text display-inline="yes-display-inline">The number of such examinations conducted in each State, the District of Columbia, or a Commonwealth, territory, or possession of the United States.</text></paragraph>
<paragraph id="H2DBE7EBDA79A42069824D1ED75F89CC9"><enum>(4)</enum><text>The numbers of each kind of health care professionals who conducted such examinations.</text></paragraph> <paragraph id="H4979AAF7FC6F41B7ACAF9652C8B14462"><enum>(5)</enum><text display-inline="yes-display-inline">The number of examinations that were erroneously conducted by a health care professional—</text>
<subparagraph id="HAD31808E379A44879558BC7E3D146C73"><enum>(A)</enum><text>without such a contract; or</text></subparagraph> <subparagraph id="H1D2CFCF3B4D24B92B35E5C4E987E8A60"><enum>(B)</enum><text>unauthorized to enter into such a contract.</text></subparagraph></paragraph>
<paragraph id="H228D2ABF5F6042F5B11C5872682B0561"><enum>(6)</enum><text>The plan of the Secretary to correct errors in the use of such authority.</text></paragraph></subsection></section> <section id="H980B9BFCAAA54A07B834DD5E21179F60"><enum>110.</enum><header>Disability examinations: study on access in rural areas; review of training; review of inadequate or unnecessary examinations</header> <subsection id="HD7A646FF9C7648E18AB83CFAC6BA0A68"><enum>(a)</enum><header>Study on improvements to Department of Veterans Affairs covered medical disability examinations in rural areas</header> <paragraph id="H7970BC1391414A19B7764F8AC2A57AD8"><enum>(1)</enum><header>Study required</header><text>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.</text></paragraph>
<paragraph id="HD84D525CA3374347813968A24378C7B0"><enum>(2)</enum><header>Elements</header>
<subparagraph id="H5748F27B1CE84685922B30568C6CA2BB"><enum>(A)</enum><header>In general</header><text>The study conducted under paragraph (1) shall include the following:</text> <clause id="H25BAAFDD32CE46919994BBD8D8E0327C"><enum>(i)</enum><text>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.</text></clause>
<clause id="H2994676BA9BC428FBB4959D080E3E303"><enum>(ii)</enum><text>A root cause analysis of differences identified pursuant to clause (i).</text></clause> <clause id="HDEE3C3F2000E40E5AAEC29CBDF1CDBB6"><enum>(iii)</enum><text>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.</text></clause></subparagraph>
<subparagraph id="HBD1F3A5072E748F68B014AB7C3D03D5E"><enum>(B)</enum><header>Number of days to complete defined</header><text>For purposes of subparagraph (A)(i), the term <quote>number of days to complete</quote> means the number of days in the period—</text> <clause id="H44E8C3901BC64C3EBDD476537A25C7DE"><enum>(i)</enum><text>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</text></clause>
<clause id="H999AC14F62304C03BE1A929B55C60BAD"><enum>(ii)</enum><text>ending on the date on which the examination was completed.</text></clause></subparagraph></paragraph> <paragraph id="HC3606490B73044A889DDB6CC3D4E521F"><enum>(3)</enum><header>Report on study</header><text>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).</text></paragraph>
<paragraph id="HC0BCAE96CDFA42919B4514CA320A6AB9"><enum>(4)</enum><header>Definitions</header><text>In this subsection:</text> <subparagraph id="H8A91DE82417147649DE37E068D060AD1"><enum>(A)</enum><text>The term <quote>covered medical disability examination</quote> 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.</text></subparagraph>
<subparagraph id="HC9B50D1D76974F8BA0183A2BFCD5E529"><enum>(B)</enum><text>The terms <quote>rural</quote> and <quote>highly rural</quote> have the meanings given those terms under the rural-urban commuting areas coding system of the Department of Agriculture.</text></subparagraph></paragraph></subsection> <subsection id="HB597E710CD36492288604834C6C61669"><enum>(b)</enum><header>Review of training for veterans service representatives and rating veterans service representatives</header> <paragraph id="HE16D75DFF4C14F5AA7680D9A05FFCB67"><enum>(1)</enum><header>Review required</header><text>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.</text></paragraph>
<paragraph id="HABFE27F715624A57A31CF1B12C90DE89"><enum>(2)</enum><header>Scope of review</header><text>The review shall include, at minimum, an evaluation of training and policies relating to—</text> <subparagraph id="HF6D13DE2C6F5423D8500F2880BF671C4"><enum>(A)</enum><text>assessing the adequacy of covered medical disability examinations for claims adjudication;</text></subparagraph>
<subparagraph id="HD5477EF94DE54BE68151ADDD6E86B7A4"><enum>(B)</enum><text>determining the necessity of medical disability examinations where claims can be adjudicated based on existing evidence without ordering additional examinations;</text></subparagraph> <subparagraph id="HD48C4672C3AE499C89E4E36957D28275"><enum>(C)</enum><text>relevant statutes, judicial decisions, regulations, and Department policies, including—</text>
<clause id="H6B660996A152492C851EECF1544B3C2C"><enum>(i)</enum><text>the duty to assist claimants;</text></clause> <clause id="HC3858EA1C0D34C8CBC9973C5C7D28B37"><enum>(ii)</enum><text>evidentiary standards regarding causation;</text></clause>
<clause id="H9A6A512A324B4BB4838CE1ADF423FAF6"><enum>(iii)</enum><text>required elements and standards for covered medical disability examinations, including the need for reasoned medical opinions; and</text></clause> <clause id="H9F7A4C37D30A4BDCAACBC57278285994"><enum>(iv)</enum><text>the absence of statutory or regulatory presumptions of service connection in covered medical disability examinations; and</text></clause></subparagraph>
<subparagraph id="H4C348EA3FE854C51B51E40833DDB7C3B"><enum>(D)</enum><text>input from impacted Department employees, including duly appointed labor representatives.</text></subparagraph></paragraph> <paragraph id="H386762EA31EF42C6A7025FC91701C7AB"><enum>(3)</enum><header>Second-level review for new employees</header><text>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.</text></paragraph>
<paragraph id="H046E66F7626E487597C307A2E233673E"><enum>(4)</enum><header>Report to Congress</header><text>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.</text></paragraph> <paragraph id="H16CAC9CFCBF64F09BE09B34AEE0972FF"><enum>(5)</enum><header>Comptroller General of the United States review of findings</header><text>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.</text></paragraph>
<paragraph id="HBF0B36053AF44ABBBF82D3D7FCAEC7B7"><enum>(6)</enum><header>Modification of reports by the Board of Veterans’ Appeals and United States Court of Appeals for Veterans Claims</header>
<subparagraph id="HFB864A55929548B48EAFFDAA2734974B"><enum>(A)</enum><header>Board of Veterans’ Appeals</header><text>Section 7101(d)(2) of title 38, United States Code, is amended—</text> <clause id="H1DD876F547944F3CA89EFF033F347886"><enum>(i)</enum><text>in subparagraph (F), by striking <quote>; and</quote> and inserting a semicolon;</text></clause>
<clause id="HF1962BFDE1C449BD9EAB74105CBA1D37"><enum>(ii)</enum><text>in subparagraph (G), by striking the period at the end and inserting <quote>; and</quote>; and</text></clause> <clause id="H284902202D41497699B84C943D60A283"><enum>(iii)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block id="H01313B2A8959473EAD6F6F37C4EB86DB" style="OLC">
<subparagraph id="HF2A304D704C74C18836A3CD63AEC1C81"><enum>(H)</enum><text>a summary of recurring issues that result in the Board remanding appeals back to the agency of original jurisdiction.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph> <subparagraph id="HFFDAF5BB100A477CBF64B75A28241017"><enum>(B)</enum><header>United States Court of Appeals for Veterans Claims</header><text>Section 7288(b) of title 38, United States Code, is amended by adding at the end the following new paragraph:</text>
<quoted-block id="H1770C216F0E04D96AF3A1F54ACF5632A" style="OLC">
<paragraph id="H97B7D00F5C18413FB2872BD944E3862D"><enum>(16)</enum><text>A summary of recurring issues that result in remands.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="HDE5DF88B8C564DF880B298A93A0DDD94"><enum>(7)</enum><header>Definition of covered medical disability examination</header><text>In this subsection, the term <quote>covered medical disability examination</quote> 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.</text></paragraph></subsection>
<subsection id="HBBC8DCA4EEF04256BBEBB090B122FF0E"><enum>(c)</enum><header>Review and priority processing of claims with inadequate or unnecessary examinations</header>
<paragraph id="H1D8B182D04494A0EA5DB2AB5D58C4F09"><enum>(1)</enum><header>Review</header><text>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.</text></paragraph> <paragraph id="H3464E2B05E03492C958BDED072738EDA"><enum>(2)</enum><header>Further sample requirements</header><text>Under each review required by paragraph (1), the Secretary shall ensure the review includes—</text>
<subparagraph id="HD5B45D587A8041179F7751D2A17724D2"><enum>(A)</enum><text>a statistically significant sample of covered medical disability examinations completed by employees of the Department of Veterans Affairs; and</text></subparagraph> <subparagraph id="HA7B09427E51E49C2939E4C7A9B2C7DEA"><enum>(B)</enum><text>a statistically significant sample of covered medical disability examinations completed by each contractor that provides such examinations for the Department.</text></subparagraph></paragraph>
<paragraph id="H8326F8F6AF2540A493B04646F245E9DC"><enum>(3)</enum><header>Analysis</header><text>Under each review required by paragraph (1), the Secretary shall—</text> <subparagraph id="H0328B5FD10024DEE8884D8F3BFD745B1"><enum>(A)</enum><text>analyze the samples specified in paragraph (2); and</text></subparagraph>
<subparagraph id="H6077B6135C064650BF4C7F308AD611C6"><enum>(B)</enum><text>pursuant to such analysis, identify—</text> <clause id="H72FDB0A533E4457CB3CB8056F1408622"><enum>(i)</enum><text>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</text></clause>
<clause id="H2489F86DAF8D494E97C7F7E77D4907EE"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph> <paragraph id="H6127A64E590043CCAD2C2D1880F24C67"><enum>(4)</enum><header>Priority processing</header> <subparagraph id="H44AD8927DFBE4F18B481EE545AD0F287"><enum>(A)</enum><header>In general</header><text>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—</text>
<clause id="H98D05C2730D54E4EACEFCE5D98530CE8"><enum>(i)</enum><text>receives another examination, if necessary, on a priority basis; and</text></clause> <clause id="H84A8A499F64041F49ACA581E175B2881"><enum>(ii)</enum><text>receives priority processing for the entirety of impacted claim.</text></clause></subparagraph>
<subparagraph id="HD34DF34417554DB3B5883DE2FD0EFD8A"><enum>(B)</enum><header>Exception</header><text>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.</text></subparagraph></paragraph> <paragraph id="H392AFEE8BAA6460C9913735AFF31342B"><enum>(5)</enum><header>Comptroller General of the United States study</header><text>The Comptroller General of the United States shall conduct a review of the methodology and effectiveness of the Departments review required in paragraph (1).</text></paragraph>
<paragraph id="HF56CE270B0C84228B6E2405DD162792A"><enum>(6)</enum><header>Covered medical disability examination defined</header><text>In this subsection, the term <quote>covered medical disability examination</quote> 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.</text></paragraph></subsection> <subsection id="H83407318792B46CA91A2C050E655503A"><enum>(d)</enum><header>Review and plan regarding department of veterans affairs scheduling of medical examinations</header> <paragraph id="H1C66B1D7002B4F14AF5D71F11F1F292E"><enum>(1)</enum><header>Review required</header><text>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.</text></paragraph>
<paragraph id="HD485B9B660E74299AA677679B7FCB702"><enum>(2)</enum><header>Plan required</header><text>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:</text> <subparagraph id="H119D0209DD9440FA80D84A5E58B19806"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="H610A8E70A0094CB2995E465BBCDB722B"><enum>(B)</enum><text>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.</text></subparagraph> <subparagraph id="H6619DDB04E8347ECB5A6276C188130B7"><enum>(C)</enum><text>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.</text></subparagraph>
<subparagraph id="HC7978EEF9C0941C393677602C54CA841"><enum>(D)</enum><text>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.</text></subparagraph> <subparagraph id="HE605398AEEBB478AA018F861B8C2C8EC"><enum>(E)</enum><text>The Department conducts customer satisfaction and experience surveys of claimants or appellants who attend medical disability examinations provided under laws administered by the Secretary.</text></subparagraph></paragraph></subsection></section>
<section id="H7DFB2F6403B54C8E9A2E022AC065E625"><enum>111.</enum><header>Improvements to processing and outreach regarding claims involving military sexual trauma</header>
<subsection id="H84BD39DFF64B447EA7AB403F06ED0F0A"><enum>(a)</enum><header>Evaluation of claims involving military sexual trauma</header>
<paragraph id="H13F2AB26739E42F7A559C2C874013EE4"><enum>(1)</enum><header>In general</header><text>Subchapter VI of chapter 11 of such title is amended by inserting after section 1166 the following new section:</text> <quoted-block id="HEA178C8BA8E0417B85CCAF5A45657B74" style="USC"> <section id="HF2A882F984CE4C7AB195471D9E238389"><enum>1166A.</enum><header>Evaluation of claims involving military sexual trauma</header> <subsection id="H3D4EDC790D82414EAB78B18829FC4C6F"><enum>(a)</enum><header>Notice and opportunity to supply evidence</header><text>The Secretary may not deny a claim of a veteran for compensation under this chapter for military sexual trauma without first—</text>
<paragraph id="HC13C40D4502845598D91BE5269A2EA62"><enum>(1)</enum><text display-inline="yes-display-inline">advising the veteran of the evidence that would constitute credible corroborating evidence of the military sexual trauma; and</text></paragraph> <paragraph id="HB28E88A45F724989952BFE602B78AD43"><enum>(2)</enum><text>allowing the veteran an opportunity to furnish such corroborating evidence.</text></paragraph></subsection>
<subsection id="H05A2600C43F54C3096874EFBF2B5AA91"><enum>(b)</enum><header>Point of contact</header><text>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.</text></subsection> <subsection id="HF9899102D391494987D60065D5531F95"><enum>(c)</enum><header>Specialized teams</header><text>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.</text>
<paragraph id="H99CF9DC6DBBE433AAD2F26CB350570C8"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="H23E2BB47F56545E5BFB1514C518FA0C1"><enum>(2)</enum><text>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.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="HDD1944341EDB4D35BE701235C6D3E5A6"><enum>(2)</enum><header>Outreach</header>
<subparagraph id="H5A392CD7ADE4490794A4D19688E21613"><enum>(A)</enum><header>In general</header><text>Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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.</text></subparagraph> <subparagraph id="HBD55DCBC54C74121B1BDC6E116146BF2"><enum>(B)</enum><header>Targeted outreach</header><text>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.</text></subparagraph></paragraph>
<paragraph id="H5954C4BC23EF430B8389AFCFB112BE8C"><enum>(3)</enum><header>Clerical amendment</header><text>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: </text> <quoted-block style="USC" id="H2A988D0A63FB4685BFB9A082D82B6524" display-inline="no-display-inline"> <toc regeneration="no-regeneration"> <toc-entry level="section">1166A. Evaluation of claims involving military sexual trauma.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H2609530A023E42EE87D1FB2B9F1697E7"><enum>(b)</enum><header>Communications from the Department of Veterans Affairs to individuals who have experienced military sexual trauma</header> <paragraph id="H5151173E3CA941C397038AA39AFDCC97"><enum>(1)</enum><header>Review working group</header> <subparagraph id="HB31958F8857148A49FC2A43083D8CA4E"><enum>(A)</enum><header>In general</header><text>The Secretary of Veterans Affairs shall establish a working group to review correspondence relating to military sexual trauma.</text></subparagraph>
<subparagraph id="H55F44FE6147440CF873817B5BCE21B13"><enum>(B)</enum><header>Membership</header><text>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—</text> <clause id="H589148CA0A24452FA4BA14BBEA2B9243"><enum>(i)</enum><text>one or more shall be appointed from among mental health providers of the Veterans Health Administration;</text></clause>
<clause id="HF8F2E68BB7364BFD8C4D4C2CAE721578"><enum>(ii)</enum><text>one or more shall be appointed from among experts on sexual assault and sexual harassment of the Veterans Benefits Administration; and</text></clause> <clause id="H6F99A1435AAA4B399F15773683D67C7F"><enum>(iii)</enum><text>one or more shall be appointed from among experts on sexual assault and sexual harassment of the Board of Veterans’ Appeals.</text></clause></subparagraph>
<subparagraph id="HF5509519DD984F50AFF7C746DEFA3535"><enum>(C)</enum><header>Duties</header><text display-inline="yes-display-inline">The working group established under subparagraph (A) shall—</text> <clause id="H73EB587E5A1C4DDC84189C9D08BB6AC7"><enum>(i)</enum><text>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</text></clause>
<clause id="HE51A516183D946799637E491D471321D"><enum>(ii)</enum><text>ensure that the correspondence—</text> <subclause id="H8EBBC0A7480D4E9B9181456204645419"><enum>(I)</enum><text>treats such individuals with dignity and respect; and</text></subclause>
<subclause id="H3E9C4D191B0C49548E658EAFD8BC3247"><enum>(II)</enum><text>does not re-traumatize such individuals.</text></subclause></clause></subparagraph> <subparagraph id="H082041E990FA411B9D1B2B074D7DC754"><enum>(D)</enum><header>Individual who has experienced military sexual trauma defined</header><text>In this subsection, the term <quote>individual who has experienced military sexual trauma</quote> means—</text>
<clause id="HDB00739D6E7841FD9863F429701582ED"><enum>(i)</enum><text>an individual who has filed a claim for compensation under chapter of title 38, United States Code, relating to military sexual trauma;</text></clause> <clause id="H58409B3582264EFFB546CE5A94172FEC"><enum>(ii)</enum><text>a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or</text></clause>
<clause id="H1BCEC3EB15074EA69C5A1816D8C31EB9"><enum>(iii)</enum><text>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.</text></clause></subparagraph></paragraph> <paragraph id="H4E40BB7BCF9D420FBA15506DEB92E801"><enum>(2)</enum><header>Contents of certain written communications to individuals who have experienced military sexual trauma</header> <subparagraph id="HD09591AC72CD43778D32CF947CC097A0"><enum>(A)</enum><header>Notice to claimants of required information and evidence</header><text>Section 5103 of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block id="H9BA837A9FC5C42BD9BF7539E66FC376C" style="OLC">
<subsection id="H405EA9DDE55F486892753B67D940BDFD"><enum>(c)</enum><header>Written communications to individuals who have experienced military sexual trauma</header>
<paragraph id="H11C89948075743A9B940F0B5E47195A8"><enum>(1)</enum><text>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:</text> <subparagraph id="H9C8F3E5288244734B71F8B791D0A4ECB"><enum>(A)</enum><text>Contact information for each of the following:</text>
<clause id="H41343FE9B2EC49FC9325A838E3341B68"><enum>(i)</enum><text>The military sexual trauma coordinator of the Veterans Benefits Administration.</text></clause> <clause id="H5B28BD2979A6425880CC41EFD58F09DA"><enum>(ii)</enum><text>The military sexual trauma coordinator of the Veterans Health Administration.</text></clause>
<clause id="HBE01637B28A344B78DFA3B8ECE4E28B0"><enum>(iii)</enum><text>The Veterans Crisis Line.</text></clause> <clause id="H8955E84CA3A34F86A0D3F3FEDC4E4C32"><enum>(iv)</enum><text>The facility of the Veterans Health Administration closest to where the individual resides.</text></clause>
<clause id="HBD1D3EDCEC8E4070BDD06C42C29DD630"><enum>(v)</enum><text>The Readjustment Counseling Service location closest to where the individual resides.</text></clause></subparagraph> <subparagraph id="HF1FACB486D3E4FC6854B4D68D338A973"><enum>(B)</enum><text>Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(v).</text></subparagraph></paragraph>
<paragraph id="H6E61038BC7E947F19A42A928D5037670"><enum>(2)</enum><text>In this subsection:</text> <subparagraph id="H9A61CC67CC1C441E8F955BA80F178E89"><enum>(A)</enum><text>The term <quote>individual who has experienced military sexual trauma</quote> means—</text>
<clause id="H9CFE5CF56A754DCC9A4E84F478CB2F14"><enum>(i)</enum><text>an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;</text></clause> <clause id="H5C03AAD61DBF4152A608901D05C1EEA8"><enum>(ii)</enum><text>a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or</text></clause>
<clause id="H111B5436AD7F4E0EA9FE12AD0158799D"><enum>(iii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="H2DC01E6FFA4B40CFAE71D69E130622EF"><enum>(B)</enum><text>The term <quote>military sexual trauma</quote> has the meaning given that term in section 1166(d)(2) of this title.</text></subparagraph>
<subparagraph id="HFF9A6D6252824B6E9FA8E14C6EF77C4B"><enum>(C)</enum><text>The term <quote>Veterans Crisis Line</quote> means the toll-free hotline for veterans established under section 1720F(h) of this title.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H051E59924F424240879A6754277D60DA"><enum>(B)</enum><header>Decisions and notices of decisions</header><text>Section 5104 of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block id="H7D756D55FFCD4210B25DBE0FCA4269C1" style="OLC">
<subsection id="HF0E3382BA207457CBD0F2522AA1706FA"><enum>(e)</enum>
<paragraph id="HD4AEBE46E7AB4D558E5A2DC94DF131DB" display-inline="yes-display-inline"><enum>(1)</enum><text>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:</text> <subparagraph id="H388CC155386D40C288694DFAEDBAB8F9" indent="up1"><enum>(A)</enum><text>Contact information for each of the following:</text>
<clause id="H3A0AD9F428BC46D1A498273DD0E1A003"><enum>(i)</enum><text>The military sexual trauma coordinator of the Veterans Health Administration.</text></clause> <clause id="H52C65AFA7B74433EA1C970BAAA1CC057"><enum>(ii)</enum><text>The Veterans Crisis Line.</text></clause>
<clause id="H0DDE43716D054463A0F50A2231ED2423"><enum>(iii)</enum><text>The facility of the Veterans Health Administration closest to where the individual resides.</text></clause> <clause id="H9DBE11A5C9E747F2AF7AB9CBB23BEE70"><enum>(iv)</enum><text>The Readjustment Counseling Service location closest to where the individual resides.</text></clause></subparagraph>
<subparagraph id="HAB4D5792EA9C460EBC38C53A0C4EF114" indent="up1"><enum>(B)</enum><text>Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv).</text></subparagraph></paragraph> <paragraph id="HE388D162F10846A59F62D3E5B49B740B" indent="up1"><enum>(2)</enum><text>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—</text>
<subparagraph id="H11921B844ED1449B9E6C22C6840F358B"><enum>(A)</enum><text>the contact information described in paragraph (1); and</text></subparagraph> <subparagraph id="H1DFD6B5F06B4433A904AC954CCD151FE"><enum>(B)</enum><text>the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.</text></subparagraph></paragraph>
<paragraph id="H11C546665A3742E0ADC664C85667C330" indent="up1"><enum>(3)</enum><text>In this subsection:</text> <subparagraph id="HA49D89243C294FB197928D60CCE619F9"><enum>(A)</enum><text>The term <quote>individual who has experienced military sexual trauma</quote> means—</text>
<clause id="HA399B2E551C94B16A9FC00EFF5200F38"><enum>(i)</enum><text>an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;</text></clause> <clause id="H4A7284F30A8C40F58D555466C4B3ABE4"><enum>(ii)</enum><text>a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or</text></clause>
<clause id="H8C66F9D32AC64E4FBD98CAC1260869AE"><enum>(iii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="H5FD1A288A25840D49CF3BA2D8B0D5533"><enum>(B)</enum><text display-inline="yes-display-inline">The term <quote>military sexual trauma</quote> has the meaning given that term in section 1166(d)(2) of this title.</text></subparagraph>
<subparagraph id="HFE5EB691E7E04648B0AE9FE8196C9818"><enum>(C)</enum><text>The term <quote>Veterans Crisis Line</quote> means the toll-free hotline for veterans established under section 1720F(h) of this title.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="HCE20D8D5667E4F3CAB4B206238C97707"><enum>(C)</enum><header>Higher-level review by the agency of original jurisdiction</header><text>Section 5104B of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block id="H72DAF4B7DFEA4B22BEDCA13FE26EA1AC" style="OLC">
<subsection id="H7CC035DEDA6648738917B256B8BC18E8"><enum>(f)</enum><header>Written communications to individuals who have experienced military sexual trauma</header>
<paragraph id="H9005B23627A3454788AF160B3B66D5BD"><enum>(1)</enum><text>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:</text> <subparagraph id="H2371DD05BCE34F2AA89BD27AA5D7F2A8"><enum>(A)</enum><text>Contact information for each of the following:</text>
<clause id="H39ED04D6BEA44BF6ABB537670F6800B9"><enum>(i)</enum><text>The military sexual trauma coordinator of the Veterans Health Administration.</text></clause> <clause id="HF53251E8AA2B4A5B859A6084059F9B58"><enum>(ii)</enum><text>The Veterans Crisis Line.</text></clause>
<clause id="H512D518BA3474EBBA7337759FE707863"><enum>(iii)</enum><text>The facility of the Veterans Health Administration closest to where the individual resides.</text></clause> <clause id="H595403DB6C4D4B3B8B29A2FECDEAE618"><enum>(iv)</enum><text>The Readjustment Counseling Service location closest to where the individual resides.</text></clause></subparagraph>
<subparagraph id="H5BC57FC9A5884FF08E6EAD3C75BE84CF"><enum>(B)</enum><text>Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv).</text></subparagraph></paragraph> <paragraph id="H3E9E3D67567D4606941A2E1760D1FC45"><enum>(2)</enum><text>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—</text>
<subparagraph id="H2E39A02600F14EF58518FD5D79F7A3B0"><enum>(A)</enum><text>the contact information described in paragraph (1); and</text></subparagraph> <subparagraph id="H3BEA3F86520B42898D5963530B5163E1"><enum>(B)</enum><text>the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.</text></subparagraph></paragraph>
<paragraph id="HD609C19E863E49E6A3C4051B840E88EB"><enum>(3)</enum><text>In this subsection:</text> <subparagraph id="H46E32FF5C40442B58612AE26B0B76DA9"><enum>(A)</enum><text>The term <quote>individual who has experienced military sexual trauma</quote> means—</text>
<clause id="H45235928F9F448AAB373E6B9ED7D4506"><enum>(i)</enum><text>an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;</text></clause> <clause id="HAEF01D3758EA49B6A2DE4948E2B51B4E"><enum>(ii)</enum><text>a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or</text></clause>
<clause id="HF48144D24F784BC89C879A6C69C90A9F"><enum>(iii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="H3DF17EFB67474A108A0D76FEA3191E6B"><enum>(B)</enum><text display-inline="yes-display-inline">The term <quote>military sexual trauma</quote> has the meaning given that term in section 1166(d)(2) of this title.</text></subparagraph>
<subparagraph id="H32A63F7F8FE540FB894E8E6EC77C8FED"><enum>(C)</enum><text>The term <quote>Veterans Crisis Line</quote> means the toll-free hotline for veterans established under section 1720F(h) of this title.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph> <subparagraph id="H56D9EBDA233A488E8DFCE7A9D5D97B41"><enum>(D)</enum><header>Board of Veterans’ Appeals</header><text>Section 7104 of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block id="HDE2F2581C35940FD9ACB19BE76E2EE34" style="OLC">
<subsection id="H3542378BE00D489C80247165B69CA590"><enum>(g)</enum>
<paragraph id="H02DDCC2E4E674CDA9CD122C2A9486269" display-inline="yes-display-inline"><enum>(1)</enum><text>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:</text> <subparagraph id="H4EF1099CC0644C68A5DD4F125ED865B8" indent="up1"><enum>(A)</enum><text>Contact information for each of the following:</text>
<clause id="HABCC01DFE53249CB8C5114680CD30840"><enum>(i)</enum><text>The military sexual trauma coordinator of the Veterans Health Administration.</text></clause> <clause id="HF71A05CD0269406EAA31CB42A2FDA952"><enum>(ii)</enum><text>The Veterans Crisis Line.</text></clause>
<clause id="HDE97251B8CE341A08F630B1885C88888"><enum>(iii)</enum><text>The facility of the Veterans Health Administration closest to where the individual resides.</text></clause> <clause id="HB7A81DEB4E714F1D882EE1D34BF80B40"><enum>(iv)</enum><text>The Readjustment Counseling Service location closest to where the individual resides.</text></clause></subparagraph>
<subparagraph id="H1AACD6D5830A4DFB965755C9FC85461F" indent="up1"><enum>(B)</enum><text>Information on the eligibility of the individual for services provided through the Readjustment Counseling Service location described in subparagraph (A)(iv).</text></subparagraph></paragraph> <paragraph id="H0F2BA11562864D1FB3AD279C88439B3A" indent="up1"><enum>(2)</enum><text>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—</text>
<subparagraph id="H1B52E4B7701E4A868ECE5DC2B7F185A4"><enum>(A)</enum><text>the contact information described in paragraph (1); and</text></subparagraph> <subparagraph id="H463A6DCE3BB648FAB64170E5BA41AEDA"><enum>(B)</enum><text>the contact information for the military sexual trauma coordinator of the Veterans Benefits Administration.</text></subparagraph></paragraph>
<paragraph id="H594E98E5A50B499FB53FD066155AF3E4" indent="up1"><enum>(3)</enum><text>In this subsection:</text> <subparagraph id="H71F1CC1B50FE4BDD9B19D4205365F77F"><enum>(A)</enum><text>The term <quote>individual who has experienced military sexual trauma</quote> means—</text>
<clause id="HAF973EB6B9F143E7BFF2424CEAA7B6FE"><enum>(i)</enum><text>an individual who has filed a claim for compensation under chapter 11 of this title relating to military sexual trauma;</text></clause> <clause id="H03C337FDFFE2488289D50CBAD490AA6D"><enum>(ii)</enum><text>a veteran who has been awarded compensation under such chapter relating to military sexual trauma; or</text></clause>
<clause id="H94C261DD1A084D57B20BB0314086D212"><enum>(iii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="H432EB17A1BD0469DA0E1656A2C7D2A6F"><enum>(B)</enum><text display-inline="yes-display-inline">The term <quote>military sexual trauma</quote> has the meaning given that term in section 1166(d)(2) of this title.</text></subparagraph>
<subparagraph id="H3BF3BC1533F54527B1065B13E29AA4BC"><enum>(C)</enum><text>The term <quote>Veterans Crisis Line</quote> means the toll-free hotline for veterans established under section 1720F(h) of this title.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection> <subsection id="H89EDD5BB77AA42C49A49945DEF1B46CA"><enum>(c)</enum><header>Study on training and processing relating to claims for disability compensation relating to military sexual trauma</header> <paragraph id="HD02A8DC5E7EF46ED852B99E129716096"><enum>(1)</enum><header>Study required</header><text>The Secretary of Veterans Affairs shall conduct a study on—</text>
<subparagraph id="H3A7E5D4B655444BBBD04695D4CCD21B2"><enum>(A)</enum><text>the quality of training provided to personnel of the Department of Veterans Affairs who review claims for disability compensation under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/11">chapter 11</external-xref> of title 38, United States Code, for disabilities relating to military sexual trauma; and</text></subparagraph> <subparagraph id="H6B3CF910B1884E198F8B033DA9BBD905"><enum>(B)</enum><text>the quality of the procedures of the Department for reviewing the accuracy of the processing of such claims.</text></subparagraph></paragraph>
<paragraph id="H0CB0C1014A724E76ACEDD5933D4F63A0"><enum>(2)</enum><header>Elements</header><text>The study required by subsection (a) shall include the following:</text> <subparagraph id="H50BA1B3944E44EB79E8F33C75D77685E"><enum>(A)</enum><text>With respect to the quality of training described in paragraph (1) of such subsection:</text>
<clause id="H40D739720B994A5E95C77291755DFC9A"><enum>(i)</enum><text>Whether the Department ensures personnel complete such training on time.</text></clause> <clause id="H7B60FBE6A21F4E7C9DDB411A33350BFC"><enum>(ii)</enum><text>Whether the training has resulted in improvements to the processing of claims described in such subsection and issue-based accuracy.</text></clause>
<clause id="HBE036BD0A58E40A78CA95E59282D9DFB"><enum>(iii)</enum><text>Such recommendations as the Secretary may have for improving the training.</text></clause></subparagraph> <subparagraph id="H61D1F3F110974A4086042B931DB00458"><enum>(B)</enum><text>With respect to the quality of procedures described in paragraph (2) of such subsection:</text>
<clause id="H5599B5BE4A7A4F64BD580F9A7377BA0A"><enum>(i)</enum><text>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.</text></clause> <clause id="H9CC5FBBD06654EE6911453E09CD14233"><enum>(ii)</enum><text>Whether such procedures adequately include mechanisms to correct errors found in such reviews.</text></clause>
<clause id="H64FEBCADC29340F794903DA11E837014"><enum>(iii)</enum><text>A summary of quality assurance reviews and reports conducted as part of such procedures.</text></clause> <clause id="H69CBBB081ECB4F1B967AAAFBB5E0C392"><enum>(iv)</enum><text>Such recommendations as the Secretary may have for improving such procedures.</text></clause></subparagraph></paragraph>
<paragraph id="HDEE70C56031B4D6F8164089BA97EA4CA"><enum>(3)</enum><header>Report required</header><text>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).</text></paragraph></subsection> <subsection id="H6CD0C0D498FC414B8D96AEBD35EF8F52"><enum>(d)</enum><header>Annual special focus review of claims for disability compensation for disabilities relating to military sexual trauma</header> <paragraph id="H176B51469C47485EAE13838849E56EEE"><enum>(1)</enum><header>Annual special focus review</header> <subparagraph id="H92DD977943B84625B28695148A425BB8"><enum>(A)</enum><header>In general</header><text>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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/11">chapter 11</external-xref> of title 38, United States Code, for disabilities relating to military sexual trauma.</text></subparagraph>
<subparagraph id="HFC9386610136439AB89B28C1C4D0FDC8"><enum>(B)</enum><header>Elements</header><text>Each review conducted under subparagraph (A) shall include a review of the following:</text> <clause id="H63BDB3E18BE841E4A500E5781C1E2DC8"><enum>(i)</enum><text>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.</text></clause>
<clause id="HBC1AA0B1A6264CD18473384DDAE96E7F"><enum>(ii)</enum><text>The accuracy of each decision made with respect to each claim described in clause (i).</text></clause> <clause id="H56795DF9216C4BA6AA380A25F9363CE1"><enum>(iii)</enum><text>The types of benefit entitlement errors found, disaggregated by category.</text></clause>
<clause id="H5CF1EEB937A04710B508E63243BA2B84"><enum>(iv)</enum><text>Trends from year to year.</text></clause> <clause id="H47E3590E802147B3908C409555FB59B3"><enum>(v)</enum><text>Training completion rates for personnel of the Department who process claims described in subparagraph (A).</text></clause></subparagraph></paragraph>
<paragraph id="H3B09DE835A6F47D3BD083497DD7C48CF"><enum>(2)</enum><header>Reprocessing of claims</header><text>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.</text></paragraph> <paragraph id="H1AA9F5B31D9F4C45B772BBB1F57B6449"><enum>(3)</enum><header>Report</header><text>Section 5501(b) of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 (<external-xref legal-doc="public-law" parsable-cite="pl/116/315">Public Law 116–315</external-xref>; 134 Stat. 5048) is amended—</text>
<subparagraph id="HEFB1D0164228409883582F52116CD1B9"><enum>(A)</enum><text>in paragraph (1), by striking <quote>through 2027</quote> and inserting <quote>until the date described in section 109(d)(4) of the <short-title>Take Care of America’s Veterans Act</short-title></quote>; and</text></subparagraph> <subparagraph id="H902D349C33EC4556A34EA74730FD45AC"><enum>(B)</enum><text>in paragraph (2), by adding at the end the following new subparagraph:</text>
<quoted-block id="H4BE907C07278445AB1124278245353B0" style="OLC">
<subparagraph id="HB2412A5AE3F24E828475F033B86AD419"><enum>(I)</enum><text>The findings of the most recent special focus review conducted under subsection (d)(1)(A) of section 109 of the <short-title>Take Care of America’s Veterans Act</short-title>, including—</text> <clause id="H349B265D0C13433CA314DA442B4F40B2"><enum>(i)</enum><text>the elements under subsection (d)(1)(B) of such section;</text></clause>
<clause id="HC3242E4927FA42BFB2757DC7BFEE7121"><enum>(ii)</enum><text>the number of claims returned for reprocessing under subsection (d)(2) of such section; and</text></clause> <clause id="H375FB5F62099438BA54DF508606A90FB"><enum>(iii)</enum><text>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.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="HA6692E6C92A945D1B74947AA9CB3463C"><enum>(4)</enum><header>Sunset</header><text>On the date that is 5 years after the enactment of this Act, paragraph (1)(A) shall cease to be in effect.</text></paragraph></subsection> <subsection id="H5A618AE6861D4678A9B17811ABEA7118"><enum>(e)</enum><header>Working group on medical examinations for claims for disability compensation for disabilities relating to military sexual trauma</header> <paragraph id="H3FEE4BCB7EF040FE81F9BD65FACADC1C"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish a working group on medical examinations for claims for disability compensation under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/11">chapter 11</external-xref> of title 38, United States Code, for disabilities relating to military sexual trauma (in this section referred to as the <quote>working group</quote>).</text></paragraph>
<paragraph id="H1FEE934D13DE4ED69E7D7D3CEAD72E42"><enum>(2)</enum><header>Membership</header><text>The working group shall be composed of the following:</text> <subparagraph id="H3D6B00177BB74C238745E05AA54B6F84"><enum>(A)</enum><text>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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/11">chapter 11</external-xref> of title 38, United States Code.</text></subparagraph>
<subparagraph id="H30ED3F75820F48FA90CE66EA886B0CAC"><enum>(B)</enum><text>Staff of the Medical Disability Examination Office of the Department.</text></subparagraph> <subparagraph id="H9F67CC4ADF724D4B837B63F70A52FC2A"><enum>(C)</enum><text>Veterans service officers who have experience with claims described in paragraph (1).</text></subparagraph>
<subparagraph id="HC636F7F69878448CA5C590E51B7248F5"><enum>(D)</enum><text>Medical examiners who have experience with such claims.</text></subparagraph> <subparagraph id="H593D26004A9E4716BEB93F8DC586B660"><enum>(E)</enum><text>Staff of the Veterans Experience Office of the Department.</text></subparagraph>
<subparagraph id="H26BE56B0D06E40DA9DA6F34FACA73AC9"><enum>(F)</enum><text>Such other individuals as the Secretary considers appropriate.</text></subparagraph></paragraph> <paragraph id="H4C0C6429033047149349049090E6F47F"><enum>(3)</enum><header>Duties</header><text display-inline="yes-display-inline">Not later than 180 days after the date of the enactment of this Act, the working group shall—</text>
<subparagraph id="H0950F708CBF3474595D5D692E7FD2858"><enum>(A)</enum><text>review the quality of medical examinations described in paragraph (1);</text></subparagraph> <subparagraph id="HE53421868FEF4CE2959071FE3AD37241"><enum>(B)</enum><text>review the feasibility of minimizing re-examinations for conditions relating to military sexual trauma; and</text></subparagraph>
<subparagraph id="H5511ECFEDDB94467BEA458033FC39EF0"><enum>(C)</enum><text>submit to the Under Secretary for Benefits of the Department and the Secretary recommendations on how to—</text> <clause id="HD77DCCBBC5874409AD340E06A84BD6FC"><enum>(i)</enum><text>eliminate re-traumatization of individuals who file claims described in paragraph (1); and</text></clause>
<clause id="H4E053F935F7C4FA2BEC2D69AC6A74080"><enum>(ii)</enum><text>reduce the overdevelopment of such claims.</text></clause></subparagraph></paragraph> <paragraph id="H91EB3443987D4E36ABC7A558F1AD8CA1"><enum>(4)</enum><header>Report</header><text>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:</text>
<subparagraph id="HEBB72604666241788A696F8F83FF4A32"><enum>(A)</enum><text display-inline="yes-display-inline">The views of the working group on efforts by the Department to eliminate re-traumatization of individuals who file claims described in subsection (a).</text></subparagraph> <subparagraph id="HCE7526C94B3C4B0AA0358B50F57917B4"><enum>(B)</enum><text>Legislative proposals to improve the experience of such individuals in pursuing such claims.</text></subparagraph>
<subparagraph id="HE42223BDBF854FC4BDC985973AB488A1"><enum>(C)</enum><text>The recommendations submitted under paragraph (3)(C).</text></subparagraph> <subparagraph id="H9488B0A6BFBA40EF9DA6B034A312364B"><enum>(D)</enum><text>The plan of the Under Secretary for Benefits of the Department and the Secretary to implement such recommendations.</text></subparagraph></paragraph>
<paragraph id="H7D6C13786A4641C5B2AC7BD7BBE6E64E"><enum>(5)</enum><header>Review and implementation</header><text>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—</text> <subparagraph id="H7524DBEE407E4D448E615CB6C55C4DE4"><enum>(A)</enum><text>review the recommendations submitted under paragraph (3)(C); and</text></subparagraph>
<subparagraph id="H1F46C1E7D0964736BCF09E61AB4E1491"><enum>(B)</enum><text>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).</text></subparagraph></paragraph> </subsection> <subsection id="H9FD80810FE70405EB32DEA21CFC2BEFC"><enum>(f)</enum><header>Military sexual trauma claims performance dashboard</header> <paragraph id="H04EB85F9B8B94F97BFBBFB9E4023348C"><enum>(1)</enum><header>Establishment</header><text>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.</text></paragraph>
<paragraph id="HFE94E69A7EBC4025A6337C48C6911E54"><enum>(2)</enum><header>Elements</header><text>The dashboard established pursuant to paragraph (1) shall cover the following:</text> <subparagraph id="H5F702E003FDC41BEBDF216C996D7C8B6"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="H8BE3CA3611264EF4A88A8249C1A5079A"><enum>(B)</enum><text>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.</text></subparagraph> <subparagraph id="HC2D9A10EBCE344BDA7F81F51D53CEED2"><enum>(C)</enum><text>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:</text>
<clause id="HFE62AB1E7C5B40759A18160BC391CFB1"><enum>(i)</enum><text>Average number of days a claim is pending review.</text></clause> <clause id="H8700EE5FEC1144DA931F1BF93B3C0D43"><enum>(ii)</enum><text>Average number of days for completed adjudication.</text></clause>
<clause id="H73D3BF233A8E4DCD950AE7A1D34B2AD9"><enum>(iii)</enum><text>Total number of pending claims, disaggregated by whether the claims have been partially adjudicated or not adjudicated at all.</text></clause> <clause id="HE992D6F8372942C1B8B664D5AA24BFCF"><enum>(iv)</enum><text>Total number of claims completely adjudicated.</text></clause>
<clause id="HE050B305FDF4414295EB04F688021C61"><enum>(v)</enum><text>Of the number specified in clause (iv), the percentage that were approved, denied, or appealed.</text></clause></subparagraph> <subparagraph id="H97995A11D0AF46FEA9273FB9D8DDD785"><enum>(D)</enum><text>The total number of claims relating to military sexual trauma submitted to the Secretary for benefits under laws administered by the Secretary.</text></subparagraph>
<subparagraph id="H29B0039C42F749C1B605D2E9CA05C95A"><enum>(E)</enum><text>The methods used for submittal of claims relating to military sexual trauma to the Secretary for benefits under laws administered by the Secretary.</text></subparagraph> <subparagraph id="HF625D3DCC642411C951B75FAA62424EE"><enum>(F)</enum><text>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.</text></subparagraph>
<subparagraph id="H0E006309D9DF431998913D20537F1A0F"><enum>(G)</enum><text>The most frequent conditions or disabilities for which a claim relating to military sexual trauma is denied.</text></subparagraph> <subparagraph id="H7E3A36F5E5824B669F138425C7F27FB9"><enum>(H)</enum><text>The most frequent conditions or disabilities for which a claim relating to military sexual trauma is submitted to the Secretary for disability compensation under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/11">chapter 11</external-xref> of title 38, United States Code, including the grant rate for such contentions.</text></subparagraph></paragraph>
<paragraph id="H5F9B725977B74CB4A9E6F6C89BB520E2"><enum>(3)</enum><header>Additional resource information</header><text>The Secretary shall make available via the performance dashboard established pursuant to subsection (a) the following information:</text> <subparagraph id="H7ECD3C752B574C6DB148D47F8FE6DF9C"><enum>(A)</enum><text>Veterans Crisis Line contact information.</text></subparagraph>
<subparagraph id="HF7E0392057664680A7C0D7206617B174"><enum>(B)</enum><text>Information regarding the availability of services from military sexual trauma coordinators of the Veterans Health Administration.</text></subparagraph> <subparagraph id="H70FC4CB28432427E825C9E6389F3926A"><enum>(C)</enum><text>Information regarding the availability of services from military sexual trauma coordinators of the Veterans Benefits Administration.</text></subparagraph>
<subparagraph id="HD09C3035F5D349B6B9498CF143F9650C"><enum>(D)</enum><text>Information on availability of specialized care, services, and benefits from the Department for individuals who have experienced military sexual trauma.</text></subparagraph> <subparagraph id="HE0F446BA479A46E8BADC985B810CB54D"><enum>(E)</enum><text>Such additional information as the Secretary considers appropriate.</text></subparagraph></paragraph>
<paragraph id="HD900B3BD91504E6191498854CAFE50D3"><enum>(4)</enum><header>Availability</header><text>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.</text></paragraph> <paragraph id="HA007795C106B4E71B31209A0DC25FAE0"><enum>(5)</enum><header>Reporting requirements</header> <subparagraph id="H246FDD93978249C0BFC6F572EA0196D1" display-inline="yes-display-inline"><enum>(A)</enum><text>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—</text>
<clause id="HF1E0D9C65389496CBBFA0F64D1147367" indent="up1"><enum>(i)</enum><text>the annual cost to implement the dashboard required by paragraph (2);</text></clause> <clause id="H1CBDC2A0514D443297ABE9308905EA3A" indent="up1"><enum>(ii)</enum><text>areas for improvement of the dashboard; and</text></clause>
<clause id="H13C28DE2FA0C498A8F26D5C1EA76979C" indent="up1"><enum>(iii)</enum><text>such additional information as the Secretary considers appropriate.</text></clause></subparagraph> <subparagraph id="HA2B4D345E24A49B982966E34B885E0B5" indent="up1"><enum>(B)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="H6B536D84C28E4AF18DAC2F02576EBF4D"><enum>(6)</enum><header>Definition</header><text>In this section, the term <quote>military sexual trauma</quote> has the meaning given such term in section 1166(d)(2) of title 38, United States Code.</text></paragraph></subsection></section> <section id="H17B0CCCE0DFA4A81B89A2CA47BBEF8FA" section-type="subsequent-section"><enum>112.</enum><header>Independent assessment of notices that the Secretary of Veterans Affairs sends to claimants</header> <subsection id="H4F460EF9C2744773BE2C472638E59576"><enum>(a)</enum><header>Agreement</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H7493EAA18D9C4D95B8DF5DC15CB12EC0"><enum>(b)</enum><header>Assessment</header><text display-inline="yes-display-inline">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:</text> <paragraph id="H8719EA99CB2549969F88E09AAF69B29C"><enum>(1)</enum><text>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.</text></paragraph>
<paragraph id="H1D4506C41B4443EDB2827FE40716F6BB"><enum>(2)</enum><text display-inline="yes-display-inline">The recommendations of the FFRDC regarding how the Secretary may make such notices clearer to claimants, better organized, and more concise.</text></paragraph></subsection> <subsection id="H4D8F0AB26A124609BF180AF2E2B4A924"><enum>(c)</enum><header>Report; implementation</header><text>Not later than 90 days after the Secretary receives the assessment under subsection (b), the Secretary shall—</text>
<paragraph id="HA6F61463BA154C938CD3913DC2B35837"><enum>(1)</enum><text>submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a copy of such assessment; and</text></paragraph> <paragraph id="H367D2D95071A4F00A72C1D1283064162"><enum>(2)</enum><text display-inline="yes-display-inline">implement the recommendations in the assessment that are in compliance with the laws administered by the Secretary.</text></paragraph></subsection>
<subsection id="HA6F9DC7DE5E3449A9C74C0B8052820DB"><enum>(d)</enum><header>Deadline for implementation</header><text>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.</text></subsection> <subsection id="H4879457AD72C4A3896F54B5D4B1DB113"><enum>(e)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H94A47ABECDA44F639EA8713FB1C8C48B"><enum>(1)</enum><text display-inline="yes-display-inline">The term <quote>FFRDC</quote> means a federally funded research and development center.</text></paragraph> <paragraph id="H1F6831DE9E0F49D888B0EF718FB4D7F1" commented="no"><enum>(2)</enum><text display-inline="yes-display-inline">The term <quote>covered entities</quote> includes—</text>
<subparagraph id="H9464F00469DB4D1FB9ABE10D03E697F2" commented="no"><enum>(A)</enum><text>the Secretary of Veterans Affairs;</text></subparagraph> <subparagraph id="H1390EE54F639486A81C03267A3F963D2" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">an expert in laws administered by the Secretary of Veterans Affairs;</text></subparagraph>
<subparagraph id="HD251B9BD75B348938C33BCB401435B9E" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">a veterans service organization recognized under section 5902 of title 38, United States Code;</text></subparagraph> <subparagraph id="HA1D3E345184248B4957A09E2BBAC8E57" commented="no"><enum>(D)</enum><text>an entity that advocates for veterans; and</text></subparagraph>
<subparagraph id="HE2F64EAD4A8448908686B68E4F6D5FDC"><enum>(E)</enum><text display-inline="yes-display-inline">an entity that advocates for the survivors of veterans.</text></subparagraph></paragraph> <paragraph id="HE8C2CACFB1624347B942062B94E61BF2"><enum>(3)</enum><text>The terms <quote>claimant</quote> and <quote>notice</quote> have the meanings given such terms in section 5100 of title 38, United States Code.</text></paragraph></subsection></section>
<section id="H4ECA2DC7E6474F08A410F79FA4371375" section-type="subsequent-section"><enum>113.</enum><header>Independent assessment of forms that the Secretary of Veterans Affairs sends to claimants</header>
<subsection id="H01AFEB70BB654D4B9A29C7B052523A3A"><enum>(a)</enum><header>Agreement</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection id="HC864C0A430CA4C32A9033A26364B5384"><enum>(b)</enum><header>Assessment</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H9555FB0227794E1E8336FB23E87764F9"><enum>(c)</enum><header>Report; implementation</header><text>Not later than 90 days after the Secretary receives the assessment under subsection (b), the Secretary shall—</text> <paragraph id="H21507C7B629F4F46B6A7562EDAB2D08B"><enum>(1)</enum><text>submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives a copy of such assessment; and</text></paragraph>
<paragraph id="H4BEF959201214F2D8D8329DB93231C04"><enum>(2)</enum><text display-inline="yes-display-inline">implement the recommendations in the assessment that are in compliance with the laws administered by the Secretary.</text></paragraph></subsection> <subsection id="HDC7C820C3B394F489EAA239C958A46C9"><enum>(d)</enum><header>Deadline for implementation</header><text>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.</text></subsection>
<subsection id="HE6698C3E708C4A52BE1E675EDBA01676"><enum>(e)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HC49BBD797B544A43A194A9609A50E6BF"><enum>(1)</enum><text display-inline="yes-display-inline">The term <quote>FFRDC</quote> means a federally funded research and development center.</text></paragraph>
<paragraph id="H7C0633AFF1BE43C49254EAD6B8D93DBA" commented="no"><enum>(2)</enum><text display-inline="yes-display-inline">The term <quote>covered entities</quote> includes—</text> <subparagraph id="H3ED642BF40C74F8E81B7ECA3A8CCB260" commented="no"><enum>(A)</enum><text>the Secretary of Veterans Affairs;</text></subparagraph>
<subparagraph id="H3587B77593C748F493E363DD83E155D7" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">an expert in laws administered by the Secretary of Veterans Affairs;</text></subparagraph> <subparagraph id="H53D35F79CBEC4C9AB18DD5B138AB4D7B" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">a veterans service organization recognized under section 5902 of title 38, United States Code;</text></subparagraph>
<subparagraph id="HF5EA853D6E574F2DAF3DB8D95809CB91" commented="no"><enum>(D)</enum><text>an entity that advocates for veterans; and</text></subparagraph> <subparagraph id="H723F6FF50DC44EDEA67193180227D24E"><enum>(E)</enum><text display-inline="yes-display-inline">an entity that advocates for survivors of veterans.</text></subparagraph></paragraph>
<paragraph id="HEABC2A721E194773827C24DA44C16E0D"><enum>(3)</enum><text>The term <quote>claimant</quote> has the meaning given such term in section 5100 of title 38, United States Code.</text></paragraph></subsection></section> <enum>II</enum><header>Education and Economic Opportunity</header> <section id="H84E4090A24BB47A2ABE388601A9B3500" section-type="subsequent-section"><enum>201.</enum><header>Vets Opportunity Act</header> <subsection id="H56D395AD623943F59B85D040DBE42C42"><enum>(a)</enum><header>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</header> <paragraph id="H3986701F3F2C4EB2BA53AC6490E28B54"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Subsection (f) of section 3327 of title 38, United States Code, is amended—</text>
<subparagraph id="HC6DD8CBD699C4150BE77E959EE4F89ED"><enum>(A)</enum><text display-inline="yes-display-inline">in paragraph (3), by striking <quote>together</quote> and all that follows through <quote>before</quote> and inserting <quote>not later than 60 days after</quote>; and</text></subparagraph> <subparagraph id="H39F866D5FBB244838687A00275BD2A88"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block style="USC" id="HCE1D1979CD86407590E275430DF0136F" display-inline="no-display-inline">
<paragraph id="H1A9AA9F101974A82982CA30314BE378B"><enum>(4)</enum><header>Additional assistance for an individual not eligible for a monthly housing stipend</header><text display-inline="yes-display-inline">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—</text> <subparagraph id="HDBF7F8CDD13F43368CAFF3BA457C8DBD"><enum>(A)</enum><text display-inline="yes-display-inline">in a lump sum calculated by multiplying—</text>
<clause id="H0E23D52993CB49069382F2F4A378F094"><enum>(i)</enum><text display-inline="yes-display-inline">the total amount of contributions described in paragraph (1)(A) with regards to such individual; and</text></clause> <clause id="H79C2EE28E17546788FFC9B1FDA55DE49"><enum>(ii)</enum><text>the sum of the number of months described in subclauses (I) and (II) of paragraph (1)(B)(i) with regards to such individual; and</text></clause></subparagraph>
<subparagraph id="HB9F16EDC29EF4DB98090EFE2BA4156B6"><enum>(B)</enum><text display-inline="yes-display-inline">to the individual not later than 60 days after the exhaustion of the individual's entitlement to educational assistance under this chapter.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H1BE58A3C0E7D4B4E8DDA0DF8DF2F0569"><enum>(2)</enum><header>Technical corrections and conforming amendment</header><text display-inline="yes-display-inline">Such subsection is further amended—</text>
<subparagraph id="H248832F39FE546BA8C4430213B8D8CD6"><enum>(A)</enum><text display-inline="yes-display-inline">by striking <quote>paragraphs (2) through (7)</quote> and inserting <quote>paragraphs (2) through (6)</quote>; and</text></subparagraph> <subparagraph id="HCC924AA9307441CDB8CB58A20B58B9ED"><enum>(B)</enum><text>in paragraph (1), in the heading, by inserting <quote><header-in-text level="paragraph" style="USC">for an individual eligible for a monthly housing stipend</header-in-text></quote> after <quote><header-in-text level="paragraph" style="USC">Additional assistance</header-in-text></quote>.</text></subparagraph></paragraph>
<paragraph id="HAB0DE1FA86054EE7A26C7D9A68561A4F"><enum>(3)</enum><header>Effective date</header><text display-inline="yes-display-inline">The amendments made by this section shall take effect on August 1, 2027.</text></paragraph></subsection> <subsection id="HE6F1C63CFFEC4A7F927651A1C113E6E4"><enum>(b)</enum><header>Treatment of certain independent study programs under educational assistance programs of Department of Veterans Affairs</header> <paragraph id="HDCA41C8B829741A8B77A55973C185B77"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Section 3680A(a)(4)(A)(ii)(III) of such title is amended—</text>
<subparagraph id="HCF08AF99B2B44907BCD518DD1A242B76"><enum>(A)</enum><text>by inserting <quote>that requires regular and substantive interaction between students and instructors</quote> after <quote>course of study</quote>;</text></subparagraph> <subparagraph id="H93878DC9A97E449FA3004725C37DA6FD"><enum>(B)</enum><text>in item (aa), by striking <quote>; or</quote> and inserting a semicolon;</text></subparagraph>
<subparagraph id="HC517588C18A445F7B387903B863A4E5A"><enum>(C)</enum><text>in item (bb), by striking <quote>; and</quote> and inserting <quote>; or</quote>; and</text></subparagraph> <subparagraph id="H2D43991D4E674520972010CC7790CB6E"><enum>(D)</enum><text>by adding at the end by following new item:</text>
<quoted-block style="USC" id="H2C4E6A75BA25438B94CC5F3CD4FD91F9" display-inline="no-display-inline">
<item id="H511F40A4D43548109F05981E4F0DB70C"><enum>(cc)</enum><text display-inline="yes-display-inline">an institution of higher education, as such term is defined in section 102 of the Higher Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/1002">20 U.S.C. 1002</external-xref>), that is approved to participate or is participating in the student financial assistance programs authorized by title IV of that Act; and</text></item><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="HC1C18AB02B5141C89A59FC993A8FACD6"><enum>(2)</enum><header>Applicability</header><text>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.</text></paragraph>
<paragraph id="H2EA71D60D1B44847824DB8EC732242B0" commented="no"><enum>(3)</enum><header>Oversight</header><text>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).</text></paragraph> <paragraph id="H07BEDC5D34F14FB78862A48B4C8806F6" commented="no"><enum>(4)</enum><header>GAO report</header><text>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—</text>
<subparagraph id="HA2B0DBC82D29462CAE180CA6F731EA56" commented="no"><enum>(A)</enum><text>the effectiveness of oversight activities conducted by the Department of Veterans Affairs and State approving agencies;</text></subparagraph> <subparagraph id="HCD2F8F2C4C574EF8A33B13B8C6796A24" commented="no"><enum>(B)</enum><text>institutional compliance with applicable requirements under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/36">chapter 36</external-xref> of title 38, United States Code;</text></subparagraph>
<subparagraph id="H0421C8E30A9046ECB329235BFB3B0659" commented="no"><enum>(C)</enum><text>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</text></subparagraph> <subparagraph id="H6AC3C6FDE20C44928626C58589C0DDF6" commented="no"><enum>(D)</enum><text>any recommendations to improve oversight, program integrity, or educational outcomes for veterans.</text></subparagraph></paragraph>
<paragraph id="HAFEDB9A8A87240EA97A2B9A248992E92" commented="no"><enum>(5)</enum><header>Applicability</header><text>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.</text></paragraph></subsection> <subsection id="HC8901FD616E841BAB0AFA670B9A57B67" commented="no"><enum>(c)</enum><header>Absence from certain education due to certain service</header> <paragraph id="HF0E2304901B44FFAAF21FCF5798A4781"><enum>(1)</enum><header>Options</header><text display-inline="yes-display-inline">Section 3691A of such title is amended by striking paragraph (1) of subsection (a) and inserting the following:</text>
<quoted-block style="USC" id="H889A6F93F8FE445E99F9446660996661" display-inline="no-display-inline">
<paragraph id="H273EDA7B9ECF48F4BC203F32E7713FAB" indent="up1"><enum>(1)</enum><text display-inline="yes-display-inline">A covered member may, after receiving orders to enter a period of covered service—</text> <subparagraph id="HE890F69C81AB46A98C2BD635FFC9E89C"><enum>(A)</enum><text display-inline="yes-display-inline">withdraw from covered education;</text></subparagraph>
<subparagraph id="H653F2C4DD8D4447CBF59F0F6729C2CB0"><enum>(B)</enum><text display-inline="yes-display-inline">take a leave of absence from covered education; or</text></subparagraph> <subparagraph id="HF3A5D2A4A45B4C3CAC532C212331F8F6"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H60D673319DB645B494E570F8070D8F80"><enum>(2)</enum><header>Conforming amendment</header><text>Such subsection is further amended, in paragraph (2)(A), by striking <quote>or takes a leave of absence</quote> and inserting <quote>, takes a leave of absence, or enters into an agreement</quote>.</text></paragraph> <paragraph id="H5615BD8202624F678E94FC3F6CF060B4"><enum>(3)</enum><header>Agreement</header><text display-inline="yes-display-inline">Such section is further amended—</text>
<subparagraph id="H6F3C7C7B2EB2465F8B73B51A768B819A"><enum>(A)</enum><text display-inline="yes-display-inline">by redesignating subsection (d) as subsection (e); and</text></subparagraph> <subparagraph id="HA71854DC8BCF4DF6BEC14D4E7820C1E8"><enum>(B)</enum><text>by inserting, after subsection (c), the following new subsection (d):</text>
<quoted-block style="USC" id="H13CE9373B573445C8486D0F26D772680" display-inline="no-display-inline">
<subsection id="HE2D1E6EF53664491A23DB64688BA3915"><enum>(d)</enum><header>Agreement with institution concerned</header><text>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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H9ED209C3FF6E46018B5E1229DD9EB91C"><enum>(4)</enum><header>Section heading</header><text>Such section is further amended by striking the heading and inserting <quote><header-in-text level="section" style="USC">Absence from certain education due to certain service</header-in-text></quote>.</text></paragraph>
<paragraph id="HE916B53BC7AB4810809A7A9010F039A0"><enum>(5)</enum><header>Table of sections</header><text>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:</text> <quoted-block style="USC" id="H614F1EFCF8BE46D4A16E8044E4A7D864" display-inline="no-display-inline"> <toc regeneration="no-regeneration"> <toc-entry level="section">3691A. Absence from certain education due to certain service.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="HBB1C46A5C7934BD98C4C0D6B30973854" display-inline="no-display-inline"><enum>(d)</enum><header>Department of Veterans Affairs compliance surveys</header><text>Section 3693 of such title is amended—</text>
<paragraph id="HB5AA437C84D245A4B69BEE8951594940"><enum>(1)</enum><text>in subsection (c)—</text> <subparagraph id="HCCED5E98568B4869BA21CC726BD0E835"><enum>(A)</enum><text>by striking <quote>not more than 10 business days of notice</quote>;</text></subparagraph>
<subparagraph id="HFB1370B9866A4AEAB50E16CAE0C02D73"><enum>(B)</enum><text>by striking <quote>this section.</quote> and inserting <quote>this section—</quote>; and</text></subparagraph> <subparagraph id="H22974BA0F19D4229A97DB3909A7F7898"><enum>(C)</enum><text>by adding at the end the following new paragraphs:</text>
<quoted-block style="USC" id="H34BC672331B84E2CBB9794C9934B5156" display-inline="no-display-inline">
<paragraph id="H5B7442024A1E414694BCAEEA583DDBAC"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph id="H1312EA4C161E4C14ACD4572463CCC341"><enum>(2)</enum><text>in the case of any other educational institution or training establishment, not more than 10 business days of notice.</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H6D2BEF3C6D9D49C1A5B55A808F939FDB"><enum>(2)</enum><text>by striking subsection (d) and inserting the following new subsection (d):</text> <quoted-block style="USC" id="HB840DC3931F747FDA0E52332C2707513" display-inline="no-display-inline"> <subsection id="HC6B9649B03B048CAA3352F94482F0E91"><enum>(d)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text>
<paragraph id="H7D331605BF214E099B90014285CE5E7F"><enum>(1)</enum><text display-inline="yes-display-inline">The terms <quote>educational institution</quote> and <quote>training establishment</quote> have the meanings given such terms in section 3452 of this title.</text></paragraph> <paragraph id="HE1522CA8AC4245E9B99973C4742F8C8C"><enum>(2)</enum><text display-inline="yes-display-inline">The term <quote>school certifying official</quote> means an employee of an educational institution with primary responsibility for certifying veteran enrollment at the educational institution.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HD401B1D7E18945A7895D4DD9A77E2ADA" commented="no"><enum>(e)</enum><header>Notification of school certifying officials of handbook updates</header>
<paragraph id="HC61FA18B48BE48558E14DFD53C1920A2" commented="no"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H8D198B128E3B469D9844E2093905FEC0" commented="no"><enum>(2)</enum><header>School certifying official defined</header><text display-inline="yes-display-inline">The term <quote>school certifying official</quote> means an employee of an educational institution with primary responsibility for certifying veteran enrollment at the educational institution.</text></paragraph></subsection></section>
<section id="HA8E508CFD8CC4113A524BB708A75ABEF"><enum>202.</enum><header>Improvements to process for making payments to automobile sellers for automobiles purchased for certain disabled veterans</header>
<subsection id="H3161288BF7904D8C83637154C874BF02"><enum>(a)</enum><header>Timeliness of payments</header><text>Section 3902 of title 38, United States Code, is amended, in subsection (a)—</text> <paragraph id="H92F433CC0CC344C6B7D6104E29C669A8"><enum>(1)</enum><text>by inserting <quote>(1)</quote> before <quote>The Secretary</quote>; and</text></paragraph>
<paragraph id="H8C7CDFAA23BB4A07A5077EABFA41714F"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block style="USC" id="HC69F8B1F71474DCDB94633BE84108CF8" display-inline="no-display-inline"> <paragraph id="H577C97252B854643917D05D7BC723426" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">The Secretary shall—</text>
<subparagraph id="H033B5FB4883C4FDC962FB387A8DDFAE4"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="HDA180D04C540491ABB623BEAE385897E"><enum>(B)</enum><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HF9472EBF7A394D63A3CC42CE70451534"><enum>(b)</enum><header>Centralization of process for making payments</header><text>Such section is amended by adding at the end the following new subsection:</text> <quoted-block style="USC" id="HB54B863B6C0949A39D57374E0AD92D36" display-inline="no-display-inline"> <subsection id="H84882184EDF84088B6A3209A0EA62497"><enum>(f)</enum> <paragraph id="H01D66003EB14445ABD5F790BEB0B2161" display-inline="yes-display-inline"><enum>(1)</enum><text display-inline="yes-display-inline">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).</text></paragraph>
<paragraph id="HFC4335BD4FA34CE8A5BD6CD4F11A3439" indent="up1"><enum>(2)</enum><text>The Secretary shall accurately track and resolve payments due to sellers under this section that are more than 90 days overdue.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H378B9EB79F384DF9BA8C8BDE56E456F3"><enum>(c)</enum><header>Reporting</header><text display-inline="yes-display-inline">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:</text>
<paragraph id="HAC29518EE65D4B6EA5289A95C8FF8AC2"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text> <subparagraph id="H96C368610B0445059672D2A76A9307AC"><enum>(A)</enum><text>the Veterans Health Administration;</text></subparagraph>
<subparagraph id="H20956BE407B147B286A3DD09305BE7CE"><enum>(B)</enum><text display-inline="yes-display-inline">the Veterans Benefits Administration; or</text></subparagraph> <subparagraph id="HEEC06FCC05B042C1AAEB4513135AC045"><enum>(C)</enum><text>the seller.</text></subparagraph></paragraph>
<paragraph id="HFA94366DADC347508AD8E7A5651A6C18"><enum>(2)</enum><text>Improvements to information technology of the Department that the Secretary determines would reduce the time required for such review or processing.</text></paragraph></subsection> <subsection id="HD57E191DDB4A4A0398ACF12B82BB3E67"><enum>(d)</enum><header>GAO report; briefing</header> <paragraph id="H70165869BA5E493887843BF8B1776E1E"><enum>(1)</enum><header>Report</header><text display-inline="yes-display-inline">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:</text>
<subparagraph id="HF40E36F677E8437CA391B4C17C55BB0E"><enum>(A)</enum><text>The capacity of the office determined by the Secretary under such subsection, to carry out processing described in such subsection, including—</text> <clause id="HF8165D817A8F4C1EAB08CD655028FE5A"><enum>(i)</enum><text>a comprehensive assessment of employees of the Department who carry out chapter 39 of such title;</text></clause>
<clause id="H24FDFDAB3ABE4B4EB12D43EE2B810CA2"><enum>(ii)</enum><text>a comprehensive skills assessment indicating what resources the Secretary requires to otherwise improve such centralization, including additional funds, employees, or contractors; and</text></clause> <clause id="H2EBCFFC829884860BAFE9FA1C60EBEB0"><enum>(iii)</enum><text display-inline="yes-display-inline">a review of systems of information technology, including systems in use or to be acquired, to carry out such centralization.</text></clause></subparagraph>
<subparagraph id="H26BA1604659A4936A362C7E80144B35D"><enum>(B)</enum><text>Recommendations to improve such processing.</text></subparagraph> <subparagraph id="H5DA04A79732446199086D3E947ABE3E8"><enum>(C)</enum><text>Estimated costs to the United States to implement such recommendations.</text></subparagraph></paragraph>
<paragraph id="HA9E74FFBD3734FB2A3FB41FB9C268FF9"><enum>(2)</enum><header>Briefing</header><text>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.</text></paragraph></subsection></section> <section id="HB5FED9D3060C465B850937C2ECA19D63" section-type="subsequent-section"><enum>203.</enum><header>Monthly housing stipend under the Post-9/11 Educational Assistance Program for individuals who pursue summer programs of education solely through distance learning</header> <subsection id="H2AA5B807FDBD45E9B1E46D799CCC3732"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 3313(c)(1)(B) of title 38, United States Code, is amended—</text>
<paragraph id="H2B5902937DD941439374A4D1340D8F8A"><enum>(1)</enum><text>in clause (i), by striking <quote>and (iii)</quote> and inserting <quote>, (iii), and (iv)</quote>;</text></paragraph> <paragraph id="H82D10E3967F7486E916D7F106C8E3B77"><enum>(2)</enum><text>by redesignating clause (iv) as clause (v); and</text></paragraph>
<paragraph id="H59B0C8305E11471B9F631757774C40A3"><enum>(3)</enum><text>by inserting after clause (iii) the following new clause (iv):</text> <quoted-block style="USC" id="H454D71E22DAF499FAC394F33EDE9A4E6" display-inline="no-display-inline"> <clause id="H71A6A0E9AABE43C98D9683B31A79F1E8"><enum>(iv)</enum><text display-inline="yes-display-inline">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—</text>
<subclause id="HF4B3660F658D4EAAAFA15522ECB79031"><enum>(I)</enum><text display-inline="yes-display-inline">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</text></subclause> <subclause id="HA21F56917AF542B2AEF8B490F957AD43"><enum>(II)</enum><text>the lesser of—</text>
<item id="H83750DCFE9814BE093EF12735C4ECF5B"><enum>(aa)</enum><text>1.0 and</text></item> <item id="H2719D8CA740B4D6A9D4E0A2356DED862"><enum>(bb)</enum><text display-inline="yes-display-inline">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.</text></item></subclause></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H958E2E75AB044C888F724052458545BF"><enum>(b)</enum><header>Effective date</header><text display-inline="yes-display-inline">The amendments made by subsection (a) shall apply to a program of education beginning on or after August 1, 2027.</text></subsection></section> <section id="HBBAADEE3323345A8BAB9602E1229599D"><enum>204.</enum><header>Clarification regarding inclusion of medically necessary automobile adaptations in Department of Veterans Affairs definition of <quote>medical services</quote></header><text display-inline="no-display-inline">Section 1701(6)(I) of title 38, United States Code, is amended to read as follows:</text>
<quoted-block style="USC" id="HDE6FD4D05D204897B852DF6087DEF33B" display-inline="no-display-inline">
<subparagraph id="HC7913FE672464040B6B4DDDBA8EE03BF" indent="up1"><enum>(I)</enum><text display-inline="yes-display-inline">The provision of any medically necessary automobile adaptations for driver or passenger use, including—</text> <clause id="HF0618420CC6D4DA5BBA41798554C1779"><enum>(i)</enum><text>ramp and kneeling systems;</text></clause>
<clause id="H83183236BACA4755A21F5CBDEB81A716"><enum>(ii)</enum><text>raised doors or lowered floors;</text></clause> <clause id="HB72EF04439C047F093269F1D6F758F61"><enum>(iii)</enum><text>raised roofs;</text></clause>
<clause id="H61923224F5BB43EC8A47F65C76513B28"><enum>(iv)</enum><text>air conditioning;</text></clause> <clause id="HF6523A02708244238DAE175CE8BE6765"><enum>(v)</enum><text display-inline="yes-display-inline">occupied and unoccupied mobility lifts;</text></clause>
<clause id="H934D86E005244F8C932BBD7D6013D6DF"><enum>(vi)</enum><text>ingress or egress accessibility modifications; </text></clause> <clause id="HC3FB63E2AE9B46E38048B9979747F65D"><enum>(vii)</enum><text>wheelchair tiedowns; and</text></clause>
<clause id="HD2069F3EE6CD4411A2F799D19A7ECC23"><enum>(viii)</enum><text display-inline="yes-display-inline">adapted seating.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="HD7D7B20805644DDDB0CF04159B5D8184" section-type="subsequent-section"><enum>205.</enum><header>Digital communications: Solid Start program; educational assistance</header> <subsection id="H1392AA557D4244C4A342362687B3B95F"><enum>(a)</enum><header>Improvement to certain outreach under Solid Start program of Department of Veterans Affairs</header><text>Section 6320(b) of title 38, United States Code, is amended—</text>
<paragraph id="HAFD20A3CD8F3443ABE78127BDC0498D7"><enum>(1)</enum><text>in paragraph (1)(B)—</text> <subparagraph id="H34A736E185984592B5AF5AAD292DC615"><enum>(A)</enum><text>by striking <quote>calling</quote> and inserting <quote>communicating with</quote>; and</text></subparagraph>
<subparagraph id="HD1E0B40EA66C4345970638926163F664"><enum>(B)</enum><text>by inserting <quote>through the use of tailored lines of communication, including mailings, text messaging, virtual chatting, and other electronic forms of messaging</quote> after <quote>Armed Forces</quote>; and</text></subparagraph></paragraph> <paragraph id="HDFA41CC5C06D43F89AE70E7D7C4430C1"><enum>(2)</enum><text>in paragraph (2), by striking <quote>tailored mailings</quote> and inserting <quote>tailored lines of communication, including mailings, text messaging, virtual chatting, and other electronic forms of messaging,</quote>.</text></paragraph></subsection>
<subsection id="H42183824723C4055B898EF4F76190BEE"><enum>(b)</enum><header>Department of Veterans Affairs use of tailored lines of communication for correspondence relating to educational assistance benefits</header><text>Section 3680 of title 38, United States Code, is amended by adding at the end the following new subsection:</text> <quoted-block id="HDB8EC1938C5E4B9BB8A3897E75EAF88C" style="OLC"> <subsection id="H52149541A06B4903B75ED68775D8C848"><enum>(i)</enum> <paragraph id="H9F0FE8BB59FB4DA9A4345385AEE3454B" display-inline="yes-display-inline"><enum>(1)</enum><text>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.</text></paragraph>
<paragraph id="H99FFB37D9AAB426BBFBF28E14F9DEE1C" indent="up1"><enum>(2)</enum><text>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).</text></paragraph> <paragraph id="H97579313E7EB4159BD6EB6DD8F9329EC" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">In this subsection, the term <quote>tailored lines of communication</quote> includes mailings, text messaging, virtual chatting, and other electronic forms of messaging.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="HA60E9A0B0FFD4E778AF068BD68B32C0B" section-type="subsequent-section" commented="no"><enum>206.</enum><header>Improvements to Transition Assistance Program and Skillbridge</header>
<subsection id="H1006939F16EF404FAC8F48E2E14EF7B3" commented="no"><enum>(a)</enum><header>Transition Assistance Program: amendments; pilot program; reports</header>
<paragraph id="H5ADDAC7CA8394CFF922397558C94185C" commented="no"><enum>(1)</enum><header>Special operations forces</header><text display-inline="yes-display-inline">Subsection (a) of section 1142 of title 10, United States Code, is amended, in paragraph (1), by inserting <quote>(including each member of the special operations forces)</quote> after <quote>armed forces</quote>.</text></paragraph> <paragraph id="H8862F90268AC4132815B010D5DDB0F43"><enum>(2)</enum><header>Requirement of preseparation counseling: number of days</header><text>Such subsection is further amended, in paragraph (1)—</text>
<subparagraph id="H535E84B3BED74C19A7399DFE2F4475BE"><enum>(A)</enum><text>by inserting <quote>(A)</quote> before <quote>Within</quote>; and</text></subparagraph> <subparagraph id="HB0C40BBC1AD54934ACB881274B963B4B"><enum>(B)</enum><text>by adding at the end the following new subparagraph:</text>
<quoted-block id="H0DA5FD5EC6AA422B9BA1FF562833110A" style="OLC">
<subparagraph id="HE7A76E8E9D7D4A28803557C3AB330229" indent="up1"><enum>(B)</enum><text>The Secretary concerned shall ensure that a member described in subparagraph (A) receives preseparation counseling in the following amounts:</text> <clause id="H9F0280032C1E4D0B9720790545CD6309"><enum>(i)</enum><text>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.</text></clause>
<clause id="H8EDED4489F7F473DBE58DE7EB180D7B3"><enum>(ii)</enum><text>In the case of a member other than a member described in clause (i), not fewer than five days.</text></clause></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H938669E5789A473EB19759DEFA6E9092"><enum>(3)</enum><header>Repeat attendance</header><text>Such subsection is further amended by adding at the end the following new paragraph:</text>
<quoted-block id="H8AFA40736DD14BE68D13D561A10AACD9" style="OLC">
<paragraph id="HCFC115E3F38640D78DBC544B7F351E2E"><enum>(6)</enum><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> <paragraph id="HADDA0427240F4CF7AB199E72EF2ACE65"><enum>(4)</enum><header>Pathways: standardization; establishment of pathway for members of the reserve components</header><text>Such section is further amended, in paragraph (1) of subsection (c), in the matter preceding subparagraph (A)(1)—</text>
<subparagraph id="HCA967B09ABC942F6B783397AAA91438C"><enum>(A)</enum><text>by striking <quote>Each Secretary concerned</quote> and inserting <quote>The Secretaries of Defense and Homeland Security</quote>; and</text></subparagraph> <subparagraph id="H2C1F8681030F465D91A607776D5C3E0F"><enum>(B)</enum><text>by striking <quote>pathways for members of the military department concerned</quote> and inserting <quote>pathways, standardized across the armed forces</quote>.</text></subparagraph></paragraph>
<paragraph id="HB21C5E4A05EC43669B27C373AC52F53A"><enum>(5)</enum><header>Pathways: record of pathway assignment</header><text>Such subsection is further amended by adding at the end the following new paragraph:</text> <quoted-block id="H8710CEA2A5A8446C99E854312218DF04" style="OLC"> <paragraph id="H7AE62FB3BB9A49ADB0FE72422750C4DF"><enum>(4)</enum><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="HC1497D17700B48CA967D98DACD80511F"><enum>(6)</enum><header>Coordination between Departments of Defense, Veterans Affairs, and Labor</header><text>Such section is further amended, in subsection (d)—</text> <subparagraph id="HC9E385D0423641CC8E71D3C29941FB66"><enum>(A)</enum><text>by striking the heading and inserting <quote><header-in-text level="subsection" style="OLC">Transmission of Certain Information to Other Departments</header-in-text></quote>;</text></subparagraph>
<subparagraph id="H4DAA57CD7DEE45368E121D3787626509"><enum>(B)</enum><text>by inserting <quote>(1)</quote> before <quote>In the case</quote>; and</text></subparagraph> <subparagraph id="H80929878ED784A958B5BFD3592D42178"><enum>(C)</enum><text>by adding at the end the following new paragraphs:</text>
<quoted-block id="HB7C9769484D94963A8BD3A3EF205EBBC" style="OLC">
<paragraph id="HE6D81AA1ED314A96A98057444747BD8B"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text> </paragraph> <paragraph id="H82F9544713494DADA348302E13DDF060"><enum>(3)</enum> <subparagraph id="HD4875E496D74401392C42DF7155F1ABE" display-inline="yes-display-inline"><enum>(A)</enum><text>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</text></subparagraph>
<subparagraph id="HB7C4FAD1A6404986876F604E94855ABE" indent="up1"><enum>(B)</enum><text>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.</text></subparagraph> <subparagraph id="HFD06CCA4FAE9411D974AA15C246FA765" indent="up1"><enum>(C)</enum><text>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.</text></subparagraph>
<subparagraph id="H02BE4CBBA1F948BCA3B9317F387226AA" indent="up1"><enum>(D)</enum><text>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 <quote>at risk for a difficult transition to civilian life</quote>.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="HBD66F85745AF4573A3E3AAC4F6CB19DA" commented="no"><enum>(7)</enum><header>Report</header><text display-inline="yes-display-inline">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. </text>
<subparagraph id="H4F6B078AD97C485F8EC4111F10941E61" commented="no"><enum>(A)</enum><text>The number of members who, in the course of such preseparation counseling, were referred to another Federal agency or department.</text></subparagraph> <subparagraph id="HB76A87D7CE134515B6B0ADEA934B9A03" commented="no"><enum>(B)</enum><text>The Federal agencies or departments to which members were so referred.</text></subparagraph>
<subparagraph id="H808EA290949F4D848567A45FBDA787DD" commented="no"><enum>(C)</enum><text>The number of members who should have been, but were not, so referred, and reasons why such referrals did not occur.</text></subparagraph> <subparagraph id="H6BE35F40FD6949F894DA651223FE18AE" commented="no"><enum>(D)</enum><text>The number of members who receive such preseparation counseling and apply for unemployment compensation under subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/85">chapter 85</external-xref> of title 5, United States Code.</text></subparagraph>
<subparagraph id="H5418F12025994518B91A890F8C832745" commented="no"><enum>(E)</enum><text>The total amount of such unemployment compensation paid to members separating from the Armed Forces.</text></subparagraph> <subparagraph id="HF0DCB28DA15341C7AA5B692ED41D9C40" commented="no"><enum>(F)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="H842824F532E845B58C509BEA7611232D" commented="no"><enum>(8)</enum><header>Contracting: standardization</header><text display-inline="yes-display-inline">Such section is further amended by adding at the end the following new subsection:</text> <quoted-block style="USC" id="H647D217AB73A447289C46BE7CF6D522C" display-inline="no-display-inline"> <subsection id="HF535B23DD38943CC97EFE74B99BDB655" commented="no"><enum>(f)</enum><header>Contracting</header><text display-inline="yes-display-inline">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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H957B755FDADB45CE8B397B43F185EB71" commented="no"><enum>(9)</enum><header>Annual report on TAP participation</header><text display-inline="yes-display-inline">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. </text></paragraph></subsection> <subsection id="H49FFD5BB3D8842D9B9525C53BDDB04DD" commented="no"><enum>(b)</enum><header>Skillbridge: GAO study</header> <paragraph id="HEB04683BD19E415D8B934D90D47724FB" commented="no"><enum>(1)</enum><header>Study required</header><text>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.</text></paragraph>
<paragraph id="HCD537B2B8759402AB17E0F41AD552D04" commented="no"><enum>(2)</enum><header>Report</header><text display-inline="yes-display-inline">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—</text> <subparagraph id="H82BF4413AFF34663A5E9BC5F60B01D20" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">differences in criteria for participation between the Armed Forces;</text></subparagraph>
<subparagraph id="HE407E712F26541838FDD58456332A438" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">other differences in Skillbridge programs between the Armed Forces;</text></subparagraph> <subparagraph id="H964ED0843B9E44DAB16FE91DF433E0F1" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">best practices in Skillbridge programs across the Armed Forces, including—</text>
<clause id="H01230EBA340B432DA8BA11B5412DCA8E" commented="no"><enum>(i)</enum><text>the selection of employers; and</text></clause> <clause id="HD305303BD90C4965BB5F283D93F38C0F" commented="no"><enum>(ii)</enum><text>the development of contracts; and</text></clause></subparagraph>
<subparagraph id="H7CF3B86D1D22425FA32EAB728E08034D" commented="no"><enum>(D)</enum><text display-inline="yes-display-inline">the feasibility of making Skillbridge programs uniform across the Armed Forces.</text></subparagraph></paragraph></subsection> </section> <section id="HC45507CD8EBF408290DA383FC5A78D26" section-type="subsequent-section"><enum>207.</enum><header>Transition Assistance Program: presentation in preseparation counseling to promote benefits available to veterans</header> <subsection id="HD6B5861557BB467E9EDEA4937C6752F0"><enum>(a)</enum><header>In general</header><text>Section 1142(b) of title 10, United States Code, is amended by adding at the end the following new paragraph:</text>
<quoted-block id="HBD1FB5618C534157BC60FABFC816B747" style="USC">
<paragraph id="HB8BAF72B96A84595B5AC18DA295AAE38"><enum>(20)</enum><text>A presentation that promotes the benefits available to veterans under the laws administered by the Secretary of Veterans Affairs. Such presentation—</text> <subparagraph id="H7AE1378A864A47E3AC78DF72EBB23778"><enum>(A)</enum><text>shall be standardized;</text></subparagraph>
<subparagraph id="H991188E2B85F4422A1C5D6BE91057724"><enum>(B)</enum><text display-inline="yes-display-inline">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;</text></subparagraph> <subparagraph id="H98B2A8A7CB564F64BEAA559172DABD3B"><enum>(C)</enum><text display-inline="yes-display-inline">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;</text></subparagraph>
<subparagraph id="HF7F65D897A0440798339ADE3EF930A40"><enum>(D)</enum><text>where available, shall be presented with the participation of—</text> <clause id="HBBFB26A501AC4C4EA09D8447B3E8A4CE"><enum>(i)</enum><text display-inline="yes-display-inline">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</text></clause>
<clause id="H0B642672AC8345C5952D3A245B53503A"><enum>(ii)</enum><text display-inline="yes-display-inline">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;</text></clause> </subparagraph> <subparagraph id="H7FDADA43144847E783B6DFC30CD2381C"><enum>(E)</enum><text>shall include information on how a veterans service organization may assist the member in filing a claim described in paragraph (19);</text></subparagraph>
<subparagraph id="HBDA48515C9A34B0A93B843AFF9B0DC52"><enum>(F)</enum><text>may not encourage the member to join a particular veterans service organization; and</text></subparagraph> <subparagraph id="HA567409B77CA4B8A96E4C73D32A3FA94"><enum>(G)</enum><text>may not be longer than one hour.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HD4FB5D3669CC41CF8FAF01852D7A98D2"><enum>(b)</enum><header>Annual report</header><text>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—</text> <paragraph id="H85F18C50C4E1411F8FD9E40E18649F20"><enum>(1)</enum><text>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);</text></paragraph>
<paragraph id="HD51136DA2EB542A09D5304E08630DC18"><enum>(2)</enum><text>contains the number of members of the Armed Forces who attended such presentations; and</text></paragraph> <paragraph id="H44824BBD8EB447BDB28995261D352122"><enum>(3)</enum><text>includes any recommendations of the Secretary regarding changes to such presentation or to such paragraph.</text></paragraph></subsection></section>
<section id="HA39C082A817345FEA8191B14D39357F0"><enum>208.</enum><header>Elimination of requirement that on-campus educational and vocational counseling is provided by certain Department of Veterans Affairs employees</header>
<subsection id="H73161F2EB6074116ADF702C56432756D" commented="no"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 3697B(a) of title 38, United States Code, is amended—</text> <paragraph id="HA01084557AB34C83983E77F89F993757" commented="no"><enum>(1)</enum><text>by striking the second sentence;</text></paragraph>
<paragraph id="HCCE7D9CFAB9A40A8A58B713DAD97A38F" commented="no"><enum>(2)</enum><text>by inserting <quote>(1)</quote> before <quote>The Secretary</quote>; and</text></paragraph> <paragraph id="HE2BFE04AD7514787B00EF7DA5D1C6504" commented="no"><enum>(3)</enum><text>by adding at the end the following new paragraph: </text>
<quoted-block style="OLC" id="HCCF3C6269E57435E8C84ADDD1E0D2DFE" display-inline="no-display-inline">
<paragraph id="HCC6D96CB481A456A8C5194D9F3E745CC" indent="up1" commented="no"><enum>(2)</enum><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="HDD539EC643F04F20AB3C2EB68352A926" commented="no" display-inline="no-display-inline"><enum>(b)</enum><header display-inline="yes-display-inline">Expansion of VetSuccess on Campus program to at least one location in each State</header> <paragraph id="H1567683CFBB9470F95141DEFB1A5E0C3" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs shall ensure that the VetSuccess on Campus program of the Department of Veterans Affairs is located in every State.</text></paragraph>
<paragraph id="HBE8ED73416FD4BF8BC66682EC9C79803" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header display-inline="yes-display-inline">Counselors</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="HD1040C9A545D43F5B90C41BB432927BA" commented="no" display-inline="no-display-inline"><enum>(3)</enum><header display-inline="yes-display-inline">Preference</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="H2B634FA629A441C4936DED8E92E9D322" commented="no" display-inline="no-display-inline"><enum>(4)</enum><header display-inline="yes-display-inline">State defined</header><text display-inline="yes-display-inline">In this section, the term <term>State</term> has the meaning given such term in section 101 of title 38, United States Code.</text></paragraph></subsection></section> <section section-type="subsequent-section" id="H9B69625E7D824A19A3AF3A77057E0B21"><enum>209.</enum><header>Expansion of entitlement for payment for licensing or certification tests for veterans entitled to educational assistance</header><text display-inline="no-display-inline">Section 3315 of title 38, United States Code, is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H745C65FA4B724F6AA153B6DCFB5404B8"><enum>(1)</enum><text display-inline="yes-display-inline">in subsection (a), by striking <quote>educational assistance under this chapter</quote> and inserting <quote>covered assistance</quote>;</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H52CF985A70E64E85B2C0B67F879FB9BE"><enum>(2)</enum><text>in subsection (b)(3), by striking <quote>under this chapter</quote> and inserting <quote>with respect to covered assistance</quote>;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H00B5641C82564B7DB41DE3184F039115"><enum>(3)</enum><text>in subsection (c), in the matter preceding paragraph (1), by striking <quote>under this chapter</quote> and inserting <quote>with respect to covered assistance</quote>; and</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H55CB9CBF7DE64629AA0ACECF33A20D17"><enum>(4)</enum><text>by adding at the end the following new subsection:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H44269B2F8D2C4DEC8B2FE3179735133C">
<subsection id="HBE4E595B57574A32BF26B22A0F2D4E5E" commented="no"><enum>(d)</enum><header>Warnings</header><text>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.</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="H37EE64ED7424460A8693EF2493E22DE8"><enum>(e)</enum><header>Covered assistance defined</header><text>In this section, the term <term>covered assistance</term> means educational assistance available under—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H30D0B513182C45C78DB99D45373D2F7B"><enum>(1)</enum><text display-inline="yes-display-inline">this chapter, chapter 30 of this title, chapter 35 of this title, or <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/10/1606">chapter 1606</external-xref> of title 10; or</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H884157B783A441C6AE6D955BEB19F159"><enum>(2)</enum><text>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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>
<section id="HA93D1915DF7241129EBD7A40F988006E"><enum>210.</enum><header>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</header><text display-inline="no-display-inline">Section 3313(g)(3)(B) of title 38, United States Code, is amended—</text> <paragraph id="H636B328C385045F79A248721CEEDDD0B"><enum>(1)</enum><text display-inline="yes-display-inline">in the matter preceding clause (i), by inserting <quote>using educational assistance under this chapter</quote>; and</text></paragraph>
<paragraph id="HB71FB4162B2540459A89173821FF8345"><enum>(2)</enum><text>in clause (i)(II), by striking <quote>80 percent</quote> and inserting <quote>100 percent</quote>.</text></paragraph></section> <section id="HEAE716EFF7A3471D81434DE93079EFFE"><enum>211.</enum><header>Improving emerging technology opportunities for veterans</header> <subsection id="H07C501CD07D644209504C2B282675941"><enum>(a)</enum><header>Inclusion of emerging technologies in high technology program</header> <paragraph id="H5CB2A7A785334890ADC3C62313758B7A"><enum>(1)</enum><header>In general</header><text>Section 3699C of title 38, United States Code, is amended—</text>
<subparagraph id="HED9C4779033349D697451551EA3328C3"><enum>(A)</enum><text>in the section heading by striking <quote><header-in-text level="section" style="USC">High technology</header-in-text></quote> and inserting <quote><header-in-text level="section" style="USC">High technology and emerging technology</header-in-text></quote>; </text></subparagraph> <subparagraph id="H495D85776ADB48398E30521867C1BC7B"><enum>(B)</enum><text>by striking <quote>high technology</quote> and inserting <quote>high technology or emerging technology</quote> each place such term appears; and</text></subparagraph>
<subparagraph id="H5899A79E7E284633BB6901950BB05234"><enum>(C)</enum><text>in subsection (c)(4) by adding at the end the following new subparagraph:</text> <quoted-block style="USC" id="H957E460720AC404AA9EEC45455719C0A" display-inline="no-display-inline"> <subparagraph id="HDE8F344E19DF413C804E77A4A4B29EF2" indent="up2"><enum>(E)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="HF031020A72844B079D187A20888AE039"><enum>(2)</enum><header>Clerical amendment</header><text display-inline="yes-display-inline">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:</text> <quoted-block style="USC" id="H5BFCBD77D0764629B3362229914DFA10" display-inline="no-display-inline"> <toc regeneration="no-regeneration"> <toc-entry level="section">3699C. High technology and emerging technology program.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> <paragraph id="HDDFCF6EE5E80475B899AC5B4DD0AD978"><enum>(3)</enum><header>Conforming amendments</header><text>Section 3680A of title 38, United States Code, is amended in subsections (a)(4)(B) and (d)(8) by striking <quote>high technology</quote> each place such term appears and inserting <quote>high technology or emerging technology</quote>. </text></paragraph></subsection>
<subsection id="H68DD973DC8D54659A944D8639FEBFAED"><enum>(b)</enum><header>Employment rate calculation for VET-TEC high technology and emerging technology program</header><text>Section 3699C of title 38, United States Code, is amended—</text> <paragraph id="HF81BB9A9910440CBBFFE03B03EFBC13F"><enum>(1)</enum><text>in subsection (f)—</text>
<subparagraph id="H8E7DCC00804F4D57B4B9B4AA8D041ECF"><enum>(A)</enum><text>in the matter preceding paragraph (1) by inserting after <quote>House of Representatives</quote> the following: <quote>, and make available to the public,</quote>; and</text></subparagraph> <subparagraph id="H9B1BD41203A842B39092A009BFBA59DB"><enum>(B)</enum><text>in paragraph (3) by adding at the end the following: <quote>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.</quote>; and</text></subparagraph></paragraph>
<paragraph id="H11CB5F86631B41BA9CF1A1BEC1812986"><enum>(2)</enum><text>in subsection (g) by adding at the end the following new paragraph:</text> <quoted-block style="USC" id="H0B4D859F1157499BA307BE4F43F95302" display-inline="no-display-inline"> <paragraph id="H3366A48583F14395A59BBB4AE2BDBDB1" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section>
<enum>III</enum><header>Health Care</header>
<section commented="no" display-inline="no-display-inline" id="HDF25650CC5204882A9B8265F7D65BA96"> <enum>301.</enum> <header>Extension and modification of transportation grant program of Department of Veterans Affairs</header> <text display-inline="no-display-inline">Section 307 of the Caregivers and Veterans Omnibus Health Services Act of 2010 (<external-xref legal-doc="public-law" parsable-cite="pl/111/163">Public Law 111–163</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1710">38 U.S.C. 1710</external-xref> note) is amended—</text> <paragraph commented="no" display-inline="no-display-inline" id="H722BDFA853474D088EAB4EBF8C4FD3E4"> <enum>(1)</enum> <text>in subsection (a)—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HE0D0673FA9A1461785B60D32CBD26AF5"> <enum>(A)</enum> <text display-inline="yes-display-inline">in paragraph (2), by adding at the end the following new subparagraphs:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H7C7DD148CBCD4960B32B7A16153AD56A"> <subparagraph id="H4A7D0C7BB8F54084ADED6C99A4C841F6"> <enum>(C)</enum> <text>Indian tribes.</text> </subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HDBF3B968D96646A98F70DE1467E69042"> <enum>(D)</enum> <text display-inline="yes-display-inline">Tribal organizations.</text> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HF5AF22EF464E481D9368CACA934F09C1"> <enum>(E)</enum> <text display-inline="yes-display-inline">Native Hawaiian organizations.</text> </subparagraph>
<subparagraph id="HB1D2BC01745448C89CB93B9E04F94587"> <enum>(F)</enum> <text>County veterans service organizations.</text> </subparagraph> <after-quoted-block>;</after-quoted-block> </quoted-block> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H82CF94885736478888E4E289165FDD01"> <enum>(B)</enum> <text>in paragraph (3), in the matter preceding subparagraph (A), by striking <quote>State veterans service agency or veterans service organization awarded</quote> and inserting <quote>recipient of</quote>; and</text> </subparagraph>
<subparagraph id="H3A16EB7E6B744A5B91F6D798D79B4419"> <enum>(C)</enum> <text>by amending paragraph (4) to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H056B25367D32496FB3747CAADF5D780D"> <paragraph id="HDF0F3E9F59534126ACCA3945323F3BF3"> <enum>(4)</enum> <header>Maximum amount</header> <subparagraph commented="no" display-inline="no-display-inline" id="H9093883ED23B44C3B947292749F5B00E"> <enum>(A)</enum> <header>In general</header> <text display-inline="yes-display-inline">Except as provided in subparagraphs (B) and (C), the amount of a grant under this section may not exceed $50,000.</text> </subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HE6DC42106D5E452389681413FB168C45"> <enum>(B)</enum> <header>Off-road communities</header> <text>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).</text> </subparagraph> <subparagraph id="HAF45646A1CD5459BA8331E92580EBE91"> <enum>(C)</enum> <header>Purchasing a vehicle</header> <clause id="H0096C29E3D224CEBAC378BF670A8AC33"> <enum>(i)</enum> <header>Amount</header> <text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/12101">42 U.S.C. 12101 et seq.</external-xref>) in carrying out this section.</text> </clause>
<clause id="HBCCD56AD4B934927810047161FFAAF0C"> <enum>(ii)</enum> <header>Limitations</header> <text>The Secretary may prescribe limitations on the number of vehicles purchased by each recipient under this section.</text> </clause> </subparagraph> </paragraph> <after-quoted-block>;</after-quoted-block> </quoted-block> </subparagraph> </paragraph> <paragraph id="H4395775C998F42459C7785E3E3E5C776"> <enum>(2)</enum> <text>by striking subsection (d);</text></paragraph>
<paragraph id="H8E341D176160486682FC02589E6F7830"><enum>(3)</enum><text>by redesignating subsections (b) and (c) as subsections (d) and (e), respectively;</text> </paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HE56BCAD260C043D9A4AD6FB37B0CF382"> <enum>(4)</enum> <text>by inserting after subsection (a) the following new subsections:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H45318DB8332C407E95EDC8225867BEBE">
<subsection commented="no" display-inline="no-display-inline" id="H4D98FBC5C72E4A989C8270F81AD7FE12"> <enum>(b)</enum> <header>Additional services</header>
<paragraph commented="no" display-inline="no-display-inline" id="HA3A13E16083D4BD6B9DCC071E9EECD57"> <enum>(1)</enum> <header>Nearby rural areas</header> <text display-inline="yes-display-inline">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.</text> </paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H4DFAA069436E4814AD892E41EDEB1653"> <enum>(2)</enum> <header>Priority</header> <text display-inline="yes-display-inline">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—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H4944D598153443AE966EDB145F7E8B1C"> <enum>(A)</enum> <text display-inline="yes-display-inline">it does not impede the services provided to veterans in highly rural areas; and</text> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H7AB2BAC754504A089496A2FB86E5F904"> <enum>(B)</enum> <text display-inline="yes-display-inline">the grantee has excess capacity and resources available to provide such services to veterans in nearby rural areas.</text> </subparagraph> </paragraph> </subsection>
<subsection commented="no" display-inline="no-display-inline" id="HBFF73A7A079D45E18D2E94B24C1D3328"> <enum>(c)</enum> <header display-inline="yes-display-inline">Eligibility of previous areas</header> <text>Areas eligible for assistance under the grant program under this section on the day before the date of the enactment of the <short-title>Supporting Rural Veterans Access to Healthcare Services Act</short-title> shall remain eligible for such assistance on and after such date of enactment.</text> </subsection> <after-quoted-block>; and</after-quoted-block> </quoted-block> </paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HE8DEE05E4666411DA794C7E2CD307D99"> <enum>(5)</enum> <text display-inline="yes-display-inline">in subsection (e), as redesignated by paragraph (2)—</text>
<subparagraph id="HE1036C3F116446CAB8BCF6399E7D2AE1"> <enum>(A)</enum> <text>by redesignating paragraph (2) as paragraph (5); and</text> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H4E7373A66A634EF294DBC85ABA3CC728"> <enum>(B)</enum> <text display-inline="yes-display-inline">by striking paragraph (1) and inserting the following:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HE206907B47544B958834FB80FC7DBF0A">
<paragraph id="HF341F2A1F30E439A934D2013E43B99F7" commented="no" display-inline="no-display-inline"> <enum>(1)</enum> <header display-inline="yes-display-inline">Indian tribe; Tribal organization</header> <text display-inline="yes-display-inline">The terms <term>Indian tribe</term> and <term>Tribal organization</term> have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act (<external-xref legal-doc="usc" parsable-cite="usc/25/5304">25 U.S.C. 5304</external-xref>).</text> </paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HD6E61EC33F3A4C1FBC0782C19CBAF956"> <enum>(2)</enum> <header>Native Hawaiian organization</header> <text>The term <term>Native Hawaiian organization</term> has the meaning given that term in section 6207 of the Elementary and Secondary Education Act of 1965 (<external-xref legal-doc="usc" parsable-cite="usc/20/7517">20 U.S.C. 7517</external-xref>).</text> </paragraph>
<paragraph id="HB159DA6F751C4D1DAAA88BA9D272F120"> <enum>(3)</enum> <header>Nearby</header> <text>The term <term>nearby</term>, 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.</text> </paragraph> <paragraph id="HEEB5C088F5984450AD65A58D5560A24D"> <enum>(4)</enum> <header>Rural; highly rural</header> <text>The terms <term>rural</term> and <term>highly rural</term> have the meanings given those terms under the Rural-Urban Commuting Areas (RUCA) coding system of the Department of Agriculture.</text> </paragraph> <after-quoted-block>.</after-quoted-block> </quoted-block> </subparagraph> </paragraph> </section>
<section section-type="subsequent-section" id="H41F6889DF7EF43A3B4BBA680AAE53DC4" display-inline="no-display-inline"> <enum>302.</enum> <header>Veteran Caregiver Reeducation, Reemployment, and Retirement Act</header>
<subsection id="H1103448F3B384BE09DE97E295A8F7844"> <enum>(a)</enum> <header>Extension of period of medical care coverage for caregivers designated as primary providers of personal care services for veterans</header> <text>Section 1781(a)(4) of title 38, United States Code, is amended by inserting before the comma at the end the following: <quote>, 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</quote>.</text> </subsection> <subsection id="HFD0E9E4A4B4E439C9FA82A85450E917F"> <enum>(b)</enum> <header>Employment and other benefits for caregivers designated as primary providers of personal care services for veterans</header> <paragraph id="H95F5E665EBF34C4FAEA56D4CE33A237C"> <enum>(1)</enum> <header>Employment assistance</header> <text display-inline="yes-display-inline">Section 1720G of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HCBB906BFA5FE4027A2D3840BD569BDD2">
<subsection id="H78F79BC816F346058D54C36B6A39D8AE"> <enum>(e)</enum> <header>Employment assistance</header>
<paragraph commented="no" display-inline="yes-display-inline" id="HCA3F2E42F8D3474381DEA1AA8EFBAC48"> <enum>(1)</enum> <text display-inline="yes-display-inline">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:</text> <subparagraph id="H604B32227E3C403D93DD4C68795B09D4" indent="up1"> <enum>(A)</enum> <text display-inline="yes-display-inline">Reimbursement of fees associated with certifications or relicensure necessary for such employment.</text> </subparagraph>
<subparagraph id="H78FDC7EFFB634B4E9B79302C2A3AEEB0" indent="up1"> <enum>(B)</enum> <text>For purposes of gaining credit for continuing professional education requirements, access to training modules of the Department at no cost.</text> </subparagraph> <subparagraph indent="up1" id="H1CC07D761B2B4F58838617F7B498E6FC"> <enum>(C)</enum> <text display-inline="yes-display-inline">In consultation with the Secretary of Defense and the Secretary of Labor, access to existing employment assistance resources and programs as considered appropriate.</text> </subparagraph> </paragraph>
<paragraph indent="up1" id="H735A43A3526F42A2937700A457DE54FD"> <enum>(2)</enum> <text display-inline="yes-display-inline">An individual described in paragraph (1) shall have access to assistance described in such paragraph—</text> <subparagraph id="HD1CAA26DE13C45A5B543840B8F7AEA5E"> <enum>(A)</enum> <text display-inline="yes-display-inline">while participating in the program established under subsection (a)(1); and</text> </subparagraph>
<subparagraph id="H4E6047675C4A4B45A878943A0EDCCA34"> <enum>(B)</enum> <text display-inline="yes-display-inline">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.</text> </subparagraph> </paragraph> <paragraph indent="up1" id="HBF1D0991F885434AB59C29591B2AB18A"> <enum>(3)</enum> <text display-inline="yes-display-inline">The maximum lifetime amount that may be reimbursed for an individual under paragraph (1)(A) is $1,000.</text> </paragraph> </subsection> <after-quoted-block>.</after-quoted-block> </quoted-block> </paragraph>
<paragraph id="HB07590593BF847DA8E57A5FD90C3C5E2"> <enum>(2)</enum> <header>Expansion of available services</header> <text>Subsection (a)(3)(A)(ii) of such section is amended—</text> <subparagraph id="H9A8857D7658B44E0874E6F50B8A9F2D1"> <enum>(A)</enum> <text>in subclause (V), by striking <quote>; and</quote> and inserting a semicolon;</text> </subparagraph>
<subparagraph id="HEE17C581149E42AA9A61404FEC228E1E" commented="no"> <enum>(B)</enum> <text>in subclause (VI)—</text> <clause id="H729D39F0F4334C8B800227F11920F8DC" commented="no" display-inline="no-display-inline"> <enum>(i)</enum> <text display-inline="yes-display-inline">in the matter preceding item (aa), by inserting <quote>or agreements</quote> after <quote>contracts</quote>;</text> </clause>
<clause id="H9E936B2C462941C989C3C05E0F0B82C1" commented="no" display-inline="no-display-inline"> <enum>(ii)</enum> <text>in item (aa), by inserting <quote>, including retirement planning services,</quote> after <quote>services</quote>; and</text> </clause> <clause id="HCF4F42D6B5BB403390CBF9B4A2E053E5" commented="no" display-inline="no-display-inline"> <enum>(iii)</enum> <text display-inline="yes-display-inline">in item (bb), by striking the period at the end and inserting <quote>; and</quote>; and</text> </clause> </subparagraph>
<subparagraph id="HA7DF0818D35142629A09F3C82C58DC8C" commented="no" display-inline="no-display-inline"> <enum>(C)</enum> <text>by adding at the end the following new subclause:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HC871814E722B42FEA39F08A1D1E1C52F"> <subclause commented="no" display-inline="no-display-inline" id="HC0418ACB8E394F11BD98656E1372834E" indent="up2"> <enum>(VII)</enum> <text>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.</text> </subclause> <after-quoted-block>.</after-quoted-block> </quoted-block> </subparagraph> </paragraph>
<paragraph id="H5D98C6BE3D904C089A8838BE9DF09ED6"> <enum>(3)</enum> <header>Assistance returning to workforce</header> <text>Subclause (VI) of such subsection is further amended—</text> <subparagraph id="H39537FC677EE4422A232F908CF5C9C6F" commented="no" display-inline="no-display-inline"> <enum>(A)</enum> <text display-inline="yes-display-inline">in item (aa), by striking <quote>; and</quote> and inserting a semicolon; and</text> </subparagraph>
<subparagraph id="H7C7EC2A92DCD4C7F8ED3F8292722A993" commented="no" display-inline="no-display-inline"> <enum>(B)</enum> <text>by adding at the end the following new item:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H316E27D4800F460DB025750F3511D0BC"> <item commented="no" display-inline="no-display-inline" id="H1487EDEDDF1D4D1582C612A18B8FBE48" indent="up2"> <enum>(cc)</enum> <text>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</text> </item> <after-quoted-block>.</after-quoted-block> </quoted-block> </subparagraph> </paragraph>
<paragraph id="H79D72AFB2FAC45AEB735753C942BA79F"> <enum>(4)</enum> <header>Bereavement counseling and support</header> <text>Subsection (a)(3)(A)(i)(III) of such section is amended by inserting before the semicolon the following: <quote>, including bereavement counseling and support following the death of the eligible veteran</quote>.</text> </paragraph> <paragraph id="H1C614BB745194E00B9607AAE25574E59"> <enum>(5)</enum> <header>Study on provision of returnship program</header> <subparagraph id="H6B0C211ADA7F439E89742BE92E23B3D6"> <enum>(A)</enum> <header>In general</header> <text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, 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.</text> </subparagraph>
<subparagraph id="H539CDAEE342A44FDBC83C21F3011E879"> <enum>(B)</enum> <header>Report</header> <text>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.</text> </subparagraph> </paragraph> <paragraph id="HF2B7C28648D245EF80FFE2A667E009DC"> <enum>(6)</enum> <header>Study on incorporating former caregivers into workforce of Department of Veterans Affairs</header> <subparagraph id="H2E257821F7824526AF0433A588446053"> <enum>(A)</enum> <header>In general</header> <text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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.</text> </subparagraph>
<subparagraph id="H8D655850124D40CBB8254F7AF285DB08"> <enum>(B)</enum> <header>Report</header> <text display-inline="yes-display-inline">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—</text> <clause id="H7228394C8785461EBBD622E2DD91E9D1" commented="no" display-inline="no-display-inline"> <enum>(i)</enum> <text display-inline="yes-display-inline">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</text> </clause>
<clause id="HB433EFB4D7394C0B9DCEBF26DD902CD4" commented="no" display-inline="no-display-inline"> <enum>(ii)</enum> <text display-inline="yes-display-inline">such recommendations for legislative or administrative action as the Secretary considers appropriate.</text> </clause> </subparagraph> </paragraph> </subsection> <subsection id="H75A71F6FA34745C7B53F214826F52A5D"><enum>(c)</enum><header>Comptroller General report on efforts of Department of Veterans Affairs in supporting family caregivers transitioning away from caregiving</header><text>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.</text></subsection>
<subsection id="HFDDA5C03025047A8AE2FBEA5457346F9"><enum>(d)</enum><header>Report on feasibility and advisability of establishing a retirement plan or retirement savings for family caregivers of certain veterans</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, in consultation with the Secretary of 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—</text> <paragraph id="HA2E4D951CE454C69A4BDA06D5FD6D443"><enum>(1)</enum><text>establishing an individual retirement plan (as defined in <external-xref legal-doc="usc" parsable-cite="usc/26/7701">section 7701(a)(37)</external-xref> of the Internal Revenue Code of 1986 (<external-xref legal-doc="usc" parsable-cite="usc/26/7701">26 U.S.C. 7701(a)(37)</external-xref>)) or similar retirement plan; or</text></paragraph>
<paragraph id="H9423C05B71CE4CB7A754DAE172004643"><enum>(2)</enum><text>permitting such individuals to join an already established pathway to retirement savings.</text></paragraph></subsection></section> <section id="H92A049E33763447CA8D4B73996ABF561"><enum>303.</enum><header>Veterans TBI Breakthrough Exploration of Adaptive Care Opportunities Nationwide Act</header> <subsection id="H9831863BF8C7488E8EAFF9C1E41FA6F0"><enum>(a)</enum><header>Department of Veterans Affairs grant program for supplemental neurorehabilitation approaches to chronic mild TBI treatment</header> <paragraph id="H597567414C984DD48850BD9238BE2F16"><enum>(1)</enum><header>Grant program</header> <subparagraph id="H396BF40909814635A07E5E9B938CE9D4"><enum>(A)</enum><header>In general</header><text>The Secretary of Veterans Affairs shall carry out a three-year program (to be known as the <quote>TBI Innovation Grant Program</quote>) 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 <quote>mTBI</quote>) in veterans.</text></subparagraph>
<subparagraph id="H1ED6EA8E2E124A2CB9448AC54C509D9B"><enum>(B)</enum><header>Relationship to other Department activities</header><text display-inline="yes-display-inline">The grant program required under subparagraph (A) shall be carried out in a manner that—</text> <clause id="H2A518B6AA1294077992B7C0945FE1B63"><enum>(i)</enum><text>supplements, and does not supplant, other clinical care and research of the Department of Veterans Affairs relating to mTBI; and</text></clause>
<clause id="H79EB26B76A6E47A0AB64B4709F315D39"><enum>(ii)</enum><text>facilitates, as practicable, coordination with Veterans Health Administration facilities for referral, continuity of care, and dissemination of findings.</text></clause></subparagraph></paragraph> <paragraph id="H901BC34770234C159ED42F29D299FBB1"><enum>(2)</enum><header>Eligible entities described</header><text>An eligible entity described in this paragraph is any of the following:</text>
<subparagraph id="HCE563C1C314645668FA115B4AA096120"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H72B21F29F95349C797197ECD27E4D5B7"><enum>(B)</enum><text display-inline="yes-display-inline">An academic institution that conducts significant research on mTBI and has demonstrated capability to conduct clinical trials relating to neurorehabilitation treatments.</text></subparagraph>
<subparagraph id="H2E65BCC782C54E19ABDBF3CCE6702852"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H98912929572449B4A8F8AD1BDB4C63D8"><enum>(D)</enum><text display-inline="yes-display-inline">A partnership or consortium of two or more entities described in subparagraphs (A) through (C).</text></subparagraph></paragraph>
<paragraph id="H98990D6F499846729F4B807BC43118F8"><enum>(3)</enum><header>Use of funds</header><text>An eligible entity in receipt of a grant under this subsection shall use such grant to support activities that include—</text> <subparagraph id="HEFF6FB0BB27142F1BE8362CB3F6A9967"><enum>(A)</enum><text>designing and testing novel or integrative treatments for mTBI that prioritize patient-centered care, including non-pharmacological therapies;</text></subparagraph>
<subparagraph id="HCC56750B8D3C486089F9EA74FC8D4064"><enum>(B)</enum><text>conducting clinical studies and assessments to measure the effectiveness of funded approaches to—</text> <clause id="HD485AC4849B34010A81AF3F7B5CDA82A"><enum>(i)</enum><text>improve mental health outcomes among veterans;</text></clause>
<clause id="HA2C3C6D4728B4CC49B1700E1872F0298"><enum>(ii)</enum><text>reduce suicidality, and common risk factors for completing suicide, including depression and substance use disorders among veterans; and</text></clause> <clause id="HFE368B243219476DB254F864D82677E5"><enum>(iii)</enum><text display-inline="yes-display-inline">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;</text></clause></subparagraph>
<subparagraph id="H99E7BFC63B9F4E8C91BCF67D97829576"><enum>(C)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="H5F78C601D3364DDFAB7B09A9CE795429"><enum>(D)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="H98AF5479DE97408083AE940754231251"><enum>(4)</enum><header>Limitation on grant amount</header><text>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.</text></paragraph> <paragraph id="HE7E0486560454D61BB80A145E65A521F"><enum>(5)</enum><header>Program administration</header> <subparagraph id="H794DB1CA7EF843828E03C2874F5D597B"><enum>(A)</enum><header>Applications</header><text>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—</text>
<clause id="HE94773AA7F7543588A8C28694A78972F"><enum>(i)</enum><text>activities proposed to be conducted using the grant;</text></clause> <clause id="H80DE57B2689C4723936DFB329597F6D9"><enum>(ii)</enum><text>expected outcomes of such activities;</text></clause>
<clause id="H22A99AE5C9DD4322B0503127113E4D97"><enum>(iii)</enum><text>plans for evaluating the effectiveness of such activities;</text></clause> <clause id="HCBCE653587B84F62BC38ED2108455EA1"><enum>(iv)</enum><text display-inline="yes-display-inline">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;</text></clause>
<clause id="H7BA480E44BF84BAA81645043192F2CE8"><enum>(v)</enum><text>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</text></clause> <clause id="HE2A7ACAD61834B0CA592827266254FBB"><enum>(vi)</enum><text>assurances of compliance with applicable Federal laws and regulations relating to human subjects protections and patient safety.</text></clause></subparagraph>
<subparagraph id="H0FC7941508E844B88546B9F4F716D759"><enum>(B)</enum><header>Priority</header><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H357C1C6218114CBFA3DC08BCA3ACD059"><enum>(C)</enum><header>Periodic reports</header><text>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—</text>
<clause id="H0AA9F94342E24499B9FCB6D7448D83F6"><enum>(i)</enum><text>a description of how the eligible entity used such grant;</text></clause> <clause id="HF137A89560C042AC8319E61D8F958548"><enum>(ii)</enum><text>a summary of the progress of activities funded with amounts from such grant;</text></clause>
<clause id="H98E867A3076F45E9B6A59DC6A8245772"><enum>(iii)</enum><text>measured outcomes relating to such activities;</text></clause> <clause id="H7A2F70E19BEA40D5A0AD5D4622AEE2EC"><enum>(iv)</enum><text display-inline="yes-display-inline">a detailed accounting of expenditures of grant funds, including administrative or overhead costs;</text></clause>
<clause id="H41E0A1DD2ECA404580510F7CE10E805D"><enum>(v)</enum><text>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</text></clause> <clause id="H0036652C9F8748798E0FF5EEB4543243"><enum>(vi)</enum><text>a description of actions taken pursuant to the coordination plan described in subparagraph (A)(iv).</text></clause></subparagraph>
<subparagraph id="HACEBE2B398414A2691DC9D6C5E171586"><enum>(D)</enum><header>Oversight; annual evaluations</header><text>The Secretary shall—</text> <clause id="H9ED2915A81ED4CB4AEC3B3D7B51BCA73"><enum>(i)</enum><text display-inline="yes-display-inline">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</text></clause>
<clause id="H5DE33A7B33E143ECAB952F24BF58A4C8"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph> <subparagraph id="HAFA0A111EAC04FFBB83D30EE02140F82"><enum>(E)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="HCB8499D7DB2C4B0FBC5B5C34483DA48D"><enum>(F)</enum><header>Enforcement authority</header><text display-inline="yes-display-inline">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. </text></subparagraph></paragraph> <paragraph id="H13CF75F94C814AA381DA3369137DA14D"><enum>(6)</enum><header>Available amounts; authorization of appropriations</header> <subparagraph id="HD6337C43EF334874AB45DD4C208E933A"><enum>(A)</enum><header>Available amounts</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="H6EDC57308A3B4863A406EB33222C3A1E"><enum>(B)</enum><header>Authorization of appropriations</header><text>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.</text></subparagraph></paragraph> <paragraph id="H8F49732107EA436BA8A95AE80A0B1F3E"><enum>(7)</enum><header>Duration; annual review</header> <subparagraph id="HCB3E5997240C4AD494BADAA5EF9D4273"><enum>(A)</enum><header>Duration</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="H65BD85AFD6744CC2B0A80920A6E827A1"><enum>(B)</enum><header>Annual review</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection> <subsection id="H5716818AF7F24737A2DFC22A161CEA1C"><enum>(b)</enum><header>Department of Veterans Affairs grant program for independent third-party research studies and treatment with respect to supplemental neurorehabilitation treatments for mTBI</header> <paragraph id="H37371E327F5D487D9378188E14CD17D1"><enum>(1)</enum><header>Establishment</header><text>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.</text></paragraph>
<paragraph id="H86D25A620A724BDF8B7795338CC9500B"><enum>(2)</enum><header>Eligible entities described</header><text>An eligible entity described in this paragraph is any of the following:</text> <subparagraph id="H9B568F452B684C73970549B5E7AD1BCC"><enum>(A)</enum><text display-inline="yes-display-inline">A nonprofit organization that has demonstrated the capability to conduct clinical trials and to evaluate traumatic brain injury treatments through patient care delivery.</text></subparagraph>
<subparagraph id="H27CFB8895AD140F5ABEA430138C0C2B2"><enum>(B)</enum><text display-inline="yes-display-inline">An academic institution that conducts significant research on traumatic brain injury and has demonstrated the capability to conduct clinical trials relating to neurorehabilitation treatments.</text></subparagraph> <subparagraph id="H6F0AC26D67284E49B70B8D023F8C41CB"><enum>(C)</enum><text display-inline="yes-display-inline">A partnership or consortium of two or more entities described in subparagraphs (A) and (B).</text></subparagraph></paragraph>
<paragraph id="H01F92F7EFC494D91BEA3F3E51C441604"><enum>(3)</enum><header>Applications</header><text>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—</text> <subparagraph id="HD60C6287FFCC4346B1EBCA70F3C2885B"><enum>(A)</enum><text>the research and treatment activities proposed to be carried out using grant funds;</text></subparagraph>
<subparagraph id="H43EE7B77644F47CEB4B8B610C35C5CF7"><enum>(B)</enum><text>the methodology to be used for such activities;</text></subparagraph> <subparagraph id="H5147FA5D8EDF4F419CDD87FD90CDAABC"><enum>(C)</enum><text>the expected outcomes of such activities;</text></subparagraph>
<subparagraph id="H7A5F2C8FEF6F46EBA301A1377497C2E4"><enum>(D)</enum><text display-inline="yes-display-inline">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;</text></subparagraph> <subparagraph id="H1E75C0555ECE414E9F87D049F19ACCAD"><enum>(E)</enum><text>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</text></subparagraph>
<subparagraph id="HA03DDA9D2D464F7E9DFB3C2A77DAF441"><enum>(F)</enum><text>assurances of compliance with applicable Federal laws and regulations relating to human subjects protections and patient safety.</text></subparagraph></paragraph> <paragraph id="HFD350CE7243F48438BCBEBDD64A499FD"><enum>(4)</enum><header>Administration</header> <subparagraph id="H01846B22697D4C18A615A9A28B9AAF5F"><enum>(A)</enum><header>Grant categories</header><text>In carrying out the grant program under this subsection, each fiscal year the Secretary shall—</text>
<clause id="HD8AB7E6B0AED4638964EB56C9922A103"><enum>(i)</enum><text>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</text></clause> <clause id="H30FCA9E8B0154EB7B666E0CC5085416C"><enum>(ii)</enum><text>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.</text></clause></subparagraph>
<subparagraph id="H59E922633C4A47359A501D23840BBA9A"><enum>(B)</enum><header>Priority</header><text>Of the grants awarded under subparagraph (A)(i), the Secretary shall award not fewer than three to nonprofit organizations.</text></subparagraph> <subparagraph id="H649DDA8213984405A59AB9468763915F"><enum>(C)</enum><header>Enforcement authority</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="H0F27FE87BE344E159DD28CAEA59082BE"><enum>(5)</enum><header>Agreement with independent organization</header>
<subparagraph id="H824B709C47BE4A82BF452065703F2944"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text> <clause id="H2B65BA884918482ABA2449AA6BBA2EE0"><enum>(i)</enum><text>administer the research grant program under this subsection;</text></clause>
<clause id="H1372A41B683347FBAFA7C5C768643C0B"><enum>(ii)</enum><text>carry out studies and implement efforts that include—</text> <subclause id="HE6472183AA8B4DA5AD4584FA15DFE55E"><enum>(I)</enum><text display-inline="yes-display-inline">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;</text></subclause>
<subclause id="HE626818438F94F46986FB330168DD5EA"><enum>(II)</enum><text display-inline="yes-display-inline">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</text></subclause> <subclause id="H8F7B70111F354A29AB98EDD3150F8A2A"><enum>(III)</enum><text>randomized, controlled clinical trials to—</text>
<item id="H9A8A029021A14045B552D11E96ACF5E5"><enum>(aa)</enum><text>validate and deliver treatments;</text></item> <item id="H6C11F1FFCB274700B4DF1440AA742B15"><enum>(bb)</enum><text>establish a standard of care; and</text></item>
<item id="H2BA9B7E223D24614BB337661024B0015"><enum>(cc)</enum><text>improve access to such treatments for veterans;</text></item></subclause></clause> <clause id="H4C819269201742D7BA90C3C91B482CD0"><enum>(iii)</enum><text display-inline="yes-display-inline">submit to the Secretary not less frequently than annually a report describing activities carried out under this section, including outcome data and methodology; and</text></clause>
<clause id="HE393A2D1614145A89E106F6E0368912A"><enum>(iv)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph> <subparagraph id="HDAB802F247A34574B9BF04E6D1118F04"><enum>(B)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="H6CCB5B54BFA941B4B7146A1BC0AD6A51"><enum>(C)</enum><header>Report</header><text>An agreement under subparagraph (A) shall include a requirement that the independent organization submits to Congress and the Secretary a comprehensive report that includes—</text> <clause id="H761B54C3843E4F75AA0F97A017E68F9E"><enum>(i)</enum><text>the findings of the studies required under such agreement;</text></clause>
<clause id="H715BADA9161A4E7DAD31C28C3955C795"><enum>(ii)</enum><text>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</text></clause> <clause id="H7C21C1A9A0F44CC8A976EF759378A80B"><enum>(iii)</enum><text display-inline="yes-display-inline">to the extent available from the reports and study materials of grant recipients, a summary of—</text>
<subclause id="H4D8E8D4CC34740498A39D6972E71A331"><enum>(I)</enum><text>the durability of outcomes at approximately six months following completion of treatment, if collected under the applicable clinical protocol;</text></subclause> <subclause id="H42C03EED9D0240D58635D217FC6A071A"><enum>(II)</enum><text>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</text></subclause>
<subclause id="H128C7B10759F4104A398BD164A85BF51"><enum>(III)</enum><text>aggregate expenditures of grant funds, including administrative or overhead costs.</text></subclause></clause></subparagraph> <subparagraph id="HC2CFAAFDA8F94091AA31DB2C1AEBCEEC"><enum>(D)</enum><header>Surveys</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="HC15B17058A7C422387E4D0E944F7A362"><enum>(6)</enum><header>Available amounts; authorization of appropriations</header>
<subparagraph id="H79D2F9E3FE1C4144B98777CDBC7C9537"><enum>(A)</enum><header>Available amounts</header><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H45A34DD7BA6B45EDAF6FF89036F9DF0E"><enum>(B)</enum><header>Authorization of appropriations</header><text>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.</text></subparagraph></paragraph>
<paragraph id="H814130FBEC994439A96392D96A25EA99"><enum>(7)</enum><header>Termination date</header><text>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.</text></paragraph></subsection> <subsection id="H8F10EF54C86F4779BB6E6D6CC606806A"><enum>(c)</enum><header>Reports to Congress</header><text>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—</text>
<paragraph id="H89BE48C8536B435B81537AE55131D99C"><enum>(1)</enum><text>the findings of the studies under subsection (a)(6)(B);</text></paragraph> <paragraph id="HC8BA7B962CEC4AF1BEF60943C7F3611B"><enum>(2)</enum><text>a description of any agreement entered into by the Secretary under subsection (b)(5)(A);</text></paragraph>
<paragraph id="HE834F96BCB1449EB85DABB33B22F24F3"><enum>(3)</enum><text>recommendations of the Secretary with respect to policy and programmatic improvements to services of the Department to treat mTBI among veterans;</text></paragraph> <paragraph id="HE0C1CA2DC4E74EBFA93F9CEF18984A93"><enum>(4)</enum><text display-inline="yes-display-inline">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</text></paragraph>
<paragraph id="HBFE40270BB3846CFAB1EA7E5FAFCFEAF"><enum>(5)</enum><text>such other matters as the Secretary determines appropriate.</text></paragraph></subsection> <subsection id="HFB8ED1FC1256443FB465C26A532C9467"><enum>(d)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H3BD5492192874506A505983B81DB082B"><enum>(1)</enum><text display-inline="yes-display-inline">The terms <quote>chronic mild traumatic brain injury</quote> and <quote>mTBI</quote> 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.</text></paragraph> <paragraph id="HB1866851EAEF451BBD1440C85BE3CDA6"><enum>(2)</enum><text display-inline="yes-display-inline">The term <quote>nonprofit organization</quote>—</text>
<subparagraph id="H434D69341B5846F28BBD9F8B94E96336"><enum>(A)</enum><text>means an organization described in <external-xref legal-doc="usc" parsable-cite="usc/26/501">section 501(c)(3)</external-xref> of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code; and</text></subparagraph> <subparagraph id="H7738C91414C44F27A06CF397CF40ABF1"><enum>(B)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="HABF74B16A488487DB60C13E520EE7F89"><enum>(3)</enum><text>The term <quote>veteran</quote> has the meaning given such term in section 101 of title 38, United States Code.</text></paragraph></subsection></section> <section id="H4BEEB3FD3C754E56B476CF0DAD79459E"><enum>304.</enum><header>Department of Veterans Affairs assignment of traveling physicians to serve territories and possessions</header> <subsection id="HA958935335634654BB7A706A12176674"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/74">chapter 74</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text>
<quoted-block style="USC" id="HCD651C4EBB89437184EFAEE128982FC6" display-inline="no-display-inline">
<section id="HFD4C39C6D03A4FE2BD493E7E1ABE6ECF"><enum>7415.</enum><header>Traveling physicians</header>
<subsection id="H496BBE6CAA4642F2A088FE144C3A4730"><enum>(a)</enum><header>In general</header>
<paragraph id="H7D8966ADB8B045BAAB5BA8121E9483C0" display-inline="yes-display-inline"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="H54C6367D346D47EA976628F470549FE5" indent="up1"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="H5C93139A2AC74112BB1ACFC4C61ECF7F"><enum>(b)</enum><header>Coordination of care</header><text>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.</text></subsection> <subsection id="HE153FA7BA5694E40878A5370815434A8"><enum>(c)</enum><header>Pay</header><text display-inline="yes-display-inline">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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H473FA3791DFF44B19261E2D872A75F58"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 7414 the following new item:</text> <quoted-block style="USC" id="HA848FFA260064FF6B097306B5C3DFB53" display-inline="no-display-inline"> <toc regeneration="no-regeneration"> <toc-entry level="section">7415. Traveling physicians.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H82601C2CA30E48C6A1C86DBC0F3D338C"><enum>(c)</enum><header>Technical and conforming amendments</header><text display-inline="yes-display-inline">Title 38, United States Code, is further amended as follows:</text>
<paragraph id="HFCA0EAFEAE094CB4A37ABD6597AEFF14"><enum>(1)</enum><text>In section 7410(a)(1), by—</text> <subparagraph id="HAA063241BE024A4D9186C6421C0A608D"><enum>(A)</enum><text display-inline="yes-display-inline"> by striking <quote>retention allowances</quote> and inserting <quote>retention bonuses</quote>; and</text></subparagraph>
<subparagraph id="H422F20AE3D624C9698F30A0FCFBA419C"><enum>(B)</enum><text>by striking the second comma after <quote>section 7401(1) of this title</quote>; and</text></subparagraph></paragraph> <paragraph id="HC5200324BCDE49E4BC617DAC9F1188A7"><enum>(2)</enum><text display-inline="yes-display-inline">In section 7431(e)(5)(B), by striking <quote>retention allowances</quote> and inserting <quote>retention bonuses</quote>.</text></paragraph></subsection></section>
<section id="HEF9F99E7CF1E4C71A6B26ECD366F6DAF" section-type="subsequent-section"><enum>305.</enum><header>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</header><text display-inline="no-display-inline">Section 1701 of title 38, United States Code, is amended, in paragraph (6)(F)(i), by inserting <quote>(including adaptive prostheses and terminal devices for sports and other recreational activities that are determined to be clinically appropriate by the Secretary)</quote> after <quote>artificial limbs</quote>.</text></section> <section section-type="subsequent-section" id="HDC7FD8FFF44A4A25AA5D3A0646AF9436"><enum>306.</enum><header>Modifications to and reauthorization of Staff Sergeant Parker Gordon Fox Suicide Prevention Grant Program of Department of Veterans Affairs</header> <subsection id="H7550050D7B624DD58EF82E531D7D2B77"><enum>(a)</enum><header>Coordination by Secretary</header><text>Subsection (b) of section 201 of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019 (<external-xref legal-doc="public-law" parsable-cite="pl/116/171">Public Law 116–171</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1720F">38 U.S.C. 1720F</external-xref> note) is amended by striking the second sentence.</text></subsection>
<subsection id="H1AB08F35E49842D18D92DE07036BE3BC"><enum>(b)</enum><header>Use of grant funds</header><text>Subsection (c) of such section is amended—</text> <paragraph id="H9110B13E7DF74B738B96CE2E03F920F4"><enum>(1)</enum><text>in the subsection heading, by inserting <quote><header-in-text level="subsection" style="OLC">; Use of Grant Funds</header-in-text></quote> after <quote><header-in-text level="subsection" style="OLC">Grants</header-in-text></quote>; and</text></paragraph>
<paragraph id="H0D693C0CA1DD4A36B75DA46B5B3362BF"><enum>(2)</enum><text>by adding at the end the following new paragraphs:</text> <quoted-block id="HA868383396D849A0BCA926042B69A7F3" style="OLC"> <paragraph id="H51D119D9B361460FA5952992E66032A3"><enum>(3)</enum><header>Renewal of grant amounts</header> <subparagraph id="H4040DC5571C74C5388FF0F2116ADD615" display-inline="no-display-inline"><enum>(A)</enum><header>In general</header><text>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—</text>
<clause id="H0A6D4F17CD1D48508997E6A318CDAF23"><enum>(i)</enum><text>the compliance by the eligible entity in administering pre- and post-intervention assessments required under subsection (e)(6); and</text></clause> <clause id="H87F629425104407F8F0EB8FDD52F5F91"><enum>(ii)</enum><text>any demonstrated improvements in participant outcomes.</text></clause></subparagraph>
<subparagraph id="HBDB7C51CCC9C403CA03CB5383CC9E90F"><enum>(B)</enum><header>Additional amounts</header><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="HB721B06717E94741A67BE54609EFB08E"><enum>(c)</enum><header>Priority for new recipients</header><text>Subsection (d) of such section is amended—</text>
<paragraph id="HAA3C123F449843F495703527205A4701"><enum>(1)</enum><text>in the subsection heading, by striking <quote>and Preference</quote> and inserting <quote>, Preference, and Priority</quote>;</text></paragraph> <paragraph id="H6DA818ED9B2F49BBA562269147ABDA9D"><enum>(2)</enum><text>in paragraph (1)(A)—</text>
<subparagraph id="H5094B226F30242128A8636B260279014"><enum>(A)</enum><text>in clause (iv), by striking the semi-colon at the end and inserting <quote>; and</quote>; </text></subparagraph> <subparagraph id="HC28A74D7BD6B4F949E1E3744A791682B"><enum>(B)</enum><text>by striking clause (v); and</text></subparagraph>
<subparagraph id="H034544BAA34B4F0EA40EA704334AF99E"><enum>(C)</enum><text>by redesignating clause (vi) as clause (v); and</text></subparagraph></paragraph> <paragraph id="H4456F9B975474C4EAFF6081FBD530745"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block id="H80C2441E74324A71B0D69E703B804C1D" style="OLC">
<paragraph id="HB9D6ABE8B1754920AD134DC2267B5171"><enum>(3)</enum><header>Priority for new recipients</header><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection> <subsection id="H66D1E827E7B742D09E748BFEBC50A820"><enum>(d)</enum><header>Requirements for receipt of grants</header><text>Subsection (e) of such section is amended—</text>
<paragraph id="H1B41671350834930B97702D0DF2629DA"><enum>(1)</enum><text>in paragraph (3)—</text> <subparagraph id="HEA93E9C3B9AD4B4C89E0D7F8DC7840C6"><enum>(A)</enum><text>by redesignating subparagraphs (B) and (C) as subparagraphs (C) and (D), respectively; and</text></subparagraph>
<subparagraph id="HC26EEA18CDFB4A4B97B15827A668B5EB"><enum>(B)</enum><text>by inserting after subparagraph (A) the following new subparagraph (B):</text> <quoted-block id="HC1499DDDC2FF46D7833F4ACEB50AC1A4" style="OLC"> <subparagraph id="H8BA7B94642B84995AB52163CDE4CD8D1"><enum>(B)</enum><text>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;</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H47A93FA2422D47B5933C5D7C52AB7C2E"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block id="HA9FC83FAE5054E60AD5C414355B3DA38" style="OLC"> <paragraph id="H9DD83C9589A248148BB353D870E5D7EB"><enum>(6)</enum><header>Assessments</header><text>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.</text></paragraph>
<paragraph id="H3D63A2740CEF453AAD9A32A82408FD37"><enum>(7)</enum><header>Metrics and outcomes</header><text>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—</text> <subparagraph id="HE6E1DA5DFB9A48E79273AD2CEB4F24EE"><enum>(A)</enum><text>throughput measures, including the number of veterans screened, referred, connected to care, and retained in services under the grant program;</text></subparagraph>
<subparagraph id="H82A1C29988DD4275B7AB8F69690BDDA6"><enum>(B)</enum><text>reductions in severity scale measurements, including reductions in suicidality identified through applicable inventories or assessments; and</text></subparagraph> <subparagraph id="HC8CF479EE9D54F89B5CEA5C3A2776628"><enum>(C)</enum><text>such other quantifiable metrics as the Secretary determines appropriate.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H249CBF86E3E24F3FAAFEDAB0D6900B3E"><enum>(e)</enum><header>Training and technical assistance</header><text>Subsection (g) of such section is amended—</text> <paragraph id="H1BC30EAE59FF47E08F60888337A0EE86"><enum>(1)</enum><text>in paragraph (1)—</text>
<subparagraph id="HE521DCEC1C6B4C1DA2C06BCB5346AB7D"><enum>(A)</enum><text>in the matter preceding subparagraph (A), by inserting <quote>, or interested in receiving such grants,</quote> after <quote>this section</quote>; and</text></subparagraph> <subparagraph id="HCAB2B6B53B2043248D4329D9A0ED45BE"><enum>(B)</enum><text>in subparagraph (A), by inserting <quote>, 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</quote> after <quote>management</quote>; and</text></subparagraph></paragraph>
<paragraph id="H9CCE12C6C411455793A4982EDA6811E3"><enum>(2)</enum><text>by adding at the end the following new paragraphs:</text> <quoted-block id="H73B4D26E085846FF947662A75FB2F88D" style="OLC"> <paragraph id="HE472015030064D12910D67330C817E12"><enum>(3)</enum><header>Training for department employees</header><text>The Secretary shall provide training to employees of the Department as the Secretary considers appropriate on the grant program under this section.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H32E58931AEEE4D20859ADFAC4379D4FD"><enum>(f)</enum><header>Briefing for local VAMCS</header><text>Subsection (h) of such section is amended by adding at the end the following new paragraph:</text> <quoted-block id="H26C1E1F7B0F642DA97022D01199941BF" style="OLC"> <paragraph id="H2C9DF74E70014FDE8AC20536072C1DF0"><enum>(5)</enum><header>Briefing for local VAMCS</header><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HF43CE0C7411F4B679F1BF39D23978909"><enum>(g)</enum><header>Duration</header><text>Subsection (j) of such section is amended by striking <quote>September 30, 2026</quote> and inserting <quote>September 30, 2029</quote>.</text></subsection> <subsection id="H90B6E1938A2846768E4D8EE0E4C51CC9"><enum>(h)</enum><header>Reports</header><text>Subsection (k)(2) is amended—</text>
<paragraph id="HC66157D4BC7043299F53307BAD81610B"><enum>(1)</enum><text>in the paragraph heading, by striking <quote><header-in-text level="paragraph" style="OLC">Final report</header-in-text></quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Annual reports</header-in-text></quote>; and</text></paragraph> <paragraph id="HC238959B0AC2448E8E7F3F4DB12C42A8"><enum>(2)</enum><text>in subparagraph (B)—</text>
<subparagraph id="HDED88DDD1F95468F805F8443615DF0B8"><enum>(A)</enum><text>by redesignating clauses (iii) and (iv) as (v) and (vi), respectively; and</text></subparagraph> <subparagraph id="HB7B9ACE082D94186A8A2879A9754DB18"><enum>(B)</enum><text>by adding the following new clauses (iii) and (iv):</text>
<quoted-block id="HBF905655752E4943B63CBD17648960B7" style="OLC">
<clause id="H4EF9FBFF89DD4139A14E843D6A356D8A"><enum>(iii)</enum><text>A description of the Secretary’s compliance with the requirement to train employees of the Department under subsection (g)(3).</text></clause> <clause id="H48C862D8F5AC4DBBAB40234949B70582"><enum>(iv)</enum><text display-inline="yes-display-inline">An optional description and inclusion of subjective or narrative stories of community or individual impact to allow grant recipients to share meaningful accomplishments.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> </subsection>
<subsection id="H2EC9407908C64E9588A38D260E0864DB"><enum>(i)</enum><header>Referral for care</header><text>Subsection (m) of such section is amended by adding at the end the following new paragraph:</text> <quoted-block id="H943F54AF488B43A3997ACB721916C1CB" style="OLC"> <paragraph id="HDDBAC6C09DFA4BE9BE4ED825666BB67C"><enum>(4)</enum><header>Required response or action</header> <subparagraph id="HA7350587126B42DDB5F572D5475D9E2C" display-inline="yes-display-inline"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="H8B55F5D4A9AA4FE5ABCD4C600D9721FE" indent="up1"><enum>(B)</enum><text>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).</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H15484743983346A0B83835B3F2BB1D2F"><enum>(j)</enum><header>Reauthorization</header><text>Subsection (p) of such section is amended—</text>
<paragraph id="H1A134A3459F749B8ACAE01CB860050D8"><enum>(1)</enum><text>by striking <quote>section a total</quote> and inserting </text> <quoted-block id="HA4F965B622B2435DAD36B7F8CF939DB0" style="OLC" display-inline="yes-display-inline"><text display-inline="yes-display-inline">section—</text>
<paragraph id="H5A48AF7C2EFC493F82C855179E2AB7D2"><enum>(1)</enum><text>a total</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block></paragraph> <paragraph id="H98C0CA8092544FE9948AC89D6C226525"><enum>(2)</enum><text>by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph>
<paragraph id="HB17C4CAD7A1449F98D56878ACA17873C"><enum>(3)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block id="H91D857672DC0455DBA81F6612640C0DF" style="OLC"> <paragraph id="H590664E7F0BC4A99814FA5EF69EC1746"><enum>(2)</enum><text>a total of $200,000,000 for fiscal years 2027 through 2029.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="HC0D1611287494532A331FEE2FB03F130"><enum>(k)</enum><header>Technical correction to definitions</header><text>Subsection (q)(5) of such section is amended, in the first sentence—</text> <paragraph id="HD86AE28ABC5F423590E21C4017E64EF2"><enum>(1)</enum><text>by striking <quote>Medical services</quote> and inserting <quote>The term <quote>emergency treatment</quote> means medical services</quote>; and</text></paragraph>
<paragraph id="H94540049CE6B4AABB476C79BA8FCE51A"><enum>(2)</enum><text>by striking <quote>was rendered</quote> and inserting <quote>rendered</quote>.</text></paragraph></subsection> <subsection id="HBFA14C3E4F0F44E799201C7EF234B3FC"><enum>(l)</enum><header>Identification of demand for other services and support</header><text>Subsection (e) of such section, as amended, is further amended—</text>
<paragraph id="HFC2AB202610344B88356D532A0C6B366"><enum>(1)</enum><text>by redesignating paragraphs (5) and (6) as (6) and (7), respectively; and</text></paragraph> <paragraph id="H25DA088954904CEA9CFAEDCE21F1D37B"><enum>(2)</enum><text>by adding after paragraph (4) the following new paragraph:</text>
<quoted-block id="HFA697DE8B31545ECA3637330C8CF4FF3" style="OLC">
<paragraph id="H7A72C4CC019F46F894FEEBAB9834E50A"><enum>(5)</enum><header>Demand for other services and support</header><text>An entity receiving a grant under this section shall submit to the Secretary information concerning—</text> <subparagraph id="HB0C89410F6D544EB884260FD5F2D3D46"><enum>(A)</enum><text>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;</text></subparagraph>
<subparagraph id="H2E6F1D93E98349F9BF740D231A53DFF2"><enum>(B)</enum><text>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</text></subparagraph> <subparagraph id="H3AE5C72B9D384A52A0597CEAA2825F5C"><enum>(C)</enum><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H06541EC8C43149248ACCA7D221F2441D"><enum>(m)</enum><header>Suicide prevention services</header>
<paragraph id="H52211914A61447D5AADF1EA00DCBC7EA"><enum>(1)</enum><header>Required use of certain screening protocol</header><text>Subsection (q)(11)(A)(ii) of such section is amended by adding at the end the following new sentence: <quote>In the case of a recipient of a grant awarded under this section on or after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</quote>;</text></paragraph> <paragraph id="HC917AB8B04A54B5288102F6DC1A056F2"><enum>(2)</enum><header>Transportation</header><text display-inline="yes-display-inline">Subsection (q)(11)(A) of such section is amended—</text>
<subparagraph id="HD9B8237EB3A2474D97EC5CFD1A3850A4"><enum>(A)</enum><text>by redesignating clause (xi) as clause (xii); and</text></subparagraph> <subparagraph id="H7DF49401F1984989A696938A5DEA6EF3"><enum>(B)</enum><text>by inserting after clause (x) the following new clause:</text>
<quoted-block id="H9E08D8F7FB34423AB2C7D291768E585B" style="OLC">
<clause id="H7A0CFE44C2FD47148979E4F5056440AA"><enum>(xi)</enum><text>Transportation and rideshare services for eligible individuals to use for appointments.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection> <subsection id="H9F911B20A2AA4E54BE02B4437BC3EE7D"><enum>(n)</enum><header>Eligible individuals</header><text>Subsection (q)(4)(C) of such section is amended by striking <quote>clauses (i) through (iv)</quote> and inserting <quote>clauses (i) through (vi)</quote>.</text></subsection>
<subsection id="HA2483F0AEF1B485188475AC0FA8D482B"><enum>(o)</enum><header>Effective date</header><text>The amendments made by this section shall take effect on—</text> <paragraph id="H2EF64AEB1ED24A0384E5CBC0C3B440B6"><enum>(1)</enum><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/116/171">Public Law 116–171</external-xref>; (<external-xref legal-doc="usc" parsable-cite="usc/38/1720F">38 U.S.C. 1720F</external-xref>)), if the Secretary determines such amendments do not require rulemaking; or</text></paragraph>
<paragraph id="HD36262EA32BA4D5292E88C88085CE366"><enum>(2)</enum><text>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.</text></paragraph></subsection> </section> <section id="H150EEE89270F4416872C7F027EE2FF99"><enum>307.</enum><header>Reports on the use of hyperbaric oxygen therapy</header> <subsection id="HC1B14F79E44E408890A1231BB1BBA304"><enum>(a)</enum><header>GAO report on the use of hyperbaric oxygen therapy to treat traumatic brain injury and post-traumatic stress disorder</header><text>Not later than one year after the date of the enactment of this Act, the Comptroller General of the United States shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives an update to the report titled <quote>Research on Hyperbaric Oxygen Therapy to Treat Traumatic Brain Injury and Post-Traumatic Stress Disorder</quote> (GAO-16-154). Such report shall include the assessment of the Comptroller General of clinical trials conducted, since the publication of such report—</text>
<paragraph id="HD948BA09CC59496B874091D7B7ABEFE5"><enum>(1)</enum><text>regarding the use of hyperbaric oxygen therapy to treat traumatic brain injury and post-traumatic stress disorder; and</text></paragraph> <paragraph id="HEB1EDE791461433994A5A21B5966F84F"><enum>(2)</enum><text>by—</text>
<subparagraph id="HC64672C1BDA2422583C3864994810FF9"><enum>(A)</enum><text>the Secretary of Veterans Affairs;</text></subparagraph> <subparagraph id="H2CA2DD7854204553BE7989C34E298721"><enum>(B)</enum><text>the Secretary of Defense; and</text></subparagraph>
<subparagraph id="HF9EFE7171B254FD5B1713CB0C4972611"><enum>(C)</enum><text>private entities.</text></subparagraph></paragraph></subsection> <subsection id="H859B6CBEF9BF4D39B015688501734392"><enum>(b)</enum><header>Follow-up study</header> <paragraph id="H2BFC3584918A408FBD3B3348AD9B9857"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="HED08F1DC50784F11952201026FC64ECE"><enum>(2)</enum><header>Elements</header><text>The review conducted under paragraph (1) shall include the following:</text> <subparagraph id="H56F176ACFDDC4977B3102721660E5981"><enum>(A)</enum><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/116/171">Public Law 116–171</external-xref>);</text></subparagraph>
<subparagraph id="H4D85708D77E64DE2BE8FD2B2C81D9C1D"><enum>(B)</enum><text>An assessment of the current parameters for research on the use by the Department of Veterans Affairs of hyperbaric oxygen therapy, including—</text> <clause id="H0F338480CF76445C985D55771F949DF2"><enum>(i)</enum><text>tests and questionnaires used to determine the efficacy of such therapy; and</text></clause>
<clause id="H390A354DEBF1410298EDD66E509D42FD"><enum>(ii)</enum><text>metrics for determining the success of such therapy.</text></clause></subparagraph> <subparagraph id="H58B6AB9C1E704555823C716BE7E4E272"><enum>(C)</enum><text>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.</text></subparagraph>
<subparagraph id="H462A89961A754FAC86C5141D968D3159"><enum>(D)</enum><text>A market assessment of available hyperbaric oxygen therapy facilities or units within facilities to assess the most effective locations and practices, including—</text> <clause id="H9B74B14CF7C24C4687A31B07C3BB07C7"><enum>(i)</enum><text>an analysis of whether multi-person chambers could reduce per-veteran costs;</text></clause>
<clause id="H5F97B7FE303240FD8D0F0F910F1262A5"><enum>(ii)</enum><text>an analysis of areas with lower prices compared to a national average; and</text></clause> <clause id="H354B62133DA74EFFAB9454706E709D45"><enum>(iii)</enum><text>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.</text></clause></subparagraph></paragraph></subsection></section>
<section id="HB2E6F81E96D340F89A779312DD5C80F7"><enum>308.</enum><header>Department of Veterans Affairs pilot program to provide grants to mental health care providers for the provision of mental health care for veterans</header>
<subsection id="H4E5D644FAF6F4443A8EA205D3EBEFF1F"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection id="H7FFF0707EA9F48A2BB954813FA28DD5C"><enum>(b)</enum><header>Eligibility</header><text>To be eligible to receive a grant under the pilot program, a mental health care provider shall—</text>
<paragraph id="HC787E01D3D4240F9A98343E76E18339D"><enum>(1)</enum><text display-inline="yes-display-inline">be a non-profit organization;</text> </paragraph> <paragraph id="H3ECEB1C9DAA54FBCA121297F897F2FA3"><enum>(2)</enum><text display-inline="yes-display-inline">have operated at least one outpatient mental health facility in the United States for a continuous period of at least three years;</text></paragraph>
<paragraph id="H385FEC5621EE4CE6A57B8076476EBC8C"><enum>(3)</enum><text>be licensed or certified under applicable state law to provide outpatient mental health services;</text></paragraph> <paragraph id="H6DE465CA4C1042CFADCB461DD70843BA"><enum>(4)</enum><text>be accredited by—</text>
<subparagraph id="HE1EA3D43036D481898663AD14137A635"><enum>(A)</enum><text>the Joint Commission on Accreditation of Healthcare Organizations;</text></subparagraph> <subparagraph id="H47A308DB1AEC455592994CF88A82B073"><enum>(B)</enum><text>the Commission on Accreditation of Rehabilitation Facilities; or</text></subparagraph>
<subparagraph id="HD21A3FE2EC3A46438AA4FCE79E05A62D"><enum>(C)</enum><text>any other nationally recognized accrediting body the Secretary determines appropriate; and</text></subparagraph></paragraph> <paragraph id="HBDB13940C4CE4A988ECE15385BF486FE"><enum>(5)</enum><text>submit to the Secretary an application that includes such information and assurances as the Secretary may require, including—</text>
<subparagraph id="H6D575EDC6E734BF9A3CCD93E1E30E884"><enum>(A)</enum><text>an identification of the outpatient facility or facilities where the mental health care services will be provided;</text></subparagraph> <subparagraph id="HF3277B78A94A4AB380EE283FCEE467AA" commented="no"><enum>(B)</enum><text>a plan for providing clinicians at each facility in receipt of grant funds with units of continuing education with respect to veterans issues; and</text></subparagraph>
<subparagraph id="H9238DB5443764BAA8399345452C0BFD8"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection> <subsection id="HD75D624E4E5944CD85C82ED67A6D22CB"><enum>(c)</enum><header>Use of funds</header> <paragraph id="H7CCFA78A0051495790CFA066BF513A03"><enum>(1)</enum><header>In general</header><text>The recipient of a grant under the pilot program shall use the grant—</text>
<subparagraph id="H7830AB4C14874E6CA9854E82CC9A25B4" commented="no"><enum>(A)</enum><text display-inline="yes-display-inline">to deliver evidence-based mental health care for veterans in person or via telehealth.</text></subparagraph> <subparagraph id="H1A357FF8574A48AB9CAA43B87771B9AD"><enum>(B)</enum><text display-inline="yes-display-inline">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;</text></subparagraph>
<subparagraph id="H12B7735922C64518B4245879EC621643"><enum>(C)</enum><text>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;</text></subparagraph> <subparagraph id="HB4CA439417834D4898CEE43756732650"><enum>(D)</enum><text>to support activities necessary to deliver or sustain care, including—</text>
<clause id="H7FDC4CF52D054ABCAB4D5E1DD327C422"><enum>(i)</enum><text>outreach;</text></clause> <clause id="H504797A380834628AC1154BE5B181111"><enum>(ii)</enum><text>care coordination;</text></clause>
<clause id="H78AE7BCA60C742D8B2801045D7104B88"><enum>(iii)</enum><text>veteran engagement;</text></clause> <clause id="HE317E10387774C0FA0FA507ACCC03C7C"><enum>(iv)</enum><text>clinician training;</text></clause>
<clause id="H5ED84753CFA049BCBE450DDC1AD27F39"><enum>(v)</enum><text>implementation support; and</text></clause> <clause id="H995F23D6731245CB9F7522C4B4C4C1C3"><enum>(vi)</enum><text>program evaluation; and</text></clause></subparagraph>
<subparagraph id="HB0B3D13D91C947449FFDAEBBEABD3347"><enum>(E)</enum><text>to support continuous quality improvement and outcomes measurement activities, including the collection and reporting of clinical outcomes and operational metrics; and</text></subparagraph> <subparagraph id="H972DB21CA53043ABAE6DCC26E186E5CB"><enum>(F)</enum><text>to support activities of the program that are not billable, reimbursable, or otherwise authorized by law, including—</text>
<clause id="HF05CCA0F20D44D419ADE9AA2D971A6D3"><enum>(i)</enum><text>outreach;</text></clause> <clause id="HA79E9D3E700743BFA26BC21267A5A5B3"><enum>(ii)</enum><text>care coordination;</text></clause>
<clause id="H8CA2D329B1A144DABA807AAE1596D0AC"><enum>(iii)</enum><text>engagement;</text></clause> <clause id="HE519584471BD4159B1F220206D9FC9D8"><enum>(iv)</enum><text>implementation support; and</text></clause>
<clause id="H80E82EF5F133435F93849008191C2669"><enum>(v)</enum><text>program evaluation; and</text></clause></subparagraph> <subparagraph id="H14C13A732122403AAD82A4739AC26915"><enum>(G)</enum><text>to provide services to individuals for which reimbursement is not otherwise available, including such individuals who are—</text>
<clause id="H5AF4C9712EF34C049CF7C50A4FCA3ADC"><enum>(i)</enum><text>uninsured;</text></clause> <clause id="HB1B4F7C194F84ECBA396A1BD1A4B5648"><enum>(ii)</enum><text>ineligible for health care furnished by the Department of Veterans Affairs; or</text></clause>
<clause id="HABA035E43B93433DAA0D97B3E6EC9376"><enum>(iii)</enum><text>in receipt of health care that is not reimbursable as of the date of the enactment of this Act.</text></clause></subparagraph></paragraph> <paragraph id="HDEACA66FC2F649468DAAC633896DF591"><enum>(2)</enum><header>Limitations on use of grant funds</header><text display-inline="yes-display-inline">The recipient of a grant under the pilot program may not—</text>
<subparagraph id="HE24A059AFBA14A44AFC66DFB0B3D74F3"><enum>(A)</enum><text>charge an eligible veteran a fee associated with the receipt of mental health care funded by such grant;</text></subparagraph> <subparagraph id="HC3E736D703C246BF8CF87D238284182A" commented="no"><enum>(B)</enum><text>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</text></subparagraph>
<subparagraph id="H0581297C6DF9402E8CB80BB037D000DC"><enum>(C)</enum><text>use grant funds to—</text> <clause id="H3907A410F36C464E89034A89636BC019"><enum>(i)</enum><text>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</text></clause>
<clause id="H6F8DCE1E78F246D98CE24F5B61EE1282"><enum>(ii)</enum><text>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.</text></clause></subparagraph></paragraph> <paragraph id="HE78C4E1DDB4848F2BE3C8F150E32270E" commented="no"><enum>(3)</enum><header>Rules of construction</header><text display-inline="yes-display-inline">Nothing in this subsection may be construed to—</text>
<subparagraph id="H414189C7FA59441EB3CB2D62A1157511" commented="no"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="H1CB60387095D41D1984924314DDFFAD5" commented="no"><enum>(B)</enum><text>authorize double billing or duplicate payments for the same clinical service or unit of service.</text></subparagraph></paragraph>
<paragraph id="H58B745AB21924BE99F0D7E03348D2128"><enum>(4)</enum><header>Spouse and dependent care</header><text>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—</text> <subparagraph id="H6D0E115CAEEE46B0A96FC2EA93B16897"><enum>(A)</enum><text>family therapy;</text></subparagraph>
<subparagraph id="HE06EE7BB6DDF4AB180E94ADFDA22E6A9"><enum>(B)</enum><text>couples therapy;</text></subparagraph> <subparagraph id="HF19953AF77FA44BF95EF5471B01EFAEA"><enum>(C)</enum><text>group therapy;</text></subparagraph>
<subparagraph id="H94A5166E8945431A9AE03DF06DF60F74"><enum>(D)</enum><text>family psychoeducation; and</text></subparagraph> <subparagraph id="H159DAE63231D4BD894FD5C753D5D8C3D"><enum>(E)</enum><text>other counseling services the Secretary determines are clinically necessary.</text></subparagraph></paragraph></subsection>
<subsection id="H6275CA74A55A4DC583274328F7341315"><enum>(d)</enum><header>Selection of facilities</header><text display-inline="yes-display-inline">In awarding grants under the pilot program, the Secretary—</text> <paragraph id="H597C742345AC482FA88FB89C5E8C2AE4"><enum>(1)</enum><text display-inline="yes-display-inline">shall ensure that grants are distributed geographically evenly among rural and urban areas;</text></paragraph>
<paragraph id="H6D8E53BB69074F8C89CEDB96691CA80E"><enum>(2)</enum><text display-inline="yes-display-inline">may consider the proportion of veterans historically served by the grant recipient; and</text></paragraph> <paragraph id="HA1AAAC146E424609934CFE70ED77B5CF"><enum>(3)</enum><text display-inline="yes-display-inline">may prioritize outpatient mental health facilities located in areas that the Secretary determines—</text>
<subparagraph id="H3BBC9CF1D2304F8AB86625465704AE0F"><enum>(A)</enum><text>are medically underserved;</text></subparagraph> <subparagraph id="H3E845E4AD73A4847BEA4456340B003CA"><enum>(B)</enum><text>have large veteran populations;</text></subparagraph>
<subparagraph id="H432E0F0D065645EDA4D6751AA007418E"><enum>(C)</enum><text>are located near military installations; or</text></subparagraph> <subparagraph id="H29D70E11CA2F4DB59EC1B927092F1783"><enum>(D)</enum><text>have large numbers of veterans at high risk of suicide.</text></subparagraph></paragraph></subsection>
<subsection id="HF5F8E078CCD6437F809D94FE3E92FCD1"><enum>(e)</enum><header>Amount of grant</header>
<paragraph id="H2D19AB174F45418993619D6642AE1FEE"><enum>(1)</enum><header>In general</header>
<subparagraph id="H15549479E69E472792E495B0C08F1476"><enum>(A)</enum><header>In general</header><text>Except as provided in subparagraph (B), no grant under the pilot program for a facility for any fiscal year may exceed $1,500,000.</text></subparagraph> <subparagraph id="H94F13EA2CCD9425CA9FA961DF4B8079A"><enum>(B)</enum><header>Limitation</header><text display-inline="yes-display-inline">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—</text>
<clause id="H08A7C2BFE8EE4332BDC89ADDF6DEC70E"><enum>(i)</enum><text>50 percent of the operating budget of the facility; or</text></clause> <clause id="H29F89DE14D794C438C56B70383D7A33F"><enum>(ii)</enum><text>$1,500,000.</text></clause></subparagraph></paragraph>
<paragraph id="H4D7E243072F240D5B067C70CDB8138BA"><enum>(2)</enum><header>Multiple grants</header><text>The recipient of a grant under the pilot program—</text> <subparagraph id="HBDBFE95C051C41939336B331B3621AA6"><enum>(A)</enum><text>may apply for, and receive, grants for more than one facility of the recipient for any fiscal year; and</text></subparagraph>
<subparagraph id="HAABC39B376D846DCA8D242C9E081F427"><enum>(B)</enum><text>may apply for, and receive, a grant for a facility that has already received a grant under the pilot program.</text></subparagraph></paragraph></subsection> <subsection id="H39BA03B6DC314900992BF2B45D94D429"><enum>(f)</enum><header>Regulations; accountability</header><text display-inline="yes-display-inline">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—</text>
<paragraph id="H0DB615ED40C5466F86966FF7E2361123"><enum>(1)</enum><text>demonstrate the capacity to provide accountability;</text></paragraph> <paragraph id="HF4B6B707C3D54FE8BC7B29AAAB575416"><enum>(2)</enum><text>demonstrate clinical outcomes;</text></paragraph>
<paragraph id="HDAA3DB19D67F44BBAB25002CCFB1E4C0"><enum>(3)</enum><text>justify the effective use of any private investment funds or Federal grant funds through data collection and reporting metrics; and</text></paragraph> <paragraph id="H0505256DB8EF449ABBC7E0A3D9266114"><enum>(4)</enum><text>collect standardized outcome measures including symptom improvement and program completion.</text></paragraph></subsection>
<subsection id="HB3F6FB4F46C842BA9D46112E9E372E76" commented="no"><enum>(g)</enum><header>Continuity of care</header><text>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.</text></subsection> <subsection id="HF2B81C02402849B69BB48D43C0B159BF"><enum>(h)</enum><header>Report</header><text>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:</text>
<paragraph id="H07E26AE504CC4D1CA6C3B26427BCB95B"><enum>(1)</enum><text display-inline="yes-display-inline">The number of veterans who received mental health care under the program.</text></paragraph> <paragraph id="HDB1C20B297434BD495171BEEC9E41F52"><enum>(2)</enum><text>An identification of the types of mental health care provided and the time period for which such care was provided.</text></paragraph>
<paragraph id="H7E7BA36BB7AF4B21AB618C5024E33E55"><enum>(3)</enum><text>An identification and summary of program outcomes.</text></paragraph> <paragraph id="HE4677E56831F4D318D22D8993C3F7BE4"><enum>(4)</enum><text>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.</text></paragraph>
<paragraph id="HC3A26D2D90454F8DB22F874012721331"><enum>(5)</enum><text>An identification of any obstacles faced by grant recipients in providing mental health care under the program.</text></paragraph> <paragraph id="H71E976A745CA4304ADCE8B540F1FF8B5" commented="no"><enum>(6)</enum><text>A summary of clinical outcomes based on pre- and post-client functioning—</text>
<subparagraph id="H529161F0CE33409BBD7F332BABB9EF30"><enum>(A)</enum><text>the number of veterans who improved clinically based on relevant clinical evaluation metrics that the Secretary determines appropriate;</text></subparagraph> <subparagraph id="H1B120DD30BF9418AB5323B0EB83B1804"><enum>(B)</enum><text>the degree of clinical improvement based on such relevant clinical evaluation metrics;</text></subparagraph>
<subparagraph id="HB5ADE85586E84B4BA7AE84B9B4A80953"><enum>(C)</enum><text>the total number of veterans participating in the program; and</text></subparagraph> <subparagraph id="H1F099B7B833446A99BE96C5057144468"><enum>(D)</enum><text>any other outcome metrics as the Secretary determines appropriate.</text></subparagraph></paragraph>
<paragraph id="H73D8D02F2B554E42BCD52F7B5DE0072B" commented="no"><enum>(7)</enum><text>Findings with respect to the sustainability of the program.</text></paragraph></subsection> <subsection id="H8C963907E8C8475382EAEE6DD396D50B"><enum>(i)</enum><header>Authorization of appropriations</header><text>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.</text></subsection></section>
<section id="H56A3F8E89B8847CF917D4B23680211AA"><enum>309.</enum><header>Furnishing of certain health services to veterans in the Freely Associated States</header>
<subsection id="HCE4E12578BF447A38CF3A9F299DA48C5"><enum>(a)</enum><header>Requirement to furnish certain health services to veterans in the Freely Associated States</header>
<paragraph id="HB9DF5BE6A3E14F2AB831143C53B98723"><enum>(1)</enum><header>Agreements required</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/48/1988">48 U.S.C. 1988(a)(4)(A)</external-xref>), 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.</text></paragraph> <paragraph id="H962072B5791A4206A21F3968D67D13E6"><enum>(2)</enum><header>Inclusion of telehealth and mail order pharmacy services required</header><text>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—</text>
<subparagraph id="HFA77FD6296124B08A7A060CC2D0F178E"><enum>(A)</enum><text>medical services authorized to be provided under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, which can be administered through telehealth; and</text></subparagraph> <subparagraph id="HBAE144BC61C3488894411A11CCEB807E"><enum>(B)</enum><text display-inline="yes-display-inline">pharmaceutical products authorized to be provided under such chapter, delivered by mail.</text></subparagraph></paragraph>
<paragraph id="H3DF8062C00A3435CAD9DA78B96738DBA"><enum>(3)</enum><header>Implementation dates</header><text>In carrying out paragraphs (1) and (2), the Secretary shall—</text> <subparagraph id="HCB837B36911D48BDB282F44DCBCD2FCF"><enum>(A)</enum><text>initiate outreach to each such government not later than 30 days after the date of the enactment of this Act;</text></subparagraph>
<subparagraph id="HF4601CBFB4CC4BEB95219DA8B49A46B5"><enum>(B)</enum><text>enter into each agreement required by paragraph (1) not later than one year after the date of the enactment of this Act; and</text></subparagraph> <subparagraph id="HF372ABD97FF34AA681F34F472F24013F"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="H9856136690134A6E9B328AEDF5C92390"><enum>(4)</enum><header>Beneficiary travel</header><text display-inline="yes-display-inline">Section 111(h)(1) of title 38, United States Code, is amended by striking <quote>the Secretary may make payments</quote> and inserting <quote>beginning not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, the Secretary shall make payments</quote>. </text></paragraph> <paragraph id="HFB1C2A696AFA4E05979022C350E530A2"><enum>(5)</enum><header>Reports</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="HA306CD65BF4143C5A91613442B795C48"><enum>(6)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this subsection:</text> <subparagraph id="HE7DC81FBEAAE46329D1C26032660B03D"><enum>(A)</enum><header>Appropriate committees of Congress</header><text display-inline="yes-display-inline">The term <quote>appropriate committees of Congress</quote> means—</text>
<clause id="HF73B1B8C960644F985B5F8DD908F77EC"><enum>(i)</enum><text>the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and</text></clause> <clause id="H254C5E05B782488B89A9CE24E3E80AF8"><enum>(ii)</enum><text>the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives.</text></clause></subparagraph>
<subparagraph id="H4B523000DA074EA4A15BA049F58FFBCE"><enum>(B)</enum><header>Freely Associated States</header><text>The term <quote>Freely Associated States</quote> has the meaning given such term in section 1724(f) of title 38, United States Code.</text></subparagraph></paragraph></subsection> <subsection id="H47E50A8C20864E8FB3143E545F7742D4" commented="no"><enum>(b)</enum><header>Assignment of traveling physicians to serve veterans in Freely Associated States</header> <paragraph id="HE61D288F5B614ED88979E80CF6AB5AE7" commented="no"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/74">chapter 74</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text>
<quoted-block style="USC" id="HC7498150A39441F881167BF10B254451" display-inline="no-display-inline">
<section id="H973B3DF638974345B6C8E11BC7EA8595" commented="no"><enum>7415.</enum><header>Traveling physicians for veterans in Freely Associated States</header><text display-inline="no-display-inline">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).</text></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> <paragraph id="HC31E14FA5EB0496EA459E3092653DB45" commented="no"><enum>(2)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 7414 the following new item:</text>
<quoted-block style="USC" id="HD39AE97B4E0B4E73A3CC76F3F1BE31A3" display-inline="no-display-inline">
<toc regeneration="no-regeneration">
<toc-entry level="section">7415. Traveling physicians for veterans in Freely Associated States.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section>
<section id="HF029578E76E449A49BE5BF9F9C80F748"><enum>310.</enum><header>Modification of Precision Medicine for Veterans Initiative; reporting on suicide by veterans and members of the Armed Forces</header>
<subsection id="H7F1648E7009C4A3B9319FCC82B96552F"><enum>(a)</enum><header>Modification of Precision Medicine for Veterans Initiative</header><text>Section 305 of the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019 (<external-xref legal-doc="public-law" parsable-cite="pl/116/171">Public Law 116–171</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1712A">38 U.S.C. 1712A</external-xref> note) is amended—</text> <paragraph id="HE178C5311FA440D9BEB57C61AFE1DD4A"><enum>(1)</enum><text>in subsection (a), by striking <quote>and such other mental health conditions</quote> and inserting <quote>repetitive low-level blast exposure, dementia, and such other brain and mental health conditions</quote>;</text></paragraph>
<paragraph id="H32C876C9D15942BDBE4D0EB63744508D"><enum>(2)</enum><text>in subsection (d)(4), by adding at the end the following new subparagraph:</text> <quoted-block id="HE396CF0A2D0D4119BAA071B749788EE8" style="OLC"> <subparagraph id="HDAAAAFD92D854B3598B5BD8A1004ADA7"><enum>(E)</enum><header>Data-sharing partnership</header> <clause id="HE0A50262B8834AEB8527EDC893B8C25A"><enum>(i)</enum><header>In general</header><text>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.</text></clause>
<clause id="H4066C5FA2DAD4637A5D4508D69037F20"><enum>(ii)</enum><header>Storage</header><text>The partnership established under clause (i) shall be stored in the open platform made available under this paragraph.</text></clause> <clause id="HCB31AB5902B24EF8A343B484CC1B0185"><enum>(iii)</enum><header>Data</header><text>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.</text></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph>
<paragraph id="H35F524E558824A5CB60145804CE0A658"><enum>(3)</enum><text>by adding at the end the following new subsections:</text> <quoted-block id="HCCA1E901CD394A449AF3C4FA2022925E" style="OLC"> <subsection id="H8769FE7D0EA6452486AA9A330D1DCAC9"><enum>(f)</enum><header>Repetitive low-level blast exposure research</header><text>In carrying out the initiative under subsection (a), the Secretary shall prioritize research—</text>
<paragraph id="H440EBEE764BF4812A918A34847171269"><enum>(1)</enum><text>to identify and validate biomarkers associated with repetitive low-level blast exposure and traumatic brain injury;</text></paragraph> <paragraph id="H1040AD63541D45B5BE93EE111BD85BBA"><enum>(2)</enum><text>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;</text></paragraph>
<paragraph id="H360C7532A35A4979986B3DBFEFA4C759"><enum>(3)</enum><text>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</text></paragraph> <paragraph id="H7FCD1CD3FFAB441C99D5892364E784AC"><enum>(4)</enum><text>to develop evidence-based strategies to reduce suicide risk among veterans with a history of low-level repetitive blast exposure or traumatic brain injury.</text></paragraph></subsection>
<subsection id="H2E0E8E64EFF84916B1073E627F3F806B"><enum>(g)</enum><header>Assistance and report by national academies of sciences, engineering, and medicine</header><text>Not later than 180 days after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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—</text> <paragraph id="HA1F81BF47B504FE9A0BB87B360678508"><enum>(1)</enum><text>work in tandem with the initiative under subsection (a) on validation of brain and mental health biomarkers among veterans; and</text></paragraph>
<paragraph id="H75C00AEE932344CABB431DCAA687CCFD"><enum>(2)</enum><text>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).</text></paragraph></subsection> <subsection id="HA9F2C98E3B024A87AA7564E5D6030B02"><enum>(h)</enum><header>Assessment</header> <paragraph id="HBD92711586174629B41139F07F0926C9"><enum>(1)</enum><header>In general</header><text>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).</text></paragraph>
<paragraph id="H4B14C6AA74D74B2E9323A038EA57D9E0"><enum>(2)</enum><header>Report</header><text>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.</text></paragraph></subsection> <subsection id="H0F4316DE0F984FF38C7037E799EBBD24"><enum>(i)</enum><header>Reports</header> <paragraph id="HBFD5943679474BEDB734CDD0F4E88EB4"><enum>(1)</enum><header>In general</header><text>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).</text></paragraph>
<paragraph id="HC6F6F4E47D3B4C608B934336074F061B"><enum>(2)</enum><header>Recommendations</header><text>Each report required by paragraph (1) may include recommendations for immediate administrative and legislative action to improve the initiative under subsection (a).</text></paragraph></subsection> <subsection id="HD3587780428D4B57B444545E4D9ACC67"><enum>(j)</enum><header>Authorization of appropriations</header><text>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.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H5AA9C726EF8D4E66924A1E4620E78804"><enum>(b)</enum><header>Inclusion of information in reports on suicide prevention among veterans and members of the Armed Forces</header>
<paragraph id="H68D3AEA9D8B9400CA941E3253E630E94"><enum>(1)</enum><header>Inclusion of information in national veteran suicide prevention annual report</header><text>Section 149(a)(4)(B) of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (<external-xref legal-doc="public-law" parsable-cite="pl/118/210">Public Law 118–210</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1709B">38 U.S.C. 1709B</external-xref> note) is amended by adding at the end the following:</text> <quoted-block id="H033EFD15009B4F919F45F0993A26BD6F" style="OLC"> <clause id="H51CAEF1F022740F1B499FF9DE713D000"><enum>(iv)</enum><text>Military occupation data of veterans who attempt or commit suicide.</text></clause><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="HFD82D851186841F0AA3B532F9249CB95"><enum>(2)</enum><header>Inclusion of information in Department of Defense annual report</header><text>The Secretary of Defense shall include in the annual report of the Defense Suicide Prevention Office, or successor office, information on—</text> <subparagraph id="H706BA0DB0C524B3F8983DE8057D52DB2"><enum>(A)</enum><text>occupational data of members of the Armed Forces who attempt suicide; and</text></subparagraph>
<subparagraph id="HF6F82C9E793B48A4B08FEA651169FA45"><enum>(B)</enum><text>outcomes of suicide prevention interventions among members of the Armed Forces.</text></subparagraph></paragraph></subsection></section> <section id="H63C1B50848E44762B5C1C072FA097ABB" section-type="subsequent-section"><enum>311.</enum><header>Establishment of the Blast Overpressure Task Force of the Department of Veterans Affairs</header> <subsection id="HE65F416E12484D2FB5A933D5956606CD"><enum>(a)</enum><header>Establishment</header><text display-inline="yes-display-inline">Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs 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 <quote>Task Force</quote>).</text></subsection>
<subsection id="H5778F9F1691B452DA636F3002566FC4D"><enum>(b)</enum><header>Membership</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection id="HE818F65DB6E3400EA22D615B74C1D802"><enum>(c)</enum><header>Duties</header><text display-inline="yes-display-inline">The duties of the Task Force are the following:</text>
<paragraph id="H2CC6E5C67A94477087DA148BFC8970C5"><enum>(1)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="HF44896871B18472F91BF398A2F518FE6"><enum>(2)</enum><text>To align research agendas and acquisition strategies of the Department regarding such health care.</text></paragraph>
<paragraph id="HE26BFEB60398455385316F7186593F5A"><enum>(3)</enum><text>To establish physiological and cognitive performance baselines for such veterans and members.</text></paragraph> <paragraph id="HA59868942D5D489BB66638CF1F18B993"><enum>(4)</enum><text display-inline="yes-display-inline">To prioritize translational research regarding such veterans and members, including research regarding—</text>
<subparagraph id="H75685F6267044165B1917D36E3D2D24A"><enum>(A)</enum><text>sleep therapy;</text></subparagraph> <subparagraph id="H0C00210FAAFC4DD3B4EE3A70C965D386"><enum>(B)</enum><text display-inline="yes-display-inline">blast-related gut health;</text></subparagraph>
<subparagraph id="HF7A6B6E1CBCF49AFBED59E0753E13005"><enum>(C)</enum><text>mobile diagnostics;</text></subparagraph> <subparagraph id="HBDA55617DA974FC2AF12A8FCDA6E0334"><enum>(D)</enum><text display-inline="yes-display-inline">vestibular dysfunction and balance impairment;</text></subparagraph>
<subparagraph id="HDDE7D1B4E3564D7B84D790419FE66021"><enum>(E)</enum><text>autonomic nervous system dysregulation;</text></subparagraph> <subparagraph id="HA908A7F2AAE8429796DF8CEF7EE2D80B"><enum>(F)</enum><text>cumulative mild traumatic brain injury;</text></subparagraph>
<subparagraph id="H66B326FD2E454C40897E68879284F0BB"><enum>(G)</enum><text>neuroinflammation and glial activation; and</text></subparagraph> <subparagraph id="H985B19F04DD84836BAFFA7D6FE1B005F"><enum>(H)</enum><text>any other issue determined appropriate by the Secretary.</text></subparagraph></paragraph>
<paragraph id="H510575CA221B47F39B2BF258476AC5D0"><enum>(5)</enum><text display-inline="yes-display-inline">To monitor sensory decline (including with regards to vision, hearing, and vestibular function) and stress-related impairments among such veterans and members.</text></paragraph> <paragraph id="H409720919F654F15BBB885BBFB8006FF"><enum>(6)</enum><text>To support continuity of such care by integrating mobile and longitudinal diagnostic tools.</text></paragraph></subsection>
<subsection id="H2184FBB8E0224418AE8BBCEFB28017E9"><enum>(d)</enum><header>Reports</header><text>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:</text> <paragraph id="H9F81D43682C2431F9A803A83F314C6B9"><enum>(1)</enum><text display-inline="yes-display-inline">Details of research initiatives, coordination outcomes, and clinical advancements of the Task Force.</text></paragraph>
<paragraph id="H938B3AF9A48A4BA6B85625A596765F27"><enum>(2)</enum><text>Recommendations of the Task Force regarding—</text> <subparagraph id="HDCE311EB783244ECB0FB861F6DE305CF"><enum>(A)</enum><text>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</text></subparagraph>
<subparagraph id="H7B305B2E73D944C6A1BA653CED13BD9E"><enum>(B)</enum><text display-inline="yes-display-inline">best practices regarding the evaluation of neurological injuries in examinations for benefits under chapters 11 or 15 of title 38, United States Code.</text></subparagraph></paragraph></subsection> <subsection id="H5630AB5B24234DDDAE6F299FCBA77152"><enum>(e)</enum><header>Sunset</header><text>The Task Force shall terminate on September 30, 2029.</text></subsection></section>
<section id="HC344981FBB1A4BC28623A53F47363EA4"><enum>312.</enum><header>Extension of sharing of Department of Veterans Affairs and Department of Defense Health Care Resources; resource sharing oversight and implementation plan</header>
<subsection id="H6ABA882E841E41EC8928FA90ED3BE8CF"><enum>(a)</enum><header>Extension</header><text>Section 8111(d)(3) of title 38, United States Code, is amended by striking <quote>September 30, 2026</quote> and inserting <quote>September 30, 2027</quote>.</text></subsection> <subsection id="H3C10E1BCA090458B8644299A89709748"><enum>(b)</enum><header>Oversight</header> <paragraph id="HAF7D7886A79041A680D4E469AEC9F98B"><enum>(1)</enum><header>Justification</header><text>Such section is further amended in subsection (a)—</text>
<subparagraph id="HD54FF24D3AA045D4A756ED873ACC1424"><enum>(A)</enum><text>by inserting <quote>(1)</quote> before <quote>To the maximum extent practicable, the Secretary</quote>; and</text></subparagraph> <subparagraph id="H9030FF746CD147C89F891F50757FE0FC"><enum>(B)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block id="HDFEA9937AEE24FE49D72F282EB5AF72E" style="OLC">
<paragraph id="H0BE32BDF384E4F1E929B7976EB07FBD4"><enum>(2)</enum><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph id="H1F1F86F8B8D144F88C3BA719BEBAE1D9"><enum>(2)</enum><header>Form of information</header><text>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.</text></paragraph>
<paragraph id="H229979340C884DC1B2BFC6EE2C1D679E"><enum>(3)</enum><header>Interference with transmission of information</header><text>In response to such a request, no official or employee of the Department of Veterans Affairs shall—</text> <subparagraph id="H4F58792396BE411E81CCA2B015E86660"><enum>(A)</enum><text>withhold, screen, or alter responsive information;</text></subparagraph>
<subparagraph id="H76CD38B5F5274D45ACE9C8D4159044DF"><enum>(B)</enum><text>delay or condition production on initial clearance or political review;</text></subparagraph> <subparagraph id="H51677935AD5F45FF93569E3F5A478019"><enum>(C)</enum><text>require a nondisclosure agreement unless required by law;</text></subparagraph>
<subparagraph id="HF03A9B03E36043678311B32C1F6045B6"><enum>(D)</enum><text>substitute summaries for requested 2 records; or</text></subparagraph> <subparagraph id="HF8A47BD3849147228D53A8F8E6F1C2F5"><enum>(E)</enum><text>otherwise impede or interfere with direct transmission of information to the Committee on Veterans’ Affairs of the House of Representatives or the Senate.</text></subparagraph></paragraph>
<paragraph id="H2B81D220E48E4AB58536AB73B8BA0B28"><enum>(4)</enum><header>Classified information</header><text>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.</text></paragraph></subsection> <subsection id="H81C4926A1A51450780667A7C09C5336B"><enum>(c)</enum><header>Implementation plan and report</header> <paragraph id="HEA0E1548B01A47EF9B38B50FA3BDC771"><enum>(1)</enum><header>Joint resource sharing implementation plan</header><text>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—</text>
<subparagraph id="H9B36F8E37D4A4D42AF4FC83758AC38F4"><enum>(A)</enum><text>a comprehensive inventory of all agreements under section 8111 of title 38, United States Code;</text></subparagraph> <subparagraph id="H50277366417043A58EF98EFB58E5B548"><enum>(B)</enum><text>a standardized reimbursement methodology;</text></subparagraph>
<subparagraph id="H21B8FF8392784AFAB66030166E469FBB"><enum>(C)</enum><text>capacity assessments of Department of Veterans Affairs and Department of Defense facilities; and</text></subparagraph> <subparagraph id="H9114784EC5B14D62BF81B779AEC06DF5"><enum>(D)</enum><text>identification of priority regions for expansion.</text></subparagraph></paragraph>
<paragraph id="HE879D0E514994DCDA7146F3A1C52ED5C"><enum>(2)</enum><header>Report</header><text>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—</text> <subparagraph id="H501DC8F4CB7B4AC8A3420AC2CBB5EEDD"><enum>(A)</enum><text>a description of use and effectiveness of agreements under such section;</text></subparagraph>
<subparagraph id="H319B0CD58D0D4D37B7844B3F475E7463"><enum>(B)</enum><text>a description of the role and output of the Joint Executive Committee under such section;</text></subparagraph> <subparagraph id="H920E1D5C62914838B7B625F86F7AA9BD"><enum>(C)</enum><text>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</text></subparagraph>
<subparagraph id="HF879132E8CAF410E830DC22A93030DE6"><enum>(D)</enum><text>a description of any statutory, operational, or cultural barriers to the implementation of such section.</text></subparagraph></paragraph></subsection></section> <section id="H1EA3FB38017D434BBD33D52F04DE48A2"><enum>313.</enum><header>Timely reporting of the death of a veteran</header> <subsection id="HEFCD1CA9651D48F7BE5E15C49607699B"> <enum>(a)</enum> <header>Findings</header> <text>Congress finds the following:</text>
<paragraph id="H4584DBC54F04406BBD8951BE314CC5CD"> <enum>(1)</enum> <text display-inline="yes-display-inline">States and counties have reported significant delays in the signing of death certificates for veterans who pass away from natural causes.</text> </paragraph> <paragraph id="H37C23C29F91C4B09BCC6EF216D97E062"> <enum>(2)</enum> <text display-inline="yes-display-inline">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.</text> </paragraph>
<paragraph id="H4C885E7C8E434ADFAF9117E6B1CCD02E"> <enum>(3)</enum> <text display-inline="yes-display-inline">Such delays prevent the timely burial of deceased veterans and access to survivor benefits.</text> </paragraph> </subsection> <subsection id="HC7569A6A64B343448FEE49D359F33FD8"> <enum>(b)</enum> <header>Timely certification of the death of a veteran</header> <paragraph id="H5180C93C0BDE42DCBAAC16EF153653A5"> <enum>(1)</enum> <header>In general</header> <subparagraph id="HE26245842A794110805C6F14D0ABD882"> <enum>(A)</enum> <header>VA physician, nurse practitioner, or physician assistant</header> <text display-inline="yes-display-inline">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.</text> </subparagraph>
<subparagraph id="HCF25A37CE34349239CB1AFDDEED13DFE"> <enum>(B)</enum> <header>Coroner or medical examiner</header> <text display-inline="yes-display-inline">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.</text> </subparagraph> </paragraph> <paragraph id="H960AF03AFAFE41EFBBB45CE4877BF6FF"> <enum>(2)</enum> <header>Report</header> <subparagraph id="HB2B3E43D121F4DF085D1CD8AD8416F0B" commented="no" display-inline="no-display-inline"> <enum>(A)</enum> <header>In general</header> <text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, and 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).</text> </subparagraph>
<subparagraph id="H66EF821786CD4062B6C859618D64271E" commented="no" display-inline="no-display-inline"> <enum>(B)</enum> <header>Elements</header> <text display-inline="yes-display-inline">Each report required under subparagraph (A) shall include, with respect to the year preceding the date of the report, the following elements:</text> <clause id="HC362B6BA2F4F41A58375F2CCD7F38F3A"> <enum>(i)</enum> <text display-inline="yes-display-inline">The percentage of cases in which a physician, nurse practitioner, or physician assistant employed by the Secretary complied with paragraph (1)(A).</text> </clause>
<clause id="H651775CDFB1C4B648B3A9C25E49C6E95"> <enum>(ii)</enum> <text display-inline="yes-display-inline">The number of cases in which such a physician, nurse practitioner, or physician assistant could not so comply.</text> </clause> <clause id="HB8F592DF8DCD461089063CF512ED9269"> <enum>(iii)</enum> <text display-inline="yes-display-inline">An identification of the most common reasons why such a physician, nurse practitioner, or physician assistant could not so comply.</text> </clause> </subparagraph> </paragraph>
<paragraph id="HAFB300D549C24903BEFDF7740D01D596"> <enum>(3)</enum> <header>Rule of construction</header> <text>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.</text> </paragraph> </subsection></section> <section id="HB0ED823FC8E346CDBF3E882FAA49814D" section-type="subsequent-section"><enum>314.</enum><header>Expansion of access by veterans to critical access hospitals and affiliated clinics under the Veterans Community Care Program</header> <subsection id="HFC9005E083F7430184313E58EE1A10A3"><enum>(a)</enum><header>Pilot program to improve care coordination for veterans from critical access hospitals and affiliated clinics</header> <paragraph id="H45033A956A354FF680FE405DB3AC4369"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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 <quote>pilot program</quote>).</text></paragraph>
<paragraph id="HF53F652CF6484EE48AA381E0B7F3A051"><enum>(2)</enum><header>Contracts, agreements, or other arrangements</header>
<subparagraph id="H1356654EC1B74E3EA9A5C93A86E1B887" commented="no" display-inline="no-display-inline"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="HE3FAACD158074D27BDF5CC128FA84B05"><enum>(B)</enum><header>Elements</header><text>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—</text>
<clause id="H61B0CCEA80384F4E8171C8C568ABD3A6"><enum>(i)</enum><text>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;</text></clause> <clause id="HB24F6E5ECA9D49C8B9A107C675A269B0"><enum>(ii)</enum><text>the provision of health care services through the pilot program is in accordance with the medical benefits package of the Department;</text></clause>
<clause id="H7D9717BCF49C4A18A9BD95DD5EC5E24C"><enum>(iii)</enum><text>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;</text></clause> <clause id="HC58D4E00AAEC472D87554266589F34F9"><enum>(iv)</enum><text>appropriate reimbursement rates, including through the consideration of cost-based reimbursements; and</text></clause>
<clause id="H8EF46214B0034D898D0AD3773F177029" commented="no" display-inline="no-display-inline"><enum>(v)</enum><text>such other considerations as the Secretary considers appropriate.</text></clause></subparagraph></paragraph> <paragraph id="H61D0566B50DB40E38462DF22A9684695"><enum>(3)</enum><header>Locations</header><text>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.</text></paragraph>
<paragraph id="H0C5ECC7280994819B4C8D514BFCCDFD6" commented="no" display-inline="no-display-inline"><enum>(4)</enum><header>Authorization for care</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H968C1AEEAE0340F0A4ACE9D43D656F0E" commented="no" display-inline="no-display-inline"><enum>(5)</enum><header>Outreach</header> <subparagraph id="H2CD4E6A9C4EB4737BA4602BCBD7CA80B"><enum>(A)</enum><header>Eligible veterans</header><text>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.</text></subparagraph>
<subparagraph id="HF7FA0485A96340138CEEA74A42DE4678"><enum>(B)</enum><header>Hospitals</header><text>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.</text></subparagraph></paragraph> <paragraph id="HB8B08602FECA4A0D934465B744EE4DB1"><enum>(6)</enum><header>Staff</header><text>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—</text>
<subparagraph id="HCE59D6F1110141A78BE232D7B54AF859" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text display-inline="yes-display-inline">administrative and technical challenges that arise from the pilot program;</text></subparagraph> <subparagraph id="H02B99C4E611E46698BE729B9E2378644" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">care coordination and follow up with the veteran and the facility participating in the pilot program after an episode of care; and</text></subparagraph>
<subparagraph id="H54FCC47FEE04479E849BE0C20C23E4A0" commented="no" display-inline="no-display-inline"><enum>(C)</enum><text display-inline="yes-display-inline">timely records return following an episode of care.</text></subparagraph></paragraph> <paragraph id="H096CEF28E87742E4B16FAA6E9E544C42" commented="no"><enum>(7)</enum><header>Limitation</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="HB3A3821475EB4DB0929FFDCA166C8141"><enum>(8)</enum><header>Report</header>
<subparagraph id="HACE14F6110734FD58BB7804E8D3A21A6" commented="no" display-inline="no-display-inline"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, and 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.</text></subparagraph> <subparagraph id="HED9535B370A54E6DA48B171673D9202D" commented="no" display-inline="no-display-inline"><enum>(B)</enum><header>Elements</header> <clause id="HA421D8D970464F44918FC95DD95998E9" commented="no" display-inline="no-display-inline"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">Each report required under subparagraph (A) shall contain the recommendation of the Secretary for the expansion or continuation of the pilot program.</text></clause>
<clause id="H696E19D1AF4F45E8AE418DDAB802E267" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><header>Initial report</header><text display-inline="yes-display-inline">The initial report required under clause (i) shall contain—</text> <subclause id="H7871EF5975EB40FE96AAA76B17A8F3F0" commented="no" display-inline="no-display-inline"><enum>(I)</enum><text display-inline="yes-display-inline">a description of the outreach conducted to critical access hospitals concerning the pilot program;</text></subclause>
<subclause id="H258AA07B414E40838210FBC61E9B073F" commented="no" display-inline="no-display-inline"><enum>(II)</enum><text display-inline="yes-display-inline">a list of facilities that have opted to participate in the pilot program;</text></subclause> <subclause id="H1598527D76B84FE486F4CDB3F4D631F0" commented="no"><enum>(III)</enum><text display-inline="yes-display-inline">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</text></subclause>
<subclause id="H783F96A934EE49F995FA4B6FEF18FD22" commented="no" display-inline="no-display-inline"><enum>(IV)</enum><text display-inline="yes-display-inline">a list of the barriers, if any, cited by facilities that opted not to participate in the pilot program.</text></subclause></clause> <clause id="HE9A0114E04D4484E8ECD11FEC0172726"><enum>(iii)</enum><header>Subsequent reports</header><text>Each report required under clause (i) after the initial report shall contain—</text>
<subclause id="H14227F8A3D0B457C9B716405B714ADE5" commented="no"><enum>(I)</enum><text>an updated list of facilities participating in the pilot program;</text></subclause> <subclause id="H5B3C283A962E49979470BAB03F94769D" commented="no"><enum>(II)</enum><text>the number of veterans participating in the pilot program, disaggregated by facility;</text></subclause>
<subclause id="H3C82602D7F25489CA5D5933CEDC2663B" commented="no"><enum>(III)</enum><text>an overview of the types of care received through the pilot program;</text></subclause> <subclause id="H41AEF8D7C1FC459B9E07D605298BFBC3" commented="no"><enum>(IV)</enum><text>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</text></subclause>
<subclause id="HE30041427FD545BA865C69EF5ABD0835" commented="no"><enum>(V)</enum><text>any additional information that the Secretary determines relevant or necessary.</text></subclause></clause></subparagraph></paragraph> <paragraph id="H9E5F7D12CE5D4DD9B53D09FBDA0718E0" commented="no" display-inline="no-display-inline"><enum>(9)</enum><header>Definitions</header><text>In this subsection:</text>
<subparagraph id="H2109FF76B921405086CD3B1C14460DD6" commented="no" display-inline="no-display-inline"><enum>(A)</enum><header>Critical access hospital</header><text display-inline="yes-display-inline">The term <term>critical access hospital</term> has the meaning given that term in section 1861(mm) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(mm)</external-xref>).</text></subparagraph> <subparagraph id="HC48EA5FF23B7463694E98C9F8F53D21D" commented="no"><enum>(B)</enum><header>Eligible veteran</header><text>The term <term>eligible veteran</term> means a veteran—</text>
<clause id="H512D013FD7C14122B70432687C665959" commented="no"><enum>(i)</enum><text>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;</text></clause> <clause id="H0BBBA6CCEAC441A1922C1D0DC862B46C" commented="no"><enum>(ii)</enum><text>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;</text></clause>
<clause id="HDCC21D17D849426EA7B9D1BE03118B5A" commented="no"><enum>(iii)</enum><text>who lives within 35 miles of a critical access hospital; and</text></clause> <clause id="HBFEBACD222CA428E9BC4D77F117F2E07" commented="no"><enum>(iv)</enum><text>who would be eligible for care or services under the Veterans Community Care Program.</text></clause></subparagraph></paragraph></subsection>
<subsection id="H0033F0BC6AC74A9CAACADA821DC190EB"><enum>(b)</enum><header>Action plan to address barriers to care for veterans living in rural areas</header>
<paragraph id="H6C50C6E58B084700B52F3AE19754AEA4"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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.</text></paragraph> <paragraph id="HE97BC4E41BDB41FAAE7A7C7EABC23779"><enum>(2)</enum><header>Elements</header><text>In developing the action plan required under paragraph (1), the Secretary shall—</text>
<subparagraph id="H1C030FE9527F42D2BC639F4F41F18FCE"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H094C07A88E614BF183AE0B8DFA69745C"><enum>(B)</enum><text>assess barriers to care in the community for veterans residing in rural and highly rural areas, including challenges with respect to—</text>
<clause id="H0A685073FF7B4121BD4FB21898AD7F22"><enum>(i)</enum><text>network adequacy;</text></clause> <clause id="H75078F0EDF47488A80C7FCC24F4EC906"><enum>(ii)</enum><text>provider participation;</text></clause>
<clause id="H22ACEDF4B50C4B0599C1BF0E76C7644D"><enum>(iii)</enum><text>geographic distance;</text></clause> <clause id="H6CBC2638E3FC4E948DC6D6E46A6E5A31"><enum>(iv)</enum><text>transportation;</text></clause>
<clause id="H453739D3E6024990933E5232324E6662"><enum>(v)</enum><text>information technology;</text></clause> <clause id="H9EF62F893F1148A490C87B42F7EA615B"><enum>(vi)</enum><text>physical infrastructure;</text></clause>
<clause id="HC740AC6C2B434E8CA4C342A3A9E66A8A"><enum>(vii)</enum><text>outreach and understanding of eligibility for such care;</text></clause> <clause id="HB46DBAD7D7D04FD491576FDBFFDD5CE3"><enum>(viii)</enum><text>timeliness of referrals, authorization, and medical documentation exchange; and</text></clause>
<clause id="HB698FAE631704992AAADB51524323016"><enum>(ix)</enum><text>any other matter the Secretary determines appropriate;</text></clause></subparagraph> <subparagraph id="H9A0C5562BB1F4BF4A8169396C865A35D"><enum>(C)</enum><text>list specific and measurable strategies and actions to address the barriers and challenges assessed under subparagraph (B), to include the consideration of—</text>
<clause id="HBF2C4A63C9714CE09DB70FB84E6104E9"><enum>(i)</enum><text>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;</text></clause> <clause id="HD6EAE7B130774EB29A7BE415F694EE7A"><enum>(ii)</enum><text>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;</text></clause>
<clause id="H546893A578894A85BCDF5328CF40E382"><enum>(iii)</enum><text>enhancing transportation assistance;</text></clause> <clause id="H4DAD711D285D4D7295DE668B76CF3091"><enum>(iv)</enum><text>increasing reimbursement rates, including through cost-based reimbursements; and</text></clause>
<clause id="H0245D83DBF3048BC95599FF295453BF5"><enum>(v)</enum><text>improving coordination with State, Tribal, and local partners; and</text></clause></subparagraph> <subparagraph id="H9B5E722167FD400A8171E0ECEFD19B52"><enum>(D)</enum><text>assess legislative and regulatory barriers, if any, to addressing the barriers assessed under subparagraph (B).</text></subparagraph></paragraph>
<paragraph id="H0F49279DC6FB49CBB4BE6B68AA26DD5B"><enum>(3)</enum><header>Implementation</header><text>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.</text></paragraph></subsection> <subsection id="H7C18FC911E2149398FA2B91F2DE58F02"><enum>(c)</enum><header>Outreach</header> <paragraph id="HF8A163DD58A949898BFFBB8D1F05CADC"><enum>(1)</enum><header>Outreach to veterans</header><text>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—</text>
<subparagraph id="H6E383EAF755E4014AEE0B16770E61772"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H307E4E5D6E774F9095D6249F0D3DA2E4"><enum>(B)</enum><text>opportunities to seek care though the Veterans Community Care Program under section 1703 of title 38, United States Code;</text></subparagraph>
<subparagraph id="H0E199140AAB348178BB692F7DB49A407"><enum>(C)</enum><text>opportunities to seek care at critical access hospitals with contracts, partnerships, or agreements with the Department of Veterans Affairs; and</text></subparagraph> <subparagraph id="H069BEA94DD4A4B92BD36578D3932B009"><enum>(D)</enum><text>any other matters the Secretary considers appropriate.</text></subparagraph></paragraph>
<paragraph id="H6F502E18424F413792878897C1BA0C52"><enum>(2)</enum><header>Outreach to providers</header><text>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—</text> <subparagraph id="H5CF79DC09729469B84A50CA8C1D9A55C" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text display-inline="yes-display-inline">conduct outreach to health care facilities and critical access hospitals in rural areas regarding—</text>
<clause id="HBBF4BE635FFB400F8791E0C80A82BCA2"><enum>(i)</enum><text>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</text></clause> <clause id="H0A75E96955D74E67BAB4237A574E68AA"><enum>(ii)</enum><text>any other matters the Secretary considers appropriate; and</text></clause></subparagraph>
<subparagraph id="HA6FFD288000B4A0B8E6D853AD147B281" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">seek to enter into contracts, partnerships, agreements, or other arrangements with health care facilities and critical access hospitals in rural areas.</text></subparagraph></paragraph> <paragraph id="HA5F9858ECB7245A3BC8CE6C8E1C9A653" commented="no" display-inline="no-display-inline"><enum>(3)</enum><header>Critical access hospital defined</header><text>In this section, the term <term>critical access hospital</term> has the meaning given that term in section 1861(mm) of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395x">42 U.S.C. 1395x(mm)</external-xref>).</text></paragraph></subsection></section>
<section section-type="subsequent-section" id="H56FED119369644BEB3090B6CA6ECC3BD"><enum>315.</enum><header>Pilot platform for services for veterans; collection from veterans of information related to social determinants of health</header>
<subsection id="H6CB61719B6F546DB9BF99D6BFB361889"><enum>(a)</enum><header>Pilot program on establishment or enhancement of community integration platform for veterans</header>
<paragraph id="HB4F2CA2F607545B8A80C19FF3C7CFAFA"><enum>(1)</enum><header>In general</header><text>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 <quote>pilot program</quote>).</text></paragraph> <paragraph id="HC1F4DE161EDC4C68A0111E4A8205D222"><enum>(2)</enum><header>Elements of pilot program</header><text>In carrying out the pilot program, the Secretary shall ensure that the community integration platform established or enhanced under the pilot program—</text>
<subparagraph id="H60702FEBB74F4856B6680451ACE6EE15" commented="no"><enum>(A)</enum><text>permits veterans to identify and connect with covered entities that furnish covered services;</text></subparagraph> <subparagraph id="H334FF8BB10E34E2BAC52F7928B3C3716" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text>permits covered entities to identify and connect with veterans in need of covered services;</text></subparagraph>
<subparagraph id="H1C457A7CB9434B039A0F3C10F5A7392C"><enum>(C)</enum><text>utilizes, to the extent practicable, existing interoperable technology networks;</text></subparagraph> <subparagraph id="HA86D9BFBD49C4690B40FA47451A31D2A"><enum>(D)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/300jj-14">42 U.S.C. 300jj–14</external-xref>), for the provision of covered services;</text></subparagraph>
<subparagraph id="H11A17E8AB8294583B6DA750FE0A6325E"><enum>(E)</enum><text>ensures that—</text> <clause id="HC128DC36D1204C68AE65D41F4C624E5F"><enum>(i)</enum><text>reasonable measures are taken to promote connectivity and interoperable exchange among covered entities and between covered entities and veterans; and</text></clause>
<clause id="HBC464904972D426F9CD75FDC9A7E456F"><enum>(ii)</enum><text>appropriate privacy and security protections are in place, in accordance with applicable Federal and State privacy law;</text></clause></subparagraph> <subparagraph id="H78AB2EE61E0140A6AAEFFFF4E1EEC04A"><enum>(F)</enum><text>is accessible by employees of the Department, covered entities, and veterans; </text></subparagraph>
<subparagraph id="H726E613D49D843949FD73F5DBFD7609F"><enum>(G)</enum><text>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</text></subparagraph> <subparagraph id="H19FF5C982C214C2EBF2BF010DBA2E966" commented="no" display-inline="no-display-inline"><enum>(H)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="HE9332D78229F4E648D8B21EEAA25D5CE"><enum>(3)</enum><header>Locations</header>
<subparagraph id="H4A21F9EEBFC146DC9BEE8196D3AF0E22"><enum>(A)</enum><header>Initial locations</header><text>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. </text></subparagraph> <subparagraph id="HC731187D50754A4F89EA054A3C4C5352" commented="no" display-inline="no-display-inline"><enum>(B)</enum><header>Expansion</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="H204B6743DBE741AFB34CE2D04D25BED2" commented="no" display-inline="no-display-inline"><enum>(C)</enum><header>Variety of facilities</header><text>In selecting facilities under subparagraph (A), the Secretary shall ensure the selection of a variety of different types of facilities, including—</text> <clause id="H75133E385C3F4FBB961DFD7986FF6392" commented="no" display-inline="no-display-inline"><enum>(i)</enum><text>frontier facilities;</text></clause>
<clause id="HEA2B6E21D04142CD8DA0F7F3C88AA914" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><text>under-resourced facilities; </text></clause> <clause id="H7E75562F8C614F21BB0C47ADD961BFBC" commented="no" display-inline="no-display-inline"><enum>(iii)</enum><text>facilities at which there are existing efforts to coordinate with community resources; and</text></clause>
<clause id="H4B4F5ECB8D4C4164A4C82FB03C560704" commented="no"><enum>(iv)</enum><text>facilities located in communities with an established community-based veteran service coordination network capable of integration with the pilot program.</text></clause></subparagraph></paragraph> <paragraph id="H4437D1E75AB24789990F83E91C5B2023" commented="no"><enum>(4)</enum><header>Procurement of technology</header><text>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.</text></paragraph>
<paragraph id="H049EBE33001941F886B40C8E2E03050E"><enum>(5)</enum><header>Application process</header>
<subparagraph id="H5C0429AD8A264125B24618F47FB3F077" commented="no" display-inline="no-display-inline"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H832C1B3A721D461BA347FECFE6D7B160"><enum>(B)</enum><header>Review</header> <clause id="H3745BAF8ECA64D8598018296E97EF3B4" commented="no" display-inline="no-display-inline"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></clause>
<clause id="H77343E173F80426F896E54FC1423545F" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><header>Due diligence</header><text>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.</text></clause></subparagraph></paragraph> <paragraph id="H633DF8CC58D748378CBBFC8F12F9FE8B" commented="no"><enum>(6)</enum><header>Screening and tracking of participants</header> <subparagraph id="H7B9227C70A964A24A9F2BA569D4273C4" commented="no" display-inline="no-display-inline"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="HF41F212B85DB42E99FED26C9183EB9DA" commented="no"><enum>(B)</enum><header>Informed consent</header><text>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.</text></subparagraph> <subparagraph id="H0A773C9EA7C34978BEC57E7CB72BF89F" commented="no"><enum>(C)</enum><header>Tracking of information</header> <clause id="H8B9CE68E87A540239D5C300FC53956BA" commented="no" display-inline="no-display-inline"><enum>(i)</enum><header display-inline="yes-display-inline">In general</header><text>The Secretary shall track—</text>
<subclause id="HE5A33EA1691F4B07BC68D66D4C26B333" commented="no"><enum>(I)</enum><text>the number of referrals of veterans to covered entities through the community integration platform under the pilot program;</text></subclause> <subclause id="H4FACF9A94CB74DD086CBA17FD09B9820" commented="no"><enum>(II)</enum><text>the response time of covered entities to which such veterans are referred; and</text></subclause>
<subclause id="H3B606716E254429E8F95E9CD9D7DBB8B" commented="no"><enum>(III)</enum><text>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.</text></subclause></clause> <clause id="H589E38F6B57B4D5792E4F4878CF2E43D" commented="no"><enum>(ii)</enum><header>Tracking by entities</header><text>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.</text></clause></subparagraph></paragraph>
<paragraph id="HA2D4EA758AD940869FEB5067000D5264"><enum>(7)</enum><header>Coordination and integration of programs</header>
<subparagraph id="H079A534A025B41EFA2C77219FF159D0C"><enum>(A)</enum><header>Coordination with existing networks</header><text>In carrying out the pilot program, the Secretary shall coordinate with existing community networks. </text></subparagraph> <subparagraph id="H0BCA296A8E464AF4A4A2D5927EB380E1" commented="no"><enum>(B)</enum><header>Coordination and integration with State medicaid programs</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="H9BB5C055AD60417B8490EB893729D64B" commented="no" display-inline="no-display-inline"><enum>(8)</enum><header>Performance benchmarks</header><text>The Secretary shall establish performance benchmarks for the pilot program, including measures of referral completion, timeliness of service connection, and veteran-reported satisfaction.</text></paragraph> <paragraph id="H624D9FB95EF9497091FE15FF4361687B"><enum>(9)</enum><header>Report and briefings</header> <subparagraph id="H1999DDE994524F4DB84A9A3A4E7D6B0D" commented="no" display-inline="no-display-inline"><enum>(A)</enum><header>Report</header><text display-inline="yes-display-inline">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—</text>
<clause id="HF4EF140D6E5949EFB883D4025CAC44A3" commented="no"><enum>(i)</enum><text>the need for such services that is being met through such platform; and</text></clause> <clause id="HC0C18442B72B47CC8AB0DD47665FAB37" commented="no"><enum>(ii)</enum><text>the need for such services that is not being met through such platform.</text></clause></subparagraph>
<subparagraph id="H2B7BCD89869441D9BB6647BEB9CD5B2E"><enum>(B)</enum><header>Briefing on entities not selected</header><text>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.</text></subparagraph></paragraph> <paragraph id="H07FE848B92754FB8923B6C77838C01D2"><enum>(10)</enum><header>Comptroller General evaluation, report, and recommendations</header> <subparagraph id="H855DD9AAE37E44EB8E74BFF086498B9A"><enum>(A)</enum><header>Evaluation</header><text display-inline="yes-display-inline">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—</text>
<clause id="H8052384AF36F4F96983067494D111453"><enum>(i)</enum><text>changes in individual and population health outcomes among veterans;</text></clause> <clause id="H6DC182A4182F4708BB494A653681F244"><enum>(ii)</enum><text>changes in access to health care or social services among veterans; and</text></clause>
<clause id="H42D8B31334404912B25509333C76DC7B" commented="no" display-inline="no-display-inline"><enum>(iii)</enum><text>such other factors as the Comptroller General considers appropriate.</text></clause></subparagraph> <subparagraph id="HDCC4BA455A824B12AD21949E6BF7AB28"><enum>(B)</enum><header>Report and recommendations</header> <clause id="H2B407F8B6CB6475EB938CA389937B40C"><enum>(i)</enum><header>In general</header><text>Not later than four years after the commencement of the pilot program, the Comptroller General shall—</text>
<subclause id="HC4413781EC3642CD974CC26ADB2CDE87"><enum>(I)</enum><text>submit to Congress a report on the evaluation conducted under subparagraph (A);</text></subclause> <subclause id="H7CA3471F59944F48802DCE02C604D39C" commented="no" display-inline="no-display-inline"><enum>(II)</enum><text display-inline="yes-display-inline">make such report publicly available; and</text></subclause>
<subclause id="H96FA678FE3BF4019BCF62B8FE7098244" commented="no" display-inline="no-display-inline"><enum>(III)</enum><text>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.</text></subclause></clause> <clause id="HE3935EB638C5400180281E91134A380F" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><header>Elements of report</header><text>The report under clause (i)(I) shall include data on—</text>
<subclause id="H0449AC90DFD3417B924CD72421540684" commented="no" display-inline="no-display-inline"><enum>(I)</enum><text>what covered sources under the pilot program are being utilized the most;</text></subclause> <subclause id="H6BCB8257889E4CE5A6CA0089533D65E4" commented="no" display-inline="no-display-inline"><enum>(II)</enum><text>what requests for services under the pilot program cannot be met; and</text></subclause>
<subclause id="H5190F569B14E48A2A0E7C338B0A721C0" commented="no" display-inline="no-display-inline"><enum>(III)</enum><text>the impact of the provision of services under the pilot program on health outcomes of veterans.</text></subclause></clause></subparagraph></paragraph> <paragraph id="H321DB9E99CC24B3697BE6F79BE7306DD" commented="no"><enum>(11)</enum><header>Limitations</header> <subparagraph id="HA259AF976FD24EE39CD9C6E99B436227" display-inline="yes-display-inline" commented="no"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="H63B0F878B8004A739C468A4EEA41CC15" indent="up1" commented="no"><enum>(B)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H9A2AB2E85F6A49FBA79248B090280E26"><enum>(12)</enum><header>Definitions</header><text>In this subsection:</text>
<subparagraph id="H8CEDFD10D3FD41CF91B286EE1089FFA2"><enum>(A)</enum><header>Appropriate committees of Congress</header><text>The term <term>appropriate committees of Congress</term> means the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives.</text></subparagraph> <subparagraph id="H4270805BF7864B29A52D53811889C782"><enum>(B)</enum><header>Community integration platform</header><text>The term <term>community integration platform</term> 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.</text></subparagraph>
<subparagraph id="H91BAB3593AAD4BBE85BEBB65708C34A6"><enum>(C)</enum><header>Covered entity</header><text>The term <term>covered entity</term> means any of the following entities or providers that have entered into an agreement with the Secretary to participate in the pilot program:</text> <clause id="H7DE4F5A1DA8542FB83896268BF257F4E"><enum>(i)</enum><text>A community-based organization that—</text>
<subclause id="HB14DD324E5EA456B8D77C1B3C3DEC4D9" commented="no" display-inline="no-display-inline"><enum>(I)</enum><text display-inline="yes-display-inline">accepts referrals from health care organizations; and </text></subclause> <subclause id="H9F632E3CC69E4376B9505C1C0E31A6DD" commented="no" display-inline="no-display-inline"><enum>(II)</enum><text display-inline="yes-display-inline">provides covered services.</text></subclause></clause>
<clause id="H71EF4F6F98FC45B1826D736E3E31F9A4"><enum>(ii)</enum><text>A public or private health care provider organization.</text></clause> <clause id="H311CE5B7B3CE463F8C1A4EB47852879A"><enum>(iii)</enum><text>A public or private funded payor of health care services, including home- or community-based services.</text></clause>
<clause id="HF1960F2E46AD4523A80A217941384774"><enum>(iv)</enum><text>A State, local, territorial, or Tribal health or social services agency.</text></clause> <clause id="H288E833EB2DC4A81A2CD49AB0DFB5B4F"><enum>(v)</enum><text>A State public housing authority or housing finance agency.</text></clause>
<clause id="H1CBD9B52AED6411B95CD220EA0AD3A95"><enum>(vi)</enum><text>A public health information exchange or public health information network, as defined by the Secretary.</text></clause> <clause id="H97167DF92E4C420CB5659EB6047B0311"><enum>(vii)</enum><text>A faith-based service provider.</text></clause>
<clause id="HDECB067594B44272BEB33199FB0AA22D"><enum>(viii)</enum><text>Any other similar entity, as determined by the Secretary.</text></clause></subparagraph> <subparagraph id="HAA31B5ADE5CC4C778D3F9351F522CDA0"><enum>(D)</enum><header>Covered services</header><text>The term <term>covered services</term> means any of the following:</text>
<clause id="H40A8D22F28BC4ACF8452F5DDADA8378F"><enum>(i)</enum><text>Nutritional assistance.</text></clause> <clause id="H93A79F1D31DD450DAC0A10FA28379FC4"><enum>(ii)</enum><text>Housing.</text></clause>
<clause id="H47943FD5050C4C4DAF1ADF37A585DD4E"><enum>(iii)</enum><text>Health care, including preventive health intervention, chronic disease management, and behavioral health care.</text></clause> <clause id="H30D75D9D59AE4F4C82DECBB154D99939"><enum>(iv)</enum><text>Transportation.</text></clause>
<clause id="H58485B8656CB4EDC8DCE93D8A56EECEE"><enum>(v)</enum><text>Job training and employment.</text></clause> <clause id="H53B0C35139764F929CBDEB0595AF1AAA"><enum>(vi)</enum><text>Child development or care.</text></clause>
<clause id="HAC69F4AA0FC145C08058222889418293"><enum>(vii)</enum><text>Caregiving and respite care.</text></clause> <clause id="HCA390CB2807C4017BBE3EE1EEBF7B388"><enum>(viii)</enum><text>Disability assistance.</text></clause>
<clause id="HD26E879638E44FB598C09BF5D3BE9CA4"><enum>(ix)</enum><text>Suicide prevention.</text></clause> <clause id="H4C78B71DAB5941CDA32A9B487CE004D1"><enum>(x)</enum><text>Sexual assault services.</text></clause>
<clause id="H82F9AE6EDF034585BEBE1AE8FCCA9C8E"><enum>(xi)</enum><text>Legal aid.</text></clause> <clause id="HEBB27BA983C94C5D849EC50545C892FF"><enum>(xii)</enum><text>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).</text></clause>
<clause id="H0792BEB55BAF45089535D6DB79D76765"><enum>(xiii)</enum><text>Assistance with utilities necessary for safe habitation.</text></clause> <clause id="H795606557E0F4512A92B6EBF02078340" commented="no" display-inline="no-display-inline"><enum>(xiv)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph>
<subparagraph id="H904A60F3EA714B45B8F8060D6BB5B5CC" commented="no"><enum>(E)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Veterans Affairs.</text></subparagraph> <subparagraph id="HAFDD9F9FFA7C4E8E82A1BA642AAD4E0B" commented="no"><enum>(F)</enum><header>State</header><text>The term <term>State</term> has the meaning given that term in section 101 of title 38, United States Code.</text></subparagraph></paragraph></subsection>
<subsection id="HFD866636C2DB456993D82ECA3D48FE5A"><enum>(b)</enum><header>Collection of information from veterans related to social determinants of health</header>
<paragraph id="H7695088A199146C0AB08266216ACAB70" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text>The Secretary of Veterans Affairs 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.</text></paragraph> <paragraph id="H4A3B11F929C5450E9B7D3FC6C80FDBF8" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Social determinants of health</header> <subparagraph id="H7ED4966BB9B44F1ABDCD4D3ED5983D02" commented="no" display-inline="no-display-inline"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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).</text></subparagraph>
<subparagraph id="H6B94A2C0057E47A895ACF0008DD59120" commented="no" display-inline="no-display-inline"><enum>(B)</enum><header>Incorporation of measures</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection></section> <section id="HC02EEA94A5614B5C9C4E50B359977336"><enum>316.</enum><header>Improvements to Department of Veterans Affairs prosthetic and rehabilitative items and service</header> <subsection id="H16968309556E410F91969F1FFBCBFCC7"><enum>(a)</enum><header>Prosthetic and Rehabilitative Items and Services Formulary</header> <paragraph commented="no" display-inline="no-display-inline" id="HD23E1DCF28FC4B4DA6AF104555EEF2FB"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">Chapter 17</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/1709C">section 1709C</external-xref> the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="H80D0AB3F79A04395A7E650077AA5B0DA">
<section id="HC563C9C7C05A4B11A17A65D67AD60457"><enum>1709D.</enum><header>Prosthetic and Rehabilitative Items and Services Formulary</header>
<subsection commented="no" display-inline="no-display-inline" id="H7265931E4A544CBCA1A96C6EE87C8B91"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall establish a list of prosthetic and rehabilitative items and services, which may be referred to as the <quote>Prosthetic and Rehabilitative Items and Services Formulary</quote> or the <quote>Formulary</quote>, for purposes of furnishing medical services under section 1701(6)(F) of this title pursuant to section 1710 of this title.</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="HB8DC25F1588D4E14878D8195F207A4DD"><enum>(b)</enum><header>Requirements</header> <paragraph commented="no" display-inline="no-display-inline" id="H86EA86475B674BB2B53CA7854E945513"><enum>(1)</enum><header display-inline="yes-display-inline">Input</header><text>In developing the Formulary, the Secretary shall solicit input from veterans and the public.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HFA2E00D9F0894A7682552D899A2FE7B8"><enum>(2)</enum><header>Availability of items</header><text>The Secretary shall ensure that all items and services included in the Formulary are available at or through all facilities of the Department.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H2885C7892DBF426CAD91FABF2D7D44AE"><enum>(3)</enum><header>Items To be included</header><text>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.</text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H4B1DBB444A804E2D8EBB91B0A5BA0765"><enum>(c)</enum><header>Publication and communication</header>
<paragraph commented="no" display-inline="no-display-inline" id="H699CF126A33A44499409BE314F9D4BB7"><enum>(1)</enum><header>Publication and update</header><text display-inline="yes-display-inline">The Secretary shall publish the Formulary on a website of the Department and shall update the Formulary periodically.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H23A5EFE0145D431196CB2B8D892212FF"><enum>(2)</enum><header>Communication</header><text>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.</text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H0D9F88C94305417EA01F1F1E0D02E264"><enum>(d)</enum><header>Contracts</header><text>The Secretary shall enter into such contracts as the Secretary considers necessary to support the availability of items and services included in the Formulary.</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="H8675326B55CC47459ECF9760286129E5"><enum>(e)</enum><header>Training</header><text>The Secretary shall ensure the availability of training on the Formulary for clinicians and other staff of the Department.</text></subsection>
<subsection id="H479C0B2FDCCF4103B3DA2195F143B04A"><enum>(f)</enum><header>Exceptions</header>
<paragraph commented="no" display-inline="no-display-inline" id="H9E93D1DA92AC4333897CED0BBADA2C4C"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HA4F744937AF74F01B8AF244597774306"><enum>(2)</enum><header>Monitoring of non-Formulary items and services</header><text>The Secretary shall monitor requests and prescriptions for and the furnishing of prosthetic and rehabilitative items and services under paragraph (1)—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HE72F70531FA04FDCBF7BFA2E57E98EF9"><enum>(A)</enum><text>to ensure that such items and services are being consistently and appropriately prescribed at all facilities of the Department; and</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H7CF5E666BD3348A68B01332E1427A86C"><enum>(B)</enum><text>to determine whether such items or services should be added to the Formulary.</text></subparagraph></paragraph>
<paragraph id="H7B8249E7C86F44969C3684F15CDEB8ED"><enum>(3)</enum><header>Prior authorization for non-formulary procurement</header><text>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.</text></paragraph> <paragraph id="H55D4015CF83F45AF8069F633149518D3"><enum>(4)</enum><header>Open market procurement</header><text>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.</text></paragraph></subsection>
<subsection id="HDF9665B5403A4A5F8EED626998FCC5C1"><enum>(g)</enum><header>Consideration</header><text>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.</text></subsection> <subsection id="H4923BB2C0980476099E02D9C1C7BB7BE"><enum>(h)</enum><header>Enterprise procurement and ordering system</header> <paragraph id="HDE0D7E0C3EE64CEAA76DDFB7D2DABEC9"><enum>(1)</enum><header>In general</header><text>The Secretary shall implement an enterprise electronic ordering system for prosthetic and rehabilitative items and services furnished under this section.</text></paragraph>
<paragraph id="H37D5C52CB654443C9471AEA8758DCCF8"><enum>(2)</enum><header>Systems elements</header><text>The system required under paragraph (1) shall—</text> <subparagraph id="H0B27B32E345D464D86744AEFBFADFAAE"><enum>(A)</enum><text>enable the automated ordering of items included on the Formulary;</text></subparagraph>
<subparagraph id="HF41B47C0D55D431A866C5F17BB5B7638"><enum>(B)</enum><text>provide visibility of contract pricing and availability across all facilities of the Department;</text></subparagraph> <subparagraph id="H27FB2DA93F884FD39DC5051BC1C32C8B"><enum>(C)</enum><text>allow enterprise loading of nationally contracted products; </text></subparagraph>
<subparagraph id="HEA7BE4F536D34ABCBA443E0CE6FD9951"><enum>(D)</enum><text>provide procurement analytics to monitor compliance with national contracts and reduce open market purchasing; and</text></subparagraph> <subparagraph id="H9E8874BEF8344E24A03CF631F09F7FEC"><enum>(E)</enum><text display-inline="yes-display-inline">contain all data elements required for the Federal Electronic Healthcare Record in a searchable format.</text></subparagraph></paragraph>
<paragraph id="H6B77403923464DC2A9312D0570FA2981"><enum>(3)</enum><header>Implementation</header><text>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.</text></paragraph></subsection> <subsection id="H4B44FC659BD3447A82EEC95D39DE6A8D"><enum>(i)</enum><header>Program management</header> <paragraph id="HB914B81CEF404CB7B0358A4ACB1C3D44"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="H1E9BA47E91044D9DB42694D2584402BE"><enum>(2)</enum><header>Staffing included</header><text>Staffing required under paragraph (1) shall include—</text> <subparagraph id="H2017012F92E24A8188C7C8953B5C731A"><enum>(A)</enum><text>dedicated program managers for major prosthetic product categories; and</text></subparagraph>
<subparagraph id="H7BCD47020F934C09A9AA54411FB0B875"><enum>(B)</enum><text>full-time clinical staff responsible for clinical evaluations and practice recommendations.</text></subparagraph></paragraph></subsection> <subsection id="H64A827C516A644CE90AE1C229F5B47CC"><enum>(j)</enum><header>Report to Congress</header><text>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—</text>
<paragraph id="HFA42763FE643482CA7A2B60AA26B7D42"><enum>(1)</enum><text>rates of compliance by the Department with national prosthetic contracts;</text></paragraph> <paragraph id="H2DC83403CAE6441EB477EB746F9B22E9"><enum>(2)</enum><text>open market purchasing trends of the Department;</text></paragraph>
<paragraph id="H3FF7AA385D5445EC97FC31A2A3FCBA96"><enum>(3)</enum><text>utilization of the Formulary across facilities of the Department; and</text></paragraph> <paragraph id="H8F64E3D2C0DA4380AFD95B409A55EEE3"><enum>(4)</enum><text>steps taken by the Department to improve enterprise procurement efficiency.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H04BF66FA9A1D467EBA2663854E478E03"><enum>(2)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1709C the following new item:</text> <toc> <toc-entry bold="off" level="section"><quote>1709D. Prosthetic and rehabilitative items and services formulary</quote>.</toc-entry></toc></paragraph></subsection> <subsection id="H020D45AA252E40E4A72796E59652E940"><enum>(b)</enum><header>Report</header> <paragraph commented="no" display-inline="no-display-inline" id="HFFDC83B2222A49598690673826E6159E"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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).</text></paragraph>
<paragraph id="HE6FAD145A98843E69EA5B3CB5487B9A1"><enum>(2)</enum><header>Elements</header><text>The report required by paragraph (1) shall identify potential impacts of the Prosthetic and Rehabilitative Items and Services Formulary on—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HD5E606CFC35C47F8A86A1533C5B9710D"><enum>(A)</enum><text display-inline="yes-display-inline">access by veterans to prosthetic and rehabilitative items and services;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H761B9CA516DD4CD098E3507D47050EFC"><enum>(B)</enum><text display-inline="yes-display-inline">clinician workload;</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HFCE60268E7AF48CF8B15DBB1EB1600A7"><enum>(C)</enum><text display-inline="yes-display-inline">procurement timelines; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H388648EB2A8242CEAC4CCF4F8F1E3277"><enum>(D)</enum><text display-inline="yes-display-inline">innovation adoption.</text></subparagraph></paragraph></subsection></section> <section commented="no" display-inline="no-display-inline" id="HEC6314778D7C4A389D59CB2B68043623"><enum>317.</enum><header display-inline="yes-display-inline">Improvement of submission of medical documentation to the Secretary of Veterans Affairs by community care providers</header> <subsection commented="no" display-inline="no-display-inline" id="H4735895FAEBB4AC6B9C6F0BAF4070D6B"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text>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.</text></subsection>
<subsection commented="no" display-inline="no-display-inline" id="HA3E91EFB061348BFA107C28D735D0B5C"><enum>(b)</enum><header>Internal Measures</header><text display-inline="yes-display-inline">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).</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="H2645816477F34BA59CEEBCC3359F6340"><enum>(c)</enum><header>Training</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H61C81694632B484098534B4C575C9999"><enum>(d)</enum><header>Outreach</header><text display-inline="yes-display-inline">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).</text></subsection> <subsection id="H06998C7B9BF04C718F4022AD5C28C492"><enum>(e)</enum><header>Submission of goals, measures, and materials</header><text>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.</text></subsection></section>
<section commented="no" display-inline="no-display-inline" section-type="subsequent-section" id="H1197E74E1FE9414FBC47068181800232"><enum>318.</enum><header>Implementation of and report on efforts of Department of Veterans Affairs to improve health care appointment scheduling</header>
<subsection id="H2DE7C3B61BD3448ABE62A961C7BBAAE7"><enum>(a)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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. </text></subsection> <subsection commented="no" display-inline="no-display-inline" id="HF8D3D2FF437D47D3A23B959E85B165A4"><enum>(b)</enum><header>Elements of plan</header> <paragraph commented="no" display-inline="no-display-inline" id="H22B2D741E14546AE8D0A8524C3785385"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The plan required by subsection (a) shall include—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H34FAB962ECD148E98515589947E85B3C"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HF42A8095BD024074AC6869DEDAE619D2"><enum>(B)</enum><text>a proposed schedule and timeline to carry out such plan.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H9D8741A336994B9799FD2CD9D768ABF3"><enum>(2)</enum><header>Objectives</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H42EF937EE6904863BF7DEE166948A570"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall ensure that the plan required by subsection (a) addresses the following objectives:</text> <clause commented="no" display-inline="no-display-inline" id="H5A733DC5DA3C47A1BB0D363A682AB864"><enum>(i)</enum><text>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.</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H7CBD5C9C62B74835AC3241A2B5CDA8A9"><enum>(ii)</enum><text>To develop or continue the development of a self-service scheduling platform, available for use by all patients of the Department, which shall—</text> <subclause commented="no" display-inline="no-display-inline" id="HC6582CF126254EA2B33FE496AB349AF1"><enum>(I)</enum><text display-inline="yes-display-inline">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;</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="H0890A426D7D34D9FAE208FBB336AF06E"><enum>(II)</enum><text>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</text></subclause> <subclause commented="no" display-inline="no-display-inline" id="H9C9AD141F3DD469698802BDC29C7B31D"><enum>(III)</enum><text>provide such patients with the ability to cancel or reschedule appointments.</text></subclause></clause>
<clause commented="no" display-inline="no-display-inline" id="H831A933D54254204BE607B80C950D045"><enum>(iii)</enum><text>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.</text></clause> <clause commented="no" display-inline="no-display-inline" id="H9A08C966AAE947F38459C58C398641D4"><enum>(iv)</enum><text>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.</text></clause></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H598E164CE95F42939AE3C5FB29FF045D"><enum>(B)</enum><header>Explanation of inability to implement certain objectives, features, or services</header><text>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—</text> <clause commented="no" display-inline="no-display-inline" id="HDB354DC5E4954B5FABD388A9B4485236"><enum>(i)</enum><text display-inline="yes-display-inline">an explanation as to why that objective, feature, or service cannot be implemented or incorporated, as the case may be; and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H480D99D4F9F6478785DECA8CE4D3CE96"><enum>(ii)</enum><text display-inline="yes-display-inline">a plan for implementing the plan required by subsection (a) without that objective, feature, or service.</text></clause></subparagraph></paragraph></subsection> <subsection id="H3FB87D498AD44FFD8DFEC044A568AB04"><enum>(c)</enum><header>Implementation</header><text>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.</text></subsection>
<subsection id="H47480A6C4BCD4E5893EE809FF0F36D0A"><enum>(d)</enum><header>Coordination with Electronic Health Record Modernization Program</header><text>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.</text></subsection> <subsection id="H384083C22E9545298570CAE2F65949DD"><enum>(e)</enum><header>Implementation reports</header><text>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—</text>
<paragraph id="H3B00E293CA6443198BB646E27F073388"><enum>(1)</enum><text>the costs incurred to implement the plan as of the date of the report;</text></paragraph> <paragraph id="H83778A72255043F98ADF5928181EC3E3"><enum>(2)</enum><text>the expected costs to complete implementation of the plan (including costs for management and technology);</text></paragraph>
<paragraph id="H0B8C9FFC1C5E45CAAB40F10EA524D389"><enum>(3)</enum><text>the schedule for deployment of any capabilities developed pursuant to the plan; and</text></paragraph> <paragraph id="H6411CB1B00BB4E238C27D0A0CBBE660A"><enum>(4)</enum><text>the goals and metrics achieved, challenges, and lessons learned in implementing the plan.</text></paragraph></subsection>
<subsection id="H5CA4D66CD3A54420BCE7D5B1E4295AD5"><enum>(f)</enum><header>Rule of construction</header><text>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.</text></subsection> <subsection id="HCFB28F2C352D4A22B5279CBF32D6FD80"><enum>(g)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="HB0119525F68441D9AD909433CFEE2859"><enum>(1)</enum><header>Appropriate committees of Congress</header><text>The term <term>appropriate committees of Congress</term> means the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives.</text></paragraph> <paragraph id="HFD5546033E3A4A9986B3E9F421ED4A5B"><enum>(2)</enum><header>Fully schedule</header><text>The term <term>fully schedule</term>, with respect to an appointment for health care, means that the appointment booking is completed, rather than simply requested.</text></paragraph></subsection></section>
<section id="HDD312FBD1ED8463483541C281250E437"><enum>319.</enum><header>Pilot program on coordination of care between Department of Veterans Affairs and Medicare program</header>
<subsection id="H03A86CE15E04470197A2B5368E1FB2AF"><enum>(a)</enum><header>In general</header><text>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 <quote>pilot program</quote>) to coordinate, navigate, and manage care and benefits for covered veterans.</text></subsection> <subsection id="H82429F09CCC24A88947EAA8CF2504039"><enum>(b)</enum><header>Purposes of pilot program</header><text>The purposes of the pilot program are as follows:</text>
<paragraph id="H64614524DFC74062823E5D77B5F56D27"><enum>(1)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>).</text></paragraph> <paragraph id="H3B5EA3E256E141F1B1F105D0EBBAC315"><enum>(2)</enum><text>To improve satisfaction with care received by covered veterans.</text></paragraph>
<paragraph id="H395CCC2207C24221909EF54845CCEBA3"><enum>(3)</enum><text>To improve quality of care received by covered veterans.</text></paragraph> <paragraph id="HEF07BEC55B0B4102A44B5467A56350A4"><enum>(4)</enum><text>To lower costs to the Federal Government for care received by covered veterans.</text></paragraph>
<paragraph id="H8083FB72E30A44AD84251112DD5C886C"><enum>(5)</enum><text>To reduce gaps in care and duplication of services and expenses for covered veterans.</text></paragraph> <paragraph id="H169D2A52A9DB4681A4B5AC6BC60478D8"><enum>(6)</enum><text>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.</text></paragraph></subsection>
<subsection id="H3B7F898C33C744939DFC6C6613AFBB67"><enum>(c)</enum><header>Locations</header><text>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—</text> <paragraph id="HA40CEB4B8DE044D68805BB0EFF42B283"><enum>(1)</enum><text>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</text></paragraph>
<paragraph id="H93B9EB08019C4911BB6F43C486C7FEAA"><enum>(2)</enum><text>locations that are in medically underserved communities (as defined in section 799B of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/295p">42 U.S.C. 295p</external-xref>)).</text></paragraph></subsection> <subsection id="H5159D9418DC5482484CC105C7C70413A"><enum>(d)</enum><header>Case manager</header><text>In carrying out the pilot program, the Secretary shall assign each covered veteran participating in the pilot program a case manager responsible for—</text>
<paragraph commented="no" display-inline="no-display-inline" id="HDA5ACB0EFF9B45D49FA08E3CA97BF1EF"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H227398D175584E209D961FB09C79DFFA"><enum>(2)</enum><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>).</text></paragraph></subsection>
<subsection id="H1FBA2160116E41ED8D64738E9B98B747"><enum>(e)</enum><header>Use of existing models</header><text>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.</text></subsection> <subsection id="HB8FBD077781944079DD51450F3557E9A"><enum>(f)</enum><header>Contracting with private sector entities</header> <paragraph id="HAB9027979F2849AD9E2FD5986CBDEABA"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="H9306B0CCD8F24280BDCB59C0CBD94FD6"><enum>(2)</enum><header>Notification</header><text>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—</text> <subparagraph id="H4B0B719709014D79B92FAA95FFCC6749"><enum>(A)</enum><text>a notification of that determination;</text></subparagraph>
<subparagraph id="HFD046ED5E1FA4015AA31872400232DD5"><enum>(B)</enum><text>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;</text></subparagraph> <subparagraph id="HFACE74BB97D44F70BA2DFE4235DF202E"><enum>(C)</enum><text>a justification for why the Secretary has determined that such contract or agreement is not necessary or practicable; and</text></subparagraph>
<subparagraph id="H8A6AB1844AD4456CA5ED8D035C13D8A4"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection> <subsection id="H7476F585051343399CBB103CDB963660"><enum>(g)</enum><header>Metrics</header> <paragraph id="HE9D679AFB58D48EE937B950CEB48B5A1"><enum>(1)</enum><header>In general</header><text>The Secretary shall track metrics under the pilot program, including the following:</text>
<subparagraph id="HF0B097547E254D7AA6F40F15EC0DEE50"><enum>(A)</enum><text>The number of veterans participating in the pilot program, disaggregated by Veterans Integrated Service Network.</text></subparagraph> <subparagraph id="H3B65E4B5873E4816B8B1348A8130A791"><enum>(B)</enum><text>Reliance on health care services administered by the Secretary.</text></subparagraph>
<subparagraph id="H22DF173C196E44F4A59B556E3CE99743"><enum>(C)</enum><text>Reliance on health care services administered under the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>).</text></subparagraph> <subparagraph id="HF1B8CD99C3B64949B3B79249D042F41B"><enum>(D)</enum><text>Quality of care, including patient outcomes.</text></subparagraph>
<subparagraph id="HE792309482954738B2C800EA94192F6D"><enum>(E)</enum><text>Cost of care.</text></subparagraph> <subparagraph id="HBE97B6400461471F9808BA082AA3DEAD"><enum>(F)</enum><text>Access to care, including under the designated access standards developed by the Secretary under section 1703B of title 38, United States Code.</text></subparagraph>
<subparagraph id="H43457FE8536D4ADB8D979C937C2E7496"><enum>(G)</enum><text>Patient satisfaction.</text></subparagraph> <subparagraph id="HFB07A9AB23CA42368BE9DE3B9B311376"><enum>(H)</enum><text>Provider satisfaction.</text></subparagraph>
<subparagraph id="H3D7A1442E4EF4204A57696514803006F"><enum>(I)</enum><text>Care coordination, including timely information sharing and medical documentation return.</text></subparagraph></paragraph> <paragraph id="H5DAC9A1F504B45FF8CE479C26D74EBF7"><enum>(2)</enum><header>Elements</header><text>In tracking metrics under paragraph (1), the Secretary shall track information relating to—</text>
<subparagraph id="HC962B17B13D84744B18C8FED40BC5A96"><enum>(A)</enum><text>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);</text></subparagraph> <subparagraph id="H4F336A1B60E14CE4B889619062B8BDB1"><enum>(B)</enum><text>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;</text></subparagraph>
<subparagraph id="H50DC31191CBB439EA4DD86FBB5E6B089"><enum>(C)</enum><text>the type of care and services provided to covered veterans; and</text></subparagraph> <subparagraph id="HD16B59552DF74074AC224DB26892526C"><enum>(D)</enum><text>the demographics of covered veterans participating in the pilot program, including age.</text></subparagraph></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H7073CAE44E904B789E16A9BC308093FF"><enum>(h)</enum><header>Supplement not supplant</header><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/115/182">Public Law 115–182</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1701">38 U.S.C. 1701</external-xref> note).</text></subsection> <subsection id="H11A8134FBDEB492A8912CBE96B175560"><enum>(i)</enum><header>Duration</header><text>The Secretary shall carry out the pilot program for a three-year period beginning on the commencement of the pilot program.</text></subsection>
<subsection id="H974845ACF62043F2B4375930169CEF22"><enum>(j)</enum><header>Reports</header>
<paragraph id="H25362742523C4237A056123DEC8FC7EB"><enum>(1)</enum><header>Development, implementation, results, and design of pilot program</header>
<subparagraph id="H35C36B2DF9E141369607C1F867212590"><enum>(A)</enum><header>In general</header><text>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).</text></subparagraph> <subparagraph id="HA0BB908E7F6B4BE6973207C0A483742B"><enum>(B)</enum><header>Final design</header><text>One of the reports required under subparagraph (A) shall contain a description of the final design of the pilot program.</text></subparagraph></paragraph>
<paragraph id="HCBC9C374FE804635A151AF9F6F38701D"><enum>(2)</enum><header>Results of pilot program</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H893CDDCFF9124878B45C4A263E346FD0"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H1D136FC97EB04610891A584EC5FAC9B4"><enum>(B)</enum><header>Final report</header><text>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.</text></subparagraph></paragraph></subsection>
<subsection id="H1C231869877D4816AF2EAC655E5DB512"><enum>(k)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HA522367621FD473D890526F49F6B2CD5"><enum>(1)</enum><header>Covered veteran</header><text>The term <term>covered veteran</term> means a veteran who is enrolled in both the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>) and the system of annual patient enrollment of the Department of Veterans Affairs under section 1705(a) of title 38, United States Code.</text></paragraph>
<paragraph id="HDD49894F8A7D45E0A4DD4C58BB3E4076"><enum>(2)</enum><header>Secretary</header><text>The term <term>Secretary</term> means the Secretary of Veterans Affairs.</text></paragraph></subsection></section> <section id="H80E77E3F4914470FBBFDF3BDD3461DB1" section-type="subsequent-section"><enum>320.</enum><header>Fisher House availability</header> <text display-inline="no-display-inline">Section 1708 of title 38, United States Code, is amended—</text>
<paragraph id="H76E43F140F7A4223A2E46E37C207F6C9"><enum>(1)</enum><text>in subsection (a), by striking <quote>in connection with</quote> and all that follows through the period at the end and inserting <quote>in accordance with this section.</quote>;</text></paragraph> <paragraph id="HC0E1736745BE4B72B26A795A8CD94E63"><enum>(2)</enum><text>in subsection (b)—</text>
<subparagraph id="H94AB3D20A5854D7884C4D8F99F065CFC"><enum>(A)</enum><text>in paragraph (2)—</text> <clause id="H477AF62F82084B45B6382B2401A5BC10"><enum>(i)</enum><text>by inserting <quote>described in paragraph (1)</quote> after <quote>family of a veteran</quote>; and</text></clause>
<clause id="HBE8ACF7DEDFF4E21B426118CB0972FA1"><enum>(ii)</enum><text>by inserting <quote>such</quote> after <quote>accompany</quote>; and</text></clause></subparagraph> <subparagraph id="H9854BBC268484DC5BEDEB190460DB3C4"><enum>(B)</enum><text>by adding at the end the following new paragraphs:</text>
<quoted-block style="USC" id="H93F5B0EC89B74248B5EE93DA15701F15" display-inline="no-display-inline">
<paragraph id="H45194F6EDE954D47A702CFC4D5919CA9"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H76EC19008ED244F8B2360D628B68DE16"><enum>(4)</enum><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="H97350CEDF65345C1A81DE4D8DFE06EE5"><enum>(5)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="HF9BF4C9941EF44EA89E6EBF832E508F4"><enum>(6)</enum><text>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.</text></paragraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H58D2A8F2DAEA425894CE3B4AA5DC7AA0"><enum>(3)</enum><text display-inline="yes-display-inline">by striking subsection (c) and redesignating subsections (d) and (e) as subsections (c) and (d), respectively;</text></paragraph> <paragraph id="HCA622C8B25D646F5A32F5787DCF6E563"><enum>(4)</enum><text>in subsection (d), as so redesignated—</text>
<subparagraph id="HDA7584E141454ADF89E928DD15D561F3"><enum>(A)</enum><text>in paragraph (2), by striking <quote>subsection (d)</quote> and inserting <quote>subsection (c)</quote>;</text></subparagraph> <subparagraph id="H7D0EAC81DB4E4A7E8C56A815E1780E9E"><enum>(B)</enum><text>in paragraph (3), by striking <quote>under subsection (b)(2)</quote> and inserting <quote>or a covered beneficiary under subsection (b)</quote>;</text></subparagraph>
<subparagraph id="H85165EAB410A488AB5100FAADFF946B1"><enum>(C)</enum><text>in paragraph (4), by striking <quote>and</quote> after the semicolon; </text></subparagraph> <subparagraph id="H03020166B903455D9575ABE9DBEF6EF4"><enum>(D)</enum><text>by redesignating paragraph (5) as paragraph (6); and</text></subparagraph>
<subparagraph id="H6091E73FD81E48A9BC7ECECFE42D9C61"><enum>(E)</enum><text>by inserting after paragraph (4) the following new paragraph (5):</text> <quoted-block style="USC" id="H477BDE63D1DD43DFA0CC7D384995D280" display-inline="no-display-inline"> <paragraph id="HD50FEC0C583E452BBECE9624AA239367"><enum>(5)</enum><text display-inline="yes-display-inline">establishing criteria for providing access to temporary lodging facilities on a space-available basis under paragraphs (3) through (6) of subsection (b); and</text></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="HAA967AF4CC5144B089A8291412748754"><enum>(5)</enum><text>by adding at the end the following new subsection:</text> <quoted-block style="USC" id="HCA647D2557A0461692FFE621946FD5BE" display-inline="no-display-inline"> <subsection id="HB20D7799F71B4215851879AD092F826C"><enum>(e)</enum><text display-inline="yes-display-inline">In this section:</text>
<paragraph id="H71FC25407ADA4742A38D20122288DC45" commented="no"><enum>(1)</enum><text display-inline="yes-display-inline">The term <quote>covered beneficiary</quote> means a member of the uniformed services, including members of the armed services regardless of duty status.</text></paragraph> <paragraph id="HC321DA7F93BE4CB2A33EA599A20297F0"><enum>(2)</enum><text>The term <quote>Fisher house</quote> means a housing facility that—</text>
<subparagraph id="H7B2E75B20E0848B590B7729D680B8353" display-inline="no-display-inline"><enum>(A)</enum><text>is located at, or in proximity to, a Department medical facility;</text></subparagraph> <subparagraph id="H1108DE7934084D99AEF527629A8CFFD0"><enum>(B)</enum><text>is available for residential use on a temporary basis by patients of that facility and others described in subsection (b); and</text></subparagraph>
<subparagraph id="H49E783BDDD88445F98635A496A28AC2E"><enum>(C)</enum><text>is constructed by, and donated to the Secretary by, the Zachary and Elizabeth M. Fisher Armed Services Foundation or the Fisher House Foundation, Inc.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="H0BA015C32E784EFF835F1020CD19EDA0"><enum>321.</enum><header>Agreements between medical facilities of Department of Veterans Affairs and rural medical facilities</header> <subsection id="H0F024946030848BDA0907939F447AE0D"><enum>(a)</enum><header>In general</header><text>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.</text></subsection>
<subsection id="H57445A20C2484211B0FB815A211CD8F1"><enum>(b)</enum><header>Pilot program</header><text>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:</text> <paragraph id="H5C2273B21D5D46BB838A74F8FD6D9EDD"><enum>(1)</enum><text>Co-location of Department and non- Department health care resources.</text></paragraph>
<paragraph id="H6251B75BB3654E3F935952943F8FC2E1"><enum>(2)</enum><text>The provision of telehealth to eligible veterans by health care providers of the Department.</text></paragraph> <paragraph id="H9557BFBD021740FF8243E803CD12ECF0"><enum>(3)</enum><text>Leasing of space or equipment by or from the Department.</text></paragraph>
<paragraph id="HDCB1D2BE6CB64AB883D1D5607C344BBC"><enum>(4)</enum><text>Training by health care providers of the Department of non-Department health care providers, subject to paragraph (4).</text></paragraph> <paragraph id="HCB49BB976AE24EF2AC91093D9047F39E"><enum>(5)</enum><text>Care coordination for authorized care furnished by the eligible entity for eligible veterans.</text></paragraph>
<paragraph id="H8F8150379D784903ADCBC1184215BFEE"><enum>(6)</enum><text>Care coordination, including transportation coordination, for emergency treatment (as defined in section 1725(h) of title 38, United States Code.</text></paragraph> <paragraph id="HF0F967AFF4C14C8BBDF049D18F1542C3"><enum>(7)</enum><text>The provision by the eligible entity of hospital care, medical services, or extended care services under section 1703 of this title.</text></paragraph>
<paragraph id="HD86A1354132246219DB3802EF6431A5A"><enum>(8)</enum><text>Such other conditions or services directly related to health care as expressly authorized under laws administered by the Secretary.</text></paragraph></subsection> <subsection id="H9101567E8DF74C8EBE7E4AFB2E304490"><enum>(c)</enum><header>Types of arrangements</header><text>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.</text></subsection>
<subsection id="H9A3452A12D34476F9A089996E4AEB048"><enum>(d)</enum><header>Report</header><text>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—</text> <paragraph id="H1F523BEEF3C74C2485C9B14A7C577C5A"><enum>(1)</enum><text>new agreements entered into, in the case of the initial report, since the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, and, in the case of any subsequent report, during the period following the previous report;</text></paragraph>
<paragraph id="HD91DF77FA06942F6BA77D217E60EBD33"><enum>(2)</enum><text>an assessment of the success of all agreements entered into pursuant to this Act in delivering services to eligible veterans, including—</text> <subparagraph id="H0867CE95E3A349E49ED1E6F31FD91622"><enum>(A)</enum><text>the number of eligible veterans, by region, who received services under an agreement compared to the previous five-year period;</text></subparagraph>
<subparagraph id="H0E9134C510D94A27AF9460DFF9A291C8"><enum>(B)</enum><text>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;</text></subparagraph> <subparagraph id="H49617F91515747C0A0B802FAE69FE379"><enum>(C)</enum><text>an overview of best practices, including new best practices, developed for such agreements and the Department more broadly;</text></subparagraph>
<subparagraph id="H80BB86F442484425A82AB096C31CC3FA"><enum>(D)</enum><text>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</text></subparagraph> <subparagraph id="HA64616649E4F41DABD86F10A96A59519"><enum>(E)</enum><text>such other factors considered appropriate by the Secretary of Veterans Affairs.</text></subparagraph></paragraph></subsection>
<subsection id="H51314B6EEE44437AA7AF691211FDA540"><enum>(e)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H065C057556684C18B53161883DE2DD13"><enum>(1)</enum><header>Appropriate committees of congress</header><text>The term <quote>appropriate committees of Congress</quote> means—</text>
<subparagraph id="H357B78B832034FE3AC6AA81DBE7A11F4"><enum>(A)</enum><text>the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and</text></subparagraph> <subparagraph id="HF93EA155E55F4ECB9A6882372FFC5FE7"><enum>(B)</enum><text>the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives.</text></subparagraph></paragraph>
<paragraph id="H4A813A4DA5614D06B26EA4CE6F01486F"><enum>(2)</enum><header>Eligible entity</header><text>The term <quote>eligible entity</quote> means a non-Department entity or provider furnishing health care or health care services in a rural area.</text></paragraph> <paragraph id="HC01A95E8567B41A8AE82C1E6D3BDA1C3"><enum>(3)</enum><header>Eligible veteran</header><text>The term <quote>eligible veteran</quote> means a covered veteran under section 1703(b)16 of this title.</text></paragraph>
<paragraph id="HDD9D9133B5994A748CA93C621EDFCAAC"><enum>(4)</enum><header>Material support</header><text>The term <quote>material support</quote> 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—</text> <subparagraph id="HAB997406180C4412B0F6CFD139284681"><enum>(A)</enum><text>the use of time or resources of health care providers of the Department;</text></subparagraph>
<subparagraph id="HEF3101026AD3464C820A5843A417A096"><enum>(B)</enum><text>the obligation or receipt of funds; and</text></subparagraph> <subparagraph id="H47FE53BAF21E4C0C853084D1B85DED24"><enum>(C)</enum><text>such other support as the Secretary determines appropriate.</text></subparagraph></paragraph>
<paragraph id="H003954AA9F4F45D7A3328B5FF77CF6A7"><enum>(5)</enum><header>Rural</header><text>The term <quote>rural</quote>, 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.</text></paragraph></subsection></section> <section id="H276495E66C58441489B3B63932589FB3"><enum>322.</enum><header>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</header> <subsection commented="no" display-inline="no-display-inline" id="H9675935B172D432AB08C27FF47C76803"><enum>(a)</enum><header>In general</header><text>Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall seek to enter into an agreement with an independent and objective organization outside the Department of Veterans Affairs under which that organization shall—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H3D84F8F1905745DDB3AB0A50AF9F3694"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HF03E96070FCD4EA29D413AF11247A2CD"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="H2A1B80C9EBEA4741B6F3799246C28740"><enum>(b)</enum><header>Timing</header><text>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.</text></subsection> <subsection id="HF0C20889A2A64F348289089F7EE7467A"><enum>(c)</enum><header>Elements</header><text>The report submitted pursuant to subsection (a)(2) shall include an assessment of the following:</text>
<paragraph id="HACEF54D8BE9C4F7A816204ECFB4E89B8"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="H699A41AD6AD141489BB847873078E76C"><enum>(2)</enum><text>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.</text></paragraph>
<paragraph id="H6CB19AC4A695486DABEB2370696D956D"><enum>(3)</enum><text>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.</text></paragraph> <paragraph id="H7C7036A048084301B3C8B3677E5A2EBB"><enum>(4)</enum><text>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.</text></paragraph>
<paragraph id="HFDC6DCDFECF04E72B8CA2AAD0685854B"><enum>(5)</enum><text>Whether veterans with co-occurring conditions receive integrated care to holistically address their needs.</text></paragraph> <paragraph id="HADFDDD4663C04DD8906551DAB2265DD8"><enum>(6)</enum><text>Whether providers monitor health outcomes continually throughout treatment and at regular intervals for up to three years after treatment.</text></paragraph>
<paragraph id="HE4DB32B7F6B24AC2B88CD879C4249A51"><enum>(7)</enum><text>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.</text></paragraph></subsection></section> <section section-type="subsequent-section" id="H5929A4BAAA7B43FC82944EE101957758"><enum>323.</enum><header>Lactation spaces in medical centers of the Department of Veterans Affairs</header> <subsection id="H3497386E31DF4A509614F4D871C8DDD0"><enum>(a)</enum><header>In general</header><text>Subchapter II of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text>
<quoted-block style="USC" id="HA2A5EEFF0AF14E6FBE1D8F51B2DB7A66">
<section id="H457E0415C6EA4E0799880A9E45E4C290"><enum>1720M.</enum><header>Lactation spaces in medical centers of the Department </header>
<subsection id="HEACA2DEB0208427EA68DA156AD317E2B"><enum>(a)</enum><header>Lactation space required</header><text display-inline="yes-display-inline">The Secretary shall ensure that each medical center of the Department contains a lactation space.</text></subsection> <subsection id="H260FE1D9839F43239DCA86ED730E1B3E"><enum>(b)</enum><header>No unauthorized entry</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="HDD0F275AEB244E42871EABB72F045383"><enum>(c)</enum><header>Lactation space defined</header><text>In this section, the term <term>lactation space</term> means a hygienic place, other than a bathroom, that—</text> <paragraph id="H5983718CB948424EBCD6B715B3E2FAD4"><enum>(1)</enum><text>is shielded from view;</text></paragraph>
<paragraph id="H5A7BDF488FA842DCBF26EE2DC29B487B"><enum>(2)</enum><text>is free from intrusion;</text></paragraph> <paragraph id="HB5E4289350674773987BE8715207ADE6"><enum>(3)</enum><text>is accessible to disabled individuals (including such individuals who use wheelchairs);</text></paragraph>
<paragraph id="HDD2FFE901B734026A07A08131C78BEF9"><enum>(4)</enum><text>contains a chair and a working surface;</text></paragraph> <paragraph id="H227CD814247E447D8C5908474442DF5E"><enum>(5)</enum><text>is easy to locate;</text></paragraph>
<paragraph id="HCF220D1D8A3C4A8DBEAB14F7378A4053"><enum>(6)</enum><text>is clearly identified with signage; and</text></paragraph> <paragraph id="HC2F251DF339B449C91850C7538AB47F3"><enum>(7)</enum><text display-inline="yes-display-inline">is available for use by women veterans and members of the public to express breast milk.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HD4F0EC67082643E3BD728738BFD6B0D8"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item related to section 1720L the following new item:</text> <quoted-block style="USC" id="H14AA52A00FAB4CDF98185A518F95E775"> <toc regeneration="no-regeneration"> <toc-entry level="section">1720M. Lactation spaces in medical centers of the Department.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H35A3D787DFC6431891798C4B072DB1F6"><enum>(c)</enum><header>Implementation</header><text>The Secretary of Veterans Affairs shall ensure that—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H86928576D7F9465AB1D7D4392C188ACC"><enum>(1)</enum><text>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</text></paragraph> <paragraph id="H562D1F17CD5B4E64A17E5BDEABAF3280"><enum>(2)</enum><text>not later than three years after such date of enactment, all medical centers of the Department are in compliance with such section.</text></paragraph></subsection>
<subsection id="HF99708D33C164EF3BBC72672396AC8C2"><enum>(d)</enum><header>Report</header>
<paragraph commented="no" display-inline="no-display-inline" id="H5FB01ACD58184177B11A7B586396ED14"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text>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—</text> <subparagraph id="HB29941A959184F88BA8865975C065131"><enum>(A)</enum><text>a list of which medical centers of the Department of Veterans Affairs currently have a lactation space;</text></subparagraph>
<subparagraph id="HAF1C7259915B4E6A95B6FF0964E48447"><enum>(B)</enum><text>a list of which medical centers of the Department do not have a lactation space; and</text></subparagraph> <subparagraph id="HF0CEE2509B184310B5C06EDD35D554EB"><enum>(C)</enum><text>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).</text></subparagraph></paragraph>
<paragraph id="H7E568E0B6B514166A2DA5AA2FCA9AAF9"><enum>(2)</enum><header>Termination</header><text>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.</text></paragraph></subsection></section> <section section-type="subsequent-section" id="H8F94A55E17A54F229E790155F0B834D4"><enum>324.</enum><header>Research related to menopause, perimenopause, and mid-life women’s health: report; plan</header> <subsection id="H01E25481C6EB43428DF2954EE858B627"><enum>(a)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H6FC7F4271DC94EFD83BECB542CA269FF" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header>Covered provider</header><text>The term <term>covered provider</term> means a health care provider employed by the Department of Veterans Affairs. </text></paragraph> <paragraph id="H57C18E92885249D2BB201BE4ED7C4DAD" commented="no"><enum>(2)</enum><header>Menopause</header><text>The term <term>menopause</term> means the stage of a woman’s life—</text>
<subparagraph id="HC155A944596C4844AC854681FFDA592A" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text display-inline="yes-display-inline">when menstrual periods stop permanently and she can no longer get pregnant; and</text></subparagraph> <subparagraph id="HC5FAF5D17BC147108E911E77A4933454" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">that is not a disease state, but a normal part of aging for women. </text></subparagraph></paragraph>
<paragraph id="HAF2ADD3BA38941AFB09D4BB30007F144"><enum>(3)</enum><header>Mid-life</header><text>The term <term>mid-life</term> means a life stage that—</text> <subparagraph id="H9283103567604BA4BFF7839D57894071"><enum>(A)</enum><text>coincides with the menopausal transition in women, which may be physical or emotional;</text></subparagraph>
<subparagraph id="H4FF4D16D8FBC42CF9B67C239A5BD9BA1"><enum>(B)</enum><text>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</text></subparagraph> <subparagraph id="HA358B0828EB4438F818A67F322A8A0B8"><enum>(C)</enum><text>often marks the onset of many chronic diseases.</text></subparagraph></paragraph>
<paragraph id="H89FD90F8BC0F42DA84FF0105AF76F70B" commented="no"><enum>(4)</enum><header>Perimenopause</header><text>The term <term>perimenopause</term> 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.</text></paragraph> <paragraph id="HECAE61D630A648C496EA4BEE928F3176" commented="no" display-inline="no-display-inline"><enum>(5)</enum><header>Postmenopausal</header><text>The term <term>postmenopausal</term> 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. </text></paragraph></subsection>
<subsection id="H5E23F169D2E549CFB3956B160B29689D"><enum>(b)</enum><header>Evaluation of certain research related to menopause, perimenopause, or mid-life women’s health</header>
<paragraph id="H38BD34B84A934CD7BEB1A004D0875122"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Veterans Affairs, shall evaluate—</text> <subparagraph id="H7DA03FFC66634304877949366EA80AF0"><enum>(A)</enum><text>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;</text></subparagraph>
<subparagraph id="HEE2B25E159484501908956A02DA41315"><enum>(B)</enum><text>the status of such research that is ongoing;</text></subparagraph> <subparagraph id="H005BBC78648F45F18FB69FAC068C8F08"><enum>(C)</enum><text>any gaps in knowledge and research on—</text>
<clause id="H42B1EE84679F47499EBC79E1FCA0EE54"><enum>(i)</enum><text>treatments for menopause-related symptoms, including hormone and non-hormone treatments;</text></clause> <clause id="H847F63ACAD094ADBA7D8077173220255"><enum>(ii)</enum><text>the safety and effectiveness of treatments for menopause-related symptoms;</text></clause>
<clause id="HE0FE9A1E1120408887C321BC7DDAE8DA"><enum>(iii)</enum><text>the impact of perimenopause and menopause on the mental health of women who are members of the uniformed services or veterans;</text></clause></subparagraph> <subparagraph id="HFC81B159BA8645E893CCFEDC97CEA604"><enum>(D)</enum><text>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</text></subparagraph>
<subparagraph id="H1EAB8E10B4C34C8E946412A8AF2CE583"><enum>(E)</enum><text>the availability of and uptake of treatments for women who are members of the uniformed services or veterans who are experiencing perimenopause or menopause. </text></subparagraph></paragraph> <paragraph id="H8A2A0E38ACE54167A5AECFA991F8214B"><enum>(2)</enum><header>Report; strategic plan</header><text>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—</text>
<subparagraph id="H72BB9148A5B545DC8099A3B0789FC52B"><enum>(A)</enum><text>the findings of the evaluation conducted under paragraph (1);</text></subparagraph> <subparagraph id="HFFBF48A4E3994FC5B04870EDC01BC6C5"><enum>(B)</enum><text>recommendations for improving professional training resources described in paragraph (1)(D) for covered providers; and</text></subparagraph>
<subparagraph id="HAE6E4FD121534BEEBD258B6AB5096E44"><enum>(C)</enum><text>a strategic plan that—</text> <clause id="H49A6D554503D4A149B2F3C7240C22BA0"><enum>(i)</enum><text>resolves the gaps in knowledge and research identified in the report; and</text></clause>
<clause id="H78B03976183E4D1695D7DD57AD44C420"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph></paragraph> <paragraph id="H563A29D0596741728F7407914EE97E9C" commented="no" display-inline="no-display-inline"><enum>(3)</enum><header>Nonduplication and supplementation of efforts</header><text>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.</text></paragraph></subsection>
<subsection id="HCFE677B465034A49892B80DD33E47E3B"><enum>(c)</enum><header>Sense of Congress on additional research related to menopause, perimenopause, or mid-life women’s health</header><text>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.</text></subsection></section> <section id="HE46645D7ABE145E0996B53FF753FF1D5"><enum>325.</enum><header>Pilot program on provision of opioid rescue medications to veterans</header> <subsection id="HFD7725BD08464BDA9A5CD5309C30C17B"><enum>(a)</enum><header>In general</header><text>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 <quote>pilot program</quote>).</text></subsection>
<subsection id="HEE37018DCEA1494BB22AA008F5496179"><enum>(b)</enum><header>Provision of medication prior to confirmation of status</header><text>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.</text></subsection> <subsection id="H7C0C9DB8693D4104B12A493B20784681"><enum>(c)</enum><header>Site selection</header><text>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.</text></subsection>
<subsection id="H88793103DD1B40BE959AF8AFB6FCE011"><enum>(d)</enum><header>Limitation on use of information</header>
<paragraph id="H0B22407A3C2E4FCF8C9B9ACE7CB05606"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="HF98BA4CF4DA0481BB9654527F5BFC37F"><enum>(2)</enum><header>Exclusion</header><text>The Secretary may not use any personally identifiable information collected under this section—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H24F12CEA59654C8F877FFD90520C7CC3"><enum>(A)</enum><text display-inline="yes-display-inline">for the purpose of preventing a veteran from employment; </text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H09324EA927BB467F9D4344B2BFD0522A"><enum>(B)</enum><text display-inline="yes-display-inline">as evidence of a history of drug use; or</text></subparagraph>
<subparagraph id="H412A9E6915954D55841886EED5940C8A" commented="no" display-inline="no-display-inline"><enum>(C)</enum><text display-inline="yes-display-inline">as evidence that an individual is an unlawful user of or addicted to any controlled substance.</text></subparagraph></paragraph></subsection> <subsection id="HA8965148B22C4DDE80DD8C484CADA985"><enum>(e)</enum><header>Provision of information</header><text>The Secretary shall ensure that any individual who receives covered medication under the pilot program also receives—</text>
<paragraph id="HB3D53F5DBE6D4924B40CC8749B806D30"><enum>(1)</enum><text>information about addiction services, suicide prevention services, mental health services, and other related services provided by the Department of Veterans Affairs; and</text></paragraph> <paragraph id="H98FD98213097441BABABC3BB740B67F9"><enum>(2)</enum><text>information on the use and application of covered medications.</text></paragraph></subsection>
<subsection id="H1C35025BBAF74F67B0F03155F200C70B"><enum>(f)</enum><header>Report</header>
<paragraph commented="no" display-inline="no-display-inline" id="HD85CC5250EFC4897A9F4670FCCBF7FA4"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HAF21F955773E4949A25B30D1C6FED5DD"><enum>(2)</enum><header>Elements</header><text display-inline="yes-display-inline">The report required by paragraph (1) shall include the following:</text>
<subparagraph id="HB961FE3134CD46D7B91C603D3C9E6B9F"><enum>(A)</enum><text>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.</text></subparagraph> <subparagraph id="H4665E8B426394EF4847D0B50A985C647"><enum>(B)</enum><text>An assessment of the feasibility of expanding the pilot program to provide covered medications to immediate family members of veterans.</text></subparagraph>
<subparagraph id="HD1A53D25D1424D979D27B25F3E8569E0"><enum>(C)</enum><text>Any considerations associated with continuing, expanding, or making permanent the pilot program.</text></subparagraph> <subparagraph id="HBBBE4B86A2D24F62B4761324FA92FDA5"><enum>(D)</enum><text>Any other recommendations of the Secretary with respect to modifying or continuing the pilot program.</text></subparagraph></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="HF74CF3BCC79043BABB1C13673AD53E76"><enum>(g)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HD40BABEE365C452EA5906BE8BC9A9222" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header>Covered medication</header><text>The term <term>covered medication</term> means any opioid overdose rescue medication, such as naloxone.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HE9B7AA905CEC4E3B8561CF2EB246CC82"><enum>(2)</enum><header>Veteran</header><text>The term <term>veteran</term> has the meaning given that term in section 101 of title 38, United States Code.</text></paragraph></subsection></section> <section id="HC34C08E7E6574291AE7B2CE628D82936"><enum>326.</enum><header>Establishment of Veterans Health Administration Policy Advisory Commission</header> <subsection id="H45B26BFDEC0C40FC8DB5F6E52A10C527"><enum>(a)</enum><header>In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/1">Chapter 1</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="H4D2D39D781264F5383FA1E5C73CA9A90">
<section id="H237758A363C84A12BE088E9487D8C8A5"><enum>120.</enum><header>Veterans Health Administration Policy Advisory Commission</header>
<subsection id="H30AD7583945C4B929E44AAE979635720"><enum>(a)</enum><header>Establishment</header><text>There is established the Veterans Health Administration Policy Advisory Commission (in this section referred to as the <quote>Commission</quote>).</text></subsection> <subsection id="HBE0AE98B11274D87A8EB1785D1A45F09"><enum>(b)</enum><header>Membership</header> <paragraph commented="no" display-inline="no-display-inline" id="H4ABEA9D5CDEB495E8950E3639DB92FDF"><enum>(1)</enum><header>Composition</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="HF38F6C6FC7324711BF7A8F4C7118B1A5"><enum>(2)</enum><header>Qualifications</header>
<subparagraph id="HE54B11B8A7C74424A2B4531509AB409D" commented="no"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H4AF886FD844045F3A2CACCFCB14C7D88"><enum>(B)</enum><header>Experience of members</header><text>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.</text></subparagraph></paragraph>
<paragraph id="HE66732F0BA7E4D19A6BC39F6887A278A"><enum>(3)</enum><header>Ethical disclosure</header><text>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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/131">chapter 131</external-xref> 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. </text></paragraph></subsection> <subsection id="H5E57A71BC0AE4534B26E405637404CD9"><enum>(c)</enum><header>Period of appointment; vacancies</header> <paragraph id="H12ACEE62492B4CEF99B7535FB4E8385D"><enum>(1)</enum><header>Vacancies</header> <subparagraph id="H72587762300B42EC8CE6340138ABD822"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph>
<subparagraph id="HD7E393F6ED9548FE88A83C94F9DF71B9"><enum>(B)</enum><header>Filling unexpired term</header><text>An individual chosen to fill a vacancy shall be appointed for the unexpired term of the member replaced.</text></subparagraph></paragraph> <paragraph id="HCDA9541349B34606B919B745009DEE72"><enum>(2)</enum><header>Expiration of terms</header><text>The term of any member shall not expire before the date on which the member’s successor takes office.</text></paragraph></subsection>
<subsection id="HEB1F5BF19E26463CAA22F32F2BA2141C"><enum>(d)</enum><header>Meetings</header>
<paragraph id="H9BAA2C51773A406FA6DFA9D70A264531"><enum>(1)</enum><header>Frequency</header><text>The Commission shall meet at the call of the Chairman, but not less frequently than once per year.</text></paragraph> <paragraph id="H34B9F11CB1784BC9A6E5337931A18E1A"><enum>(2)</enum><header>Quorum</header><text>A majority of the members of the Commission shall constitute a quorum, but a lesser number of members may hold meetings.</text></paragraph></subsection>
<subsection id="H7EE4B54962384853993DE83099DFD932"><enum>(e)</enum><header>Chairman and Vice Chairman</header><text>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.</text></subsection> <subsection id="H2929030B0AE54DEA818C8DCE3169029A"><enum>(f)</enum><header>Duties of the Commission</header> <paragraph id="H9CB32AF43B9D441EA9CAC2A56A0C0577"><enum>(1)</enum><header>Review</header><text>The Commission shall—</text>
<subparagraph id="HAB079033A6A8425FA685E6696A642838"><enum>(A)</enum><text>review operations at the Veterans Health Administration; and</text></subparagraph> <subparagraph id="HD7F05C3E187A4213BE5A0B2C4209A67A"><enum>(B)</enum><text>prepare reports for Congress based on such review, including recommendations to Congress.</text></subparagraph></paragraph>
<paragraph id="HAE148EA2BB7B4B579E869B486E7D589C"><enum>(2)</enum><header>Topics to be reviewed</header><text>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:</text> <subparagraph id="H94571B220A91498CACB0C70E2DC06622"><enum>(A)</enum><text>Information technology infrastructure at medical facilities of the Department, including with respect to electronic health record systems.</text></subparagraph>
<subparagraph id="HAA737D98E2F8441C93B9EDC782C9A604"><enum>(B)</enum><text>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.</text></subparagraph> <subparagraph id="H665F172EB8AB4440B5E025758F7DD64D"><enum>(C)</enum><text>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.</text></subparagraph>
<subparagraph id="HA4B697FBB6D64752B9FE5C51EE2E95BD"><enum>(D)</enum><text>The quality of health care furnished by the Department and through the Veterans Community Care Program.</text></subparagraph> <subparagraph id="H2F1628753B204B96B3A444A17855449F"><enum>(E)</enum><text>Workforce issues, including workforce performance, recruitment, and retention factors.</text></subparagraph>
<subparagraph id="H46D4BC2A98C146CCB92F7422BBCB9C7A"><enum>(F)</enum><text>Patient satisfaction and customer service at medical facilities of the Department and through the Veterans Community Care Program.</text></subparagraph> <subparagraph id="HD1FA5D46C9A845C7ADCC29B17674D030"><enum>(G)</enum><text>The training of health care providers and the standards of care at facilities of the Department and in the Veterans Community Care Program.</text></subparagraph>
<subparagraph id="H4ED5CFC5DF2F4354B527519F38EA5BDE"><enum>(H)</enum><text>The long-term budgetary outlook of the Veterans Health Administration, as well as key components driving budgetary changes over time.</text></subparagraph> <subparagraph id="HD76C9B9E0456441AAAD0F5596B977485"><enum>(I)</enum><text>The research program of the Department, including both internal and external research.</text></subparagraph>
<subparagraph id="H95EEE2C3B011464E8085FD3F11DF3EC1"><enum>(J)</enum><text>The interaction of care under the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>), the Medicaid program under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), the TRICARE program under <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/10/55">chapter 55</external-xref> of title 10, and commercial health care plans with care furnished by the Veterans Health Administration.</text></subparagraph></paragraph> <paragraph id="HF539797744DD48D48F873C7AD5B996AC"><enum>(3)</enum><header>Use of existing data</header><text>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—</text>
<subparagraph id="H371B5653636E49CB8495624041D751F3"><enum>(A)</enum><text>data described in subsection (c)(1) of section 1704A of this title; and</text></subparagraph> <subparagraph id="H9B4F01A2A7D54E2DBE14B788916F22B4"><enum>(B)</enum><text>the results of the independent assessments conducted under such section.</text></subparagraph></paragraph>
<paragraph id="H273E266E4873451BA5FA696243A6E87F"><enum>(4)</enum><header>Issues regarding veteran health care delivery generally</header><text>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.</text></paragraph> <paragraph commented="no" id="HE26E44B289A34B878410A6C570ED0422"><enum>(5)</enum><header>Transmittal of certain reports</header><text>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.</text></paragraph>
<paragraph id="HFE07CED1590A47E98A761EAD598837E4"><enum>(6)</enum><header>Consultation and additional reviews and studies</header>
<subparagraph id="H042C578EE5C8411FAC4A54D573128BD4"><enum>(A)</enum><header>Consultation</header><text>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.</text></subparagraph> <subparagraph id="HECC77596BA4348B082E69AA6572A0670"><enum>(B)</enum><header>Additional reviews and reports</header><text>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.</text></subparagraph>
<subparagraph id="HE8952CA1836A47A7BA5FC7F1CA402F18"><enum>(C)</enum><header>Special studies</header><text>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.</text></subparagraph></paragraph> <paragraph id="HD5214913ABD44934BE70FF4AB845C6E0"><enum>(7)</enum><header>Coordination</header><text>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.</text></paragraph>
<paragraph id="HC07FB5A8977442608484ADE14E9D523E"><enum>(8)</enum><header>Budgetary considerations</header><text>Before making any recommendations to Congress, the Commission shall examine the budget consequences of such recommendations, directly or through consultation with appropriate expert entities.</text></paragraph> <paragraph id="H8F771B5D61EF41129046E51AB514D430"><enum>(9)</enum><header>Report</header> <subparagraph id="HF7A8FB612F9544BCB9CD732D85230BF8"><enum>(A)</enum><header>In general</header><text>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).</text></subparagraph>
<subparagraph id="H7B9E0BD595DF404688C42E5DCF73CA57"><enum>(B)</enum><header>Inclusion of recommendations</header><text>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.</text></subparagraph></paragraph> <paragraph id="H8302EC55403D48ADA88C35D6FEC04828" commented="no"><enum>(10)</enum><header>Limitation</header><text display-inline="yes-display-inline">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.</text></paragraph></subsection>
<subsection id="HBDD1FCEB719C45248537DCF7819B9E7B" commented="no"><enum>(g)</enum><header>Powers of Commission</header>
<paragraph id="H4B7B30BCA51443FFB57BB2C4C442A4AE" commented="no"><enum>(1)</enum><header>In general</header><text>The Commission may—</text> <subparagraph id="H8CF3E26D6A3B4A949CB61A34E33D9801" commented="no"><enum>(A)</enum><text>employ and fix the compensation:</text>
<clause id="HCB12C6C008D14BF79429FEE922D0FF11" commented="no"><enum>(i)</enum><text>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</text></clause> <clause id="H7B209C85FDE04B2E95D164537A044C00" commented="no"><enum>(ii)</enum><text>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;</text></clause></subparagraph>
<subparagraph id="H0EEDCEDFD293496AA9E363D663B952BA" commented="no"><enum>(B)</enum><text>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;</text></subparagraph> <subparagraph id="H8FC4849C8D384C279BC7449601805CAD" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">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;</text></subparagraph>
<subparagraph id="HFC1A6A6C689A4B0086009B9A6729D32C" commented="no"><enum>(D)</enum><text>make advance, progress, and other payments that relate to the work of the Commission;</text></subparagraph> <subparagraph id="H237A060B94B043CA8961A6B4E2906FEF" commented="no"><enum>(E)</enum><text>provide transportation and subsistence for individuals serving the Commission without compensation; and</text></subparagraph>
<subparagraph id="H05DD03243E5A44E59BBE2BAB7CDB86B7" commented="no"><enum>(F)</enum><text>prescribe such rules and regulations as the Commission determines necessary with respect to the internal organization and operation of the Commission.</text></subparagraph></paragraph> <paragraph id="H6C46738F3D5C43B19F19B840E6EE88DC" commented="no"><enum>(2)</enum><header>Data collection</header><text>In order to carry out its functions, the Commission shall—</text>
<subparagraph id="H70AA61DCACAA4367827881F27864DC36" commented="no"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H455399C4820843DF88DFF3E2058C354B" commented="no"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph>
<subparagraph id="HCD3115B3DB3C4E74ACAC3B0D7AAB8CCD" commented="no"><enum>(C)</enum><text>adopt procedures allowing any interested party to submit information for use by the Commission in making reports and recommendations.</text></subparagraph></paragraph> <paragraph id="HD487545F97934667B9B035AA60062BE0" commented="no"><enum>(3)</enum><header>Information from Federal agencies</header> <subparagraph commented="no" display-inline="no-display-inline" id="H0F49652F856A47768B6C0527D38643A1"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HC18747F353664EF59772242F66C26B68"><enum>(B)</enum><header>Timing</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection> <subsection id="H8DA74573EC0F4F438D2843F7C46F6EA9"><enum>(h)</enum><header>Compensation</header> <paragraph commented="no" display-inline="no-display-inline" id="HD60398818A01473AA1AD58FD00F0EB56"><enum>(1)</enum><header>Members</header> <subparagraph commented="no" display-inline="no-display-inline" id="HA6AD4D776270472BB96A3322124E005A"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H33B9BAD4033440D0834A44ACAC040940"><enum>(B)</enum><header>Travel expenses</header><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HA689A2CFBF0640689A0CF29EEF49858D"><enum>(2)</enum><header>Physician comparability allowance for personnel</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HCD6B7C949D114B1686A1E87C165B1F1F"><enum>(3)</enum><header>Treatment of personnel</header><text display-inline="yes-display-inline">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. </text></paragraph></subsection> <subsection id="H6DAF145DD8C14B95AF0CDDECFF6E1BBE"><enum>(i)</enum><header>Detail of Federal employees</header><text>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.</text></subsection>
<subsection id="H4EDA97F662904B8994A693F8E658EADD"><enum>(j)</enum><header>Access of congressional support agencies to information</header><text>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.</text></subsection> <subsection id="H59F080D3F884449A806928C78D882D51"><enum>(k)</enum><header>Authorization of appropriations</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H3ACBE7AFB59846A39F23B91F81CCAB60" commented="no"><enum>(l)</enum><header>Termination</header>
<paragraph id="HED584EAA193546BB84FCB77DF0EB6A23" commented="no"><enum>(1)</enum><text>The Commission shall terminate on September 30, 2032.</text></paragraph> <paragraph id="HBDA967C8B7E840A898F437192333DFA6" commented="no"><enum>(2)</enum><text>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.</text></paragraph>
<paragraph id="H3ECD2B91D2824E99B1959FA84BB25D20" commented="no"><enum>(3)</enum><text>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.</text></paragraph> <paragraph id="H99B0845B4C20493ABAF77BD2FE25F6BA" commented="no"><enum>(4)</enum><text>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.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H77AC1686637D437EAF85DB207B440CFA"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 119 the following new item:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HEE2047672B804123973931807E9C3D41"> <toc> <toc-entry bold="off" level="section">120. Veterans Health Administration Policy Advisory Commission.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H54B234FE08D34D8E8274DE02132C732A" commented="no" display-inline="no-display-inline"><enum>(c)</enum><header>Initial appointment</header><text>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.</text></subsection></section>
<section id="H426E405BFB0544C1B5AA49971FED00B4"><enum>327.</enum><header>Access to health care</header>
<subsection id="H7196F4E5C61C4E299A71787ED19C75D7"><enum>(a)</enum><header>Connection to Veterans Health Administration when a disability claim related to military sexual trauma is submitted to Veterans Benefits Administration</header><text>Section 2 of the MST Claims Coordination Act (<external-xref legal-doc="public-law" parsable-cite="pl/117/303">Public Law 117–303</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1166">38 U.S.C. 1166</external-xref> note) is amended—</text> <paragraph id="HD3BFB93A9DB942DBAF08CD4282442EAD"><enum>(1)</enum><text>in subsection (a)(1)—</text>
<subparagraph id="H0D7EF02F08764499B5362ABB03F04C88"><enum>(A)</enum><text>in subparagraph (C), by striking <quote>; and</quote> and inserting a semicolon; and</text></subparagraph> <subparagraph id="HC45A135C46FA409FA51C3F776F259021"><enum>(B)</enum><text>by striking subparagraph (D) and inserting the following:</text>
<quoted-block id="H5C7E4A4AED5F4B6EA921FAAE5610732F" style="OLC">
<subparagraph id="H5D077F533D1844578E3679A5F9701584"><enum>(D)</enum><text>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;</text></subparagraph> <subparagraph id="H1F7F1C0A273442E0833EB2976C69D527"><enum>(E)</enum><text>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;</text></subparagraph>
<subparagraph id="HA95FB6D3532649A8A514D5F85C7E174B"><enum>(F)</enum><text>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</text></subparagraph> <subparagraph id="HF04A8ED615A549D5B7DFB780F884B00F"><enum>(G)</enum><text>such other information on services, care, or resources for military sexual trauma as the Secretary determines appropriate.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H1F5483A0BB4F4121ABBB4EB36763E6B4"><enum>(2)</enum><text>in subsection (d)—</text> <subparagraph id="H46B14078D8F945969F415A81B442E72B"><enum>(A)</enum><text>in paragraph (3)—</text>
<clause id="HFE4256B4BA0149F49D950CEF180834A2"><enum>(i)</enum><text>in subparagraph (B), by striking <quote>; and</quote> and inserting a semicolon;</text></clause> <clause id="HB1AC51B8D4EF435E9FC80BEC28489088"><enum>(ii)</enum><text>in subparagraph (C), by striking the period and inserting <quote>; and</quote>; and</text></clause>
<clause id="HAA70706E5F6240C9A41CCBC28D7A56EC"><enum>(iii)</enum><text>by adding at the end the following:</text> <quoted-block id="HE7222623F05A4D43BA5BD00CC7A0FC89" style="OLC"> <subparagraph id="H11C6A92C391C4300A953E81F9E319451"><enum>(D)</enum><text>submitting a claim for disability compensation to the Veterans Benefits Administration for a disability relating to military sexual trauma.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></clause></subparagraph>
<subparagraph id="H10F7776F0EC348529F382A74C26CE184"><enum>(B)</enum><text>by amending paragraph (5) to read as follows:</text> <quoted-block id="H076019FD5FFD4E0D823158AA5FC97499" style="OLC"> <paragraph id="H00F6E4C01B374602B4F41CC9063F64BE"><enum>(5)</enum><text>The term <quote>military sexual trauma</quote> with respect to eligibility for health care, has the meaning given such term in section 1166(d)(2) of title 38, United States Code.</text> </paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection>
<subsection id="H2FF5235096324BC5987BB38F163C40FD"><enum>(b)</enum><header>Care relating to military sexual trauma for individuals who withdraw from or otherwise do not complete service at service academies</header>
<paragraph id="H2CD26CADE40D4CD180D6636AA9449A05"><enum>(1)</enum><header>In general</header><text>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—</text> <subparagraph id="H6AB35513E2874F26BC9E604D0F585815"><enum>(A)</enum><text>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</text></subparagraph>
<subparagraph id="H521DE63EA953480890DF4164415BE0BE"><enum>(B)</enum><text>the option to receive copies of—</text> <clause id="H999C07A374A34FCBA776A1F1A7AC6E78"><enum>(i)</enum><text>the individual’s service treatment records or military personnel records that document military sexual trauma;</text></clause>
<clause id="H9F4FB00A388844CD8D43497C19E188D3"><enum>(ii)</enum><text>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</text></clause> <clause id="HAC54566C4C3542ED93D2DA2914147738"><enum>(iii)</enum><text>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.</text></clause></subparagraph></paragraph>
<paragraph id="H02A2AF4140824AE5B7084A3FEF482815"><enum>(2)</enum><header>Definitions</header><text>In this subsection:</text> <subparagraph id="HB5C1F79EA02747DA9998E7CB4E9A40CF"><enum>(A)</enum><header>Military sexual trauma</header><text>The term <quote>military sexual trauma</quote> has the meaning given such term in section 1166(d)(2) of title 38, United States Code.—</text></subparagraph>
<subparagraph id="H8A4BC3BD2E514E509EC84E56FF5712F8"><enum>(B)</enum><header>Service academy</header><text>The term <quote>service academy</quote> means any of the following:</text> <clause id="H06939263AA4E49E08E8E813FF70A2F30"><enum>(i)</enum><text>The United States Military Academy.</text></clause>
<clause id="HA744611DDE794A0C8FD315CB757367B2"><enum>(ii)</enum><text>The United States Naval Academy.</text></clause> <clause id="H61F0162E0E164AABA422FF6FEC10C6E4"><enum>(iii)</enum><text>The United States Air Force Academy.</text></clause>
<clause id="HEC7892B7A1414E6A91EDAA59971C3898"><enum>(iv)</enum><text>The United States Coast Guard Academy.</text></clause> <clause id="H09CF58A567FB44C4B76C4DCC78E5D5F3"><enum>(v)</enum><text>The United States Merchant Marine Academy.</text></clause></subparagraph></paragraph></subsection></section>
<section id="HA35EAEE56B474547932023E3204FAB29" section-type="subsequent-section"><enum>328.</enum><header>Research on health conditions of descendants of toxic-exposed veterans</header>
<subsection id="HC1756D8D3BFC47FA967A153E62B1D3CD"><enum>(a)</enum><header>Research on diagnosis and treatment of health conditions of descendants of individuals exposed to toxic substances while serving in Armed Forces</header>
<paragraph id="H54E560CD31604DE6B08F28AA732C8D99"><enum>(1)</enum><header>Contract or agreement</header><text>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 <quote>Agency</quote>) to perform the services covered by this section.</text></paragraph> <paragraph id="HEB0F9C919A94490589AE6371ABBB11CA" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Services</header><text>Under a contract or agreement between the Secretary and the Agency under this section, the Agency shall—</text>
<subparagraph id="H7C55220F144745CA85DA5A25FE0849D0" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text display-inline="yes-display-inline">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; </text></subparagraph> <subparagraph id="HE193B32236F54D6CA98D93A306D44AF8" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">not later than 180 days after completing the literature review under subparagraph (A) establish and maintain a publicly available report with information on—</text>
<clause id="H9D1BD9A32B8F4DF3ACDE5DD2C0D82A78" commented="no" display-inline="no-display-inline"><enum>(i)</enum><text display-inline="yes-display-inline">the findings of the Agency with respect to such literature review; and</text></clause> <clause id="HEBEA829BFE654B3B880D54305FF3C16F" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><text display-inline="yes-display-inline">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</text></clause></subparagraph>
<subparagraph id="HE9735A5E0C22405FA1898B119E58ED97" commented="no" display-inline="no-display-inline"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph> <paragraph id="H612285BF466743DC9CC40152E0B8D05D" commented="no"><enum>(3)</enum><header>Sunset</header><text display-inline="yes-display-inline">On the date that is 7 years after the date of enactment of this Act.</text></paragraph>
<paragraph id="H7D6B66F47E4F4414A81FC291A6DEC533"><enum>(4)</enum><header>Literature review</header>
<subparagraph id="HF8AAFF4610CE4DF397561780BE544CE3"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph> <subparagraph id="H818F284743CD4ECA96AAC4D753A260B1"><enum>(B)</enum><header>Report</header><text>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).</text></subparagraph>
<subparagraph id="HC7EBC0B647384A73BF437AB0311A0829"><enum>(C)</enum><header>Plan</header>
<clause id="H5CE2621E3B7D470BAE47A08981720474"><enum>(i)</enum><header>In general</header><text>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).</text></clause> <clause id="HE90002110EFB47728FEA9FC5485830C7"><enum>(ii)</enum><header>Contents</header><text>The plan submitted pursuant to clause (i) shall include—</text>
<subclause id="H3274A82F2699400DBAD24F74327DE617"><enum>(I)</enum><text>the scope and key research questions to be addressed; and</text></subclause> <subclause id="HFBA6C84348DD4027A49A9EA8673B5093"><enum>(II)</enum><text>the methodology to be used in identifying, evaluating, and synthesizing relevant scientific and medical literature.</text></subclause></clause></subparagraph></paragraph>
<paragraph id="H80BA69E7BE4E4FF59D1BC550794C80E4"><enum>(5)</enum><header>Consultation</header><text>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.</text></paragraph> <paragraph id="HD875B1A543EC4FAC98F30ACFB5435E8F" commented="no"><enum>(6)</enum><header>Prohibition on expansion of services</header><text>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.</text></paragraph></subsection>
<subsection id="H3654D4337F9148B2816CA9DB83E98C28"><enum>(b)</enum><header>Program for monitoring health of descendants of veterans and members of the Armed Forces subjected to toxic exposure in the Armed Forces</header>
<paragraph id="H5BE56B3A8D9B473A9C685DA43308115D"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="H21F5B8F1EC0E43CC9FF2A31D2135107E" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Requirements</header><text display-inline="yes-display-inline">In carrying out the program required by paragraph (1), the Secretary shall—</text>
<subparagraph id="HCF3E617E6AA94CC1AD99445D429F31A7"><enum>(A)</enum><text>leverage Government data sets to improve the program;</text></subparagraph> <subparagraph id="H0691331095EB4FCF91469E0AC943AE70"><enum>(B)</enum><text>recruit additional descendants;</text></subparagraph>
<subparagraph id="HFF85DA5B38B94693BFFD63BF908C753D"><enum>(C)</enum><text>consult with relevant stakeholders to develop a strategy to coordinate collection of information under the program; and</text></subparagraph> <subparagraph id="H18656FEBA941430299449CCA81635D2C"><enum>(D)</enum><text>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).</text></subparagraph></paragraph>
<paragraph id="H3A1F227C6A8D4D66BA8D0B6C1467FD29"><enum>(3)</enum><header>Mechanisms for administration</header><text>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.</text></paragraph> <paragraph id="H8F4B7E64A8094CE2900B33C006A208B1"><enum>(4)</enum><header>Collection of information</header><text>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.</text></paragraph>
<paragraph id="H2AB7487DEAAD4EBFB09B1FB7B80ED275"><enum>(5)</enum><header>Consultation</header><text>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.</text></paragraph> <paragraph id="H4E9360269BFF4FCC8079D1C2811AECE8" commented="no"><enum>(6)</enum><header>Sunset</header><text>On the date that is 7 years after the date of enactment of this Act. </text></paragraph>
<paragraph id="H0E15F587C4554F1AB29B90322C3398C0" commented="no"><enum>(7)</enum><header>Prohibition on expansion of services</header><text>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.</text></paragraph></subsection> <subsection id="H25B8A2033D124EC3A56D89197CDCDD9C"><enum>(c)</enum><header>Definitions</header><text>In this subsection:</text>
<paragraph id="HFF8C010B9DE14AAB8C126387E73277F7"><enum>(1)</enum><header>Active military, naval, air, or space service</header><text>The term <term>active military, naval, air, or space service</term> has the meaning given such term in section 101 of title 38, United States Code.</text></paragraph> <paragraph id="HA3CF8540B87A49BFA056C62A644AF77D"><enum>(2)</enum><header>Relevant stakeholders</header><text>The term <term>relevant stakeholders</term> means—</text>
<subparagraph id="H785333E42BF0472197E72FDF2B2F4C67"><enum>(A)</enum><text>public health experts with experience in developing and maintaining registries;</text></subparagraph> <subparagraph id="HA603EF7E53014FA59D2990E5F0D2578F"><enum>(B)</enum><text>epidemiologists with experience in studying health effects of toxic exposure on the descendants of toxic-exposed veterans;</text></subparagraph>
<subparagraph id="HF52F44F6464B4DFAAD868017CEA7BB84"><enum>(C)</enum><text>descendants of toxic-exposed veterans; and</text></subparagraph> <subparagraph id="H9D35544C7E2F41C189864244D0185664"><enum>(D)</enum><text>veterans service organizations.</text></subparagraph></paragraph>
<paragraph id="HB264745C86D74D679E40653FE2B33216" commented="no" display-inline="no-display-inline"><enum>(3)</enum><header>Toxic-exposed member of the Armed Forces</header><text>The term <term>toxic-exposed member of the Armed Forces</term> 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.</text></paragraph> <paragraph id="HEFE398017C3242B4B98D1DE73483084B" commented="no" display-inline="no-display-inline"><enum>(4)</enum><header display-inline="yes-display-inline">Toxic-exposed veteran</header><text>The term <term>toxic-exposed veteran</term> means a veteran who was subject to a toxic exposure in line of duty in the active military, naval, air, or space service.</text></paragraph>
<paragraph id="H8FC98610F0274DA59E2C8664271C8851"><enum>(5)</enum><header>Toxic exposure</header><text>The terms <term>toxic exposure</term> and <term>toxic-exposed veteran</term> have the meanings given such terms in section 101 of title 38, United States Code.</text></paragraph></subsection></section> <section id="H807714A9CB1548FA96C352AC553A6BA8"><enum>329.</enum><header>Veterans Spinal Trauma Access to New Devices Act</header><text display-inline="no-display-inline">Section 1706 of title 38, United States Code, is amended by adding at the end the following new subsection:</text>
<quoted-block style="USC" id="HD00BD243B1F8407BA864AD37F81F67BD" display-inline="no-display-inline">
<subsection id="HF907FEDD74BE492EAA49F72BE033D81A"><enum>(d)</enum>
<paragraph commented="no" display-inline="yes-display-inline" id="HC0734DDC3A19440499861C1BDB1BAB3B"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="H6B0693D56A8B4338B9518B10BBECC6AA" indent="up1"><enum>(2)</enum><text>The evaluation described in paragraph (1) shall include the following:</text>
<subparagraph id="H52B27A2ECFC24C76B2EA6762A0FC848E"><enum>(A)</enum><text>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.</text></subparagraph> <subparagraph id="H708C798B62C043369114C9A04F6151E0"><enum>(B)</enum><text>An assessment regarding chronic pain and, if applicable, the management of chronic pain.</text></subparagraph>
<subparagraph id="H668C6A60D1624A068CF4126684C8AF0C"><enum>(C)</enum><text>An assessment regarding dietary management and weight management.</text></subparagraph> <subparagraph id="H651CBF3F9D4542B3819E833F002CB5AB"><enum>(D)</enum><text>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.</text></subparagraph>
<subparagraph id="H1C1F696758D54CBC9030D7FC7E09B604"><enum>(E)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph> <paragraph id="H0181AB15409F475B873B794F3B69679F" indent="up1"><enum>(3)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="H9F51F2DC99B045F8A255D35EFF917611"><enum>(A)</enum><text display-inline="yes-display-inline">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—</text>
<clause id="H2F2D577303D14AA5AD30BC000AFAECDD" indent="up1"><enum>(i)</enum><text>the spinal cord injury and disorder program managers of the Department;</text></clause> <clause id="H58F6E2D8169C4D6CB76503340B7C780D" indent="up1"><enum>(ii)</enum><text>clinicians employed by the Department as specialists in spinal cord injuries and disorders;</text></clause>
<clause id="H70A49B7B67BE4D70A1F07D409B66B03A" indent="up1"><enum>(iii)</enum><text>clinicians and technologists with demonstrated expertise in spinal cord neuromodulation therapies, including non-invasive transcutaneous approaches; and</text></clause> <clause id="HEBE3A104608248E6B1147D83F023EACC" indent="up1"><enum>(iv)</enum><text>representatives of organizations recognzied under section 5902 of this title.</text></clause></subparagraph>
<subparagraph id="H5813E428DAF043BA82011AACBFD500F8" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="HA362C7E8DC4F435A8D9F0A52A4A60586" indent="up1" commented="no"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="H9146DA91226C4BEA9AAC56BBB8235670" display-inline="no-display-inline" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">As the Secretary determines clinically appropriate, the Secretary may provide training, programming, remote monitoring, and follow-up for assistive technologies through telehealth.</text></paragraph> <paragraph id="H5A5451D0261F454483E847BDE268AB90" indent="up1"><enum>(5)</enum><text>Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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:</text>
<subparagraph id="H1550D356262F4652845F58925291508E"><enum>(A)</enum><text>For the period covered by the report—</text> <clause id="HEDAA151701AE4357903B02E64C572E4E"><enum>(i)</enum><text>the number of veterans who—</text>
<subclause id="H916A531C2F504711AC25C5545102F550"><enum>(I)</enum><text>received medical care or hospital services from the Department and used an assistive technology;</text></subclause> <subclause id="H9D50D94EB534456C94C00B8F6E123BF4"><enum>(II)</enum><text display-inline="yes-display-inline">received medical care or hospital services from the Department and were assessed for the provision of an assistive technology; and</text></subclause>
<subclause id="H517C9BF682F54801B924569E67680789"><enum>(III)</enum><text display-inline="yes-display-inline">received medical care or hospital services from the Department and were prescribed an assistive technology.</text></subclause></clause> <clause id="H38BB4564C93A4101B5D9E68389E1CBFD"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph>
<subparagraph id="H1563E68CDD8542CC977A1522D5AF62CD"><enum>(B)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="HBB2C732F58AC48C8A9128DC58DF673F9" indent="up1"><enum>(6)</enum><text>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).</text></paragraph>
<paragraph id="HC684691125094090AB711575275A1D75" indent="up1" commented="no"><enum>(7)</enum><text display-inline="yes-display-inline">In this subsection, the term <term>assistive technology</term> 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:</text> <subparagraph id="H9744D09A0A344C739E6E53A1A479E559" commented="no"><enum>(A)</enum><text>A personal mobility device, including a powered exoskeleton device.</text></subparagraph>
<subparagraph id="H41A781024B264EDD9209C6D7D5F14E63" commented="no"><enum>(B)</enum><text>A speech generating device.</text></subparagraph> <subparagraph id="HD60589ECED1745B2AD881B2C51912D57"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="H61506AAA3A46415698D029E470655BA0"><enum>(D)</enum><text>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.</text></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section> <section id="HAC1BFF4974934E54A8CE2577FE2D7D4F"><enum>330.</enum><header>Department of Veterans Affairs pilot program to award grants for the provision of service dogs to veterans</header> <subsection id="H5D59316661BA44198B367BAE1403181E"><enum>(a)</enum><header>In general</header> <paragraph id="HA82B5126A9C645189EB0A79B904FA0C5"><enum>(1)</enum><header>Pilot program required</header><text>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.</text></paragraph>
<paragraph id="H51A0BDFE80C4445F90785F13C5823C5C"><enum>(2)</enum><header>Duration</header><text>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.</text></paragraph></subsection> <subsection id="H101E980E18F943E3A14DFCEEB72F0F71"><enum>(b)</enum><header>Applications</header> <paragraph id="H68BFE417AD1D41CC9690DDB59C6363E7"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="HA7ED74D8EAAF4D28A8797A6B19F7F065"><enum>(2)</enum><header>Elements</header><text>An application submitted by a nonprofit entity under paragraph (1) shall include the following:</text> <subparagraph id="H0A96C8C2127B4DF098169FDDB42F346B"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="HAA63A0B85941455983112BA6F285D050"><enum>(B)</enum><text>A description of the following services or commitments to be provided by the nonprofit entity:</text> <clause id="H4CE3813C963542C89A15594B13BC5706"><enum>(i)</enum><text>The training that will be provided to eligible veterans.</text></clause>
<clause id="H992926DE5C014972A467EC288C1D48B0"><enum>(ii)</enum><text>The training of dogs that will serve as service dogs.</text></clause> <clause id="HDB08E2A5A20449E698CF66516D2116D6"><enum>(iii)</enum><text>Any additional support or services that will be provided for such dogs and eligible veterans.</text></clause>
<clause id="H6B926E5B32F04A9AB77B8258F476A82B"><enum>(iv)</enum><text>The plan for publicizing the availability of such service dogs through a marketing campaign that targets eligible veterans.</text></clause> <clause id="HE2FB2AE1F4F64DBE8A26ECC652A0CF87"><enum>(v)</enum><text>The commitment to have humane standards for animals.</text></clause>
<clause id="H41E80A6FEEFE467C8E5FF65FDC782A38"><enum>(vi)</enum><text>The demonstrated experience of the nonprofit entity in training service dogs in compliance with the requirements of the Americans with Disabilities Act of 1990 (<external-xref legal-doc="usc" parsable-cite="usc/42/12101">42 U.S.C. 12101 et seq.</external-xref>).</text></clause></subparagraph></paragraph></subsection> <subsection id="H4DF78429B2274AC2A0CA776D2C33CB54"><enum>(c)</enum><header>Award of grants</header> <paragraph id="H2C969F6FFD854DFAB663D13DA3F4C3DE"><enum>(1)</enum><header>In general</header><text>The Secretary shall award a grant to each nonprofit entity for which the Secretary has approved an application submitted under subsection (b)(1).</text></paragraph>
<paragraph id="HFC5A553FD5E24E99A840021941768543"><enum>(2)</enum><header>Agreement required</header><text>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.</text></paragraph> <paragraph id="HEB37F9EE33B54AA9922B43AD69A55721"><enum>(3)</enum><header>Maximum grant amount</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="H8DF49C8E6CA046788D0CDF4410D6B5BC"><enum>(4)</enum><header>Payments</header><text>The Secretary shall establish intervals of payment for the administration of each grant awarded under this section.</text></paragraph></subsection> <subsection id="H66BB8567AE664AF1909F31E797B3617C"><enum>(d)</enum><header>Use of funds</header> <paragraph id="HDF60D159A9834B288AD29303B1E0E575"><enum>(1)</enum><header>In general</header> <subparagraph id="H62B9434177674F5582FEEB3CDC87054D"><enum>(A)</enum><header>Requirement</header><text>A recipient of a grant under this section shall use the grant amounts to plan, develop, implement, and manage one or more covered programs.</text></subparagraph>
<subparagraph id="HDC5A9E41163843D3B91A8BC839DF2810"><enum>(B)</enum><header>Covered program defined</header><text>In this paragraph, the term <quote>covered program</quote> means a program under which—</text> <clause id="H103C1B274A7C47F08EBDBDD15C8DA01A"><enum>(i)</enum><text>service dogs are provided to participants in the program; and</text></clause>
<clause id="HBFD028FBAE3C415BA5F9F813C1B77107"><enum>(ii)</enum><text>only eligible veterans are allowed to participate in the program.</text></clause></subparagraph></paragraph> <paragraph id="HF93DF59D306D4AF0BB061A36496F61DA"><enum>(2)</enum><header>Administrative expenses</header><text>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.</text></paragraph>
<paragraph id="H20F73C52C2E04B0F9F9F701E356386C8"><enum>(3)</enum><header>Other conditions and limitations</header><text>The Secretary may establish other conditions or limitations on the use of grant amounts under this section.</text></paragraph></subsection> <subsection id="H7765D9146BE143A7B5F66A4339B404A1"><enum>(e)</enum><header>Requirements for grant recipients</header> <paragraph id="H2168AF84AABD43B1B1665E77D7EB3676"><enum>(1)</enum><header>Notifications and information</header><text>A recipient of a grant under this section shall—</text>
<subparagraph id="H2BDC1477A6A84544B4C07157314AC6C2"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="HA0B1EF5C122E4944B208FED8DAE4D74D"><enum>(B)</enum><text>inform each such veteran of the benefits and services available from the Secretary for the veteran and the service dog.</text></subparagraph></paragraph>
<paragraph id="H7F5EAE74496F4844B6A92593ADA1D852"><enum>(2)</enum><header>Prohibition on certain fees</header><text>A recipient of a grant under this section may not charge a fee to a veteran receiving a service dog through such grant.</text></paragraph></subsection> <subsection id="HEC042039D28C421D8FBD4B6D41C96BDA"><enum>(f)</enum><header>Veterinary insurance</header> <paragraph id="H41A43CDEF9774735A11ACD55968B45B1"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="H3AD338F5AEE9424C80187EFFB255A31E"><enum>(2)</enum><header>Continuation</header><text>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.</text></paragraph></subsection> <subsection id="H318D181D34D84A818DCE44391A8D72DF"><enum>(g)</enum><header>Training and technical assistance</header><text>The Secretary may provide training and technical assistance regarding grant application and administration to recipients of grants under this section.</text></subsection>
<subsection id="H854489E63A8E4C5287B11D316EDB1740"><enum>(h)</enum><header>Oversight and monitoring</header><text>The Secretary—</text> <paragraph id="H9ACF41EC46D14F339019784F384AECCC"><enum>(1)</enum><text>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;</text></paragraph>
<paragraph id="H5998866416604E39B855AF930EF5C05A"><enum>(2)</enum><text>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</text></paragraph> <paragraph id="HF48804F3244A497F8C73F1BB96B777D8"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection>
<subsection id="H4FAC5ACC3C384375846AFC8AB2752187"><enum>(i)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HE1EBDC6F5AA14CAC9EC9A7BE75683603"><enum>(1)</enum><header>Eligible veteran</header><text display-inline="yes-display-inline">The term <quote>eligible veteran</quote> means a veteran (as defined in section 101 of title 38, United States Code) who—</text>
<subparagraph id="H88F4D7CAED19409DA032E25CDD099346"><enum>(A)</enum><text>as determined by a physician, has one or more disabilities, conditions, or diagnoses described in paragraph (2); and</text></subparagraph> <subparagraph id="HC23A4EC3C9B64824B15BD43ACA73ABC5"><enum>(B)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="H8E0FBF3574894F889A98EA630238BF2B"><enum>(2)</enum><header>Disability, condition, diagnosis described</header><text>A disability, condition, or diagnosis described in this subparagraph is any of the following:</text> <subparagraph id="HCBC51F223B404D40BF013902444A4881"><enum>(A)</enum><text>Blindness or visual impairment.</text></subparagraph>
<subparagraph id="H1253345275034250A2CE0C3BCA794CC3"><enum>(B)</enum><text>Loss of use of a limb, paralysis, or other significant mobility issue.</text></subparagraph> <subparagraph id="HA375C1B5D0754DEF81E14F5F57195476"><enum>(C)</enum><text>Loss of hearing.</text></subparagraph>
<subparagraph id="H64BB6BDC07BB4826888470B48BE86FBB"><enum>(D)</enum><text>Post-traumatic stress disorder.</text></subparagraph> <subparagraph id="H9756D598FD97469D8C4707DB937570ED"><enum>(E)</enum><text>Traumatic brain injury.</text></subparagraph>
<subparagraph id="H99A83B2C9E33465881E1DAA324E812FE"><enum>(F)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H77FF63DB49D84D2E8912FF41698E65A6"><enum>(3)</enum><header>Pilot program</header><text>The term <quote>pilot program</quote> means the pilot program required by subsection (a)(1).</text></paragraph>
<paragraph id="H52A8889D640A42759E93D8BC3F80959B"><enum>(4)</enum><header>Service dog</header><text>The term <quote>service dog</quote> means any dog that is individually trained to do work or perform tasks that are—</text> <subparagraph id="H39EEE9A1B9DB457CA34A0236D66F0CE8"><enum>(A)</enum><text>for the benefit of a veteran with a disability, condition, or diagnosis described in paragraph (1)(B); and</text></subparagraph>
<subparagraph id="H938CD37EDEDC4345A88CBFD26BFD6FBC"><enum>(B)</enum><text>directly related to the disability, condition, or diagnosis of the veteran.</text></subparagraph></paragraph></subsection> <subsection id="H9A9D019DAAE34D0C9CD7198789D1F43D"><enum>(j)</enum><header>Authorization of appropriations</header><text>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).</text></subsection>
<subsection id="H8BE4D9FB15CB414B898FB2460BBCDFDD"><enum>(k)</enum><header>Termination</header>
<paragraph id="HEAECD1CC4E0F46DAA9915DB71F101F77"><enum>(1)</enum><text>The authority to carry out a pilot program under this section shall terminate on September 30, 2029.</text></paragraph> <paragraph id="H8C32F8C36FDE49DD92839DB0A0E26AB4"><enum>(2)</enum><text>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.</text></paragraph></subsection></section>
<section id="HB92AA04916A44947A343E96E13FDBCC5" commented="no"><enum>331.</enum><header>Authorization of major medical facility project of Department of Veterans Affairs for fiscal year 2027 in Manchester, New Hampshire</header>
<subsection id="HE3B4D4FD4B8249FAB99A45E35E6C08EB"><enum>(a)</enum><header>Authorization of major medical facility project of Department of Veterans Affairs for fiscal year 2027 in Manchester, New Hampshire</header>
<paragraph id="HF242947AD88D4EDFB763E5E8662F50BD" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text>The Secretary of Veterans Affairs 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.</text></paragraph> <paragraph id="H6ED0F6E4F1164FDCB94D49934FFE68BD"><enum>(2)</enum><header>Non-Department Federal entity waiver</header><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/114/92">Public Law 114–92</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/8103">38 U.S.C. 8103</external-xref> note) for a non-Department Federal entity to be engaged in project management and other activities for the project under paragraph (1).</text></paragraph>
<paragraph id="H66B72AA53283427F8AC004D9272DE0EF"><enum>(3)</enum><header>Notification</header><text>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.</text></paragraph> <paragraph id="H4CB587E1296248EBBBE032C5AE9A1E7D"><enum>(4)</enum><header>Authorization of appropriations</header><text>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.</text></paragraph>
<paragraph id="HA471A68A64C24082BC67D5953FA73409" commented="no" display-inline="no-display-inline"><enum>(5)</enum><header>Appropriate committees of Congress defined</header><text display-inline="yes-display-inline">In this section the term <term>appropriate committees of Congress</term> means—</text> <subparagraph id="HA454CE9913004E258964DD735AE372A3" commented="no" display-inline="no-display-inline"><enum>(A)</enum><text display-inline="yes-display-inline">the Committee on Veterans’ Affairs and the Committee on Appropriations of the Senate; and</text></subparagraph>
<subparagraph id="HB342B6AAFB9D42B89CBAAFB871DC1706" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text display-inline="yes-display-inline">the Committee on Veterans’ Affairs and the Committee on Appropriations of the House of Representatives. </text></subparagraph></paragraph></subsection> <subsection id="HE9168DABA8404AF8A186E6D8700FEA54"><enum>(b)</enum><header>Access to information for medical facility construction projects and leases</header> <paragraph id="H807D22DEF6CB4C1EB2211F3199FB8AC7" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header display-inline="yes-display-inline">In general</header><text>Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/8106">section 8106</external-xref> the following:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="HC1115DCEDEB940B585F4B7E8A1FBEBB4">
<section commented="no" display-inline="no-display-inline" id="HD46473736E2C4DB3B5C11C98BFBA93D7"><enum>8107.</enum><header>Access to information for medical facility construction projects and leases</header>
<subsection id="H40169FACF7384F23A6D4C8C980229891"><enum>(a)</enum><header>In general</header><text>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.</text></subsection> <subsection id="H954D350271EE4091A9CB9028968F98D7"><enum>(b)</enum><header>Prohibition on withholding information</header><text>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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></paragraph>
<paragraph id="H1A303734996847748F68AC0EACDAC2CC" commented="no" display-inline="no-display-inline"><enum>(2)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 8106 the following new item:</text> <quoted-block style="USC" id="H434FCE95E9394C63A33BF564DA7722CB"> <toc> <toc-entry level="section" idref="HD46473736E2C4DB3B5C11C98BFBA93D7">8107. Access to information for medical facility construction projects and leases.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection></section> <section id="HD9C013EA141443BDA8E1349247D7A1DA" display-inline="no-display-inline" section-type="subsequent-section"><enum>332.</enum><header>Bowel and bladder care program of Department of Veterans Affairs</header> <subsection id="H8B6BCFE4B1A74C4C9D741C293C8E9A64"><enum>(a)</enum><header>Findings; Sense of Congress</header> <paragraph id="H497802CF9DED49CA8A83BCE2032FF00C"><enum>(1)</enum><header>Findings</header><text>Congress finds the following:</text>
<subparagraph id="H150CF762017D4423A508091B8245F8B2"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="HBC253408C1CE41EEB977E791AF709638"><enum>(B)</enum><text display-inline="yes-display-inline">Inadequate care will lead to complications and problems such as autonomic dysreflexia that can be potentially life-threatening and result in illness and hospitalization.</text></subparagraph>
<subparagraph id="HCCA3EAA1F2B54EAB8291562162E1F9B9"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="HC88F4974BC6D46459F169028D0C36CA1"><enum>(D)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph>
<paragraph id="HCD0BE25EE3CD4F34AB10A9EC21A34353"><enum>(2)</enum><header>Sense of Congress</header><text display-inline="yes-display-inline">It is the sense of Congress that—</text> <subparagraph id="H915B52C2F1484BEB9E0FCC0540C9FE29"><enum>(A)</enum><text display-inline="yes-display-inline">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;</text></subparagraph>
<subparagraph id="H7B01C88F74FC4A75BE701147B2B9EEEA"><enum>(B)</enum><text display-inline="yes-display-inline">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</text></subparagraph> <subparagraph id="HD4B42E0ABE05422F846342110084DC6B"><enum>(C)</enum><text display-inline="yes-display-inline">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.</text></subparagraph></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H0A108F55E76244D184B702763784667A"><enum>(b)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">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 <quote>program</quote>).</text></subsection> <subsection id="H49444C9F74474B08A5C22753B25CF2FB"><enum>(c)</enum><header>Provision of care</header> <paragraph commented="no" display-inline="no-display-inline" id="H334251B5F269448C8B97B2B9F247E9F6"><enum>(1)</enum><header>Clinical need</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H02983FB724844C5A870B06D6BBC3264E"><enum>(2)</enum><header>Caregiver or agency</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HDB208E8CBE024107B0E2076A5861B046"><enum>(3)</enum><header>Individualized assessment</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HB14FF683D93749FCAF0446C890F03163"><enum>(4)</enum><header>Denial of care</header><text display-inline="yes-display-inline">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.</text></paragraph></subsection> <subsection id="H093584E984A9497E872D0E4BE3C246FE"><enum>(d)</enum><header>Coordination of care and benefits</header><text>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.</text></subsection>
<subsection id="HC66CF86FFC2E457689E90EAA7348C08C"><enum>(e)</enum><header>Supportive medical training and qualifications</header>
<paragraph commented="no" display-inline="no-display-inline" id="H935FA28E31C945B6B6F2471CA5E755F6"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H89C08EA814804D4483BF40B7DF859C3C"><enum>(2)</enum><header>Qualifications</header><text>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.</text></paragraph></subsection>
<subsection id="HC7B23865005947468608A19FC7349F05"><enum>(f)</enum><header>Payment</header>
<paragraph commented="no" display-inline="no-display-inline" id="HE1BC70E251B64E4A82FB31727BFBCFCD"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H8F65B1ABF7EE45AFA1C678D1CB08FB62"><enum>(2)</enum><header>Limitation</header> <subparagraph commented="no" display-inline="no-display-inline" id="H260F1A64248A4F5A9E28B0FB0C34AF07"><enum>(A)</enum><header display-inline="yes-display-inline">Family members and individually employed caregivers</header><text display-inline="yes-display-inline">The stipend for a family member or individually employed caregiver for care provided to a covered veteran under the program—</text>
<clause commented="no" display-inline="no-display-inline" id="H85E0BBA7312242D496E78FDD48B3412E"><enum>(i)</enum><text display-inline="yes-display-inline">shall be determined by the Secretary;</text></clause> <clause commented="no" display-inline="no-display-inline" id="HEA5AD104FC97455DAA2CE2E1FAE63DF0"><enum>(ii)</enum><text display-inline="yes-display-inline">shall be based on the amount and degree of assistance provided; and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="HF523644DD7764EC08DD7B15BD2230977"><enum>(iii)</enum><text display-inline="yes-display-inline">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.</text></clause></subparagraph> <subparagraph id="H55867E559AF24277AD199CF821B1B053"><enum>(B)</enum><header>Home health agencies</header><text>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.</text></subparagraph></paragraph></subsection>
<subsection id="HD72D7E90ADC4404EA29FF44F75A8F328"><enum>(g)</enum><header>Submission of documentation</header><text>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.</text></subsection> <subsection id="HBD78F75EE48D49FD81D61C589AA48397"><enum>(h)</enum><header>Continued participation in program</header><text>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.</text></subsection>
<subsection id="H2E3E966ED66C4C20A04B0AB13F7D27E6"><enum>(i)</enum><header>Not vendors or contractors</header><text>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.</text></subsection> <subsection id="H77376CF67EC24D03996F024372AF55D2"><enum>(j)</enum><header>Limitation</header><text>Care may not be provided under the program to a veteran who can perform the bowel and bladder functions of the veteran without assistance.</text></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H4686EE20F48E4964AB9EED49C3747434"><enum>(k)</enum><header display-inline="yes-display-inline">Covered veteran defined</header><text>In this section, the term <term>covered veteran</term> means a veteran who—</text> <paragraph id="HCB829B0382BD453D8614A3D5AA32D0FA"><enum>(1)</enum><text>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;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H333B09C6EC56404AA89D3A313BCC3983"><enum>(2)</enum><text>has a spinal cord injury or disorder; and</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H0B534DE1FFA8465E8039B1657C7B4A29"><enum>(3)</enum><text>is dependent upon others for bowel and bladder care while residing in non-institutional settings.</text></paragraph></subsection></section>
<enum>IV</enum><header>Organization </header>
<section id="HA36EC4BCD6F84D168BF2B18B86B13900" commented="no"><enum>401.</enum><header>Authorization of appropriations to the Office of Information and Technology of the Department of Veterans Affairs for certain purposes</header>
<subsection id="H4BF4B80278B34A979E52D3180FA08BBA" commented="no"><enum>(a)</enum><header>Authorization of appropriations</header><text>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).</text></subsection> <subsection id="H2A459F59C6F04454821E8D1F5B2201AA" commented="no"><enum>(b)</enum><header>Use of funds</header><text>Funds shall be allocated and expended only as follows:</text>
<paragraph id="HB355CDC7671E431D905A7E739B580FAF" commented="no"><enum>(1)</enum><text>$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.</text></paragraph> <paragraph id="H3700CA4DFEB84AA8AB4A926C1030BC45" commented="no"><enum>(2)</enum><text>$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.</text></paragraph>
<paragraph id="HEFA1A61ACAC8430CA884D1C2924E9C52" commented="no"><enum>(3)</enum><text display-inline="yes-display-inline">$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.</text></paragraph></subsection> <subsection id="H210BC3DE4ED943139A9CE0C856F6E390" commented="no"><enum>(c)</enum><header>Oversight and protection of sensitive information</header> <paragraph id="HC46E1749D3754017B9639739EC9A2AC1" commented="no"><enum>(1)</enum><text>The Secretary may obligate and expend amounts under this section in classified, controlled, or protected environments consistent with applicable law.</text></paragraph>
<paragraph id="H0094ECF5E6F1433E969D16704D94A9A6" commented="no"><enum>(2)</enum><text>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—</text> <subparagraph id="H0D53350C0B054F9EB122243BDA827A73" commented="no"><enum>(A)</enum><text>activities carried out using funds made available under this section;</text></subparagraph>
<subparagraph id="H53EC5DA9DFC74D889BCD81F31C00C059" commented="no"><enum>(B)</enum><text>progress on improving cybersecurity, resiliency, continuity, logistics, communications, digitization, and mission assurance capabilities; and</text></subparagraph> <subparagraph id="H0B15E9F2A51E424BB03B918282D15C6C" commented="no"><enum>(C)</enum><text>coordination with other Federal agencies, as appropriate. Such reports may include a classified annex.</text></subparagraph></paragraph>
<paragraph id="HDCCF74221C4A4C098FD7B78192BFB2DB" commented="no"><enum>(3)</enum><header>Detailed implementation plan and quarterly briefings</header>
<subparagraph id="H00D6683D04354F29B249828DD18711AB" commented="no"><enum>(A)</enum><text>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—</text> <clause id="HF713DF5EDC1F4334B7F4D7451FBC0F18" commented="no"><enum>(i)</enum><text>specific milestones, deliverables, and performance metrics for each category of activities in subsection (b);</text></clause>
<clause id="H8A26221E68D946AE8F2A98ACE4EA8704" commented="no"><enum>(ii)</enum><text>a zero trust architecture strategy with timelines and technical requirements;</text></clause> <clause id="H97D0CCA0BF5B43EE8ECA666E783C0EF9" commented="no"><enum>(iii)</enum><text>a detailed expenditure plan by fiscal quarter and by activity category; and(iv) any proposed interagency or private-sector partnerships.</text></clause></subparagraph>
<subparagraph id="HC69EAEEB59664088BDD3D99091595F43" commented="no"><enum>(B)</enum><text>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—</text> <clause id="HFFFF86F23BD64481B07972BED8FC0CF5" commented="no"><enum>(i)</enum><text>obligations and expenditures to date, by category;</text></clause>
<clause id="H9B46F0E5480D41299E96378D5BC50727" commented="no"><enum>(ii)</enum><text>progress against the implementation plan;</text></clause> <clause id="H1FE4F9CEE83C4417BEE7BBE883EC4794" commented="no"><enum>(iii)</enum><text>any deviations from the plan and corrective actions; and</text></clause>
<clause id="HC3CD02AECBFE451E9C49E0271CE05BF2" commented="no"><enum>(iv)</enum><text>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.</text></clause></subparagraph></paragraph></subsection> <subsection id="HC06E07A913404A3EA7EBDBDB9014568D" commented="no"><enum>(d)</enum><header>Limitation</header><text>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.</text></subsection>
<subsection id="HE389B9366ED84FE8BF113EC030F2AEA0" commented="no"><enum>(e)</enum><header>Supplement, not supplant</header><text>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.</text></subsection> <subsection id="H637FE24A64274CADBBA852D4B32EC22F" commented="no"><enum>(f)</enum><header>Rule of construction</header><text>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.</text></subsection>
<subsection id="HC452BC0CFBC446BB87BA760BE548C417" commented="no"><enum>(g)</enum><header>Reauthorization and sunset</header>
<paragraph id="HC5508BA04C3E447FA4ABDC4AE57D1BB5" commented="no"><enum>(1)</enum><header>Reauthorization required</header><text>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.</text></paragraph> <paragraph id="H8BEC4139AFF84C20BF93A8E604478F32" commented="no"><enum>(2)</enum><header>Limitation on new obligations after sunset</header><text>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.</text></paragraph>
<paragraph id="H8642D96B4D3B4AC4A50886EEFD97EDA0" commented="no"><enum>(3)</enum><header>Continuation of existing activities</header><text>Nothing in paragraph (2) shall be construed to prohibit the Secretary from—</text> <subparagraph id="H4D1387D4232A453B800CD21BA7720D3E" commented="no"><enum>(A)</enum><text>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</text></subparagraph>
<subparagraph id="H0D689284031044D0BC570132480F05C7" commented="no"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection> <subsection id="H016C38B9DB8E47BC93C1E447B808E900" commented="no"><enum>(h)</enum><header>Use of existing contracting authorities</header><text>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.</text></subsection> </section>
<section id="HC9F87AC40AC34FEEBE98721A09694036" commented="no"><enum>402.</enum><header>Establishment of Under Secretary for Management and Chief Financial Officer</header>
<subsection id="H4128B144C2B64B628340A893CA703BFB" commented="no"><enum>(a)</enum><header>Chief Financial Officer; Office of Budget</header><text>Section 309 of title 38, United States Code, is amended to read as follows:</text> <quoted-block id="HAE8C93128D0B4E9085F71D4D95BCB24C" style="USC"> <section id="HE642AFE153AE4FAB82C411224F4D4E37" commented="no"><enum>309.</enum><header>Under Secretary for Management and Chief Financial Officer</header> <subsection id="H4AE5A38C89DE44FA811AFE2D84907BC9" commented="no"><enum>(a)</enum><header>Under Secretary for Management and Chief Financial Officer</header> <paragraph id="H15300669D8F645C2ACE7BC812ED13048" commented="no"><enum>(1)</enum><text>The Under Secretary for Management and Chief Financial Officer shall be the principal management and financial officer of the Department.</text></paragraph>
<paragraph id="H8B64BDC893E8463EA281E2FB3D942416" commented="no"><enum>(2)</enum><text>The Under Secretary shall report directly to the Secretary.</text></paragraph> <paragraph id="HFEE650D38A3B4D28A1291CD4D1DBBB5A" commented="no"><enum>(3)</enum><text>The Under Secretary shall serve as the Chief Financial Officer of the Department for purposes of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/31/9">chapter 9</external-xref> of title 31.</text></paragraph>
<paragraph id="HC4400B4F81074A1D976B589382F05796" commented="no"><enum>(4)</enum><text>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.</text></paragraph></subsection> <subsection id="H926F5D9F217D4796B19F8A493D3E0EEB" commented="no"><enum>(b)</enum><header>Duties</header><text>The duties of the Under Secretary include the following:</text>
<paragraph id="H19219DA7B659467B838A468D8003077B" commented="no"><enum>(1)</enum><text>To advise the Secretary on financial management of the Department.</text></paragraph> <paragraph id="HAE346CC162C24654A0B14F5DB2DC173A" commented="no"><enum>(2)</enum><text>To formulate, justify, execute, oversee, and certify the budget of the Department.</text></paragraph>
<paragraph id="H4385172DF4B94A98830C1B843843B8A9" commented="no"><enum>(3)</enum><text>To control, account for, audit, and report on the finances of the Department.</text></paragraph> <paragraph id="HFFA6F1D5BF4043D49C840660EECD1E56" commented="no"><enum>(4)</enum><text>To coordinate and assist the Chief Acquisition Officer with the life cycle of major acquisition programs of the Department.</text></paragraph>
<paragraph id="H7FF1A4CD747F43FEB0857458B9C54FB5" commented="no"><enum>(5)</enum><text>To exercise the authority and carry out the functions specified in section 902 of title 31.</text></paragraph> <paragraph id="H9CB461822427434B90B71E20701F54F5" commented="no"><enum>(6)</enum><text>To ensure compliance with sections 1341, 1342, 1349, 1350, and 1511 through 1519 of title 31.</text></paragraph>
<paragraph id="HA505EE92A81549DF94B55A0ADF523546" commented="no"><enum>(7)</enum><text>To provide to Congress, or a congressional committee upon request, information regarding the budget, finances, and fiscal condition of the Department.</text></paragraph> <paragraph id="H38D6ED4A09DD479EAD938A5768BA9381" commented="no"><enum>(8)</enum><text>To serve as the head of the Office of Budget of the Department.</text></paragraph>
<paragraph id="HAD4796EE683B442B8051817FF15D740E" commented="no"><enum>(9)</enum><text>To establish and oversee Department-wide financial management policies, accounting systems, internal controls, enterprise risk management programs, strategic planning processes, and capital planning activities.</text></paragraph> <paragraph id="HEF9F2D0F001342FEBBE4ADB40E1D754D" commented="no"><enum>(10)</enum><text>To oversee infrastructure investment planning, financial systems modernization, and business transformation initiatives of the Department.</text></paragraph></subsection>
<subsection id="H9980962433F94A818EA4EA73CE8AFDFD" commented="no"><enum>(c)</enum><header>Deputy Assistant Secretary</header>
<paragraph id="H3335E65A1CA141B68F9C00A479659186" display-inline="yes-display-inline" commented="no"><enum>(1)</enum><text>There is in the Department a Deputy Assistant Secretary for Infrastructure and Construction.</text></paragraph> <paragraph id="H2FD5A13FBA324EA39F7A63DCECD0317D" commented="no" indent="up1"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="H89103A4E1E8543DAB85CF6C801797303" commented="no"><enum>(d)</enum><header>Office of Infrastructure and Construction</header><text>There is an Office of Infrastructure and Construction in the Department.</text></subsection> <subsection id="H77D94FF2F8064F35B39644044607C4A6" commented="no"><enum>(e)</enum><header>Budget and Appropriations Affairs Office</header> <paragraph id="HA7ACE6A0AF16444088F1D98C9695CD50" commented="no" display-inline="yes-display-inline"><enum>(1)</enum><text display-inline="yes-display-inline">There is within the Office of Management a Budget and Appropriations Affairs Office (in this subsection referred to as the <quote>BAA office</quote>). The Undersecretary shall appoint a head of the BAA Office who shall report exclusively to the Undersecretary.</text></paragraph>
<paragraph id="H2B1AC82310FC42C19D06E2A3A10A8E6D" commented="no" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H5FCF8CED5E0E4CB3BD1E7801982AA66C" commented="no" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">Congress or a congressional committee may submit a request for information described in paragraph (2) directly to the BAA Office.</text></paragraph>
<paragraph id="H319A6DC044D04C4FBE8A421226FE4A6F" commented="no" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H239B1153E6AF4B0F991145A49A4AB6FD" commented="no" indent="up1"><enum>(5)</enum><text display-inline="yes-display-inline">Not more than six full-time equivalent employees, including supervisors, may be assigned to the BAA Office.</text></paragraph></subsection>
<subsection id="H21DC25DA9E6E4C0FB20D609C2C86D4AC" commented="no"><enum>(f)</enum><header>Limitation on authority to appoint</header><text>The Secretary may not establish an employee position—</text> <paragraph id="H077E20AB28A2424AB9D4615E2D9E0CA1" commented="no"><enum>(1)</enum><text display-inline="yes-display-inline">that performs a function substantially similar to the function of the Budget and Appropriations Affairs Office established under section 309(e); and</text></paragraph>
<paragraph id="H0D848C2C9D0749AB9190E45B485767B8" commented="no"><enum>(2)</enum><text display-inline="yes-display-inline">that is not within the Office of Management.</text></paragraph></subsection> <subsection id="H05FCD7D06DD646819A8017766D7048D3" commented="no"><enum>(g)</enum><header>Transfer of functions</header> <paragraph id="H3D4BB23D39734BA1A6AB5252496D0A3A" commented="no" display-inline="yes-display-inline"><enum>(1)</enum><text>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.</text></paragraph>
<paragraph id="H3FC2117503FB476DBA06E8BCED53FD46" commented="no" indent="up1"><enum>(2)</enum><text>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.</text></paragraph></subsection> <subsection id="H36B027AF5CB843CF8AC4EE361A498100" commented="no"><enum>(g)</enum><header>References</header><text>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.</text></subsection> </section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HCC6A792F84704403B5B1C235D6ED69D9" commented="no"><enum>(b)</enum><header>Technical and conforming amendments</header>
<paragraph id="HC0E12095AEC2426BAB8318A56BC23DE3" commented="no"><enum>(1)</enum><text>The table of sections for <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/3">chapter 3</external-xref> of title 38, United States Code, is amended accordingly.</text></paragraph> <paragraph id="HE2FC060AE07C43D380F88C55710095DC" commented="no"><enum>(2)</enum><text>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.</text> </paragraph></subsection></section>
<section section-type="subsequent-section" id="H62879BCCFA354D36AC823DCD93CE8247"> <enum>403.</enum> <header>Department of Veterans Affairs acquisition reform and cost assessment</header>
<subsection id="H6C71240724A34D7CA75F019D14574073"> <enum>(a)</enum> <header>Department of Veterans Affairs acquisition organization</header>
<paragraph id="H3B3ACF4B492340DD9B27B5A3F3016ADC"> <enum>(1)</enum> <header>Definitions</header> <text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">Chapter 81</external-xref> of title 38, United States Code, is amended by inserting after subchapter VI the following new subchapter:</text> <quoted-block style="USC" display-inline="no-display-inline" id="H9D67048459A24AA28B1A52EBCE4B2FD5"> <subchapter id="HAE2C701FC53A42239035B95B86BDBDF4"> <enum>VII</enum> <header>Acquisition Organization, Cost Assessment, and Program Evaluation</header> <section id="H893AC42959AE4F37BADE510D0FEF232F"> <enum>8181.</enum> <header>Definition of major acquisition program</header> <text display-inline="no-display-inline">In this subchapter, the term <term>major acquisition program</term> 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—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H381152D492D246A69B7C72AE4FC571CD"> <enum>(1)</enum> <text display-inline="yes-display-inline">$1,000,000,000 (adjusted pursuant to section 1908 of title 41) for the total life cycle cost of the program; or</text> </paragraph> <paragraph id="H063FBD0A03B04908BB7643B43452C4A8"> <enum>(2)</enum> <text>$200,000,000 (adjusted pursuant to section 1908 of title 41) annually.</text> </paragraph> </section> </subchapter> <after-quoted-block>.</after-quoted-block> </quoted-block> </paragraph>
<paragraph id="H07507314756E4DB6B9CE083F393AA5D3" commented="no" display-inline="no-display-inline"> <enum>(2)</enum> <header>Assistant Secretary for Acquisition</header> <text>Section 308 of such title is amended—</text> <subparagraph id="HD9A3BF8C761B47FA8FE7A0FDF95BF073" commented="no" display-inline="no-display-inline"> <enum>(A)</enum> <text display-inline="yes-display-inline">in subsection (a)(1), by striking <quote>seven</quote> and inserting <quote>eight</quote>; and</text> </subparagraph>
<subparagraph id="HE2F538828E4E447BB1488BD829195358"> <enum>(B)</enum> <text>in subsection (b)(10), by striking <quote>Procurement functions</quote> and inserting <quote>Acquisition functions</quote>.</text> </subparagraph> </paragraph> <paragraph id="HD6B3B29D54F747A28A31E766EC03ECC4" commented="no" display-inline="no-display-inline"> <enum>(3)</enum> <header display-inline="yes-display-inline">Acquisition organization</header> <text>Subchapter VII of chapter 81 of such title, as added by paragraph (1), is amended by adding at the end the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="H63D4A9A7D84E4035AC588E431AC21B9B">
<section id="H5E0618DA7766463FA0AC90191D025389"> <enum>8182.</enum> <header>Acquisition organization</header>
<subsection commented="no" display-inline="no-display-inline" id="HC12735BD5EC14B81B5F2CB7CC1D9C5EF"> <enum>(a)</enum> <header>Assistant Secretary for Acquisition; Chief Acquisition Officer</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H432ACAAFEE3A4B7D85C289527B73E0AD"> <enum>(1)</enum> <text>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.</text> </paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H3D8A639885AF4F18A9CE575712EAC539" indent="up1"> <enum>(2)</enum> <text display-inline="yes-display-inline">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.</text> </paragraph> </subsection>
<subsection commented="no" display-inline="no-display-inline" id="H206D02432FF6429A8C3AC4F51D53D5DE"> <enum>(b)</enum> <header>Office of Acquisition</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H4AC6D71075924310B2E83CF8C2083122"> <enum>(1)</enum> <text display-inline="yes-display-inline">There is in the Department an Office of Acquisition.</text> </paragraph> <paragraph indent="up1" commented="no" display-inline="no-display-inline" id="H70E9B18D02CB4015813D34CFAA26EEFB"> <enum>(2)</enum> <text>The head of the Office of Acquisition shall be the Assistant Secretary of Veterans Affairs for Acquisition designated pursuant to subsection (a).</text> </paragraph>
<paragraph id="H5656CB2893C64ACB93C35B6FEB635E3B" indent="up1"> <enum>(3)</enum> <text>The Secretary shall take such actions as may be necessary to ensure that major acquisition program offices<italic></italic> of the Department align under the Office of Acquisition and report directly to the Assistant Secretary of Veterans Affairs for Acquisition.</text> </paragraph> <paragraph id="HAC102A72FD784A1B9CBC5066F27C6786" indent="up1"> <enum>(4)</enum> <text>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). </text> </paragraph> </subsection>
<subsection commented="no" display-inline="no-display-inline" id="H9346C807462A45CB9CF1630D07C4D7D7"> <enum>(c)</enum> <header>Deputy Assistant Secretary for Logistics</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H93287F037F8A4B24B29DABACFA522E90"> <enum>(1)</enum> <text>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.</text> </paragraph> <paragraph indent="up1" commented="no" display-inline="no-display-inline" id="HB90E0731446F48C5BEA50E4EB44F3C7F"> <enum>(2)</enum> <text>The Deputy Assistant Secretary of Veterans Affairs for Logistics shall be responsible for administration of logistics and supply chain operations of the Department.</text> </paragraph> </subsection>
<subsection id="H8C17180792DB4445807BB017B247DEB7"> <enum>(d)</enum> <header>Deputy Assistant Secretary for Procurement</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H9F2985EFB5B9401B81542F21A76DF0C7"> <enum>(1)</enum> <text>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.</text> </paragraph> <paragraph id="H1416A069CF5444AA9089EEB93413CE55" indent="up1"> <enum>(2)</enum> <text>The Deputy Assistant Secretary of Veterans Affairs for Procurement shall be responsible for all procurement and contracting organizations of the Department.</text> </paragraph> </subsection>
<subsection id="H226632120A73491A9D7B37768701F59C"> <enum>(e)</enum> <header>Deputy Assistant Secretary for Acquisition, Program Management, and Performance</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H340EF7CF93924E709694CDA4FC2C83B4"> <enum>(1)</enum> <text>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.</text> </paragraph> <paragraph indent="up1" commented="no" display-inline="no-display-inline" id="H956DC4FBA24E4A2A97D5E386DF84C9B3"> <enum>(2)</enum> <text>The Deputy Assistant Secretary for Acquisition, Program Management, and Performance shall be responsible for the following:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H670D7F67303C4130B1B58DCED3427C26"> <enum>(A)</enum> <text display-inline="yes-display-inline">Lifecycle management.</text> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H112D5B6821194B8E853B66931344966C"> <enum>(B)</enum> <text display-inline="yes-display-inline">Requirements planning.</text> </subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H2387FB8E05394157BE222F785F735067"> <enum>(C)</enum> <text display-inline="yes-display-inline">Programming and budgeting.</text> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HB44A8675B5AB4B48A5E8BEF47CFCB13A"> <enum>(D)</enum> <text display-inline="yes-display-inline">Policy.</text> </subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HB43CD6B1515C41989FA3CA48C7F34E68"> <enum>(E)</enum> <text display-inline="yes-display-inline">Performance standards.</text> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HD1B48BEEC0184241B0F50E5A409B93AB"> <enum>(F)</enum> <text display-inline="yes-display-inline">Governance.</text> </subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H3C43CDE329674D6EA0B0A97D27C85395"> <enum>(G)</enum> <text display-inline="yes-display-inline">Enhancing the capabilities of the acquisition workforce.</text> </subparagraph> </paragraph> </subsection> <subsection id="HE1B4FE0D42824AEA87E8330EFBACF954"> <enum>(f)</enum> <header>Program Executive Officers</header> <paragraph commented="no" display-inline="yes-display-inline" id="HAE143EEC105249E590BB66E78039F89C"> <enum>(1)</enum> <text>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:</text>
<subparagraph id="H0ABA321086F540338ED0CDA5237C0FAC" indent="up1"> <enum>(A)</enum> <text>Medical.</text> </subparagraph> <subparagraph id="HA08A28B8A9194EE9A4026C431F35DDF0" indent="up1"> <enum>(B)</enum> <text>Information technology.</text> </subparagraph>
<subparagraph id="HA7F0F2BAB8174353B02B34B8AB2AC25D" indent="up1"> <enum>(C)</enum> <text>Professional services.</text> </subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HEB46393CDF7E4E0492164A3A3740C920" indent="up1"> <enum>(D)</enum> <text>Other areas not included in subparagraphs (A) through (C).</text> </subparagraph> </paragraph>
<paragraph id="H98B54AB5E0D94127AFF57B675D86F278" indent="up1"> <enum>(2)</enum> <text>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.</text> </paragraph> <paragraph id="HA151654DA75F4232B3E5C8C99DA3EDCE" indent="up1"> <enum>(3)</enum> <text>Each Program Executive Officer shall be—</text>
<subparagraph id="HDE0C1A4EA372491395CD0BFE93D9D646"> <enum>(A)</enum> <text>certified in project management at level three by—</text> <clause id="H210F7F9FAE8B48B8856589BD4346E03D"> <enum>(i)</enum> <text>the Department;</text> </clause>
<clause id="H6771CEDD932F44119B5FD170A93C7394"> <enum>(ii)</enum> <text>the Federal Acquisition Institute pursuant to section 1201 of title 41; or</text> </clause> <clause id="HB2CC749078B4446480D3F7C99FB0C535"> <enum>(iii)</enum> <text>the Department of Defense pursuant to section 1701a of title 10; or</text> </clause> </subparagraph>
<subparagraph id="HD180453B99C742639423372E8EC18B0D"> <enum>(B)</enum> <text>hold an equivalent certification by a private sector project management certification organization, as determined appropriate by the Secretary.</text> </subparagraph> </paragraph> </subsection> </section> <after-quoted-block>.</after-quoted-block> </quoted-block> </paragraph> </subsection> <subsection id="H1D77FA9337F148C59617925DB358330F" commented="no" display-inline="no-display-inline"> <enum>(b)</enum> <header>Department of Veterans Affairs major acquisition program managers</header> <text>Subchapter VII of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> of title 38, United States Code, as added by subsection (a), is amended by adding at the end the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="H47BF84595CF742618FE8C888BF8910E7">
<section id="H9C0335B75B86446AAEFC6ACA743030E7"> <enum>8183.</enum> <header>Major acquisition program managers</header>
<subsection id="H5F8E7856AD564CE8932DF458663BA369"> <enum>(a)</enum> <header>Appointments</header> <text display-inline="yes-display-inline">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.</text> </subsection> <subsection id="H3CFD8D9602974078B26C6E62BA5B7840"> <enum>(b)</enum> <header>Qualifications</header> <text>Each manager appointed pursuant to subsection (a) shall be—</text>
<paragraph id="H68603496F76F42979F22A93E4F22AD05"> <enum>(1)</enum> <text>certified in project management at level three by—</text> <subparagraph id="HB81A2857B7EB4C24A496E6051A26E8C7"> <enum>(A)</enum> <text>the Department;</text> </subparagraph>
<subparagraph id="HC3AA758ABEEC46A3B1CD26699256C3B0"> <enum>(B)</enum> <text>the Federal Acquisition Institute pursuant to section 1201 of title 41; or</text> </subparagraph> <subparagraph id="H6E5C13A076FE4D0B98FB95DB570E4031"> <enum>(C)</enum> <text>the Department of Defense pursuant to section 1701a of title 10; or</text> </subparagraph> </paragraph>
<paragraph id="HF5D8E48030AA49EC9F421C5F02F764A0"> <enum>(2)</enum> <text>hold an equivalent certification by a private sector project management certification organization, as determined appropriate by the Secretary.</text> </paragraph> </subsection> <subsection id="HF4FAF0EF6D2547B0AA8072ABB2F56988"> <enum>(c)</enum> <header>Duties</header> <text>Each manager appointed pursuant to subsection (a) for a major acquisition program shall—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H40FBF365E25549A8B51D500F01EADBF3"> <enum>(1)</enum> <text display-inline="yes-display-inline">report to the Assistant Secretary for Acquisition through the Program Executive Officer responsible for the major acquisition program; and</text> </paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H9655D9FD5CCF42B7803AA5763E55E090"> <enum>(2)</enum> <text display-inline="yes-display-inline">shall be responsible for, with respect to the major acquisition program—</text>
<subparagraph id="H9B7416464708430FB1C3CFFF6137DC46"> <enum>(A)</enum> <text>developing, in coordination with the Program Executive Officer, a plan to administer major acquisition program, which shall be known as the <quote>program baseline</quote> for the major acquisition program, that includes—</text> <clause display-inline="no-display-inline" id="H03FC4028D682428BA6516C1CC6DC7991"> <enum>(i)</enum> <text>a description of each acquisition phase of the major acquisition program; </text> </clause>
<clause id="H35EC13115B4141E5B3BBBE084E5CC875"> <enum>(ii)</enum> <text>for each such acquisition phase, requirements for advancing the major acquisition program to a subsequent acquisition phase; and</text> </clause> <clause id="HAC806D5CA3B34FB5B550D7DB8437099E"> <enum>(iii)</enum> <text>estimates of the cost, schedule, and performance of the major acquisition program that account for the entire life cycle of the major acquisition program;</text> </clause> </subparagraph>
<subparagraph id="H38633223C13C45629B2DD1497B6500BB"> <enum>(B)</enum> <text>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;</text> </subparagraph> <subparagraph id="H70A7B3B6DE7E4BAEA722C3CE454A522A"> <enum>(C)</enum> <text display-inline="yes-display-inline">developing resource requests and justifications necessary to satisfy such requirements; and</text> </subparagraph>
<subparagraph id="H2F30FA9D309A4DB382298DB6A2813BF0"> <enum>(D)</enum> <text display-inline="yes-display-inline">on a continuous basis, assessing and managing risks to satisfying the requirements of such program baseline relating to cost and schedule.</text> </subparagraph> </paragraph> </subsection> <subsection id="HEE5B4BFF045F4229A2D569848FED6D00"> <enum>(d)</enum> <header>Program decision authority</header> <text>The Secretary shall ensure that—</text>
<paragraph id="HBC7E316437BA4C70B8B4B0FCEB9D9E05"> <enum>(1)</enum> <text>program decision authority for oversight of a major acquisition program is the Assistant Secretary for Acquisition; and</text> </paragraph> <paragraph id="HECDC6BFB51F64C559B2C22E7BF3DC56D"> <enum>(2)</enum> <text>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. </text> </paragraph> </subsection>
<subsection id="H38189C7845A84F4DB17A0A3165AC6940"> <enum>(e)</enum> <header>Program decision authority notification required</header> <text>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). </text> </subsection> </section> <after-quoted-block>.</after-quoted-block> </quoted-block> </subsection> <subsection id="HB0CD4F574AD4497AACAC2582972F039C" commented="no" display-inline="no-display-inline"> <enum>(c)</enum> <header>Department of Veterans Affairs acquisition and procurement reorganization matters</header> <paragraph id="HADF6F2F1595141ADB2F3B221B79E31A8"> <enum>(1)</enum> <header>Organizational consolidation</header> <text>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—</text>
<subparagraph id="H3CCFCA4E6509406DBCC22B2E68A0C125" commented="no"> <enum>(A)</enum> <text>acquisition;</text> </subparagraph> <subparagraph id="H1CEBDB51DFF84E1B91570A5062A18295" commented="no"> <enum>(B)</enum> <text>procurement and contracting; or</text> </subparagraph>
<subparagraph id="HD000AC34ADC749C1A3CF85CC51CB5353" commented="no"> <enum>(C)</enum> <text>logistics and supply chain.</text> </subparagraph> </paragraph> <paragraph id="H439B7D9D939D4B62A96E7D2B8DC361E7"> <enum>(2)</enum> <header>Relocation</header> <text>Paragraph (1) shall not be construed to require the physical relocation of employees of the Department.</text> </paragraph>
<paragraph id="H0F40191693854ECD8BCD0F6C3F9B5C58" commented="no" display-inline="no-display-inline"> <enum>(3)</enum> <header>Plan and briefing</header>
<subparagraph id="H4AA6FB5F3E7A425A821F7717B145CABC" commented="no" display-inline="no-display-inline"> <enum>(A)</enum> <header>In general</header> <text display-inline="yes-display-inline">Not later than 90 days after commencing organizational consolidation under subsection (a), the Secretary shall—</text> <clause id="H3EB547C3975B456BB367C1AD0CBF844F" commented="no" display-inline="no-display-inline"> <enum>(i)</enum> <text display-inline="yes-display-inline">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</text> </clause>
<clause id="HD2EFE45E8F9646BBB60FDA14E1676CF6" commented="no" display-inline="no-display-inline"> <enum>(ii)</enum> <text>provide such committees a briefing on such plan.</text> </clause> </subparagraph> <subparagraph id="H46040E6B7E6040239A347621096DD7CB" commented="no" display-inline="no-display-inline"> <enum>(B)</enum> <header>Contents</header> <text>The plan submitted pursuant to subparagraph (A)(i) shall include the following:</text>
<clause id="H85088D16ED714C23A84C9ADDF10633A6" commented="no" display-inline="no-display-inline"> <enum>(i)</enum> <text>A timeline.</text> </clause> <clause id="HB3B64CC0B3EE4FD5BDCFDE8D988C70C0" commented="no" display-inline="no-display-inline"> <enum>(ii)</enum> <text>A plan for communication and training activities for relevant Department personnel.</text> </clause>
<clause id="HB2D04CA7EA45477582B1BB3CC7F6EED2" commented="no" display-inline="no-display-inline"> <enum>(iii)</enum> <text>A plan for modification of relevant Department policy and guidance.</text> </clause> <clause id="H4A8B1A63547D4819B813AFD2F28E2989" commented="no" display-inline="no-display-inline"> <enum>(iv)</enum> <text display-inline="yes-display-inline">Such other matters as the Secretary considers relevant and appropriate.</text> </clause> </subparagraph> </paragraph> </subsection>
<subsection id="H7E2561B8C96140A0B99181B21BD1D5D0"> <enum>(d)</enum> <header>Independent verification and validation of major acquisition programs of Department of Veterans Affairs</header>
<paragraph id="H7A27B49A6C744DD1B921EFF8F394BD5D"> <enum>(1)</enum> <header>Contracting authority</header> <text>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).</text> </paragraph> <paragraph id="H0C196DDAF2EE4EC0BF605147E9E91AA2"> <enum>(2)</enum> <header>Eligibility</header> <subparagraph id="H7FBA7433BFA84DDCB5E45BCAB5250188" commented="no" display-inline="no-display-inline"> <enum>(A)</enum> <header>In general</header> <text>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—</text>
<clause id="HFEBE7683EFE5436CB1483C6854AA339C"> <enum>(i)</enum> <text>the independent verification and validation services or equivalent services, including systems engineering and technical advisory (SETA) support of major acquisition programs; or</text> </clause> <clause id="H3E07741CD71A4DFCB26BC17F007C6B1A"> <enum>(ii)</enum> <text>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.</text> </clause> </subparagraph>
<subparagraph id="H78FCD735C6D144118552C30EB499D96F"> <enum>(B)</enum> <header>Past performance</header> <text>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.</text> </subparagraph> <subparagraph id="HA0B9BFE5BF8B44A3BFEE857D06A81ADC" commented="no" display-inline="no-display-inline"> <enum>(C)</enum> <header>Demonstration of lack of conflict of interest</header> <text>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).</text> </subparagraph>
<subparagraph id="H4CFF087859954579BE9BF42752A2D8A7" commented="no" display-inline="no-display-inline"> <enum>(D)</enum> <header>No mitigation plans acceptable</header> <text>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.</text> </subparagraph> </paragraph> <paragraph id="H14BE2AA4B06E4CDA8334893E9B7F61F8"> <enum>(3)</enum> <header>Functions</header> <text>The functions specified in this subsection are the following:</text>
<subparagraph id="H62FA084B4660493380568650B943F13F"> <enum>(A)</enum> <text>The independent verification and validation of each major acquisition program project—</text> <clause id="H18C898C2E83A4A8F82FB5D5BB433030C"> <enum>(i)</enum> <text>when such major acquisition program is initiated, with respect to its design and the development of its requirements and acquisition;</text> </clause>
<clause id="H121A2E7FB0104E61900BC805BDB5D753"> <enum>(ii)</enum> <text>at the conclusion of such program; and</text> </clause> <clause id="HE4215640138041C7877893A38888ADEA"> <enum>(iii)</enum> <text>at any other intervals during such program selected by the Chief Acquisition Officer of the Department.</text> </clause> </subparagraph>
<subparagraph id="HDDA6EAA6B0584166A35388EA246A2A9E"> <enum>(B)</enum> <text>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.</text> </subparagraph> </paragraph> <paragraph id="H725E1F137F144A00854487917DCCE11D"> <enum>(4)</enum> <header>Funding</header> <text>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.</text> </paragraph>
<paragraph id="HA7DF06F162214248841911877AE9F809"> <enum>(5)</enum> <header>Definitions</header> <text>In this section:</text> <subparagraph id="H3DDEB1A02E1D4363A244A46EDF6CAB49" commented="no" display-inline="no-display-inline"> <enum>(A)</enum> <header>Covered contract</header> <text display-inline="yes-display-inline">The term <term>covered contract</term> means any prime or subcontract with the Department, including—</text>
<clause id="H6741B08CA3E543EFABED6E3FB4C1DF11"> <enum>(i)</enum> <text>information technology support or software or system design, development, sustainment, or maintenance services;</text> </clause> <clause id="H686BB542686646C0A722D0E9F3611315"> <enum>(ii)</enum> <text>professional or management consulting services; or</text> </clause>
<clause id="HDF36DEC29B8B407093E0D55E03B15003"> <enum>(iii)</enum> <text>advisory and assistance services.</text> </clause> </subparagraph> <subparagraph id="HEDD909B0889140559A80E5153F2A1055"> <enum>(B)</enum> <header>Independent verification validation</header> <text>The term <term>independent verification and validation</term> 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)—</text>
<clause id="H9C9DAFEE4F044E629174BD221FC047ED"> <enum>(i)</enum> <text>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</text> </clause> <clause id="H3D2BFDAFE9674496A0BC64169A48F1E1"> <enum>(ii)</enum> <text>to validate cost, schedule, and performance baselines of current programs and measure program effectiveness.</text> </clause> </subparagraph> </paragraph> </subsection>
<subsection id="H3F1275475448470FA089B839AED02C03" commented="no" display-inline="no-display-inline"> <enum>(e)</enum> <header>Department of Veterans Affairs cost assessment and program evaluation</header>
<paragraph id="HAC31422662904EBDB94C709F224577E0" commented="no" display-inline="no-display-inline"> <enum>(1)</enum> <header>In general</header> <text display-inline="yes-display-inline">Subchapter VII of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> 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:</text> <quoted-block style="USC" display-inline="no-display-inline" id="HB2F97B9D5AC247DE81EB059CFE6BA60D"> <section id="H34457754793E4FF88F78D03DC738F11E"> <enum>8184.</enum> <header>Cost assessment and program evaluation</header> <subsection id="H5A305E5AF9EE4F7FB4023A0D19567528"> <enum>(a)</enum> <header>Director of Cost Assessment and Program Evaluation</header> <text>There is in the Department a Director of Cost Assessment and Program Evaluation, who shall report directly to the Secretary.</text> </subsection>
<subsection id="H5BBD1D7E183749D38F82D2E55D96EBA3"> <enum>(b)</enum> <header>Responsibilities</header> <text>The responsibilities of the Director are as follows:</text> <paragraph id="HF0AB0DEF72744C74990F4AC572160936"> <enum>(1)</enum> <text>To develop policies and procedures for cost estimation and analysis of major acquisition programs of the Department.</text> </paragraph>
<paragraph id="HBE457B0D28AF48048F16A23633D93902"> <enum>(2)</enum> <text>To conduct independent cost estimates and analyses for major acquisition programs to support acquisition decisions, or any other acquisitions as directed by the Secretary,</text> </paragraph> <paragraph id="HC8F260A031294B5781FEA0763E7CF70B" commented="no"> <enum>(3)</enum> <text>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.</text> </paragraph>
<paragraph id="HAE438B50C2894C70810671A74CFF5673"> <enum>(4)</enum> <text>To evaluate the effectiveness of major acquisition programs in meeting Department objectives.</text> </paragraph> <paragraph id="H9CF70AC74CCE48DDBF47C8D1EF57732B"> <enum>(5)</enum> <text>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.</text> </paragraph> </subsection>
<subsection commented="no" display-inline="no-display-inline" id="HDAA3189132144342A47392DB4D4B8DB6"> <enum>(c)</enum> <header>Support and resources</header> <text display-inline="yes-display-inline">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.</text> </subsection> </section> <after-quoted-block>.</after-quoted-block> </quoted-block> </paragraph> <paragraph id="H8145BDFFD7E848239A92401D16636A67"> <enum>(2)</enum> <header>Report on monitoring of operating and support costs for major acquisition programs</header> <subparagraph id="H22F094CD1A924965B1951048BA2AC2DD"> <enum>(A)</enum> <header>Report to Secretary of Veterans Affairs</header> <text>Not later than one year after the date of the enactment of this Act, and not less frequently than once each year thereafter 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.</text> </subparagraph>
<subparagraph id="H39C2109A66DE457F9ED4DB3B41C88589"> <enum>(B)</enum> <header>Transmittal to Congress</header> <text>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.</text> </subparagraph> </paragraph> </subsection> <subsection id="H45C82120546C4333AA093F5E82135DC5"> <enum>(f)</enum> <header>Improvements to hiring of entry-level acquisition positions in Department of Veterans Affairs</header> <paragraph id="H72721487C9E048D3800A81CB1F793F3B"> <enum>(1)</enum> <header>Priority use of internship programs for hiring into entry-level positions in acquisitions</header> <text>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.</text> </paragraph>
<paragraph id="H14EF91A139954DA4BD04A094FEC7E641"> <enum>(2)</enum> <header>Annual number of participants in acquisition internship programs</header>
<subparagraph id="H4A0D6609D70541FB930D91EBC9E0ABC6"> <enum>(A)</enum> <header>In general</header> <text>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—</text> <clause id="H5292FB7BCE0442CD93F0B0AEF2D610CD"> <enum>(i)</enum> <text>not fewer than twice the number of participants in such programs during fiscal year 2025; and</text> </clause>
<clause id="H1BE46B31E60D4890B383EE3E1C4B02A9"> <enum>(ii)</enum> <text>not more than 4 times the number of participants in such programs during such fiscal year.</text> </clause> </subparagraph> <subparagraph id="HF76DC0D011D64C619087B97E7886A881"> <enum>(B)</enum> <header>Termination</header> <text>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.</text> </subparagraph>
<subparagraph id="HE1F018560A624E379EFADDD542D00674"> <enum>(C)</enum> <header>Appropriate committees of Congress defined</header> <text>In this subsection, the term <term>appropriate committees of Congress</term> means the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives.</text> </subparagraph> </paragraph> </subsection> <subsection id="H92A4454DE2EB4E8A962CD412E0E71D1F"> <enum>(g)</enum> <header>Independent analysis of acquisition process of Department of Veterans Affairs</header> <paragraph id="H335E04539A8A4D0A9E22046D98E78210" commented="no" display-inline="no-display-inline"> <enum>(1)</enum> <header>Systems engineering analysis</header> <text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans' Affairs shall 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.</text> </paragraph>
<paragraph id="H05E3082C24244323916AB49FABE8544A" commented="no" display-inline="no-display-inline"> <enum>(2)</enum> <header>Report</header> <text display-inline="yes-display-inline">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.</text> </paragraph> </subsection> <subsection id="HD0E2C5E647BD4B98AA5C97FCDECB0387"> <enum>(h)</enum> <header>Requirements development process</header> <paragraph id="HDF45B79D2F684C18BF70247F53F0324C" commented="no" display-inline="no-display-inline"> <enum>(1)</enum> <header>In general</header> <text display-inline="yes-display-inline">Subchapter VII of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> 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:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="HC1C0B294D40F466783CC0CF9B5A06E33">
<section commented="no" display-inline="no-display-inline" id="HC0DF1EAC2C054789A5DCE230CE94180E"> <enum>8185.</enum> <header>Requirements development process</header>
<subsection commented="no" display-inline="no-display-inline" id="H385146CED4DF4797B135AEA11754D8CD"> <enum>(a)</enum> <header display-inline="yes-display-inline">Establishment of process</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H7DF1B3431C0E44DA9EBC5DDA638EBECC"> <enum>(1)</enum> <text>The Secretary shall establish a standardized requirements development process for major acquisition programs.</text> </paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HB42F74C39DC644D0AFCBB10D4F53BCF6" indent="up1"> <enum>(2)</enum> <text display-inline="yes-display-inline">The process established pursuant to paragraph (1) shall—</text>
<subparagraph id="HC05A12BDF2E04F22AEB20B0BEAC5D05B"> <enum>(A)</enum> <text>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;</text> </subparagraph> <subparagraph id="HB79252694E4447FE9230D176CE0161BF"> <enum>(B)</enum> <text>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</text> </subparagraph>
<subparagraph id="HAF3E4EED8B1E4695A4FB4FFCA1324CCD"> <enum>(C)</enum> <text>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.</text> </subparagraph> </paragraph> </subsection> <subsection commented="no" display-inline="no-display-inline" id="HFE1625F857C9497DAAB8F0E6ABA40C3D"> <enum>(b)</enum> <header>Limitation on personnel</header> <text>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.</text> </subsection> </section> <after-quoted-block>.</after-quoted-block> </quoted-block> </paragraph>
<paragraph id="HEF0A73F8C89B4BBAA38FC1EA2FB82D16"> <enum>(2)</enum> <header>Report</header> <text>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.</text> </paragraph> </subsection> <subsection id="H7A4B0DBDE0E148F3AF7FDF1418411AF6" commented="no" display-inline="no-display-inline"> <enum>(i)</enum> <header display-inline="yes-display-inline">Conforming amendments</header> <text>Subchapter VI of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> of title 38, United States Code, is amended—</text>
<paragraph id="HF4110958C6ED4352B67A939F3139FA7B"> <enum>(1)</enum> <text>in section 8171, by striking paragraphs (5) and (6); and</text> </paragraph> <paragraph id="H4980E27575074CFCA969ABF6E41152E0" commented="no" display-inline="no-display-inline"> <enum>(2)</enum> <text>by striking section 8172.</text> </paragraph> </subsection>
<subsection id="H00771A4D26F34CB79C1F8F9F80F865B2" commented="no" display-inline="no-display-inline"> <enum>(j)</enum> <header display-inline="yes-display-inline">Clerical amendments</header> <text>The table of sections at the beginning of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> of title 38, United States Code, is amended—</text> <paragraph id="HDC259EC0841442218E348F4F9286EAF5" commented="no" display-inline="no-display-inline"> <enum>(1)</enum> <text display-inline="yes-display-inline">by striking the item relating to section 8172; and</text> </paragraph>
<paragraph id="HB71028B3BAD7403DAE1B430841F3EBC7" commented="no" display-inline="no-display-inline"> <enum>(2)</enum> <text display-inline="yes-display-inline">by adding at the end the following:</text> <quoted-block style="USC" display-inline="no-display-inline" id="H136A1F1A1FB54F41A1AB99917B262B2C"> <toc> <toc-entry level="subchapter">SUBCHAPTER VII—Acquisition Review, Cost Assessment, and Program Evaluation </toc-entry> <toc-entry level="section">8181. Definition of major acquisition program. </toc-entry> <toc-entry level="section">8182. Acquisition reorganization. </toc-entry> <toc-entry level="section">8183. Major acquisition program managers. </toc-entry> <toc-entry level="section">8184. Cost assessment and program evaluation.</toc-entry> <toc-entry level="section" bold="off">8185. Requirements development process.</toc-entry> </toc> <after-quoted-block>.</after-quoted-block> </quoted-block> </paragraph> </subsection></section> <section commented="no" display-inline="no-display-inline" id="HBC93EEA937664D359F5DCD86D738D8BE"><enum>404.</enum><header>Improvement of telephone communication by Department of Veterans Affairs</header> <subsection commented="no" display-inline="no-display-inline" id="H76D2C07459D8496B899E28F0989EA2DE"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline"><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/63">Chapter 63</external-xref> of title 38, United States Code, is amended by adding at the end the following new section: </text>
<quoted-block style="USC" id="H1398D8B251E14FFFB5A2F98061E6F1A5" act-name="">
<section section-type="subsequent-section" id="H73E7866B2AF340E79EE1912EF421ED7F" commented="no"><enum>6321.</enum><header>Telephone communication</header>
<subsection commented="no" display-inline="no-display-inline" id="H3183973C43D24C7AB569E3759185ADCD"><enum>(a)</enum><header>Calls associated with Department</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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—</text> <paragraph id="HE9572CBADD2E43769736112F8951973A" commented="no"><enum>(1)</enum><text>is made from a single, well-known telephone number; and </text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H93367290A0B04AFA9B8242F5EFADB17B"><enum>(2)</enum><text display-inline="yes-display-inline">uses caller identification branding that indicates to the individual that the call is from or on behalf of the Department. </text></paragraph></subsection> <subsection id="H078FD602DC844FC18895AFEE82F3C655" commented="no"><enum>(b)</enum><header>Call centers for health care appointments and referrals</header> <paragraph commented="no" display-inline="no-display-inline" id="H9D5AB02CC6FE48A8B3B22FB3C70A303A"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HD49FB0ED59C44552BC4C4CFFCC5F20EC"><enum>(2)</enum><header>Existing efforts and call centers</header><text>In carrying out paragraph (1), the Secretary—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HEBF9377352A54718A09849C0B4B0DC9C"><enum>(A)</enum><text display-inline="yes-display-inline">shall ensure coordination with existing efforts of the Department to improve call center operations; and </text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HFF488A45A4A14596BA6FD36CDDB8EB69"><enum>(B)</enum><text>may use existing call centers to meet the requirements of such paragraph. </text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HA49F7EE6DF1A4A058CA2A413A0996CCC"><enum>(3)</enum><header>Time zones specified</header><text display-inline="yes-display-inline">The time zones specified in this paragraph are the following:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H952D9855CC4F4B8E8D76A0475B0781E8"><enum>(A)</enum><text>Eastern time. </text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H4B4B57C3DBD64E5298D69FC916404D30"><enum>(B)</enum><text display-inline="yes-display-inline">Central time. </text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H16163843EDA74F59B188215483F9611E"><enum>(C)</enum><text display-inline="yes-display-inline">Mountain time. </text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H584E76F0E18848689E4FB063175B1741"><enum>(D)</enum><text display-inline="yes-display-inline">Pacific time. </text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H99247C6E83604143BB329E811FC7BF44"><enum>(E)</enum><text display-inline="yes-display-inline">Alaska time. </text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HA83EDABB31AF4352A3BD0682CC6E784E"><enum>(F)</enum><text display-inline="yes-display-inline">Hawaii time. </text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H94FE43DEC2094DF795CCF82E007907C6"><enum>(4)</enum><header>Clarification</header><text display-inline="yes-display-inline">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.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H89A9A63A6F6B4B5986A44F76648C59F4" commented="no"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of chapter 63 of such title is amended by adding at the end the following new item: </text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H90564B9E83DA40D9ACDB6D2BB6BF8C74">
<toc>
<toc-entry bold="off" level="section">6321. Telephone communication.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="HA9C45A3D6D6C4B84B411439550588A55" commented="no"><enum>(c)</enum><header>Report</header><text display-inline="yes-display-inline">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.</text></subsection></section> <section section-type="subsequent-section" id="H39C1C5B16648477CAA59973CBCBB2E67"><enum>405.</enum><header>Advancing Department of Veterans Affairs emergency response to crisis</header> <subsection id="H015DF121C2724FA6AB60E54C84675FBC"><enum>(a)</enum><header>Report on emergency management roles for Department of Veterans Affairs</header> <paragraph id="H70E677C05BF6453DAE9F64D039FE96FA" commented="no" display-inline="no-display-inline"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than 180 days after the date of the enactment of this Act, the Secretary of Veterans Affairs 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.</text></paragraph>
<paragraph id="HF06B9CDD56EA4D73A555F05447CBC961"><enum>(2)</enum><header>Consultation</header><text>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.</text></paragraph> <paragraph id="H11CD1AE272684ED9B4EC117A1BA6BDDB"><enum>(3)</enum><header>Contents</header><text>The report submitted pursuant to paragraph (1) shall include the following:</text>
<subparagraph id="H4332804B13804A978221F8B50A516434"><enum>(A)</enum><text>A description of the organizational structure of each office, both during normal operations and during emergency or disaster operations.</text></subparagraph> <subparagraph id="HA15E1E428EF547D1B7D080C417DC03ED"><enum>(B)</enum><text>The roles and responsibilities of each office.</text></subparagraph>
<subparagraph id="HAFD70BBA10FD43018A33A7FC4D72AC39"><enum>(C)</enum><text>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.</text></subparagraph> <subparagraph id="HF5645D0DF6A2426CB377FFB67842EFD5"><enum>(D)</enum><text>Recommendations for improving the structure and alignment of relevant offices to better prepare the Department for emergencies, remove redundancies, and improve accountability.</text></subparagraph>
<subparagraph id="HB759C6406E1F470FA8BADAA74CAF09A3"><enum>(E)</enum><text>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. </text></subparagraph></paragraph></subsection> <subsection id="H2DD5180389BB4918849FAC8B328631B0"><enum>(b)</enum><header>Plan to allow fuel sharing and increased coordination between the Federal Emergency Management Agency and the Department of Veterans Affairs</header><text>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—</text>
<paragraph id="HE800A7F56A22470B8794DEF77914DAFC"><enum>(1)</enum><text>the current limitations preventing the Federal Emergency Management Agency from providing fuel or other resources to the Department of Veterans Affairs during emergencies;</text></paragraph> <paragraph id="HC56C5D791B9B481794B46C093DB8C6C9"><enum>(2)</enum><text>whether the Department requires action by Congress to allow such resource provision to occur;</text></paragraph>
<paragraph id="H6D23D3D6331949D3A41EB2F7BA36071D"><enum>(3)</enum><text>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;</text></paragraph> <paragraph id="HE45940D5D1154A05AF53BCB7EAC6CFE2"><enum>(4)</enum><text>whether the Secretary requires action by Congress to address any of the issues mentioned under paragraph (3); and </text></paragraph>
<paragraph id="HA978C7B4EF294FA1ADC4D6A016A97EE7"><enum>(5)</enum><text>whether the Secretary requires action by Congress to address the issue of Department employees or responders being unable to use Department-purchased fuel.</text></paragraph></subsection></section> <section id="HD4A1ABDEF4C4476C834FFE1949AFA90A"><enum>406.</enum><header>Membership of Department of Veterans Affairs Geriatrics and Gerontology Advisory Committee</header><text display-inline="no-display-inline">Section 7315 of title 38, United States Code, is amended, in subsection (a)—</text>
<paragraph id="H16CCB59BDE2E432EA158EEB363737008"><enum>(1)</enum><text>in the second sentence, by striking <quote>and at least one representative of a national veterans service organization</quote> and inserting <quote>, 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</quote>; and</text></paragraph> <paragraph id="HB4641CD84C5B43EF869447BFAF71DF50"><enum>(2)</enum><text>by designating the first, second, and third sentences as paragraphs (1) through (3), respectively (and adjusting the margins accordingly).</text></paragraph></section>
<section id="HFCBAA68E435F46E0B994E2D86001959E" section-type="subsequent-section"><enum>407.</enum><header>Scheduling of appointments under the Veterans Community Care Program</header>
<subsection id="HCD31C4D1E729494CAEA2614C8B543945"><enum>(a)</enum><header>In general</header>
<paragraph id="H701A93034D02474C9389B378894DA44E"><enum>(1)</enum><header>Electronic process</header><text display-inline="yes-display-inline">Subsection (d) of section 3101 of the Johnny Isakson and David P. Roe, M.D. Veterans Health Care and Benefits Improvement Act of 2020 (<external-xref legal-doc="public-law" parsable-cite="pl/116/315">Public Law 116–315</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1701">38 U.S.C. 1701</external-xref> note) is amended to read as follows:</text> <quoted-block style="OLC" id="H78DBAFF2C5374094BAF0D4DC3C8D58F0" display-inline="no-display-inline"> <subsection id="H335E793EC2AE4B2EB2E12CF2B131DD19"><enum>(d)</enum><header>Electronic process</header> <paragraph id="H25CA8F70D21A47539C1E56746634FFC7" display-inline="yes-display-inline"><enum>(1)</enum><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph id="HE2975070C28043D0A2EBF6629FB96F83" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">The electronic process under this subsection shall allow a scheduler, with regards to appointments described in—</text> <subparagraph id="H38851887B58B441299FB15965D5BA325"><enum>(A)</enum><text display-inline="yes-display-inline">either clause of subparagraph (A) of subsection (a)(1), to view, search, and sort such appointments by type of care, location, and date; and</text></subparagraph>
<subparagraph id="H371EF2AE7B70432F931045AD1AE13176"><enum>(B)</enum><text display-inline="yes-display-inline">clause (ii) of such subparagraph—</text> <clause id="H9E0467D4C16A40B8ADEC2B8F938C63A1"><enum>(i)</enum><text display-inline="yes-display-inline">to schedule such an appointment;</text></clause>
<clause id="HB527E271297A452CB9A02BC71F1BD14A"><enum>(ii)</enum><text>to provide referral and authorization documents directly to a non-Department provider; and</text></clause> <clause id="H10B4389AF30847B28D08D2628EEC2AA9"><enum>(iii)</enum><text>to perform any other function the Secretary determines necessary.</text></clause></subparagraph></paragraph>
<paragraph id="H0D645A3A4A044871A529851A73E205D4" indent="up1"><enum>(3)</enum><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph id="H1DBE06CB01454E9F8783A13DAC350522" indent="up1"><enum>(4)</enum><text display-inline="yes-display-inline">The Secretary shall implement the electronic process through an existing agreement if practicable.</text></paragraph>
<paragraph id="H40DBCBA2332144F699960DDD2BA64A4D" indent="up1"><enum>(5)</enum><text display-inline="yes-display-inline">The Secretary shall submit to the Committees on Veterans’ Affairs of the Senate and House of Representatives the following regarding the electronic process:</text> <subparagraph id="HD52FC5D4E2B4434C9F28E0AB2DB49972"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="HF67933A6677D4D46B94E54F1F7EA1A74"><enum>(B)</enum><text display-inline="yes-display-inline">Not later than six months after the date of the enactment of <short-title>Take Care of America’s Veterans Act</short-title>, 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:</text> <clause id="H0BB5F40A56F542FA9BAFB79EED4FC703" commented="no"><enum>(i)</enum><text display-inline="yes-display-inline">The number of non-Department health care providers that participated in such electronic process, disaggregated by—</text>
<subclause id="H718275BD710C45308461D934784A9D5E"><enum>(I)</enum><text>category of hospital care or medical services provided; and</text></subclause> <subclause id="H7248B194E3C4468893D8E929CD3009B7"><enum>(II)</enum><text>medical center of the Department; </text></subclause></clause>
<clause id="H3BABC64E122643C896F3D8C8E0C14FA1"><enum>(ii)</enum><text display-inline="yes-display-inline">The number of appointments scheduled pursuant to the electronic process, disaggregated by—</text> <subclause id="H7E522F7D15444A0FAD0C43E3B1D9E405"><enum>(I)</enum><text display-inline="yes-display-inline">category of hospital care or medical services provided;</text></subclause>
<subclause id="H5348D2FC70FE4C4D858FDA2475627757"><enum>(II)</enum><text>medical center of the Department; and</text></subclause> <subclause id="HE5DB740ED34C42BE88E35A39609FF6CC"><enum>(III)</enum><text display-inline="yes-display-inline">month.</text></subclause></clause>
<clause id="H6E56C4207C974E929A66BEFA7C1180B0"><enum>(iii)</enum><text display-inline="yes-display-inline">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.</text></clause> <clause id="HD1FBAB7018FA460AA17C473F8779F137" display-inline="no-display-inline"><enum>(iv)</enum><text display-inline="yes-display-inline">The rates at which veterans cancelled appointments scheduled through the electronic process.</text></clause>
<clause id="H6637ADB4745449E49179225C66904D52"><enum>(v)</enum><text display-inline="yes-display-inline">The rates at which veterans did not appear for appointments scheduled through the electronic process.</text></clause></subparagraph></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph> <paragraph id="HC1DDF95DA7224C3C8D7535BA1BDCC7D0"><enum>(2)</enum><header>Implementation</header> <subparagraph id="H0DB5BEE3DD904E9CA20A64B07B0BFCF3"><enum>(A)</enum><header>Date</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph id="H32FFBB074DFE4B4AA4389A899CD66367"><enum>(B)</enum><header>Guidelines</header><text display-inline="yes-display-inline">Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall establish guidelines. Such guidelines shall include the following:</text> <clause id="H2AB5B90A42F6480CA87EA0AD8D577B45" display-inline="no-display-inline"><enum>(i)</enum><text display-inline="yes-display-inline">Procedures for schedulers and other employees of the Department involved in the scheduling of appointments described in such section.</text></clause>
<clause id="H8A4CAB086AC148FAB1DCF7AB9D2E5BF9"><enum>(ii)</enum><text>A directive that employees described in clause (i) use the electronic process to the extent practicable.</text></clause> <clause id="HC0C2F38541F243C48DD81FD8BFF20726"><enum>(iii)</enum><text display-inline="yes-display-inline">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.</text></clause>
<clause id="H534FD1BB81144F10B9D16BD4B9FBDDE2"><enum>(iv)</enum><text>Procedures for engaging with non-Department health care providers in specialized cases.</text></clause> <clause id="H9992572E24D04E10AFB623F26ACDC892"><enum>(v)</enum><text>Standards regarding timeliness and accuracy.</text></clause>
<clause id="HEA2A9C68D3B0468280C98037BD74EADE"><enum>(vi)</enum><text>Escalation protocols for scheduling failures or delays.</text></clause></subparagraph> <subparagraph id="H7EF4F269B1EA40F0A76884C0BF5A2D70"><enum>(C)</enum><header>Training</header><text display-inline="yes-display-inline">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).</text></subparagraph>
<subparagraph id="HC58152E91AF44BD091E13E5DD8FF5059" display-inline="no-display-inline"><enum>(D)</enum><header>Evaluation</header><text display-inline="yes-display-inline">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—</text> <clause id="H3845B6D21E784AB3BDC50A47623E9D67"><enum>(i)</enum><text>time between a referral and a scheduled appointment; </text></clause>
<clause id="H445B91CF6A824849968407583A882686"><enum>(ii)</enum><text>patient satisfaction; and</text></clause> <clause id="H9833FA14E44447E69ED70EFFADC80920"><enum>(iii)</enum><text>the percentage of appointments scheduled exclusively through the electronic process.</text></clause></subparagraph>
<subparagraph id="H7A110C2CB0A04B7B8E88FD5C81618DD3"><enum>(E)</enum><header>Outreach</header><text display-inline="yes-display-inline">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—</text> <clause id="H5BF5475B31614852A493B553FD2F70C3"><enum>(i)</enum><text display-inline="yes-display-inline">include contacting each such provider during such 90 days;</text></clause>
<clause id="HEB9278C44B824CFD99AE421018653353"><enum>(ii)</enum><text>include seeking to enter into an agreement with each such provider under which the provider shall participate in the electronic process;</text></clause> <clause id="H03BB895659EF4E0BA08FACB1311CFD24"><enum>(iii)</enum><text display-inline="yes-display-inline">include collaborating with State hospital associations and rural health associations to promote such participation;</text></clause>
<clause id="HEC993C4AC7154F6C8E2368E42FEF7D16"><enum>(iv)</enum><text>focus on providers in specialties or underserved areas, as determined by the Secretary; and</text></clause> <clause id="HB4A823279B444E0F92EBB3B7767E951D"><enum>(v)</enum><text>include the publication, on a publicly accessible website of the Department, of information regarding—</text>
<subclause id="HB9FAB88310B148B49222BBC6311407B7"><enum>(I)</enum><text display-inline="yes-display-inline">details of the electronic process;</text></subclause> <subclause id="H8CCED83A53434F7BA3500234EA5BCE8E"><enum>(II)</enum><text display-inline="yes-display-inline">how a provider may elect to participate in the electronic process; and</text></subclause>
<subclause id="H8CFAD0EF7FEF44428A09EB12CBC8C65B"><enum>(III)</enum><text display-inline="yes-display-inline">a point of contact in the Department regarding the electronic process.</text></subclause></clause></subparagraph> <subparagraph id="H5506CC3008104D89A0AB6532E0EA9E99"><enum>(F)</enum><header>Oversight</header><text display-inline="yes-display-inline">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:</text>
<clause id="H13DBFB4328F244D5B06412F8A1C1CF8A"><enum>(i)</enum><text display-inline="yes-display-inline">Not later than 30 days after the Secretary establishes guidelines under subparagraph (B) of this paragraph, a copy of such guidelines.</text></clause> <clause id="HDE273C09FD75458DB28BE94237145F50"><enum>(ii)</enum><text display-inline="yes-display-inline">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.</text></clause>
<clause id="H9760F99846A041F7B2DD7671A0BAAF5F"><enum>(iii)</enum><text>Not later than 180 days after the date of the enactment of this Act, the benchmarks and metrics prescribed under subparagraph (D).</text></clause></subparagraph></paragraph> <paragraph id="HC7C10DA8EF1C40B19911C470D56F7C1B"><enum>(3)</enum><header>Expansion</header><text display-inline="yes-display-inline">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:</text>
<subparagraph id="H64EE4F04AF8846F89551A904B0A27ED0"><enum>(A)</enum><text>A timeline to implement such plan.</text></subparagraph> <subparagraph id="HD08361F6D0F8454880102319D7C04824"><enum>(B)</enum><text>Estimated costs to carry out such plan.</text></subparagraph>
<subparagraph id="H2296ECC869DB4AACB2CAB0ED73DF710A"><enum>(C)</enum><text display-inline="yes-display-inline">Changes to policies and procedures of the Department the Secretary determines necessary to implement such plan.</text></subparagraph></paragraph> <paragraph id="HBD58F7AA6920494592F18D69FA9F4378"><enum>(4)</enum><header>Codification</header> <subparagraph id="H6578ABA7B2D84A79A31EE449CF1299A2"><enum>(A)</enum><header>In general</header><text>Section 3101 of such Act, as amended by paragraph (1), is transferred to subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, inserted after section 1703G, and redesignated as section 1703H.</text></subparagraph>
<subparagraph id="H04C329066D454F78BB3D5373C4313B4D"><enum>(B)</enum><header>Conforming amendments</header><text display-inline="yes-display-inline">Section 1703H of such title, as transferred and redesignated by this subsection, is amended—</text> <clause id="HAD98A704DE344EED9E27150E3739818A"><enum>(i)</enum><text display-inline="yes-display-inline">by striking any heading that is not a section heading or subsection heading and conforming the margins accordingly;</text></clause>
<clause id="HC6BBDA0286EE48C49B789CEDF4E96067"><enum>(ii)</enum><text>by striking <quote>of title 38, United States Code</quote> both places it appears and inserting <quote>of this title</quote>;</text></clause> <clause id="H777934C1ED7A4F5784D4DD4900DD57F0"><enum>(iii)</enum><text>in subsection (b)(1), by striking <quote>Not later than one year after the date of the enactment of this Act, the Secretary</quote> and inserting <quote>The Secretary</quote>;</text></clause>
<clause id="HD5EBE88F9C7543F0952CC1727C665757"><enum>(iv)</enum><text>in subsection (c)—</text> <subclause id="H9844B4D03B694E0D8B117EE6D6BDE622"><enum>(I)</enum><text>in paragraph (1), in the matter preceding subparagraph (A), by striking <quote>Not later than 180 days after the date of the enactment of this Act, the Secretary</quote> and inserting <quote>The Secretary</quote>; and</text></subclause>
<subclause id="H368D279CCCA6453AA2DEE41E8B450D63"><enum>(II)</enum><text>in paragraph (2), by striking subparagraphs (A) and (B) and inserting <quote>The Secretary shall require each medical facility of the Department to use the method or tool described in paragraph (1).</quote>;</text></subclause></clause> <clause id="H75F55CC5C8B04FC2A6C7B21BC4FC86DF"><enum>(v)</enum><text>in the section enumerator, by striking <quote><header-in-text level="section" style="OLC">Sec.</header-in-text></quote> and inserting <quote><header-in-text level="section" style="USC">§</header-in-text></quote>; and</text></clause>
<clause id="HCF7AC73AD2D14C46ADB71A907040A8E7"><enum>(vi)</enum><text>in the section heading—</text> <subclause id="H5998FDE66D57482B9F0BA3E4015C3D9F"><enum>(I)</enum><text display-inline="yes-display-inline">by striking <quote><header-in-text level="section" style="OLC">Process and requirements for scheduling appointments for health care from Department of Veterans Affairs and non-Department health care.</header-in-text></quote> and inserting <quote><header-in-text level="section" style="OLC">Scheduling of appointments</header-in-text></quote>; and</text></subclause>
<subclause id="HD09758E2F47546708CC630A50AF7C728"><enum>(II)</enum><text display-inline="yes-display-inline">by conforming the typeface and typestyle, including capitalization, to the typeface and typestyle used in the section heading of section 1703G of such title.</text></subclause></clause></subparagraph> <subparagraph id="HAD3B2DF014CA44CFA0DD2745FA554E43"><enum>(C)</enum><header>Table of sections</header><text>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:</text>
<quoted-block style="USC" id="HDD76F40DC5F5406CA3DEFBA9ED4ECF38" display-inline="no-display-inline">
<toc regeneration="no-regeneration">
<toc-entry level="section">1703H. Scheduling of appointments.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection> </section>
<enum>V</enum><header>Memorial Affairs </header>
<section id="H3C19CF6D514141CEA7CDEEF1102738D6"><enum>501.</enum><header>Expansion of eligibility for Department of Veterans Affairs memorial headstone or marker for certain individuals</header><text display-inline="no-display-inline">Section 2306(b)(2) of title 38, United States Code, is amended in subparagraphs (B) and (C) by striking <quote>who dies on or after November 11, 1998,</quote> each place it appears.</text></section> <section id="H9D58016D8BC44DB8870383CCD1C6FA13"><enum>502.</enum><header>Department of Veterans Affairs provision of additional burial benefits when an urn or commemorative plaque is furnished</header> <subsection commented="no" display-inline="no-display-inline" id="HC343928F5190415183196396F4C41025"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Paragraph (2) of section 2306(h) of title 38, United States Code, is amended to read as follows: </text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HED6E852BCCF24CC7BF1EE4B19082EF24">
<paragraph indent="up1" id="H17364682774C4D75A04C14F05C377351"><enum>(2)</enum><text>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—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H1AFB5E6796664A9BBCEF2FF453E12E99"><enum>(A)</enum><text>in the case of a request for a headstone or marker under this section—</text>
<clause commented="no" display-inline="no-display-inline" id="H3470040FEAD24936AF2425A0670D43B0"><enum>(i)</enum><text display-inline="yes-display-inline">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 </text></clause> <clause commented="no" display-inline="no-display-inline" id="H7657AF55A61840E38973635BB28F21FE"><enum>(ii)</enum><text display-inline="yes-display-inline">the Secretary furnishes one headstone or marker inscribed for both individuals; or</text></clause></subparagraph>
<subparagraph id="H7A2F0F3162274B44AAB6697C17A218F7"><enum>(B)</enum><text>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. </text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H8F18B671D6D54F85B402979CDC4BFEE6"><enum>(b)</enum><header>Applicability</header><text>The amendment made by subsection (a) shall apply with respect to an individual who dies on or after January 5, 2021.</text></subsection></section>
<section id="H0C13C0F0D07F4A819DD629B6EC4F43B9" section-type="subsequent-section"><enum>503.</enum><header>Fallen Servicemembers Religious Heritage Restoration Program</header>
<subsection id="HEB086E521DBB497CBEC0CD91BCC76047"><enum>(a)</enum><header>Findings</header><text>Congress finds the following:</text> <paragraph id="H94F14E25DD3E4C5C90EA77364343C7FB"><enum>(1)</enum><text>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.</text></paragraph>
<paragraph id="H0F301AE284814190BA71CFF9E2C18013"><enum>(2)</enum><text>In 2022, more than 2,000,000 people visited the United States World War I and World War II cemeteries in foreign countries.</text></paragraph> <paragraph id="H179168F4D59F41329315209415F178D5"><enum>(3)</enum><text>American-Jewish servicemembers played a vital role in the Allied victories in World War I and World War II.</text></paragraph>
<paragraph id="H7A2599D36F6048BA947E9F95417AC053"><enum>(4)</enum><text>American-Jewish servicemembers who fought and died for the United States must have their heritage properly recognized and honored.</text></paragraph> <paragraph id="H6C417DEB0FCF4C25B2F99474B4D8E5AC"><enum>(5)</enum><text>The United States Government has a solemn responsibility to ensure that every American servicemember killed in action and buried overseas is properly honored.</text></paragraph>
<paragraph id="H91C0308134EB4BCC8C09374EEF824278"><enum>(6)</enum><text>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.</text></paragraph></subsection> <subsection id="H5C6DF65602B44301A96F76C90FED04BA"><enum>(b)</enum><header>Fallen servicemembers religious heritage restoration program</header> <paragraph id="H2BA722E9A35D40D3995704E88C45B377"><enum>(1)</enum><header>Establishment</header><text>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 <quote>Fallen Servicemembers Religious Heritage Restoration Program</quote>.</text></paragraph>
<paragraph id="HFD2BA10112494C6D8918DD80CDD625E5"><enum>(2)</enum><header>Duration</header><text>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.</text></paragraph> <paragraph id="HB1285CA84FD34F9BBCC446D66F4E89E6"><enum>(3)</enum><header>Contracts</header> <subparagraph id="HFD314B90F01149968AF96B4698CB4262"><enum>(A)</enum><header>Authority</header><text>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).</text></subparagraph>
<subparagraph id="H6542E4C650384E079248F4E55F65D42D"><enum>(B)</enum><header>Term; amount</header><text>Each contract under this subsection shall be for one year and in the amount of $500,000 to the nonprofit organization.</text></subparagraph> <subparagraph id="HD58B3EF186F44477B57C3FD14C1C03B1"><enum>(C)</enum><header>Priority</header><text>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).</text></subparagraph></paragraph>
<paragraph id="HF7EE69D46CAF474F924D2A8EF9F31229"><enum>(4)</enum><header>Definitions</header><text>In this section:</text> <subparagraph id="H4D4C2C2DFEC34CC28FA1FDE0772A021C"><enum>(A)</enum><text>The term <quote>covered member</quote> means a deceased member of the Armed Forces who was Jewish and buried—</text>
<clause id="H97E586FB16F249D8AEB6A15423DE5230"><enum>(i)</enum><text>in a United States military cemetery located outside the United States; and</text></clause> <clause id="H5D054021482240C8BB8956408D38D48C"><enum>(ii)</enum><text>under a marker that indicates such member was not Jewish.</text></clause></subparagraph>
<subparagraph id="HE7D2055528CF4DEDA41A1DE375D7090F"><enum>(B)</enum><text>The term <quote>nonprofit organization</quote> means an organization described in <external-xref legal-doc="usc" parsable-cite="usc/26/501">section 501(c)(3)</external-xref> of the Internal Revenue Code of 1986 and exempt from taxation under section 501(a) of such Code.</text></subparagraph></paragraph></subsection> </section> <enum>VI</enum><header>Veterans’ Assuring Critical Care Expansions to Support Servicemembers</header> <subtitle id="HF8F698FB78774C4A8C94F0AD150F7B93"><enum>A</enum><header>Improvement of Veterans Community Care Program</header> <section id="H06861066F3BF4D888B5351FC6DEF9295"><enum>601.</enum><header>Codification of requirements for eligibility standards for access to community care from Department of Veterans Affairs</header> <subsection id="H604AD84C8E4C47B0A34018A2805A8C92"><enum>(a)</enum><header>Eligibility access standards</header><text>Section 1703B of title 38, United States Code, is amended—</text>
<paragraph id="H81F58FBF84E94873AECB311DA398DE72"><enum>(1)</enum><text>by striking subsections (a) through (e) and inserting the following:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H23620A15C7854DB086A5FDFDDBC06560"> <subsection id="H0AC04F94FE8848CBB04348FD94837C38"><enum>(a)</enum><header>Access standards for community care</header> <paragraph commented="no" display-inline="yes-display-inline" id="H7FCCEF1963CF408980AF0A393B70ADAE"><enum>(1)</enum><text>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:</text>
<subparagraph id="H707183E5ABD0423B8B0AC8ED0A3818BD" indent="up1"><enum>(A)</enum><text>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—</text> <clause id="H2C661890BB8E4AB9B2A4AAC45C6AAB21"><enum>(i)</enum><text>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</text></clause>
<clause id="H6F8DA5D6EFA24B33B4C916F85E6CC2D5"><enum>(ii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="H80C0B498CA04438EBF257628B22B5E14" indent="up1"><enum>(B)</enum><text>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—</text>
<clause id="H9CEA83F441AA4DB591F90FE7745DC76B"><enum>(i)</enum><text>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</text></clause> <clause id="H1CD83345AB9547958BAB0FB885DADEA3"><enum>(ii)</enum><text>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.</text></clause></subparagraph>
<subparagraph id="H0D5C496DB33D4B4DB9D7A0798E66B704" indent="up1"><enum>(C)</enum><text>With respect to a covered treatment program, the Secretary must—</text> <clause id="H6E0A9358B44B4FD9AD72EB63A7848719"><enum>(i)</enum><text>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</text></clause>
<clause id="H631C4DB68DE0453E9B5FB08BD4161645" commented="no"><enum>(ii)</enum><text>if the veteran is determined eligible for priority admission to a covered treatment program—</text> <subclause commented="no" display-inline="no-display-inline" id="HE4B1B05204B948249AC0D986FFA31351"><enum>(I)</enum><text display-inline="yes-display-inline">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</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="H2A293ACCB1EB432AA446E3B8C7834BDB"><enum>(II)</enum><text display-inline="yes-display-inline">give the veteran the option of seeking care at a non-Department facility pursuant to section 1792(e) of this title.</text></subclause></clause></subparagraph></paragraph> <paragraph id="H4C0E413E649D4F7D81601F33C6A5A34C" indent="up1"><enum>(2)</enum><text>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.</text></paragraph>
<paragraph id="HC37330B33264496EA579CB3BD860FF13" indent="up1"><enum>(3)</enum><text>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.</text></paragraph> <paragraph id="HB9D7CB9C9BFA4383B0D0ADC359DB0245" indent="up1"><enum>(4)</enum><text>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.</text></paragraph>
<paragraph id="H11EBAFFC2EF14AE9BA5685CBCC7C20EB" indent="up1"><enum>(5)</enum><text>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 <short-title>Take Care of America’s Veterans Act</short-title>.</text></paragraph> <paragraph indent="up1" commented="no" display-inline="no-display-inline" id="HF67B529923AB4527B7C36AACBFBB161E"><enum>(6)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="H038F2D13564D429A97077359EBA255F4"><enum>(A)</enum><text display-inline="yes-display-inline">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 <short-title>Take Care of America’s Veterans Act</short-title>.</text></subparagraph>
<subparagraph id="H78A7995E08DB49F683EE30757B44DD36" indent="up1"><enum>(B)</enum><text>Not later than seven years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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—</text> <clause commented="no" display-inline="no-display-inline" id="HEA099C4A443940EBA89B823F61F78F97"><enum>(i)</enum><text display-inline="yes-display-inline">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</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H243221732BE749B78CDECA939C64D288"><enum>(ii)</enum><text display-inline="yes-display-inline">the recommendation of the Secretary for continued codification of such standards along with a justification for such recommendation.</text></clause></subparagraph> <subparagraph indent="up1" commented="no" display-inline="no-display-inline" id="H33E74B4471944767A6B29B5BB59418B9"><enum>(C)</enum><text>On and after the date that is eight years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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—</text>
<clause commented="no" display-inline="no-display-inline" id="H37492D67A163405D8072F64BC1A94238"><enum>(i)</enum><text>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</text></clause> <clause commented="no" display-inline="no-display-inline" id="HEA5A1658FA6B4991BD0F6B0449F2C8FD"><enum>(ii)</enum><text display-inline="yes-display-inline">a joint resolution of approval is enacted that approves such different standards.</text></clause></subparagraph>
<subparagraph id="H404CFB8668FD4103916778FB9DD0EC1D" indent="up1"><enum>(D)</enum><text>For purposes of this subsection, the term <term>joint resolution of approval</term> means only a joint resolution the matter after the resolving clause of which is as follows: <quote>That Congress approves the access standards established by the Secretary submitted on __ relating to __.</quote>, with the first blank space filled by the appropriate date and the second blank space filled with a description of the access standards.</text></subparagraph> <subparagraph indent="up1" commented="no" display-inline="no-display-inline" id="HF8D4D7B0A31E43A6A4C4BEA6BE12D7B9"><enum>(E)</enum><text>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.</text></subparagraph></paragraph></subsection>
<subsection id="H2472BCDD822048E19A56301A8280CAB3" commented="no"><enum>(b)</enum><header>Application</header><text>The Secretary shall ensure that the eligibility access standards established under subsection (a) apply—</text> <paragraph id="HCDEDCFDD9ECA4953BD7B653BC1CF7963" commented="no"><enum>(1)</enum><text>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</text></paragraph>
<paragraph id="H4AC7504092614A6EBF2A358ECFE9BF78" commented="no"><enum>(2)</enum><text>to all covered veterans, regardless of whether a veteran is a new or established patient.</text></paragraph></subsection> <subsection id="HA6BCAD0ADFC1492CA955CCFAFC8BEE23" commented="no"><enum>(c)</enum><header>Periodic review of access standards</header> <paragraph commented="no" display-inline="yes-display-inline" id="HDB1C83B4E98944F682787139210FCB94"><enum>(1)</enum><text>Not later than three years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, and not less frequently than once every three years thereafter, the Secretary shall—</text>
<subparagraph id="H5DD7A9B2A17E4BE7BBB596CBF2B9EECB" indent="up1" commented="no"><enum>(A)</enum><text>conduct a review of the eligibility access standards under subsection (a) in consultation with—</text> <clause id="H8B6B3E81B30040C7A50D8A1AD500EA0F" commented="no"><enum>(i)</enum><text>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;</text></clause>
<clause id="H7D374DF73840411E81DB608ED9FE9D0F" commented="no"><enum>(ii)</enum><text>entities and individuals in the private sector, including—</text> <subclause id="HB0E1ED5BDD334B44A6C8C9F7EB7987CF" commented="no"><enum>(I)</enum><text>veteran patients;</text></subclause>
<subclause id="HC5FE67CC2F6B41D59B1455C24A06E53C" commented="no"><enum>(II)</enum><text>representatives of veterans, including individual veterans and participants from veteran stakeholder organizations selected through an open and transparent process; and</text></subclause> <subclause id="HBBE13A7608924413A84FA36FA9983651" commented="no"><enum>(III)</enum><text>health care providers participating in the Veterans Community Care Program under section 1703 of this title; and</text></subclause></clause>
<clause id="H3D0FDDA6931848EC85E19326EF48C0E7" commented="no"><enum>(iii)</enum><text>other entities that are not part of the Federal Government; and</text></clause></subparagraph> <subparagraph id="H9D6E58847E674791831C6785F906C334" indent="up1" commented="no"><enum>(B)</enum><text>submit to the appropriate committees of Congress a report on—</text>
<clause id="H136F5466DB564E9AB2CAFBE9981039AA" commented="no"><enum>(i)</enum><text>the findings of the Secretary with respect to the review conducted under paragraph (1); and</text></clause> <clause id="H08EBCA3986C445909C2F0B5163809617" commented="no"><enum>(ii)</enum><text>such recommendations as the Secretary may have with respect to the eligibility access standards under subsection (a).</text></clause></subparagraph></paragraph>
<paragraph id="H031E1D88FEB248A18B9C91CFD697D1FE" indent="up1" commented="no"><enum>(2)</enum><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/10">Chapter 10</external-xref> of title 5 shall not apply to the consultation required by paragraph (1)(A).</text></paragraph></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph> <paragraph id="H27F0B61EDA544876B71F37D5298BD099" commented="no"><enum>(2)</enum><text>by striking subsection (g);</text></paragraph>
<paragraph id="HC089360F161A424AB0E84D1B1945622D" commented="no"><enum>(3)</enum><text>by redesignating subsections (f), (h), and (i) as subsections (d), (e), and (f), respectively;</text></paragraph> <paragraph id="H5CFAD4FE65F644B8A611B898D3D7E6BC" commented="no"><enum>(4)</enum><text>in subsection (d), as redesignated by paragraph (3)—</text>
<subparagraph id="HF4C719F5380145ECB005A718448C2B81" commented="no"><enum>(A)</enum><text>by striking <quote>established</quote> each place it appears; and</text></subparagraph> <subparagraph id="H69A1F5F24B0E444A950E1622DEA98CD1" commented="no"><enum>(B)</enum><text>in paragraph (1), by striking <quote>(1) Subject to</quote> and inserting <quote><header-in-text style="USC" level="subsection">Compliance by Community Care Providers With Access Standards</header-in-text>.—(1) Subject to</quote>;</text></subparagraph></paragraph>
<paragraph id="HA45AB2A1715B4F20BBEBBF550169F79C" commented="no"><enum>(5)</enum><text>in subsection (e), as so redesignated—</text> <subparagraph id="HF89A5FB7A72946E9AE4C96E4B7E569D5" commented="no"><enum>(A)</enum><text>in paragraph (1)—</text>
<clause id="H23F1457DD2014BABA07635BB3536EA4B" commented="no"><enum>(i)</enum><text>by striking <quote>(1) Consistent with</quote> and inserting <quote><header-in-text style="USC" level="subsection">Determination Regarding Eligibility</header-in-text>.—(1) Consistent with</quote>; and</text></clause> <clause id="HFD8EDF70E28C471FBE45A599A64143AF" commented="no"><enum>(ii)</enum><text>by striking <quote>designated access standards established under this section</quote> and inserting <quote>eligibility access standards under subsection (a)</quote>; and</text></clause></subparagraph>
<subparagraph id="H910F962ABFFB4C2EBEBF818664CB61DD" commented="no"><enum>(B)</enum><text>in paragraph (2)(B), by striking <quote>designated access standards established under this section</quote> and inserting <quote>eligibility access standards under subsection (a)</quote>; and</text></subparagraph></paragraph> <paragraph id="HA7674EA5D12D435D90E3D563196FEE10" commented="no"><enum>(6)</enum><text>in subsection (f), as redesignated by paragraph (2)—</text>
<subparagraph id="H9A37ACAF05A745498CFD1B90B30D1E8B" commented="no"><enum>(A)</enum><text>in the matter preceding paragraph (1), by striking <quote>In this section</quote> and inserting <quote><header-in-text style="OLC" level="subsection">Definitions</header-in-text>.—In this section</quote>; and</text></subparagraph> <subparagraph id="H63F30020816F43E388E79844ACAD163E" commented="no"><enum>(B)</enum><text>in paragraph (2)—</text>
<clause id="H8382C2CCD9BD4F68B41FE4064854FDF7" commented="no"><enum>(i)</enum><text>by striking <quote>covered veterans</quote> and inserting <quote>covered veteran</quote>;</text></clause> <clause id="HE3A01BFD34AE43618684B51FE3B943FA" commented="no"><enum>(ii)</enum><text>by striking <quote>veterans described</quote> and inserting <quote>a veteran described</quote>;</text></clause>
<clause id="HAABA5F0425BC4CF0A5BCEE150EC46927" commented="no"><enum>(iii)</enum><text>by redesignating paragraphs (3) and (4) as paragraphs (4) and (5), respectively; and</text></clause> <clause id="HDFB0CB7DA4BB40F8A7379A6622329E7D" commented="no"><enum>(iv)</enum><text>by inserting after paragraph (2) the following new paragraph (3):</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H60F39012ADCC4B61AB0E0BBDB943FC74">
<paragraph id="H6BE6E68AD4D54AC0AC6F0CF59799D80A" commented="no"><enum>(3)</enum><text>The term <term>covered treatment program</term> has the meaning given such term in section 1791 of this title.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></clause></subparagraph></paragraph></subsection> <subsection id="H14CA9E1E5A7542CABD704364D46AB83E" commented="no"><enum><added-phrase committee-id="SSVA00" reported-display-style="italic">(b)</added-phrase></enum><header>Conforming amendments</header><text>Section 1703(d) of such title is amended—</text>
<paragraph id="HB649A830625841269CF71E6A53ECBB2B" commented="no"><enum>(1)</enum><text>in paragraph (1)(D), by striking <quote>designated access standards developed by the Secretary under section 1703B of this title</quote> and inserting <quote>eligibility access standards under section 1703B(a) of this title</quote>;</text></paragraph> <paragraph id="H31A9022EE0C6491A8735465AB2C4B125" commented="no"><enum>(2)</enum><text>in paragraph (3), by striking <quote>designated access standards developed by the Secretary under section 1703B of this title</quote> and inserting <quote>eligibility access standards under section 1703B(a) of this title</quote>; and</text></paragraph>
<paragraph id="H03EA6E95D11547A698F95F9277ED6BD7" commented="no"><enum>(3)</enum><text>in paragraph (4), by striking <quote>designated access standards developed by the Secretary under section 1703B of this title</quote> and inserting <quote>eligibility access standards under section 1703B(a) of this title</quote>.</text></paragraph></subsection></section> <section id="HB42AC1AB47EA4629B19CF2CCE8853A59"><enum>602.</enum><header>Requirement that Secretary notify veterans of eligibility for care or denial of request for care under Veterans Community Care Program</header> <subsection id="H0C84A0E4C2454B75945924636884E85A"><enum>(a)</enum><header>In general</header><text>Section 1703(a) of title 38, United States Code, is amended by adding at the end the following new paragraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HE2EB405D57E747DC99284D7C30EFBE32">
<paragraph id="H551E0056DE3846929CF5D5AAC6D8C032" indent="up1"><enum>(5)</enum>
<subparagraph commented="no" display-inline="yes-display-inline" id="H773942F69A0C405EAEEA214237A0DB24"><enum>(A)</enum>
<clause commented="no" display-inline="yes-display-inline" id="H959BE61D2EAF434CBF9CA30F971814C7"><enum>(i)</enum><text>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.</text></clause> <clause id="H590071E9032E4408A36DCC3EBF147491" indent="up2"><enum>(ii)</enum><text>The Secretary is required to notify a covered veteran under clause (i) only at the start of an episode of care for such veteran.</text></clause>
<clause id="HEEC42C5C26174A14B8B1CEADD37660B9" indent="up2"><enum>(iii)</enum><text>The Secretary shall allow a covered veteran to opt out of receiving notification under clause (i).</text></clause></subparagraph> <subparagraph id="HC09B4B584FFF4C7D8CE2DC57CF776099" indent="up1"><enum>(B)</enum><text>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.</text></subparagraph>
<subparagraph id="HD603459872F74F04972EEBFEDAD25AF2" indent="up1"><enum>(C)</enum><text>Any notification or reminder under this paragraph may be provided electronically.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H8826090EDB114747A3E19B0236AED460" indent="up1"><enum>(6)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="H68E3CEFFED9F4C06B4E52E76A22EFC5E"><enum>(A)</enum><text display-inline="yes-display-inline">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—</text>
<clause id="H40184DC42A6E41759848F5842669A581" indent="up1"><enum>(i)</enum><text>of the reason for the denial; and</text></clause> <clause id="H0E52648B1DBF400FAAE947174B494D37" indent="up1"><enum>(ii)</enum><text>with instructions on how to appeal such denial using the clinical appeals process of the Veterans Health Administration.</text></clause></subparagraph>
<subparagraph id="H4118874773B543B5857798148EDB6175" indent="up1"><enum>(B)</enum><text>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.</text></subparagraph> <subparagraph id="H0A3720B71D7D4B87B860A6A8CFAEEBCD" indent="up1"><enum>(C)</enum><text>The Secretary shall allow a covered veteran to opt out of receiving notification under subparagraph (A).</text></subparagraph>
<subparagraph id="H0541EB3972B3445CBC1CDFA90488B3B1" indent="up1"><enum>(D)</enum><text>Any notification under this paragraph may be provided electronically.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HE2028F648D214A5E90D5E2D9A6669403"><enum>(b)</enum><header>Reports to Congress</header><text display-inline="yes-display-inline"> 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—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H45C716B201084BC3A1AD78E4A35181EA"><enum>(1)</enum><text display-inline="yes-display-inline">an assessment of the timeliness of the notifications required by those amendments;</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H49B8A0C0C6C140ED890540E42F22750E"><enum>(2)</enum><text display-inline="yes-display-inline">a description of barriers to increasing the timeliness of those notifications; and</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HF99456546E0C4B53AB4EB909753835E3"><enum>(3)</enum><text display-inline="yes-display-inline">the number of veterans who opt out of receiving those notifications.</text></paragraph></subsection></section> <section id="H54FC77C3B38E4C21A2F72E73A96C9662"><enum>603.</enum><header>Consideration under Veterans Community Care Program of continuity of care and need for caregiver or attendant</header><text display-inline="no-display-inline">Section 1703(d) of title 38, United States Code, is amended—</text>
<paragraph id="H6751453E3AAF4FD18378D857ABFA4CD3"><enum>(1)</enum><text>in paragraph (2), by adding at the end the following new subparagraphs:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H94EEF71496DE441D84C5608DE11363B9"> <subparagraph id="HADCC7968D37F4BBEB7736BFF941CF679" indent="up1"><enum>(F)</enum><text>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.</text></subparagraph>
<subparagraph id="H741C07459346470B89F6BA86C6FA0C1B" indent="up1"><enum>(G)</enum><text>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.</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph> <paragraph id="H8E40C97C4CD64F848F8234A509337A21"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H8246AC75A5664C21A31A59CCD1B4B3D6">
<paragraph id="H64E7B8E140794B2DB51C2A93122A901B" indent="up1"><enum>(5)</enum><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="HEEA93FC8B0254E0E93E206E2222517E5"><enum>604.</enum><header>Discussion of telehealth options under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703 of title 38, United States Code, is amended—</text>
<paragraph id="H07DE885D835848F48010F30EB6F8963B"><enum>(1)</enum><text>by redesignating subsection (q) as subsection (r); and</text></paragraph> <paragraph id="H7821A9E973C247569F9CCF338C2C0DF6"><enum>(2)</enum><text>by inserting after subsection (p) the following new subsection (q):</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HEE24510F39F742EDB392C094E51090D9">
<subsection id="H1ED181DF9D964A76AF350B4DFC8B2CB7"><enum>(q)</enum><header>Discussion of options for telehealth</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H7266A0B7555B42AAA3D8C8646824DDD7"><enum>(1)</enum><text>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—</text> <subparagraph id="H95196ACD859C4F8AB4AD369DB8D9B8AB" indent="up1"><enum>(A)</enum><text>telehealth is—</text>
<clause commented="no" display-inline="no-display-inline" id="H5E5DEF0C14614D089C30217AA9FEE183"><enum>(i)</enum><text display-inline="yes-display-inline">available to the veteran;</text></clause> <clause id="HA60827ADF5A0428FAC01643D15896D9E"><enum>(ii)</enum><text>appropriate for the type of care or services the veteran is seeking, as determined by the Secretary; and</text></clause>
<clause id="HFF2F3D30CF944084AFF582A6C6C4388A"><enum>(iii)</enum><text>is acceptable to the veteran; or</text></clause></subparagraph> <subparagraph id="HF2AECAD8D26C4EACB0EAAAE6EFAF57E9" indent="up1"><enum>(B)</enum><text>the care or services the veteran is seeking is only or primarily available through telehealth.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H6F17B22663E44E1695D10E4491E4B8F2" indent="up1"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="H1871959D822142F2B1B763E53A25A912"><enum>605.</enum><header>Extension of deadline for submittal of claims by health care entities and providers under prompt payment standard</header><text display-inline="no-display-inline">Section 1703D of title 38, United States Code, is amended—</text>
<paragraph id="HA7162C67733241D4A8857C75C8FF8435"><enum>(1)</enum><text>in subsection (a)(2), by striking <quote>the reason for denying the claim and what, if any, additional information is required to process the claim</quote> and inserting <quote>the reason for denying the claim and request additional missing information, if any, that is required to process the claim</quote>;</text></paragraph> <paragraph id="HE4D0C14A6E4D4195B36A7217641DC1BD"><enum>(2)</enum><text>by amending subsection (b) to read as follows:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HCDFB1BBD4DC14F22A38DFC831DD7E099">
<subsection id="HC708261F27D04CCC8372C556EE98AA8E"><enum>(b)</enum><header>Submittal of claims by health care entities and providers</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H4EE07945B7F246B3888AC8CA75D61751"><enum>(1)</enum><text>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.</text></paragraph> <paragraph indent="up1" commented="no" display-inline="no-display-inline" id="H3718DA5BFC6948F094C9CF666136EF67"><enum>(2)</enum><text>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).</text></paragraph></subsection><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph>
<paragraph id="H4093475D3AD84FB9824986DB236FA087"><enum>(3)</enum><text>in subsection (c), by adding at the end the following new paragraph:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H2854E279C6B94D7E8D37247C1C996E73"> <paragraph id="H0D2CF6D894C8482180A6E95FBFD49507" indent="up1"><enum>(3)</enum> <subparagraph commented="no" display-inline="yes-display-inline" id="HB93FE0E5AEC84032909D45B3DA14EEA8"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="H931A1C2C3FF3463987AB7EDB5FAFEF23" indent="up1"><enum>(B)</enum><text display-inline="yes-display-inline">Before imposing a suspension under subparagraph (A) with respect to an entity or provider, the Secretary shall—</text> <clause id="H812764EBE69A4C79BED9596A40C5C8DB"><enum>(i)</enum><text>provide written notice to the entity or provider identifying the basis for the proposed suspension;</text></clause>
<clause id="H7DB7660A453B4A2489A11A78E135151F"><enum>(ii)</enum><text>afford the entity or provider an opportunity to respond within a period of 30 days; and</text></clause> <clause id="H1A4FA8E2F3B445DB882A1CB21DD27D2E"><enum>(iii)</enum><text>consider any evidence or explanation submitted by the entity or provider.</text></clause></subparagraph>
<subparagraph id="HA1F89E30243847EAB375C3D69884CA28" indent="up1"><enum>(C)</enum>
<clause commented="no" display-inline="yes-display-inline" id="HBD481A99E6F3486086C973F5ABF9AC9B"><enum>(i)</enum><text>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.</text></clause> <clause indent="up1" commented="no" display-inline="no-display-inline" id="H2974702C2F164A33BD71D7B0BB9E0C3F"><enum>(ii)</enum><text display-inline="yes-display-inline">Any extension under clause (i) of a suspension shall—</text>
<subclause commented="no" display-inline="no-display-inline" id="HE052049CF60149E8A151D51DDD8BC420"><enum>(I)</enum><text display-inline="yes-display-inline">be for an additional period of not longer than one year; and</text></subclause> <subclause commented="no" display-inline="no-display-inline" id="H5AB6293A26614188A26DD0EAF247ED83"><enum>(II)</enum><text display-inline="yes-display-inline">shall be reported to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives.</text></subclause></clause></subparagraph>
<subparagraph indent="up1" commented="no" display-inline="no-display-inline" id="HEADCB133403D417B9AA632FA68EABCF4"><enum>(D)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H0AAB3D4F64864A7ABD0DA289F9CA0A5E" indent="up1"><enum>(E)</enum><text display-inline="yes-display-inline">The Secretary shall coordinate actions under this paragraph with the Office of Inspector General of the Department.</text></subparagraph>
<subparagraph id="H0F348D214071467FB03D980F528A0B51" indent="up1"><enum>(F)</enum><text>The Secretary shall prescribe regulations to carry out this paragraph, including standards of evidence, notice, and appeal procedures.</text></subparagraph> <subparagraph id="HDE5678DCECC04A15824C6A62E4013DA3" indent="up1"><enum>(G)</enum> <clause commented="no" display-inline="yes-display-inline" id="HEEA0BEDB678D49E2927C375861D77C16"><enum>(i)</enum><text>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—</text>
<subclause id="H9425A47B359548A5B4D94B1F917792F7" indent="up1"><enum>(I)</enum><text>the identity of the suspended entity or provider;</text></subclause> <subclause id="HB7F69D8C5E5D443793440AC73BED7B6C" indent="up1"><enum>(II)</enum><text>the statutory or regulatory basis for the suspension;</text></subclause>
<subclause id="HDF9E91F0414D4DA3B89D7CDA3CB9F5E6" indent="up1"><enum>(III)</enum><text>a summary of the factual findings or evidence supporting the action; and</text></subclause> <subclause id="H24B0C3226D2346C5BA2937AE49FCBF7E" indent="up1"><enum>(IV)</enum><text>the status of any related investigation of or referral to the Office of Inspector General of the Department or any other appropriate Federal agency.</text></subclause></clause>
<clause id="HF24FAC728E7F425AA64EA363F93C9218" indent="up1"><enum>(ii)</enum><text>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.</text></clause> <clause id="HB0F94FDCB917431DABB923D0B5E48F52" indent="up1"><enum>(iii)</enum><text>Failure by the Secretary to provide notice under clause (i) shall be treated as a failure to comply with a statutory reporting requirement.</text></clause></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>
<section id="H45AD1116040F492D8C3C1F6AA4768107"><enum>606.</enum><header>Audit of representative sample of veterans receiving care and services under Veterans Community Care Program</header><text display-inline="no-display-inline">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—</text> <paragraph id="H97FD45BCE67A43F78E3655B7EF0156CA"><enum>(1)</enum><text>conduct an audit, for the one-year period preceding the audit, of—</text>
<subparagraph id="H42905795105A44029C524059956294E1"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H0CDA1D95F6B24BCF88107879BB8DA9BE"><enum>(B)</enum><text>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;</text></subparagraph>
<subparagraph id="HC1B0B757F57846C2A3E22A2D7CCF69C0"><enum>(C)</enum><text>the number of veterans who opt to seek care or services under such section;</text></subparagraph> <subparagraph id="HECAC0CD3F4364194B3E43ED7CE12053E"><enum>(D)</enum><text>the number of veterans who do not opt to seek care or services under such section;</text></subparagraph>
<subparagraph id="H7F97655763434A61BA3D6D5234241439"><enum>(E)</enum><text>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;</text></subparagraph> <subparagraph id="HD143E62F50F340A4B3C8D012D398BB94"><enum>(F)</enum><text>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;</text></subparagraph>
<subparagraph id="H6659D1AFB05A4AE48C27275D7387DC75"><enum>(G)</enum><text>the timeliness of each such appeal; and</text></subparagraph> <subparagraph id="HFA6649930C2549DC83CBDE83419F2417"><enum>(H)</enum><text>the outcome of each such appeal; and</text></subparagraph></paragraph>
<paragraph id="H76D2A83DC30E4D828EE83C561AF79AA8"><enum>(2)</enum><text>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).</text></paragraph></section> <section id="H569298E8D2AB4B828F7CB808EF177B33"><enum>607.</enum><header>Information on wait time and drive time options for receipt of care by veterans</header> <subsection id="HD6FB70CCD0324944BA48CA06297AAA6A"><enum>(a)</enum><header>In general</header><text>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—</text>
<paragraph id="H36F8CBC5D90A4E3591EC067AB6367D46" commented="no"><enum>(1)</enum><text>in person at a facility of the Department of Veterans Affairs;</text></paragraph> <paragraph id="HF9C50006C5104090941093F86A559752" commented="no"><enum>(2)</enum><text>via telehealth through a provider of the Department.</text></paragraph>
<paragraph id="H4DFE9472176246A6B036EB55B5987FDA"><enum>(3)</enum><text>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</text></paragraph> <paragraph id="HA153D81CD49346F592764BE34EBC5593"><enum>(4)</enum><text>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.</text></paragraph></subsection>
<subsection id="H5AEA4B450E724C2481E6FF14158763B6"><enum>(b)</enum><header>Form of information</header><text>Information provided under subsection (a)—</text> <paragraph id="HF0228195767A491296E6F0FDF29E4297"><enum>(1)</enum><text>may be provided electronically; and</text></paragraph>
<paragraph id="H06047B9AEBB743B185D91E5ECE023CAC"><enum>(2)</enum><text>shall be documented in the health record of the veteran.</text></paragraph></subsection> <subsection id="H51AEF8636C0D4BB182D97BB5B71530EB"><enum>(c)</enum><header>Opt out</header><text>The Secretary shall permit a veteran to opt out of receiving information under subsection (a).</text></subsection></section>
<section id="HC95FBCE8993C4A4AA4B0E5D7D1F8081F"><enum>608.</enum><header>Establishment of period during which a referral under Veterans Community Care Program remains valid</header><text display-inline="no-display-inline">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:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H1F16F30DB3C74DA78345011932B1E90E"> <paragraph id="HBBC40270D609471E81FC7592EECE10A0" indent="up1"><enum>(7)</enum><text>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.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="HC387EFF8AFC544069A4C436446E93A10"><enum>609.</enum><header>Updates to contracting requirements under Veterans Community Care Program</header><text display-inline="no-display-inline">Section 1703(h) of title 38, United States Code, is amended—</text> <paragraph id="H5B390ED5B5D940BD97CC04130D394E7E"><enum>(1)</enum><text>in paragraph (3)—</text>
<subparagraph id="HC08A5269CB324FF9BBE0B5A6CD9BC50C"><enum>(A)</enum><text>by amending subparagraph (A) to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H13A1CE4585244692B7DAA7318580DDE1"> <subparagraph id="H85CE809BDC9940CF88321E00060B9A97" indent="up2"><enum>(A)</enum><text>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—</text>
<clause id="H5127C2A1C0094D578E414C3591E078F3"><enum>(i)</enum><text>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;</text></clause> <clause id="H97FC0154DFE8498FB4F86BEB7445CD0C"><enum>(ii)</enum><text>it is reasonable to terminate the contract based on the health care needs of veterans; or</text></clause>
<clause id="H6FE5B8DFB2214ABEAE27F3DE376B37C0"><enum>(iii)</enum><text>it is reasonable to terminate the contract based on coverage provided by contracts or sharing agreements entered into under authorities other than this section.</text></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph> <subparagraph id="HADB08383110A4856BF1A5BC0A2E62E7A" commented="no"><enum>(B)</enum><text>by redesignating subparagraph (B) as subparagraph (D);</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H57210B187E9949D995E54005254BDE84"><enum>(C)</enum><text display-inline="yes-display-inline">by inserting after subparagraph (A) the following new subparagraphs:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H153B2125E5BB48F48AB4DEF1437CB937"> <subparagraph id="HA83D7BFCE55449248CC0649423C7B254" indent="up2"><enum>(B)</enum> <clause commented="no" display-inline="yes-display-inline" id="H8524A2D84D0A49BAB1A621B336F217DC"><enum>(i)</enum><text>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—</text>
<subclause id="HA6A503E7EB024CD0B20C523B7B2765D2" indent="up1"><enum>(I)</enum><text>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);</text></subclause> <subclause id="HC1115EC22C7842CC8AB3A57EACA4C63F" indent="up1"><enum>(II)</enum><text>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</text></subclause>
<subclause id="H481D4F7EF8E54843AEADFA6A3810718B" indent="up1"><enum>(III)</enum><text>is identified as an excluded source on the list maintained in the System for Award Management, or any successor system.</text></subclause></clause> <clause id="H049D97FEA17E4A0D9347A47052F2A748" indent="up1"><enum>(ii)</enum><text>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.</text></clause></subparagraph>
<subparagraph id="HA2A992026D8544AD972ACC3E04BB892D" indent="up2"><enum>(C)</enum><text>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.</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HC5E385AF46DF479BB759EDA366705974"><enum>(D)</enum><text>in subparagraph (D), as redesignated by subparagraph (B) of this paragraph, by striking <quote>in subparagraph (A)</quote> and inserting <quote>in this paragraph</quote>; and</text></subparagraph></paragraph>
<paragraph id="H39032B9BB7A344E6B66ABDC96CCBED9C"><enum>(2)</enum><text>by adding at the end the following new paragraph:</text> <quoted-block id="H88304E72A3ED4AB194664F627424C501" display-inline="no-display-inline" style="OLC"> <paragraph id="HB0E25FEE18C74EBEA4AB51DEAF6463C7" indent="up1"><enum>(7)</enum><text>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—</text>
<subparagraph id="H7926D31B32614EB89BD48BF399DB229B"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H1F4714471FB041EEB9D94128DB236B5C"><enum>(B)</enum><text>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</text></subparagraph>
<subparagraph id="HFC101DD7CC534B96A1B4EF106CB4131A" commented="no" display-inline="no-display-inline"><enum>(C)</enum><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section> <section id="HFF95FA618743437A82F4139C25E79451"><enum>610.</enum><header>Publication of community care network sufficiency and payment waiver requests and approvals</header><text display-inline="no-display-inline">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—</text>
<paragraph id="H047086479EB847EDB3EA011D0BC37226"><enum>(1)</enum><text>the information contained in the most recent report required by section 1703(p) of title 38, United States Code; and</text></paragraph> <paragraph id="HF8B04A68F26F4AF5B17E71D460DDB8F1" commented="no" display-inline="no-display-inline"><enum>(2)</enum><text>an overview, disaggregated by region, of the waivers requested, approved, and denied under section 1703B(f)(3) of such title.</text></paragraph></section>
<section id="HA89952EC88414C89B2D01A565C17E275"><enum>611.</enum><header>Requirements relating to quality of community care providers</header>
<subsection id="H01107636C69C43FB935A4BE7EFABDDE8"><enum>(a)</enum><header>Monthly checks against list of excluded individuals or entities</header><text>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.</text></subsection> <subsection id="HF2D94366A6E64BA3BF5BB647B57E2033"><enum>(b)</enum><header>Revision of provider exclusion standard operating procedures</header><text>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.</text></subsection>
<subsection id="H8C901F42EB7D49AEAAB064343CA23159"><enum>(c)</enum><header>Process to identify department providers terminated or resigning from employment</header><text>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.</text></subsection> <subsection id="HA6C496C08E604019A94FC36A223C65DE"><enum>(d)</enum><header>Update of information on providers</header><text>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—</text>
<paragraph id="H5483E43AEC7A494A897DF935D13D8830"><enum>(1)</enum><text>update their lists of community care providers to reflect accurate provider contact information;</text></paragraph> <paragraph id="H419B2C4EE3FF4C0C8E47F0B9047C8BDD"><enum>(2)</enum><text>annotate providers that are not currently accepting patients under the Veterans Community Care Program; and</text></paragraph>
<paragraph id="H85FE864818CD478CA6C42859EEB79E8B"><enum>(3)</enum><text>remove providers from the provider profile management system that—</text> <subparagraph id="HBE5023CCD66F4BA9836A5FA0318B4E1E"><enum>(A)</enum><text>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;</text></subparagraph>
<subparagraph id="H07D5AE2111F4442AB7A41248D665200D"><enum>(B)</enum><text>are in the system for award management exclusions of the General Services Administration; or</text></subparagraph> <subparagraph id="H61C550F29B964B9298A6F473E81B5633"><enum>(C)</enum><text>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.</text></subparagraph></paragraph></subsection>
<subsection id="H42BF1638DBCA4E7C951922CAA817D8D0"><enum>(e)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H52BF0739AF334DAA90954770F26E7E60"><enum>(1)</enum><header>Community care provider</header><text>The term <term>community care provider</term> means a health care provider specified under section 1703(c) of title 38, United States Code.</text></paragraph>
<paragraph id="HA983E753CFBE468DBF2435F9739D539A"><enum>(2)</enum><header>Veterans Community Care Program</header><text>The term <term>Veterans Community Care Program</term> means the Veterans Community Care Program under section 1703 of title 38, United States Code.</text></paragraph></subsection></section> <section id="HE36E03A746D747739BAD4D8AF07D64E6"><enum>612.</enum><header>Provider training</header> <subsection id="HE5A6744671DC4D379BCFD8E3E9EF2C10"><enum>(a)</enum><header>Development of plan</header><text>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.</text></subsection>
<subsection id="H0B4E7389E1E0465F93036F5DF470A04D"><enum>(b)</enum><header>Elements</header><text>The plan required under subsection (a) shall—</text> <paragraph id="H5D2311E2DF1A420BA4768AD0F8AD35EA"><enum>(1)</enum><text>identify existing training requirements or incentives applicable to health care providers of the Department;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H7A3743D21B914BC3A02B98FC32D1687A"><enum>(2)</enum><text>identify existing training requirements or incentives applicable to health care trainees or residents of the Department;</text></paragraph> <paragraph id="H3F096B5A403E45B8B74CA44D4BB960C2"><enum>(3)</enum><text>identify existing training requirements or incentives applicable to community care providers;</text></paragraph>
<paragraph id="H7FF0BADB0AFB40398128B0FB57BD0E2B"><enum>(4)</enum><text>assess gaps between training requirements and incentives for health care providers of the Department, trainees or residents of the Department, and community care providers;</text></paragraph> <paragraph id="H87F9472ED9AF4668A78E69356EB337A3"><enum>(5)</enum><text>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</text></paragraph>
<paragraph id="HDD21B0625EEC4520BE303158AEBAC3A7"><enum>(6)</enum><text>provide a strategy, assessment of barriers, and timeline for implementing such baseline training requirements, including—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HC0D1EC57B5B045F6940755F0E41E17C9"><enum>(A)</enum><text display-inline="yes-display-inline">through online modules and continuing medical education programs; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H34CFF417D5C34A92994F6906B4D04943"><enum>(B)</enum><text display-inline="yes-display-inline">within such strategy—</text> <clause commented="no" display-inline="no-display-inline" id="HACE68C911D47453682BB79F85BAC6E78"><enum>(i)</enum><text display-inline="yes-display-inline">metrics to measure the effectiveness of baseline training requirements in improving clinical quality, satisfaction of veterans, and health outcomes for veterans;</text></clause>
<clause id="H9DE4B576A3A241F28155D7CED9B755B1"><enum>(ii)</enum><text>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;</text></clause> <clause id="HF150095E3CF747B797216A2FC9A08220"><enum>(iii)</enum><text>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;</text></clause>
<clause id="HC35388E13CB541F7960298E9C93BFAB3"><enum>(iv)</enum><text>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</text></clause> <clause id="H1F038411229C4ADBB0864A9FA146D47E"><enum>(v)</enum><text>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.</text></clause></subparagraph></paragraph></subsection>
<subsection id="HF7DD4F392CC140F0BC0C81C08E7D75C0"><enum>(c)</enum><header>Implementation</header><text>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).</text></subsection> <subsection id="H3F7AB733D3B5447F8488974DA9EB01AA"><enum>(d)</enum><header>Report to Congress</header><text>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—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H90DB423AAF9C4583B12074ED9C944401"><enum>(1)</enum><text display-inline="yes-display-inline">the plan required under subsection (a);</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H0F372361A4224D6BBB30A83B808EF221"><enum>(2)</enum><text display-inline="yes-display-inline">a description of identified gaps between training or incentives for providers of the Department, trainees or residents of the Department, and community care providers;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H51EA52DAECC44C758D809B0CA1E305DC"><enum>(3)</enum><text display-inline="yes-display-inline">the estimated costs associated with implementation of the plan; and</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H17DBB1A86FEB4D2CA4951312F6BEA764"><enum>(4)</enum><text display-inline="yes-display-inline">a description of any legislative or regulatory changes necessary to carry out the plan.</text></paragraph></subsection>
<subsection id="HA2FC6E773A954333B7FD4DE6CC259BD5"><enum>(e)</enum><header>Annual updates</header><text>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—</text> <paragraph commented="no" display-inline="no-display-inline" id="H3C9AA50BC5C740DFA0A2401BED864D0C"><enum>(1)</enum><text display-inline="yes-display-inline">describing progress in implementing the plan required under subsection (a);</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HC8A20DCB229642FCAB86C2FB639EF2A2"><enum>(2)</enum><text display-inline="yes-display-inline">assessing any measurable impacts of such implementation on quality of care; and</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HC75B550A66644FBDA20E459CFBB11054"><enum>(3)</enum><text display-inline="yes-display-inline">assessing any improvements in rates of compliance with training requirements among health care providers, trainees, and residents of the Department and community care providers.</text></paragraph></subsection>
<subsection id="HDFD2315AAFBD4499AFBE31B21D2B849A"><enum>(f)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="HAF4E5877A7594A2E88BB1C8D9EE4829E"><enum>(1)</enum><header>Community care provider</header><text>The term <term>community care provider</term> means a health care provider specified under section 1703(c) of title 38, United States Code.</text></paragraph>
<paragraph id="H6BDD167AB9984AA197CDCDF4B0A42416" commented="no"><enum>(2)</enum><header>Training</header><text>The term <term>training</term> includes training relating to—</text> <subparagraph id="H16ED460D3AA04918AD064786838F92C7" commented="no"><enum>(A)</enum><text>veteran-specific cultural competency;</text></subparagraph>
<subparagraph id="HF784BB54473546B4BFD63CDA5AEA2391" commented="no"><enum>(B)</enum><text>health conditions related to military service, including toxic exposures, post-traumatic stress disorder, traumatic brain injury, and military sexual trauma;</text></subparagraph> <subparagraph id="H51525AD16BB44B7FAD1192DCC3B2E708" commented="no"><enum>(C)</enum><text>suicide prevention;</text></subparagraph>
<subparagraph id="HBD34BE8403F148F0A8344D820AC7540B" commented="no"><enum>(D)</enum><text>pain management and opioid safety; and</text></subparagraph> <subparagraph id="HEDED04694B2145739C7A379A64851491" commented="no"><enum>(E)</enum><text>any other matter the Secretary determines appropriate.</text></subparagraph></paragraph>
<paragraph id="HFBB5E9C81CCA488E9CC87969631B7A3D" commented="no" display-inline="no-display-inline"><enum>(3)</enum><header>Veterans Community Care Program</header><text>The term <term>Veterans Community Care Program</term> means the Veterans Community Care Program under section 1703 of title 38, United States Code.</text></paragraph></subsection></section> <section id="H6CC34FCBD1464E5F9DA75AEDBE7179A9"><enum>613.</enum><header>Oversight authority over community care</header> <subsection id="HE52D30F033A347A9B37C38C2744F0C75"><enum>(a)</enum><header>In general</header><text>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.</text></subsection>
<subsection id="HCC9DF3A84D9D4DEF970DB1506186A943"><enum>(b)</enum><header>Third party administrators</header>
<paragraph commented="no" display-inline="no-display-inline" id="H9D0ED50D3C434020A7BD6544CF0878DB"><enum>(1)</enum><header>Requirement</header><text display-inline="yes-display-inline">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).</text></paragraph> <paragraph id="H8C7F9BC44ADB4708A24E3582ADC56CCC"><enum>(2)</enum><header>Notification</header><text>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.</text></paragraph></subsection>
<subsection id="H4F0851F7DD0646DBB40A34D087E0DAA8"><enum>(c)</enum><header>Standard contract language</header><text>The Secretary shall establish standard contract language under this section in consultation with the Inspector General of the Department of Veterans Affairs.</text></subsection> <subsection id="H8DD16EE2F67D4948A7A118522C309144" commented="no" display-inline="no-display-inline"><enum>(d)</enum><header>Veterans Community Care Program defined</header><text>In this section, the term <term>Veterans Community Care Program</term> means the Veterans Community Care Program under section 1703 of title 38, United States Code.</text></subsection></section></subtitle>
<subtitle style="OLC" id="H25CF13F5858E427F9B4C5B0952A99719"><enum>B</enum><header>Mental Health Treatment Programs</header>
<section id="HA500118DEB074C859714215A087E88A8"><enum>621.</enum><header>Veteran participation in certain mental health programs</header>
<subsection id="HC14F2D63597B47DCA34284743712E260"><enum>(a)</enum><header>Establishment</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">Chapter 17</external-xref> of title 38, United States Code, is amended by adding at the end the following new subchapter:</text> <quoted-block style="USC" display-inline="no-display-inline" id="HE352DFC58E604ACAB568A217FA0E3E32"> <subchapter id="HA0EC1CB43D8A4B1EA5F7D75CB57161AF"><enum>IX</enum><header>Participation by Veterans in Certain Mental Health Treatment Programs</header> <section id="H5C4BE9F252734059A93AD83715AB2DB4"><enum>1791.</enum><header>Definitions</header><text display-inline="no-display-inline">In this subchapter:</text>
<paragraph id="H38FF9997D7014DE69A391D8546DF2B09"><enum>(1)</enum><header>Activities of daily living</header><text>The term <term>activities of daily living</term> 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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H239669FA31AE4A4C965FD04E27920BC0"><enum>(2)</enum><header display-inline="yes-display-inline">Covered treatment program</header> <subparagraph commented="no" display-inline="no-display-inline" id="H4EAC080F691049B7A69CBDE3B8A59201"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">The term <term>covered treatment program</term>—</text>
<clause id="H80CC9B4DE2534106A79F220EFFEA6535"><enum>(i)</enum><text>means—</text> <subclause id="HD56AA2BFC7E0454F8F8CDE72DF245914"><enum>(I)</enum><text>a mental health residential rehabilitation treatment program of the Department; or</text></subclause>
<subclause id="H2470CB772C4246AEBA1D2828DB926FF2"><enum>(II)</enum><text>a program of the Department for residential care for mental health and substance use disorders;</text></subclause></clause> <clause id="H8BB75C960AE64B94981EE9D991D3B795"><enum>(ii)</enum><text>includes—</text>
<subclause id="H30B5D923D80049C7820F67F9FB34E4B2"><enum>(I)</enum><text>the programs designated as of the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title> as domiciliary residential rehabilitation treatment programs; and</text></subclause> <subclause id="H27BF2B6322EC4766BD4E9792D30F3877"><enum>(II)</enum><text>any programs designated as domiciliary residential rehabilitation treatment programs on or after such date of enactment; and</text></subclause></clause>
<clause id="HF9399DEF4FE84F3295018B68FF66D6F3"><enum>(iii)</enum><text>does not include—</text> <subclause commented="no" display-inline="no-display-inline" id="H4C5367F0BD7D4C628E4FFFB96C8E9864"><enum>(I)</enum><text display-inline="yes-display-inline">Compensated Work Therapy Transition Residence programs of the Department; or</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="H353F11C3DF434B03A73B497D1BDBA829"><enum>(II)</enum><text display-inline="yes-display-inline">Department or non-Department programs in which more than 20 percent of the care provided is provided through telehealth.</text></subclause></clause></subparagraph> <subparagraph id="H4E38235EE6A24568862D1EFDDE9396EF"><enum>(B)</enum><header>Accreditation</header><text>A program described in subparagraph (A) must maintain accreditation by the Commission on Accreditation of Rehabilitation Facilities and the Joint Commission.</text></subparagraph></paragraph>
<paragraph id="HC24B4683BA6146478EAD268F5D61ACFD"><enum>(3)</enum><header>Covered veteran</header><text>The term <term>covered veteran</term> means a veteran described in section 1703(b) of this title.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H00E15D4F083245FEB3189BC8DD914944"><enum>(4)</enum><header>Evidence-based treatment</header><text>The term <term>evidence-based treatment</term> 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.</text></paragraph>
<paragraph id="H82C9954E456E4927B01FC4276F793F50"><enum>(5)</enum><header>Social support systems</header><text>The term <term>social support systems</term>, with respect to a covered veteran—</text> <subparagraph id="HFB2EC4F3E3E446A4AB4DCF9491BE72CB"><enum>(A)</enum><text>means—</text>
<clause id="H3A45491788C348CE9ED55E06A6B950A2"><enum>(i)</enum><text>a member of the family of the covered veteran, including a parent, spouse, child, step-family member, or extended family member; or</text></clause> <clause id="HD298974D4889456BA4DEA8BA39F3A75F"><enum>(ii)</enum><text>an individual who lives with the veteran but is not a member of the family of the veteran; and</text></clause></subparagraph>
<subparagraph id="HCC1706A604834C58B2D1BBA7E7A4C1A8"><enum>(B)</enum><text>does not include a facility-organized peer support program.</text></subparagraph></paragraph></section> <section id="HD987785BAC6B48EEA12DBEC495E232C3"><enum>1792.</enum><header>Standardized process to determine eligibility of covered veterans for participation in certain mental health treatment programs</header> <subsection id="H62EADFBC2ECD434B980B0F3F754D2A55"><enum>(a)</enum><header>Standardized screening process</header><text>Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></subsection>
<subsection id="H2E05394E3DFC42D1AAE2A4FB7EDACF6F"><enum>(b)</enum><header>Eligibility criteria for priority admission</header>
<paragraph id="H3270971DC69848E5AC3B46032E73C18F"><enum>(1)</enum><header>In general</header><text>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:</text> <subparagraph id="H14B936228A6A456985DDC613A31A6ABC"><enum>(A)</enum><text>A clinical assessment of the symptoms of the veteran, including symptoms that—</text>
<clause id="HF4B7E09B0DEC4B0299930BC21E887409"><enum>(i)</enum><text>significantly affect activities of daily life; and</text></clause> <clause id="HCB11AF285DD648B5B2951AB928A9253C"><enum>(ii)</enum><text>increase the risk of adverse outcomes, such as overdose, suicide, self-harm, or an unsafe living situation.</text></clause></subparagraph>
<subparagraph id="H2CC2BC52A9F841EBBB8A68F424FDB67B"><enum>(B)</enum><text>The lack of availability and applicability of other treatment options.</text></subparagraph> <subparagraph id="H646DED246C294BA48D8343B3AA2DF7A5"><enum>(C)</enum><text>Whether the veteran has a recent suicide or overdose attempt.</text></subparagraph>
<subparagraph id="H9024E1F0A92A4E8380C90176DE3A4CE7"><enum>(D)</enum><text>Whether the veteran is determined to be a high risk for suicide or overdose.</text></subparagraph> <subparagraph id="H09A6470D9D1A4819A583EDDC91248CD8"><enum>(E)</enum><text>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—</text>
<clause id="H1EA0F5B9A7B84247A27B885C37A3BDAF"><enum>(i)</enum><text>is licensed by a State;</text></clause> <clause id="H4906238FF8AC4DA99516B2DF580E05E4"><enum>(ii)</enum><text>is accredited by the Commission on Accreditation of Rehabilitation Facilities or the Joint Commission; and</text></clause>
<clause id="H633248FFF3A649CEB49EE18868B0FCF0"><enum>(iii)</enum><text>provides evidence-based treatment.</text></clause></subparagraph> <subparagraph id="HED71D12AF7F144879B6A07C8DA422AF4"><enum>(F)</enum><text>Such other criteria as the Secretary determines appropriate, in consultation with Congress.</text></subparagraph></paragraph>
<paragraph id="H18FF453A531F4E5E9173B02DC5549FCD"><enum>(2)</enum><header>Consideration</header><text>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—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HC04938ABC9A64DDCAE8334913F89BEF3"><enum>(A)</enum><text display-inline="yes-display-inline">consider any referral of a health care provider of a covered veteran; and</text></subparagraph>
<subparagraph id="H09DB8DA96EDC4FA596D5CD2EABEC620B"><enum>(B)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="HE62105C9243B4840BD429F069931B9B2"><enum>(3)</enum><header>Provision of higher-level care</header><text>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.</text></paragraph></subsection>
<subsection id="H144D94171174451EA8CEF76818C94400"><enum>(c)</enum><header>Screening for traumatic brain injury</header><text>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.</text></subsection> <subsection id="HFED6666737674FEFBB8C239BDEF216EC"><enum>(d)</enum><header>Considerations</header><text>In making placement decisions in a covered treatment program for veterans who meet criteria for priority or routine admission, the Secretary shall—</text>
<paragraph id="H8B7753EE41634C6AB111A03096CAEB01"><enum>(1)</enum><text>consider the input of the covered veteran with respect to the—</text> <subparagraph id="H8EAF751F0ECC4441B8AC9948BB57A412"><enum>(A)</enum><text>program specialty, subtype, and treatment track offered to the covered veteran; and</text></subparagraph>
<subparagraph id="HE56D2866149D45B5A9F9A0D05CD4667F"><enum>(B)</enum><text>geographic placement of the covered veteran, including proximity to the current residence, time zone, or geographic region of the covered veteran;</text></subparagraph></paragraph> <paragraph id="H244FE8125CC240B1A256D3EBB8C80DDF"><enum>(2)</enum><text>maximize the proximity of the covered veteran to social support systems; and</text></paragraph>
<paragraph id="H8E473EBC7C3D48168ACD628563B19576"><enum>(3)</enum><text>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.</text></paragraph></subsection> <subsection id="H56289CEB74634D06B09C925AE5888A81"><enum>(e)</enum><header>Conditions under which care shall be furnished through non-Department providers</header> <paragraph id="HD342FEDAE5B149AE935CA43F463FE999"><enum>(1)</enum><header>Priority admission</header><text>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—</text>
<subparagraph id="HC94F9889D883458CAD17E805CFA09631"><enum>(A)</enum><text>can admit the covered veteran within the period required by section 1703B(a)(1)(C)(ii)(I) of this title;</text></subparagraph> <subparagraph id="H5AC5BCF697C6424A981D921552EC1CA4"><enum>(B)</enum><text>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;</text></subparagraph>
<subparagraph id="HFE04BE96CE8E4576B404B9B384AB3997"><enum>(C)</enum><text>is licensed by a State;</text></subparagraph> <subparagraph id="H2B117462F75E4223B674186DDE192D85"><enum>(D)</enum><text>is accredited by the Commission on Accreditation of Rehabilitation Facilities or the Joint Commission; and</text></subparagraph>
<subparagraph id="H18052D7AF7A048F6A5D080A34D6483AA"><enum>(E)</enum><text>provides evidence-based treatment.</text></subparagraph></paragraph> <paragraph id="H6255BCC632984C9789B615E3B62FEF22"><enum>(2)</enum><header>Routine admission</header><text>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—</text>
<subparagraph id="HFC893F4E237E4D1EA198FAB8404C102F"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H32158BA4CC994CF0878AB51540591631"><enum>(B)</enum><text>is licensed by a State;</text></subparagraph>
<subparagraph id="H5E3391FB09404AF69D2173BB3A8501C2"><enum>(C)</enum><text>is accredited by the Commission on Accreditation of Rehabilitation Facilities or the Joint Commission; and</text></subparagraph> <subparagraph id="H2D7C08F3900547149D420F2E47CE6D77"><enum>(D)</enum><text>provides evidence-based treatment.</text></subparagraph></paragraph>
<paragraph id="HEC1AFD09483B47F8BEF8970B7EA23FCA"><enum>(3)</enum><header>Rule of construction</header><text>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 <short-title>Take Care of America’s Veterans Act</short-title>.</text></paragraph></subsection></section> <section id="H936A70E5AA034483A900E092AB9F575B"><enum>1793.</enum><header>Improvements to Department of Veterans Affairs mental health residential rehabilitation treatment program</header> <subsection id="H80D029F79BEC435FB8E96B468D4FC9B5"><enum>(a)</enum><header>Performance metrics</header> <paragraph id="H3B2B4B784362472182A2815A69507699"><enum>(1)</enum><header>In general</header><text>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—</text>
<subparagraph id="H6C3F2D2730354C4EAE6EE73839760CF2"><enum>(A)</enum><text>screening, under section 1792 of this title, for a covered treatment program; </text></subparagraph> <subparagraph id="HD83CEBAEE39F4AA9B37D4D2648C81F1C"><enum>(B)</enum><text>timely admission, under section 1792 of this title, to a covered treatment program pursuant to such screening; and</text></subparagraph>
<subparagraph id="H0EDC53B500354679A04FB5296D25BBC7"><enum>(C)</enum><text>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—</text> <clause id="H81EF54E84FBB43AAB5BDCFAB2A2923D1"><enum>(i)</enum><text>using placement criteria established by the American Society of Addiction Medicine; and</text></clause>
<clause id="HBA00DA09FF4046399F22D70015169AB0"><enum>(ii)</enum><text>maintaining standards to meet accreditation by the Commission on Accreditation of Rehabilitation Facilities or the Joint Commission.</text></clause></subparagraph></paragraph> <paragraph id="H924B3187867D487D82BB541D3DB46E01"><enum>(2)</enum><header>Elements</header><text>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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HD240486C54684B2D9615E9B5237F1DC0"><enum>(3)</enum><header>Consultation</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HC21B9D16495C4F84A2CE483777133FD1"><enum>(4)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></paragraph></subsection>
<subsection id="H2C24FB01873B41B48D7FF1751C3E9E2C"><enum>(b)</enum><header>Oversight</header>
<paragraph id="HD63A97161E964AA186F007B4C37F20B8"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="HDB952E4C03004CD499EB44BBA1B3B714"><enum>(2)</enum><header>Elements</header><text>The processes required under paragraph (1) shall include assessments of—</text>
<subparagraph id="HD412D059806F433F864C02AB8147F61D"><enum>(A)</enum><text>the extent to which providers at the facility deliver evidence-based treatments to covered veterans;</text></subparagraph> <subparagraph id="H3F9B1F3DBE8048D191F2DF83193E7AEB"><enum>(B)</enum><text>clinical outcomes for covered veterans, including those outcomes assessment pursuant to a subsequent clinical screening under subsection (g)(3)(E);</text></subparagraph>
<subparagraph id="H8ABC2F78B7A048C99680A31C5755FDB5"><enum>(C)</enum><text>the ratio of licensed independent practitioners per resident;</text></subparagraph> <subparagraph id="H94C8349F23B84FCFB74A1C18E2CF1B78"><enum>(D)</enum><text>the rate of completion of training under section 1795 of this title by licensed independent practitioners;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H83392EAD316140A8B7C4AAC8A237D9E4"><enum>(E)</enum><text display-inline="yes-display-inline">whether non-Department facilities and providers generally meet the criteria outlined in section 1792(e) of this title; </text></subparagraph> <subparagraph id="HDD5C72658BE74760A7206C891ABF8823"><enum>(F)</enum><text>the timeliness, completeness, and rate of transmission, if applicable, of medical records during and following treatment of covered veterans; and</text></subparagraph>
<subparagraph id="H3FBEF4AAD43E42489EFC1199F3E4F6C4"><enum>(G)</enum><text>potentially wasteful, fraudulent, or inappropriate referral or billing practices.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H097AACCEE33543409E896159B581F9D9"><enum>(3)</enum><header>Consultation</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HCC92FA20C03C493E8A14EAA4F5E75D22"><enum>(4)</enum><header>Report</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></paragraph></subsection> <subsection id="H888CEB099CA143779C820CE8960FB9DA"><enum>(c)</enum><header>Placement; transportation</header> <paragraph id="H26B4BCA3100342868D78C3F9568C7C2D"><enum>(1)</enum><header>Locations</header><text>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—</text>
<subparagraph id="H863CF799D04D4B5ABB0D17262B48AA43"><enum>(A)</enum><text>the standards for screening under section 1792 of this title; and</text></subparagraph> <subparagraph id="H8E7AE9BEEC8848CFB8A9B425037D7DFF"><enum>(B)</enum><text>the care needs of the covered veteran, including applicable treatment tracks.</text></subparagraph></paragraph>
<paragraph id="HAED0CAC5D476497FA8944F1D988B24EB"><enum>(2)</enum><header>Transportation coverage</header>
<subparagraph commented="no" display-inline="no-display-inline" id="H41CA7D02CA8C425D9E4235F01BB8ED7D"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text> <clause id="H7A5482184C5E45DABD867232E7116189"><enum>(i)</enum><text>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</text></clause>
<clause id="H4DA5D41468E843E691FA3D6DBB628E41"><enum>(ii)</enum><text>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.</text></clause></subparagraph> <subparagraph id="HEB1027781EA24C3089DD727351B382F6"><enum>(B)</enum><header>Limitations</header> <clause commented="no" display-inline="no-display-inline" id="HD66B883272A74E9E8500D9E9898C9AF9"><enum>(i)</enum><header>Costs incurred by veterans</header><text display-inline="yes-display-inline">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.</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H8ADCB9C7CD5D4D6D93E17A155C5402B8"><enum>(ii)</enum><header>No coverage of transportation provided by covered treatment program</header><text display-inline="yes-display-inline">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.</text></clause></subparagraph></paragraph></subsection> <subsection id="HD9FF254775A64EB8B3B2F0CC2B5381D8"><enum>(d)</enum><header>Appeals</header> <paragraph id="H3C9B1133E56F441FA811AA33B8C2A311"><enum>(1)</enum><header>In general</header><text>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—</text>
<subparagraph id="HB4B7391BC60D4B6A96EDB738CDE4875A"><enum>(A)</enum><text>denied admission into a covered treatment program; or</text></subparagraph> <subparagraph id="HF1E55A00D53D42648FD0767EF7FD4291"><enum>(B)</enum><text>accepted into a covered treatment program but is not offered bed placement in a timely manner.</text></subparagraph></paragraph>
<paragraph id="H2C55F3409018408AB4D60FE941271192"><enum>(2)</enum><header>Timeliness standards for review</header>
<subparagraph id="H3C2997A206474D55BE6D6EC7315FEFCF"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph> <subparagraph id="H1A27332B74B64DACB355A8C74F8EA030"><enum>(B)</enum><header>Decision</header><text>The Secretary shall review and respond to any appeal under paragraph (1) not later than 72 hours after the Secretary receives such appeal.</text></subparagraph></paragraph>
<paragraph id="H0228F24820F24A8A9A1167046E8560D7"><enum>(3)</enum><header>Public guidance</header><text>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—</text> <subparagraph id="H7AEB6406BA8C4094B3AB9B2E2891AA9F"><enum>(A)</enum><text>if the covered veteran is denied admission into a covered treatment program;</text></subparagraph>
<subparagraph id="H89F9DFCCCF30466BB6E620C8B4F4F39B"><enum>(B)</enum><text>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</text></subparagraph> <subparagraph id="H6BC1A6F6C4B04D91B1AA20177A29A618"><enum>(C)</enum><text>with respect to such other factors as the Secretary may specify.</text></subparagraph></paragraph>
<paragraph id="H6FAC99060D10499091321C77C16A7824"><enum>(4)</enum><header>Rule of construction</header><text>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.</text></paragraph></subsection> <subsection id="HF8F577BB32DD4FC8B4D3E23C652FAB62"><enum>(e)</enum><header>Tracking of availability and wait times</header> <paragraph id="H544B80F9301645FCA0D9D5EC997AB255"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="H3F05F2BA5719434085F5608464AB89BA" commented="no"><enum>(2)</enum><header>Availability of information</header><text>The Secretary shall make the information tracked under paragraph (1) available, in real time to—</text> <subparagraph id="H60A70EC8F9A84186BC137A92E32EC669" commented="no"><enum>(A)</enum><text>the mental health treatment coordinators at each facility of the Department;</text></subparagraph>
<subparagraph id="H93FE27F108324713A91150030CF1A03F" commented="no"><enum>(B)</enum><text>the leadership of each medical center of the Department;</text></subparagraph> <subparagraph id="HFD8B22B21FF0411AA43FD4FD5A8581B4" commented="no"><enum>(C)</enum><text>the leadership of each Veterans Integrated Service Network; and</text></subparagraph>
<subparagraph id="H3FE5D1FF5E8E4251B7234C2FD3AEBEAC" commented="no"><enum>(D)</enum><text>the Office of the Under Secretary for Health of the Department.</text></subparagraph></paragraph> <paragraph id="H41B447BBBD174775A187453B7C82E4F7" commented="no"><enum>(3)</enum><header>Publication of information</header><text>Not less frequently than monthly, the Secretary shall publish the information tracked under paragraph (1) on a publicly accessible website of the Department.</text></paragraph></subsection>
<subsection id="HE1B1FF3AB3B1442A9B6BC9DA63E56C32"><enum>(f)</enum><header>Staffing matters</header>
<paragraph id="H8DB911E50F9D4581A02613AC4B5C406A"><enum>(1)</enum><header>Training</header>
<subparagraph id="H5F3DACCC8C884B959565700A997C7FF3"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph> <subparagraph id="H5B8496AD90BF4627BDB4469EF2050392"><enum>(B)</enum><header>Covered veterans awaiting admission</header><text>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.</text></subparagraph>
<subparagraph id="H5ABAC7E430BC442F8218BCEA136151C0"><enum>(C)</enum><header>Timing of training</header>
<clause id="H79946F7D935E46829F2D755F07F61BD3"><enum>(i)</enum><header>In general</header><text>The Secretary shall require the training under subparagraph (A) to be completed by staff required to complete such training—</text> <subclause id="H89D628ACEB5C47A8A004C5D86121248B"><enum>(I)</enum><text>not later than 60 days after beginning employment at the Department in a position that includes work directly involving a covered treatment program; and</text></subclause>
<subclause id="HFD6A0DFD99284AA5A444A28708B840CF"><enum>(II)</enum><text>not less frequently than annually.</text></subclause></clause> <clause id="H4DA987837FB141869B656AA536DC9578"><enum>(ii)</enum><header>Tracking</header><text>The Secretary shall track completion of training required under clause (i) by staff required to complete such training.</text></clause></subparagraph></paragraph>
<paragraph id="HF139E1D1039F4F728373EA01C80EB468"><enum>(2)</enum><header>Oversight standards</header><text>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.</text></paragraph> <paragraph id="HC526F7C456394C06B08D73A3CDD9C263"><enum>(3)</enum><header>Staff coverage</header><text>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.</text></paragraph></subsection>
<subsection id="HB7A2BF9FC3FE4116AA3ED77704AA9BF3"><enum>(g)</enum><header>Care coordination and follow-up care</header>
<paragraph id="H443E9FFB0B5D4D9C865C16CAECC68A97"><enum>(1)</enum><header>Continuity of care</header><text>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.</text></paragraph> <paragraph id="H3249601B0FB048C38150CEE2F44CFF6C"><enum>(2)</enum><header>Care coordination for substance use disorder</header><text>For a covered veteran being treated for substance use disorder, the Secretary shall—</text>
<subparagraph id="HB6B3EF69C6C142E59997B3CD533CCD73"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="HA812E5C576514B46BF9B2188C0F84B10"><enum>(B)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="HACA0D54AC49745C7AE3542CA8E3DE886"><enum>(3)</enum><header>Care planning and clinical screening</header>
<subparagraph id="H4785EA882D004CF99E6330EE28F1318E"><enum>(A)</enum><header>In general</header><text>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—</text> <clause commented="no" display-inline="no-display-inline" id="H889A8FFA47FE48699E88BA015898F64B"><enum>(i)</enum><text display-inline="yes-display-inline">overall mental health;</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H1107B8F2F98147DE8890A31D523F0F03"><enum>(ii)</enum><text display-inline="yes-display-inline">risk for suicide;</text></clause> <clause commented="no" display-inline="no-display-inline" id="HC6D89768F73D472BB29B807149F6811F"><enum>(iii)</enum><text display-inline="yes-display-inline">risk for overdose;</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H657522DA36344804822812F514F9C9E2"><enum>(iv)</enum><text display-inline="yes-display-inline">housing insecurity;</text></clause> <clause commented="no" display-inline="no-display-inline" id="H5B40E5AAE5D04BAA9CE736FE2EEB498C"><enum>(v)</enum><text display-inline="yes-display-inline">food insecurity;</text></clause>
<clause commented="no" display-inline="no-display-inline" id="HFF62A7F273E74019B91556119B61EF39"><enum>(vi)</enum><text display-inline="yes-display-inline">employment; </text></clause> <clause commented="no" display-inline="no-display-inline" id="H72D015A25FF642488870E986D9FDAC6C"><enum>(vii)</enum><text display-inline="yes-display-inline">complex medical needs and diagnoses; and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H3F4CDA9D45954A00B649D852CBC0BDAE"><enum>(viii)</enum><text display-inline="yes-display-inline">any other factors the Secretary determines necessary.</text></clause></subparagraph> <subparagraph id="HC43D74A02E3A4B6E945CC07E272A2A1C"><enum>(B)</enum><header>Matters to be included</header><text>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.</text></subparagraph>
<subparagraph id="H44AB93351E7A4498AAB5CDA15EC84337"><enum>(C)</enum><header>Length of stay</header>
<clause commented="no" display-inline="no-display-inline" id="H5907A88D35294E93A00A324E8BA9F1A9"><enum>(i)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></clause> <clause commented="no" display-inline="no-display-inline" id="HBD619CF594504824BA5D79FC18A4BB3D"><enum>(ii)</enum><header>Approval required</header><text display-inline="yes-display-inline">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.</text></clause></subparagraph>
<subparagraph id="HC122A1877A024827846EF0FC408B6FD1"><enum>(D)</enum><header>Sharing of care plan</header><text>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.</text></subparagraph> <subparagraph id="H10D64F7165AE4DD88E9D31BDE7F7ABE4"><enum>(E)</enum><header>Discharge from non-Department facility</header><text>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).</text></subparagraph>
<subparagraph id="H29775B49667946C48387B9D3D4FE556B"><enum>(F)</enum><header>Subsequent clinical screening</header><text>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.</text></subparagraph> <subparagraph id="HE990AA0288EB4A48AA6FFCE79E071C06"><enum>(G)</enum><header>Complex medical needs</header><text>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—</text>
<clause commented="no" display-inline="no-display-inline" id="H153E58BF8C104DE5B7D4CA88CD1ADA70"><enum>(i)</enum><text display-inline="yes-display-inline">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</text></clause> <clause commented="no" display-inline="no-display-inline" id="H39615BDCDEDC4401A72D5E5F487CD34D"><enum>(ii)</enum><text display-inline="yes-display-inline">complex medical needs, including chemotherapy or other oncology care, dialysis, recurring blood transfusions, or physical or occupational therapy.</text></clause></subparagraph></paragraph></subsection>
<subsection id="H677CC902AD2843B4A9557965F674BE97"><enum>(h)</enum><header>Data collection</header><text>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.</text></subsection> <subsection id="HE937E9666D7641068CF191AC0D8ED6F0"><enum>(i)</enum><header>Reports to Congress</header> <paragraph id="H96B365208AF64BF1B0FBFEEC0CD79E90"><enum>(1)</enum><header>Report on modifications to programs</header> <subparagraph id="HD0A89794265B43F289183041B69C0F9C"><enum>(A)</enum><header>In general</header><text>Not later than two years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></subparagraph>
<subparagraph id="H1C47BBDE8C244C0D8213BEA0607C685D"><enum>(B)</enum><header>Elements</header><text>The report required by subparagraph (A) shall include—</text> <clause id="H9096D89092504E599C4AA491D1C07CD3"><enum>(i)</enum><text>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;</text></clause>
<clause id="H5DCFB40E783641AFAF4F42F3B3367F6F"><enum>(ii)</enum><text>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 <external-xref legal-doc="public-law" parsable-cite="pl/117/328">Public Law 117–328</external-xref>; 136 Stat. 5515), including—</text> <subclause id="H1F9A42C38670486C901B4FA16393D038"><enum>(I)</enum><text>such actions with respect to—</text>
<item id="HEA5AF7D1173B450C895FFE9DDDA13AAC"><enum>(aa)</enum><text>any new locations added for covered treatment programs;</text></item> <item id="HCB1B91CB239642E49D5A7AF1065142AB"><enum>(bb)</enum><text>any beds added at existing facilities of such programs; and</text></item>
<item id="HCA838C8746DE47C7BC51CFC4D05B926D"><enum>(cc)</enum><text>any additional treatment tracks or sex-specific programs created or added at facilities of the Department; and</text></item></subclause> <subclause id="HA48A0C3A66F84ABFA54A6A4EDC4157DB"><enum>(II)</enum><text>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</text></subclause></clause>
<clause id="H7F48038C2D9A478DA3A5FAC71C14C114"><enum>(iii)</enum><text>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.</text></clause></subparagraph></paragraph> <paragraph id="HAA351220487F44E5AC3C4DDFE9ACDF4E"><enum>(2)</enum><header>Annual report on operation of programs</header> <subparagraph id="H6C3C2B6CFCDD44A8B7426DEDE75AA8A0"><enum>(A)</enum><header>In general</header><text>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.</text></subparagraph>
<subparagraph id="H7E72692605724D79ADD66A3FE94A5E7F"><enum>(B)</enum><header>Elements</header><text>Subject to subparagraph (C), each report required by subparagraph (A) shall include the following:</text> <clause id="H3102173AC0EA40A2AFCF09C4DBB18E9B"><enum>(i)</enum><text>The number of covered veterans served by a covered treatment program, disaggregated by—</text>
<subclause id="HDF3E5D55DA6A407184E9CA061A9A66C0"><enum>(I)</enum><text>Veterans Integrated Service Network in which the covered veteran receives care;</text></subclause> <subclause id="H593742EF3B574A3B8C2E6EE3819EEA26"><enum>(II)</enum><text>facility, including facilities of the Department and non-Department facilities, at which the covered veteran receives care;</text></subclause>
<subclause id="HF3F3CF6E42DC4132A64DAC09C60D956F"><enum>(III)</enum><text>type of residential rehabilitation treatment care received by the covered veteran under such program;</text></subclause> <subclause id="H2F83D123909B4CE6B0E590FECC1EFF1B"><enum>(IV)</enum><text>sex of the covered veteran; and</text></subclause>
<subclause id="H5DD0EB4076C242BC8AE06EEB6B82264B"><enum>(V)</enum><text>race or ethnicity of the covered veteran.</text></subclause></clause> <clause id="H92F19A517FD34E44805CDA8C2676B81A"><enum>(ii)</enum><text>Wait times under a covered treatment program for the most recent year data is available, disaggregated by—</text>
<subclause id="H5018A64D8FCE4F43B3A9E77C1E13B8EE"><enum>(I)</enum><text>treatment track or specificity of residential rehabilitation treatment care sought by the covered veteran;</text></subclause> <subclause id="HAEEB7DC12A234B9192BC56E948C61744"><enum>(II)</enum><text>sex of the covered veteran;</text></subclause>
<subclause id="H801DC48BEF4B4A079C467AEDBCFE4B5B"><enum>(III)</enum><text>State or territory in which the covered veteran is located;</text></subclause> <subclause id="H5F3C4BAE37F3467F8723405594E91219"><enum>(IV)</enum><text>Veterans Integrated Service Network in which the covered veteran is located; and</text></subclause>
<subclause id="H63283543DD2842FCA63C920AF633FAE1"><enum>(V)</enum><text>facility of the Department at which the covered veteran seeks care.</text></subclause></clause> <clause id="HBF6232F56BB34731B546E69FF5C54C75"><enum>(iii)</enum><text>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.</text></clause>
<clause id="HDF752896860F4FCBA6EF9FA421F40572"><enum>(iv)</enum><text>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.</text></clause> <clause id="HCB9AE08CD67C4FDAA5FEEE8E79C43B50"><enum>(v)</enum><text>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.</text></clause>
<clause id="HF6FBE1DD95EA4E9FA1BA43C924ACF21C"><enum>(vi)</enum><text>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—</text> <subclause commented="no" display-inline="no-display-inline" id="H4DF1E2CAFA6D4699B4635FCF8BBE90CB"><enum>(I)</enum><text display-inline="yes-display-inline">a list of facilities that had unstaffed beds or closed beds due to lack of staffing at any point in the previous year;</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="HA18615F94DE84D76A7E71D43D009F257"><enum>(II)</enum><text display-inline="yes-display-inline">the number of additional staff needed to staff those beds;</text></subclause> <subclause commented="no" display-inline="no-display-inline" id="H04FFFA7123364DA9AB59470898D6BD46"><enum>(III)</enum><text display-inline="yes-display-inline">the number of beds at each facility;</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="H8798EE66E4C041DA82D769A5A0261CC4"><enum>(IV)</enum><text display-inline="yes-display-inline">the average wait-times for the covered treatment program, disaggregated by month, during the periods of bed closures; and</text></subclause> <subclause commented="no" display-inline="no-display-inline" id="H6949721375D548FDA166B76E1D63A7BF"><enum>(V)</enum><text display-inline="yes-display-inline">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.</text></subclause></clause>
<clause id="H4249DDB965E64B05B7690BF91B075A1F"><enum>(vii)</enum><text>An overview of data collected pursuant to a subsequent clinical screening under subsection (g)(3)(F).</text></clause> <clause id="HB868A6A435A5457D9EDE62D0716D95DC"><enum>(viii)</enum><text>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.</text></clause>
<clause id="H8FAF9B02776644E5A68B0A299BF75E6A"><enum>(ix)</enum><text>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.</text></clause> <clause id="H5FF7393FFEBF4025A0B88D5790EC4011"><enum>(x)</enum><text>Any recommendations for changes to the operation of covered treatment programs, including any policy changes, guidance changes, training changes, or other changes.</text></clause></subparagraph>
<subparagraph id="HA5C609203D484E23845ECEEB5AAE12B3"><enum>(C)</enum><header>Anonymity</header><text>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—</text> <clause id="H9135F88EBF444E05A1AB28C9F02B0240"><enum>(i)</enum><text>section 552a of title 5 (commonly known as the <quote>Privacy Act of 1974</quote>);</text></clause>
<clause id="HA931A5B407BD48ED8ECDD8B5F1520D8F"><enum>(ii)</enum><text>the Health Insurance Portability and Accountability Act of 1996 (<external-xref legal-doc="public-law" parsable-cite="pl/104/191">Public Law 104–191</external-xref>);</text></clause> <clause id="H570FA58750B04989AE406BA448299D64"><enum>(iii)</enum><text>parts 160 and 164 of title 45, Code of Federal Regulations, or successor regulations; and</text></clause>
<clause id="HB5F0359F0FA246C992DD580943E08654"><enum>(iv)</enum><text>sections 5701, 5705, and 7332 of this title.</text></clause></subparagraph></paragraph> <paragraph id="H1F5093C4E077466B82F52A911388CEF0"><enum>(3)</enum><header>Notification to Congress of beds not available due to lack of staffing</header><text>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—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HD4F7CE578DE94BB38B0EABCB471F3C78"><enum>(A)</enum><text display-inline="yes-display-inline">information on the staff needed to reopen beds that are closed;</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H82BFC76756314ACF8E26CBFF8BD14353"><enum>(B)</enum><text display-inline="yes-display-inline">plans to recruit and retain staff;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H112CD36C5BC9483DBECB7F96512609AF"><enum>(C)</enum><text display-inline="yes-display-inline">the total number of beds closed or expected to be closed;</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H49D29B8513CC4E95BEF1913EB2D745E8"><enum>(D)</enum><text display-inline="yes-display-inline">the estimated length of time until those closed beds are made available; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HD417675F75024FA8AC7A6E72FF9A5E8D"><enum>(E)</enum><text display-inline="yes-display-inline">the current wait time for access to those beds.</text></subparagraph></paragraph></subsection> <subsection id="HDE5ACD4531E7414CA4446AE89D74C118"><enum>(j)</enum><header>Third-party assessment</header> <paragraph commented="no" display-inline="no-display-inline" id="HC01AA3F57D55492CBA0C01297629A323"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than two years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></paragraph>
<paragraph id="H4E95DD66DE644BF7962F9E825B0DA1F7"><enum>(2)</enum><header>Elements</header><text>The study required under paragraph (1) shall include a review of—</text> <subparagraph id="H5966CC8F68074BC2BEE3D860A5A747DD"><enum>(A)</enum><text>whether facilities are meeting requirements of the Department pursuant to law, regulation, or policy;</text></subparagraph>
<subparagraph id="H00221A409F1B4E3B9C8B06C2CD0D4869"><enum>(B)</enum><text>staffing models used by facilities and level of adherence to those models;</text></subparagraph> <subparagraph id="H400D0CD7A91241F98C38CDB64D86C378"><enum>(C)</enum><text>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;</text></subparagraph>
<subparagraph id="H5618D6F7AD7C475A8D3AF929BEC05A49"><enum>(D)</enum><text>adherence of non-Department facilities to timelines for claim submission and record returns to the Department; and</text></subparagraph> <subparagraph id="HF387ED6CA94E4245A9F6BADE375BEAC8"><enum>(E)</enum><text>any other factors the Secretary or the appropriate entity determines relevant or appropriate to include.</text></subparagraph></paragraph>
<paragraph id="H5AB5D13EA4C24616AC3E2543E1A498FC"><enum>(3)</enum><header>Completion of study</header><text>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 <short-title>Take Care of America’s Veterans Act</short-title>, complete the study required under such paragraph and submit to the Secretary a report on the study.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HEC5064B98BE2494E85D4A3075AF487E6"><enum>(4)</enum><header>Action plan and commentary</header><text display-inline="yes-display-inline">Not later than five years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HA78B807072BD4AB99650D5F5FEC95C03"><enum>(A)</enum><text display-inline="yes-display-inline">the results of the study required under paragraph (1);</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H3BE7E95374764F7FB17D525373CC1833"><enum>(B)</enum><text display-inline="yes-display-inline">action plans for improvement based on the results of the study; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H380CCA8CD4484661B6B8AB89B6E47D9F"><enum>(C)</enum><text display-inline="yes-display-inline">general commentary and feedback on the results of the study.</text></subparagraph></paragraph> <paragraph id="H3DEAE5FCBFC04B0E836EE96431CF8EE8"><enum>(5)</enum><header>Appropriate entity defined</header><text>In this subsection, the term <term>appropriate entity</term> means—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H8EC1B2C67F5B42E892D40E76D2B84C0D"><enum>(A)</enum><text display-inline="yes-display-inline">a nongovernmental entity with experience in assessing programs that deliver services provided under covered treatment programs on a large scale; or</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HDE492C70967D460A800DFF3987C964BE"><enum>(B)</enum><text display-inline="yes-display-inline">a federally funded research and development center.</text></subparagraph></paragraph></subsection>
<subsection id="H5C66C8F0CCFC4FD8A5308D7DCEE0EDA1"><enum>(k)</enum><header>Revision of guidance</header><text>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.</text></subsection> <subsection id="HDE6B3334F1894F7BA7EA179D0348D660"><enum>(l)</enum><header>Deadline</header><text>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 <short-title>Take Care of America’s Veterans Act</short-title>.</text></subsection>
<subsection id="H36A81E6080294352BFB83BEB23CE78DD"><enum>(m)</enum><header>Comptroller General review</header>
<paragraph id="H201E0D6BCE554E1BB4A767F03A57DA5B"><enum>(1)</enum><header>In general</header><text>Not later than two years after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></paragraph> <paragraph id="H7372F6DE6EF54D13B72EDBFB7F5D9E95"><enum>(2)</enum><header>Elements</header><text>The review required by paragraph (1) shall include the following:</text>
<subparagraph id="HD0FB36CFE03E426DA9C59576936E0CBA"><enum>(A)</enum><text>A review of wait times for covered veterans under a covered treatment program, disaggregated by—</text> <clause id="HD388062914414014A1E5911AFEAB825A"><enum>(i)</enum><text>treatment track or specificity of residential rehabilitation treatment care needed;</text></clause>
<clause id="HB5570309F9DE4B95A7D21580E7F99B77"><enum>(ii)</enum><text>sex of the covered veteran;</text></clause> <clause id="H4C9B2525C5EB479D9A18903B4D4F2C4C"><enum>(iii)</enum><text>home State of the covered veteran;</text></clause>
<clause id="HE40FB9436C0E4B5CA8A071C3F5D30A15"><enum>(iv)</enum><text>home Veterans Integrated Service Network of the covered veteran; and</text></clause> <clause id="HBA14AABB7AD240A78596C1C9F54EB2C2"><enum>(v)</enum><text>wait times for—</text>
<subclause id="H6E5A23E0A6EF477EB0070427DBB855BB"><enum>(I)</enum><text>facilities of the Department; and</text></subclause> <subclause id="H03EB94B2E91A4130B340DA28A7C452C3"><enum>(II)</enum><text>non-Department facilities.</text></subclause></clause></subparagraph>
<subparagraph id="H229DBBF8FC254E0DB0D04D6A2C0387B5"><enum>(B)</enum><text>A review of policy and training of the Department on screening, admission, and placement under a covered treatment program.</text></subparagraph> <subparagraph id="H2A3547D51C214E4689CC10231BC2AB50"><enum>(C)</enum><text>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.</text></subparagraph>
<subparagraph id="HCD4E0503D17946369C9C04D33785F73D"><enum>(D)</enum><text>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—</text> <clause id="H2D80C1722A1F45CC81B35256E05032B7"><enum>(i)</enum><text>program specialty, subtype, or treatment track offered to the covered veteran; and</text></clause>
<clause id="H6652C72B848A49FD91D0E95E09D6A002"><enum>(ii)</enum><text>the geographic placement of the covered veteran, including family- or occupation-related preferences or circumstances.</text></clause></subparagraph> <subparagraph id="H8BB1624892744353B4AB29406C99CCD9"><enum>(E)</enum><text>A review of staffing and staffing needs and gaps of covered treatment programs, including with respect to—</text>
<clause id="HA0B74D26E7D24797B9C13F752A588CAF"><enum>(i)</enum><text>mental health providers and coordinators at the facility level;</text></clause> <clause id="H8F311B6F6A3A47A3B0B7FFD46EB6E622"><enum>(ii)</enum><text>staff of facilities of such programs;</text></clause>
<clause id="H080122AD78994F5184C035D7FF27AF28"><enum>(iii)</enum><text>staff of Veterans Integrated Service Networks; and</text></clause> <clause id="HEDF1F251B0074D938B0DDCFA7C086492"><enum>(iv)</enum><text>overall administration of such programs at the national level.</text></clause></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H7D05AB0DD20A4CF49660ABAD4EE07D1C"><enum>(F)</enum><text>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).</text></subparagraph> <subparagraph id="H18BE0FB4F92C4E56AD802C904AD3C747"><enum>(G)</enum><text>Recommendations for improvement of access by covered veterans to care under a covered treatment program, including with respect to—</text>
<clause id="HA247629119AA4477865B2551E8F60551"><enum>(i)</enum><text>any new sites or types of programs needed or in development;</text></clause> <clause id="H504700E5E0DA41CC9DB210379E68F746"><enum>(ii)</enum><text>changes in training or policy;</text></clause>
<clause id="HDCBB10CEEB8C49FCAA512D470F6632B4"><enum>(iii)</enum><text>changes in communications with covered veterans; and</text></clause> <clause id="H6A000A5727DB42AF932CE60BF3930986"><enum>(iv)</enum><text>oversight of covered treatment programs by the Department.</text></clause></subparagraph></paragraph></subsection></section>
<section id="H869112C803E5403395C358FFB443E847"><enum>1794.</enum><header>Fee schedule</header>
<subsection id="HFE4BB081FCD342F1AA40C1BE8C5AE35D"><enum>(a)</enum><header>In general</header><text>Not later than 180 days after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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. </text></subsection> <subsection commented="no" display-inline="no-display-inline" id="HB9F65425F9184D279F2E86F03CAD6615"><enum>(b)</enum><header>Elements</header><text display-inline="yes-display-inline">The fee schedule required under subsection (a) for a covered treatment program shall—</text>
<paragraph id="H0C2530B1742A4F90A80CB1D1305DF3CA"><enum>(1)</enum><text>reflect reasonable charges for the services provided;</text></paragraph> <paragraph id="HAF7CFFBA03BA4377B573EFCDE93504F6"><enum>(2)</enum><text>be based on the amounts customarily paid for similar services under the Medicaid program under title XIX of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>) and by commercial health insurance providers;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HA29EC7EFD864418BBA206FB639492754"><enum>(3)</enum><text display-inline="yes-display-inline">to the greatest extent practicable, be consistent with payment rates under section 1703(i) of this title; </text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H2BFB805D5C6A46CE8515E639D3A7F790"><enum>(4)</enum><text display-inline="yes-display-inline">be comprehensive to include a variety of possible types of care, services, and charges; and</text></paragraph>
<paragraph id="HB6AC660B042849C6ABE22F1DED11B813"><enum>(5)</enum><text>be sufficient to ensure a robust network of qualified community providers able to provide services under a covered treatment program to covered veterans.</text></paragraph></subsection> <subsection id="HB4E45AB11D45405CAFD46B22BFD38EA9"><enum>(c)</enum><header>Coordination of payment rates</header><text>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.</text></subsection>
<subsection id="H5D03E5E7564A4D5386B7654093AFBEC8"><enum>(d)</enum><header>Recoupment of amounts</header>
<paragraph commented="no" display-inline="no-display-inline" id="H98BDCB873A984CFBA682F3F599666912"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H84B495847D304E47A16908625D52C518"><enum>(2)</enum><header>Limitation</header><text display-inline="yes-display-inline">A non-Department entity shall not bill a veteran for any charges recouped under paragraph (1).</text></paragraph></subsection></section>
<section id="HEAA5EDEA2D0D4BE98E443E7D07E47A3B"><enum>1795.</enum><header>Training</header>
<subsection commented="no" display-inline="no-display-inline" id="H2D61AB1139144461A2939591E546D00D"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, the Secretary shall—</text> <paragraph commented="no" display-inline="no-display-inline" id="H7F64516D551F451D8DFB9F12C23110A9"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H3F8FE51EDD0640EDAB9AFA67279A1C44"><enum>(2)</enum><text>submit that plan to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives.</text></paragraph></subsection> <subsection commented="no" display-inline="no-display-inline" id="HDB0B628DCD9A4D87B3647D632B641950"><enum>(b)</enum><header>Elements of training</header><text display-inline="yes-display-inline">Training required under subsection (a) shall—</text>
<paragraph commented="no" display-inline="no-display-inline" id="HBABCD2255C554DAF8691C6CC40F68CD5"><enum>(1)</enum><text display-inline="yes-display-inline">be easily accessible, no-cost, and offered in such a manner as to qualify for or fulfill continuing education requirements for health care professionals;</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H31B4C59C9D6A46A7A88AB93AB727B2DD"><enum>(2)</enum><text display-inline="yes-display-inline">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</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H7904BD9EF1E141F682A553B45C12727C"><enum>(3)</enum><text display-inline="yes-display-inline">be offered through Department and non-Department entities or organizations.</text></paragraph></subsection> <subsection commented="no" display-inline="no-display-inline" id="H631BB7FBD76E406C8E936ADFF652A68A"><enum>(c)</enum><header>Elements of plan</header><text display-inline="yes-display-inline">The plan required under subsection (a) shall—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H7C53603A9FEF4DA68344B99F4DECDCB8"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HEA32BC26FC0C4DB4A5ED57F25A97D898"><enum>(2)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H659EAE74DA554518B4627FAC7F99CBA5"><enum>(d)</enum><header>Consultation</header><text display-inline="yes-display-inline">The Secretary shall consult with relevant professional organizations with respect to the content of relevant training required under subsection (a).</text></subsection></section></subchapter><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HBB219C1E2F064158B001F07B6BF23929" commented="no"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by adding at the end the following new items:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H333752F7618C42AFB9FEEC16822EC03C">
<toc>
<toc-entry level="subchapter" idref="HA0EC1CB43D8A4B1EA5F7D75CB57161AF">SUBCHAPTER IX—Participation by Veterans in Certain Mental Health Treatment Programs </toc-entry>
<toc-entry level="section" idref="H5C4BE9F252734059A93AD83715AB2DB4">1791. Definitions. </toc-entry>
<toc-entry level="section" idref="HD987785BAC6B48EEA12DBEC495E232C3">1792. Standardized process to determine eligibility of covered veterans for participation in certain mental health treatment programs. </toc-entry>
<toc-entry level="section" idref="H936A70E5AA034483A900E092AB9F575B">1793. Improvements to Department of Veterans Affairs mental health residential rehabilitation treatment program. </toc-entry>
<toc-entry level="section" idref="H869112C803E5403395C358FFB443E847">1794. Fee schedule. </toc-entry>
<toc-entry level="section" idref="HEAA5EDEA2D0D4BE98E443E7D07E47A3B">1795. Training.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="H2BB9087128834C27943AE0626EE81275"><enum>622.</enum><header>Access to mental health residential rehabilitation treatment programs for veterans with spinal cord injury or disorder</header>
<subsection id="H1512C29C611B409DA111FFA928FC4ABE"><enum>(a)</enum><header>Plan</header>
<paragraph id="H46DB49170503472AA7DE6F652B269C66"><enum>(1)</enum><header>In general</header><text>Not later than 90 days after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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.</text></paragraph> <paragraph id="H372B1493DBA2470F8235F69F8A96E374"><enum>(2)</enum><header>Elements</header><text>The plan required under paragraph (1) shall include—</text>
<subparagraph id="HD851C5ADA0464570AFC388B487431BE4"><enum>(A)</enum><text>a staffing plan, which shall include a plan for how the Department will—</text> <clause id="HD7F5E2A878D547E283F7AA1DAB9EC475"><enum>(i)</enum><text>incorporate staff from other facilities to support the pilot program required under subsection (b); and</text></clause>
<clause id="HB52BDFC5264D43998974AF68FD9B0DB2"><enum>(ii)</enum><text>ensure adequate staffing to support the needs of veterans with a spinal cord injury or disorder;</text></clause></subparagraph> <subparagraph id="H320366DD799544F7AC96C8D4A0266534"><enum>(B)</enum><text>an assessment of medical equipment needs; and</text></subparagraph>
<subparagraph id="H19EDE0C04DBD4E50B60EA3DC15AFF00F"><enum>(C)</enum><text>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.</text></subparagraph></paragraph></subsection> <subsection id="HFD06A4AA316245CBBEE601EDD060EC60"><enum>(b)</enum><header>Pilot program</header> <paragraph commented="no" display-inline="no-display-inline" id="HEC58B036D7BD4FF69F9A104ABFEDD66E"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H47B51916EFDD4968998FD382D1B3D9FA"><enum>(2)</enum><header>Selection of locations</header><text display-inline="yes-display-inline">In selecting sites for the pilot program under paragraph (1), the Secretary shall prioritize sites in the following areas:</text> <subparagraph id="H0A891590C6F44DB891EB6A3ABDF8BD11"><enum>(A)</enum><text>Areas with geographic diversity, including areas that serve veterans residing in rural or highly rural areas.</text></subparagraph>
<subparagraph id="HBBA5556954DD4921A22BDC5267BCB170"><enum>(B)</enum><text>Areas with a significant number of veterans with spinal cord injury or disorder.</text></subparagraph></paragraph></subsection> <subsection id="HFC36167736E641D9A061D3105C940F47"><enum>(c)</enum><header>Report</header><text>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—</text>
<paragraph id="H3469766257064C2A830B10BB4D3C2AC7"><enum>(1)</enum><text>the implementation of the plan required under subsection (a);</text></paragraph> <paragraph id="H3C6C0237BAA4415FBA55453D83E2B034"><enum>(2)</enum><text>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;</text></paragraph>
<paragraph id="HA2C910882DCA48E39530C7A3A304639C"><enum>(3)</enum><text>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</text></paragraph> <paragraph id="H1469C4E92D3D41DFB0048160DC06EB7E"><enum>(4)</enum><text>Such other matters as the Secretary considers appropriate.</text></paragraph></subsection></section></subtitle>
<subtitle style="OLC" id="H4911DB8A3551481C84F830612C7BAA30"><enum>C</enum><header>Staffing Matters</header>
<section id="H504D9647F06E479DB6B6A88CAA3DC302"><enum>631.</enum><header>Treatment of psychologists</header>
<subsection id="H8A5B7E57E0CF449F9785344471F05EB0"><enum>(a)</enum><header>Treatment as title <enum-in-header>38</enum-in-header> employees</header><text>Section 7401 of title 38, United States Code, is amended—</text> <paragraph id="HD56B69258454419285F9430133F513B4"><enum>(1)</enum><text>in paragraph (1), by inserting <quote>psychologists,</quote> after <quote>chiropractors,</quote>; and</text></paragraph>
<paragraph id="HD8563249377F4A2D874159DA854F098A"><enum>(2)</enum><text>in paragraph (3), by striking <quote>psychologists,</quote>.</text></paragraph></subsection> <subsection id="HF926F59894164D3085ABB1CB942CED5E" commented="no" display-inline="no-display-inline"><enum>(b)</enum><header>Inclusion in contracts for scarce medical specialist services</header><text>Section 7409(a) of title 38, United States Code, is amended by inserting <quote>psychologists,</quote> after <quote>chiropractors,</quote>.</text></subsection></section>
<section id="H4E77AFC424DC47498C71553F9833C3EE"><enum>632.</enum><header>Mentorship program for executive leadership teams at medical centers of the Department of Veterans Affairs</header>
<subsection id="HA6D891218BC942059759CD3E874640B9"><enum>(a)</enum><header>In general</header><text>The Secretary of Veterans Affairs may establish a program to connect covered individuals (in this section referred to as <quote>mentees</quote>) 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 <quote>mentorship program</quote>).</text></subsection> <subsection id="HDC1F17C8E1304245906F7EFD846F9605"><enum>(b)</enum><header>Covered individual defined</header><text>In this section, the term <term>covered individual</term> means—</text>
<paragraph id="H37E2794E942244EA9AFA3553F1F837C6"><enum>(1)</enum><text>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</text></paragraph> <paragraph id="H46344DC9CA074D0D8FC89C1B5EA97BC7"><enum>(2)</enum><text>any other employee of the Department who is determined by the Secretary to be an executive leader at a medical center of the Department.</text></paragraph></subsection>
<subsection id="HED70B864DA3049D191BD25F01559E229"><enum>(c)</enum><header>Eligibility</header><text>The following employees of the Department are eligible for participation as mentees in the mentorship program:</text> <paragraph id="HDDA765E3A0C04140858F6DD5EF88D963"><enum>(1)</enum><text>An employee appointed to a position as a covered individual who has been in that position for less than one year.</text></paragraph>
<paragraph id="HB811E89B92AA48A19F9BC767A64D0076"><enum>(2)</enum><text>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:</text> <subparagraph id="H74CCE59E7AAD49758E994B02012CD1A2"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="H752E51552D714A6186DDFA76F2856B72"><enum>(B)</enum><text>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—</text> <clause id="HBE8ABF8D5F014AA5B6A51778E612CF2A"><enum>(i)</enum><text>does not consistently meet the level reported in the community surrounding such medical center, as determined by the Secretary; or</text></clause>
<clause id="H5D24D20AAB1642AEA9130CCD03E0E1ED"><enum>(ii)</enum><text>does not meet a threshold level determined by the Secretary.</text></clause></subparagraph> <subparagraph id="H4DE4614E04EC4360A4B8860FB39D6663"><enum>(C)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="HD071967CECCE4595B35292AEA1823B73"><enum>(3)</enum><text>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.</text></paragraph></subsection> <subsection id="H588F1C2529B54B24BDC76B6987F222A0"><enum>(d)</enum><header>Criteria for peer mentors</header><text>Each peer mentor to be paired with a mentee under subsection (a) shall meet each of the following criteria:</text>
<paragraph id="H4F9D7E5A1F16452E84E358DDFEFFB1F7"><enum>(1)</enum><text>Previous or current employment in the same position title as the mentee.</text></paragraph> <paragraph id="H9A361A4AAB674C3A80AEEFFB8933D122"><enum>(2)</enum><text>Employment in that position for not less than two years.</text></paragraph>
<paragraph id="H982814901BAE4D4D8B3D2AEDD4467EDF"><enum>(3)</enum><text>Employment at a medical center of the Department that reports—</text> <subparagraph id="HC0DE619348C8465097B73112200875A8"><enum>(A)</enum><text>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</text></subparagraph>
<subparagraph id="H627AF5C91D3C498C93832D3A3789F4D5"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection> <subsection id="H7AAD1D6175D44A42A5E0FEC8F5B8824A"><enum>(e)</enum><header>Report</header><text>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—</text>
<paragraph id="HB26CFAE0F1EA4510B24AE105BB5C6DE5"><enum>(1)</enum><text>the number of mentees and peer mentors participating in the mentorship program, disaggregated by medical center of the Department;</text></paragraph> <paragraph id="H888FA6ED842B4D85A016348C16188861"><enum>(2)</enum><text>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;</text></paragraph>
<paragraph id="HD2C1C91A90674141863448A5142A7939"><enum>(3)</enum><text>a description of the actions taken by the Department to encourage communication between mentees and peer mentors;</text></paragraph> <paragraph id="H50319DB2E5174457BDC555F2EEF9AA79"><enum>(4)</enum><text>aggregated feedback from participants in the mentorship program; and</text></paragraph>
<paragraph id="H25B381FD70F4442D88AF42FE1EBF4F61"><enum>(5)</enum><text>the turnover rate for mentee participants in the mentorship program.</text></paragraph></subsection> <subsection commented="no" display-inline="no-display-inline" id="H89792856879D45C8AF201CB4DCAE5BAF"><enum>(f)</enum><header>Termination</header><text>The authority under this section shall terminate on September 30, 2030.</text></subsection></section>
<section id="H3216BF78623348B4B7C63E5C5C41A16F"><enum>633.</enum><header>Requirement for equivalent role postings for vacant positions at Department of Veterans Affairs</header>
<subsection commented="no" display-inline="no-display-inline" id="H20C5038A4FB94D78B40F552A7E8014CD"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="H6C0C446B484E4F5398A2F89DCE8A215D"><enum>(b)</enum><header>Application to certain positions</header><text display-inline="yes-display-inline">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.</text></subsection></section>
<section id="H16DF0AB953A2473D9D5C9B732F578DEB"><enum>634.</enum><header>Improvements to Department of Veterans Affairs hiring processes</header>
<subsection id="H1BE2BB7D39FE474C95E36ACD0F668619"><enum>(a)</enum><header>In general</header><text>Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/7">chapter 7</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/701">section 701</external-xref> the following new section:</text> <quoted-block style="USC" display-inline="no-display-inline" id="H6F05DDDDBC4A4393AE8EE53DF35A90CF"> <section id="H1623DFE4211E4277B6F5880046B6D957"><enum>702.</enum><header>Hiring processes</header> <subsection id="H74795F4B8C284C4FA5FDC250A3381197"><enum>(a)</enum><header>Standardized approval process for filling vacant positions</header> <paragraph id="H8ED539DE6FEA4811B572A98B20D9CC92"><enum>(1)</enum><header>Process required</header> <subparagraph id="H04FA41CE52B241F9B201008AC8BB97BB"><enum>(A)</enum><header>In general</header><text>The Secretary shall establish a standardized, nationwide approval process for filling vacant employment positions within the Department.</text></subparagraph>
<subparagraph id="H37D9C570367D4B74B27BC89B5F847D62"><enum>(B)</enum><header>Variability</header><text>The process required by subparagraph (A) may be different for each type of employment position in the Department.</text></subparagraph> <subparagraph id="HD7C575820F56414F85FAB983E61E33A5"><enum>(C)</enum><header>Approval windows</header><text>The process required by subparagraph (A) shall include a standardized approval window for each approval step.</text></subparagraph></paragraph>
<paragraph id="H31572D5DA53D44FE83D1D7B49F9CDC51"><enum>(2)</enum><header>Delegation</header><text>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.</text></paragraph> <paragraph id="HAF196592131F47EC863BBE2E9CA7FD7E"><enum>(3)</enum><header>Time to fill goal</header><text>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.</text></paragraph></subsection>
<subsection id="HB783608C0F844FD9A335614B670899BB"><enum>(b)</enum><header>Process for tentative offers of employment</header><text>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.</text></subsection> <subsection id="H1C1EABE312EC4F8390B7D3CB2F18A94B"><enum>(c)</enum><header>Third-party contracts</header><text>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.</text></subsection>
<subsection id="H66DF5AD1183F45B1B24DEAAF909285F9"><enum>(d)</enum><header>Electronic signatures</header>
<paragraph id="H9E38363806614A859B1110C9A889CD1A"><enum>(1)</enum><header>Authority</header><text>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).</text></paragraph> <paragraph id="H98134C88F9B04FC181E62AEFFD81814E"><enum>(2)</enum><header>Standardized process</header><text>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.</text></paragraph></subsection>
<subsection id="H122EF258DD014F50920080E49981648E"><enum>(e)</enum><header>Employee community building program</header><text>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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H4A211FC6E45F435BAB88D6DE933713AA"><enum>(b)</enum><header>Clerical amendment</header><text>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:</text>
<quoted-block style="USC" id="HEA8E57F01CAC43C7AD9EF14EA3035B92">
<toc>
<toc-entry level="section" idref="H1623DFE4211E4277B6F5880046B6D957">702. Hiring processes.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="H5C20725AD5A64B0CB39351EF7D3DA54E"><enum>635.</enum><header>Department of Veterans Affairs telework policy</header>
<subsection id="H05E6706146B9441CA6BF8C2073B2FCD0"><enum>(a)</enum><header>Policy required</header><text>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.</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="H476AA16AD7794600B32B22178F46569A"><enum>(b)</enum><header>Locations</header><text display-inline="yes-display-inline">The policy established under subsection (a) may be different for different locations, specialties, and categories of employees, as determined appropriate by the Secretary.</text></subsection>
<subsection id="H7EE41CF167FA4FB599C48359B47639A1"><enum>(c)</enum><header>Assessment</header><text>In developing the policy required by subsection (a), the Secretary shall assess the following for each category of employees at the Department—</text> <paragraph id="HE81CFEF9A704487CAF19ACE303FEE62C"><enum>(1)</enum><text>staffing levels and trends over the last 5 years;</text></paragraph>
<paragraph id="HC017508163A942A5BC2E6B6DCEB76BF7"><enum>(2)</enum><text>exit survey data related to telework;</text></paragraph> <paragraph id="HFF10281B88AA4C8F83032A0D8FCB35BB"><enum>(3)</enum><text>the availability of dedicated work space at facilities of the Department to enable onsite work at a duty station;</text></paragraph>
<paragraph id="H35F2D231ACD44D88B10B53128A19E7E1"><enum>(4)</enum><text>a comparison of productivity levels when duties are performed on site or through telework;</text></paragraph> <paragraph id="HA17A1C2EED7D4FC3B9C0B288A439A1FE"><enum>(5)</enum><text>telework flexibilities for comparable categories of employees in the private sector and in other Federal agencies; and</text></paragraph>
<paragraph id="HA09AA054857F4903B346F62460BD55F0"><enum>(6)</enum><text>particular duties that necessitate on site work.</text></paragraph></subsection> <subsection id="H8006B0BBDB4646B281335DDF4D37FEBF"><enum>(d)</enum><header>Notice and reporting</header> <paragraph id="HCBDBD7650C94497EA21EB2E62A144EC3"><enum>(1)</enum><header>In general</header><text>For any change made to the policy established pursuant to subsection (a), the Secretary shall—</text>
<subparagraph id="HF720C6AF5039462092CB68278861C717"><enum>(A)</enum><text>notify all affected employees of the Department of the changes; and</text></subparagraph> <subparagraph id="H1E0CBB5583544FBBA3E02399ABC1AFDF"><enum>(B)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="HA3DAB0D0075A4B789FE1B47C8B7BC259"><enum>(2)</enum><header>Report contents</header><text>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.</text></paragraph> <paragraph id="H7FB7245276AB4615A6FAB2DA11068EDD"><enum>(3)</enum><header>Deadline</header><text>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.</text></paragraph></subsection>
<subsection id="HF7D8CC4650594306A42B408F9DF8D470"><enum>(e)</enum><header>Report on budgetary impact</header><text>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.</text></subsection> <subsection id="HB21DAD3C84C74DC495CDEB33839768C8"><enum>(f)</enum><header>Effective date and changes</header> <paragraph id="H30A86314E302477CA4C364511EBA7D46"><enum>(1)</enum><header>Effective date of initial policy</header><text>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.</text></paragraph>
<paragraph id="HBF8673F8790E4D5EAC77ACA2D2DFF9E7"><enum>(2)</enum><header>Effective date of subsequent changes</header><text>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.</text></paragraph> <paragraph id="H7A1DAF3D4DBD4547A350E8AABF3E7F69"><enum>(3)</enum><header>Notice</header><text>For any change made to the policy established pursuant to subsection (a) after the effective date set forth in paragraph (1), the Secretary shall—</text>
<subparagraph id="HF604EEB3A52B41E7B2519529256F975A"><enum>(A)</enum><text>notify all affected employees of the Department of the changes; and</text></subparagraph> <subparagraph id="H1F38474B8E1B4358A75195B7DE848719"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection></section>
<section id="H58D111028836467987764DF7921AB1F7"><enum>636.</enum><header>Expansion of reimbursement of continuing professional education expenses</header>
<subsection id="H68CAF5AB94BE4515A5A7615DBE58D612"><enum>(a)</enum><header>In general</header><text>Section 7411 of title 38, United States Code, is amended to read as follows:</text> <quoted-block style="USC" display-inline="no-display-inline" id="H9BB5BA46E2474F6DA8A7B1FDB882C485"> <section id="HA61507D2CA174346A42062EB4D30D7A4"><enum>7411.</enum><header>Reimbursement of continuing professional education expenses</header> <subsection id="H73D8715A629B457D8BE2C979979759EC"><enum>(a)</enum><header>Required reimbursement</header><text>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.</text></subsection>
<subsection id="HE39DDB5D5A7F46B4B29A38C59E38FFD1"><enum>(b)</enum><header>Authorized reimbursement</header><text>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. </text></subsection> <subsection commented="no" display-inline="no-display-inline" id="H72F59E3B67AC43C4BAEB10C77F6A7B16"><enum>(c)</enum><header>Maximum number of individuals reimbursed</header><text>The total number of individuals who may be reimbursed under this section may not exceed 50,000 per year.</text></subsection>
<subsection id="HA7A50B49A4E44AF4BA2B8B322CC6FFD8"><enum>(d)</enum><header>Priority reimbursements</header><text>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.</text></subsection> <subsection id="H706B9D488C86426F8EFF978488242D91"><enum>(e)</enum><header>Report required</header> <paragraph id="H6BACFBDC2EEB465B88715379DCBA7D79"><enum>(1)</enum><header>In general</header><text>Not less frequently than annually after the end of the first fiscal year following the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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—</text>
<subparagraph id="HE8D7738E691841D28657326EBFDAB4BD"><enum>(A)</enum><text>locations at which reimbursement is claimed;</text></subparagraph> <subparagraph id="H1EEB6658193F43BBA41985DAF4ECF276"><enum>(B)</enum><text>position title and specialty of the individual claiming reimbursement;</text></subparagraph>
<subparagraph id="H9320BF96CAF8486E8A6C876C0B72AA73"><enum>(C)</enum><text>average amount claimed per position and specialty; and</text></subparagraph> <subparagraph id="H40BFF8DD974541F8BC405EB18AB1CB79"><enum>(D)</enum><text>percent utilization by each position and specialty overall.</text></subparagraph></paragraph>
<paragraph id="H7082A12F09DF4C6381E177D60F755C3D"><enum>(2)</enum><header>Authority to include in existing report</header><text>The information required under paragraph (1) may be submitted independently or included in another annual report to Congress.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="HEF52852644D74C4EAAAB5F6A69070EA7"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/74">chapter 74</external-xref> of title 38, United States Code, is amended by striking the item relating to section 7411 and inserting the following new item:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H3D461F002B7E4133A45991C5E40072BA">
<toc>
<toc-entry level="section" bold="off">7411. Reimbursement of continuing professional education expenses.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="H3D1F93C199654DFDBD04DEDCDD08DB33"><enum>637.</enum><header>Department of Veterans Affairs personnel transparency</header>
<subsection id="H855307C5B6D5407E9F3EF086D714000D"><enum>(a)</enum><header>In general</header><text>Section 505 of the John S. McCain III, Daniel K. Akaka, and Samuel R. Johnson VA Maintaining Internal Systems and Strengthening Integrated Outside Networks Act of 2018 (<external-xref legal-doc="public-law" parsable-cite="pl/115/182">Public Law 115–182</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/301">38 U.S.C. 301</external-xref> note) is amended—</text> <paragraph id="HA28F8AD6CCA9453F9089C0A671E869EE"><enum>(1)</enum><text>in subsection (a)—</text>
<subparagraph id="HAC16180C5B1D4300BAB0E3CEA216F00E"><enum>(A)</enum><text>in paragraph (1)—</text> <clause id="H97359D91224642B982813E4F2CBFE1A0"><enum>(i)</enum><text>in the matter before subparagraph (A), by striking <quote>information,</quote> and all that follows through <quote>facility:</quote> and inserting <quote>information:</quote>;</text></clause>
<clause id="H9A47A522F86641B0B49D942DC2BBC04B"><enum>(ii)</enum><text>in subparagraph (B)—</text> <subclause id="H4A727C059C984EE79583FA12EE3D7448"><enum>(I)</enum><text>by inserting <quote>(i)</quote> before <quote>The number</quote>; and</text></subclause>
<subclause id="HA1EC7148D8904809808E5DD26F682081"><enum>(II)</enum><text>by adding at the end the following new clause:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HCEA91B9341914FD4A1E5E424D3DD11AC"> <clause id="H16A5E53D26724434B3902E89ABECE157" indent="up1"><enum>(ii)</enum><text>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.</text></clause><after-quoted-block>;</after-quoted-block></quoted-block></subclause></clause>
<clause id="HEA4DCA7693B84A318E81037E59A5CF82"><enum>(iii)</enum><text>in subparagraph (C), by striking <quote>vacancies, by occupation.</quote> and inserting <quote>positions currently undergoing a recruitment action, disaggregated by occupation and by stage of recruitment.</quote>;</text></clause> <clause id="H48617CA3445341A1B2D8EC3399B2099D"><enum>(iv)</enum><text>in subparagraph (E)(iii), by striking <quote>potential hires or</quote>; and</text></clause>
<clause id="H4FF6A4675ED24C76ABCF68B0839361AF"><enum>(v)</enum><text>by adding at the end the following new subparagraph:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H1C31FD99440949D683A144EB2A95A10D"> <subparagraph id="HCC68596DE5454AA7BCCD5279F8160488"><enum>(F)</enum><text>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.</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></clause></subparagraph>
<subparagraph id="H46F53EA82F634AEA8BBBB5A1A2D052EA"><enum>(B)</enum><text>by redesignating paragraph (5) as paragraph (6);</text></subparagraph> <subparagraph id="H14224C0C7C0F45C5BB75943D12BE79C1"><enum>(C)</enum><text>by inserting after paragraph (4) the following new paragraph (5):</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="HF2D7E34BD80B434DA422F368D917067B">
<paragraph id="H9F18E32978E44509AA109A4282912702"><enum>(5)</enum><header>Display of information</header><text>The display of information made publicly available on a website of the Department pursuant to paragraph (1) shall be disaggregated—</text> <subparagraph id="H0272642953F0404484C5140B1AF484ED"><enum>(A)</enum><text>by departmental component;</text></subparagraph>
<subparagraph id="H3FD05043A92A4B8E8BA92D35A66D5374"><enum>(B)</enum><text>in the case of information relating to Veterans Health Administration positions, by medical facility; and</text></subparagraph> <subparagraph id="H7F59ECAADD714FFEBEE12615A797D48A"><enum>(C)</enum><text>in the case of information relating to Veterans Benefits Administration positions, by regional office.</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="HADCB43EDE86D4394B92AB533DE877502"><enum>(D)</enum><text>in paragraph (6), as redesignated by subparagraph (B), by striking <quote>shall</quote> and all that follows and inserting the following: “shall—</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H8C5518AED33D4920B33673CBD6D497AA"> <subparagraph id="H018318ED45A7402FAA6505BAF9C66108"><enum>(A)</enum><text>review the administration of the website required under paragraph (1);</text></subparagraph>
<subparagraph id="H2799C507155B4799B1E1064A90D8A5B6"><enum>(B)</enum><text>develop recommendations relating to the improvement of such administration; and</text></subparagraph> <subparagraph id="H1D6B2FAD0F8249E98D7415F7A7319DEE"><enum>(C)</enum><text>submit to the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives a report containing—</text>
<clause id="H656068E5ACD94494A89C06D5F5EEFC78"><enum>(i)</enum><text>the findings of the Inspector General with respect to the most recent review conducted under subparagraph (A); and</text></clause> <clause id="H71C5AC1CB67D412DBFD6B7A5233F8222"><enum>(ii)</enum><text>the recommendations most recently developed under subparagraph (B).</text></clause></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H55B5A6A4A56F4CF2BB86963707BDC69D"><enum>(2)</enum><text>by amending subsection (b) to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H9B2E896493414F19A4B1EBEE1A846B7A"> <subsection id="H0DA3CE71203340568D7F4B43FD7B4EE8"><enum>(b)</enum><header>Annual report</header><text>Each year, the Secretary shall submit to Congress an annual report that includes the following:</text>
<paragraph id="H3612B01707104B8CBF18E01DC73C367A"><enum>(1)</enum><text>A description of the steps the Department is taking to achieve full staffing capacity.</text></paragraph> <paragraph id="HD11982A81FC14854B16B905CFFB6FBB4"><enum>(2)</enum><text>A description of the actions the Department is taking to improve the onboard timeline for facilities of the Department, including—</text>
<subparagraph id="HB3730247FDB74EBCBCDFF7CF15714783"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="HEEBA420559E84969B37AE7BABF0E0A90"><enum>(B)</enum><text>in the case of the Veterans Benefits Administration, for regional offices that exceed the time-to-hire target of the Office of Personnel Management.</text></subparagraph></paragraph>
<paragraph id="H86BDF099F8E647D19FB2085E856260DF"><enum>(3)</enum><text>The amount of additional funds necessary to enable the Department to reach full staffing capacity.</text></paragraph> <paragraph id="H694E25FAB8B840B5A4AE614DC5A46F05"><enum>(4)</enum><text>Such recommendations for legislative or administrative action as the Secretary may have in order to achieve full staffing capacity at the Department.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection>
<subsection id="H767F14DD08544CD3B6620BE22EA1ABC4"><enum>(b)</enum><header>Effective date</header><text>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.</text></subsection></section> <section id="H6F04DF94F7DE45F2B6B705F61425F4AB"><enum>638.</enum><header>Modification of authority of licensure of health care professionals providing treatment via telemedicine</header><text display-inline="no-display-inline">Section 1730C of title 38, United States Code, is amended—</text>
<paragraph id="H0615CA453FF64759A970272FCA52FDA3"><enum>(1)</enum><text>by amending subsection (a) to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H75D00D0B965E444EB0F1545B9C851A44"> <subsection id="HE2366A7A8B67454DBE6C17227F936D48"><enum>(a)</enum><header>In general</header><text>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.</text></subsection><after-quoted-block>;</after-quoted-block></quoted-block></paragraph>
<paragraph id="H26CDD832B5114B14A8BFFE2DA4A22045"><enum>(2)</enum><text>in subsection (b), by adding at the end the following new paragraph:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HCC886160CBB443AC842E331A9E6B51E5"> <paragraph id="H1519C4FB0748427C9E5E81E1249202E5"><enum>(4)</enum><text>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:</text>
<subparagraph id="H378B0A4474E44CFEA22BA0CCECBEB1E4"><enum>(A)</enum><text>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.</text></subparagraph> <subparagraph id="HB223E87765924421B72C0007A6544DE5"><enum>(B)</enum><text>A health care professional conducting disability compensation evaluations pursuant to a contract with the Department.</text></subparagraph></paragraph><after-quoted-block>;</after-quoted-block></quoted-block></paragraph>
<paragraph id="HD103F3EEFA144710A099CA2B4A9DB5AF"><enum>(3)</enum><text>in subsection (d)—</text> <subparagraph id="H0EE3F46B9EC34AC8BF189CEF6D6F3704"><enum>(A)</enum><text>by redesignating paragraph (2) as paragraph (3); and</text></subparagraph>
<subparagraph id="H5951EF191FE74B49B330BE127390EBA8"><enum>(B)</enum><text>by inserting after paragraph (1) the following new paragraph (2):</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H45B660D8D10143868FFF90F02EB680ED"> <paragraph id="HDF1ED2F149354CF19D3F4643BF7A9FBA" indent="up1"><enum>(2)</enum><text>State laws that may be inconsistent under paragraph (1) include—</text>
<subparagraph id="H77DB8385008A4389922B0723617E8197"><enum>(A)</enum><text>the laws of—</text> <clause id="H67AAEDD447EA46E891BE2B7AD1162910"><enum>(i)</enum><text>the State of licensure, certification, or registration of the covered health care professional;</text></clause>
<clause id="H01672333B98E437DA42D8CD7A3B64A3A"><enum>(ii)</enum><text>the State of practice of the covered health care professional;</text></clause> <clause id="HB41EEB67ECF84907ACAD52DB68E48CEA"><enum>(iii)</enum><text>the State in which the patient is located; or</text></clause>
<clause id="H078896DACB5E48E5A1310A4C827D23B7"><enum>(iv)</enum><text>the State of residence of the patient; and</text></clause></subparagraph> <subparagraph id="HF8E8EC7CB0874EF4A4AD38F3CC7C24D7"><enum>(B)</enum><text>such laws specified under subparagraph (A) as incorporated by the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/801">21 U.S.C. 801 et seq.</external-xref>).</text></subparagraph></paragraph><after-quoted-block>; and</after-quoted-block></quoted-block></subparagraph></paragraph>
<paragraph id="H63D3E8E10DAE430E9162C3AD02729C08" commented="no" display-inline="no-display-inline"><enum>(4)</enum><text>in subsection (e), striking <quote>Nothing</quote> and inserting <quote>Except as provided in subsections (a) and (d), nothing.</quote>.</text></paragraph></section> <section id="H0B7DCCC8A62340F588686962CB477B6B"><enum>639.</enum><header>Provision of data on educational assistance programs of Veterans Health Administration</header> <subsection id="H06F765E93D3B41098E519EE7F5737F32"><enum>(a)</enum><header>In general</header><text>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.</text></subsection>
<subsection id="H9AE34CC6703B4E9486E198A0E0ADA18C"><enum>(b)</enum><header>Elements</header><text>The data required to be provided under subsection (a) shall include, for each program, the following:</text> <paragraph id="HA7F6BACE57E3402AB91F189786AC207D"><enum>(1)</enum><text>The number of active participants, broken down by position or expected future position or licensure.</text></paragraph>
<paragraph id="H8F6C5878A7314C2CA6E0FA9FCFE28979"><enum>(2)</enum><text>The amount of funds spent each fiscal year.</text></paragraph> <paragraph id="HE884BC053A6D4856B39ED4183D8E3921"><enum>(3)</enum><text>The number of participants who have completed their education and are currently completing their service requirements at the Department of Veterans Affairs.</text></paragraph>
<paragraph id="H8687C254DE4E4BC597995CB62BF2CDB2"><enum>(4)</enum><text>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.</text></paragraph> <paragraph id="HEB03E84DA38D4287ACAA33FA0931CCE2"><enum>(5)</enum><text>An overview of outreach by the Department to prospective participants in the program.</text></paragraph>
<paragraph id="H525ADA8D340D43C58CEBD037E5DEC0DB"><enum>(6)</enum><text>Such other information as the Secretary considers appropriate.</text></paragraph></subsection> <subsection id="H7EDBDD3AC01D477996A48579A3C7F035"><enum>(c)</enum><header>Update and submittal of data</header><text>The data required to be provided under subsection (a)—</text>
<paragraph id="HE40CD3C141774D47B43AC2C24495A929"><enum>(1)</enum><text>shall be updated not less frequently than annually; and</text></paragraph> <paragraph id="H0CE36320832A491DB9D86201428FA334"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="HBDBF26596A094CBB96CF85EE7BF5C16C"><enum>(d)</enum><header>Initial data</header><text>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 <external-xref legal-doc="public-law" parsable-cite="pl/115/141">Public Law 115–141</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/7601">38 U.S.C. 7601</external-xref> note), including the current status of the pilot program and a timeline of the status of the pilot program since its initial implementation.</text></subsection></section></subtitle> <subtitle style="OLC" id="H271A8C548EA34E5289D222F913E83100"><enum>D</enum><header>Optimization of Workforce</header> <section id="H8AA4E88413B1415AAA914C8A89832ADB" section-type="subsequent-section"><enum>641.</enum><header>Department of Veterans Affairs strategic human capital plan</header> <subsection commented="no" display-inline="no-display-inline" id="HDB38EA82A128474D9B4224E3273F105E"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text>Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/7">chapter 7</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="H641D4705A2DE489F9F630ED5FD04EE77">
<section commented="no" display-inline="no-display-inline" id="H63086EBE2A5C4AA09DD9BDC7BC80708D"><enum>729.</enum><header>Strategic human capital plan</header>
<subsection id="H3B4F00ACFD994E64B23B3606A68EF8BC"><enum>(a)</enum><header>Plan development</header>
<paragraph commented="no" display-inline="yes-display-inline" id="H42A53C3AD58040408151B2A1746419D4"><enum>(1)</enum><text>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.</text></paragraph> <paragraph indent="up1" commented="no" display-inline="no-display-inline" id="HC444B8F555624C489739ECD0EF349CE7"><enum>(2)</enum><text>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. </text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H2C3C97FE268D4A1CBEBD35C89F822044"><enum>(b)</enum><header>Requirements</header>
<paragraph commented="no" display-inline="yes-display-inline" id="HD9EDD26647D848BDACAA8DFF1BF38813"><enum>(1)</enum><text>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.</text></paragraph> <paragraph indent="up1" commented="no" display-inline="no-display-inline" id="H2F96E880BF7A4E319D1CE4436F57C57C"><enum>(2)</enum><text>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.</text></paragraph></subsection>
<subsection id="H34889EB1355C4629A8D608D238E79014"><enum>(c)</enum><header>Contents</header><text>The strategic human capital plan required by subsection (a) shall incorporate leading practices, including the following: </text> <paragraph id="H2411837C61E94DFDAA3FBAD9280DE7B4"><enum>(1)</enum><text>A workforce gap analysis, including an assessment of—</text>
<subparagraph id="H5D9F6A7B2D4C4B85B4A2970B3340E6FF"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="H1B2E781765434847AD211A26F38022F1"><enum>(B)</enum><text>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</text></subparagraph>
<subparagraph id="HD91A4A068C064EC4AB2CE4C3A26723C9"><enum>(C)</enum><text>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. </text></subparagraph></paragraph> <paragraph id="H3F59957FA12741D281DC4172B69A99FD"><enum>(2)</enum><text>An implementation plan that includes the following:</text>
<subparagraph id="H177FCDDF94E848EA843DCEAA9D9E42EF"><enum>(A)</enum><text>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.</text></subparagraph> <subparagraph id="HCA8ED2805E1B44E9A5DBF2099FAF5968"><enum>(B)</enum><text>Specific strategies—</text>
<clause commented="no" display-inline="no-display-inline" id="HDDBC461577FF403B8F9293DB05C57714"><enum>(i)</enum><text display-inline="yes-display-inline">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</text></clause> <clause commented="no" display-inline="no-display-inline" id="H4DCC422063354425AF0068E4EF6275E7"><enum>(ii)</enum><text display-inline="yes-display-inline">that are informed by applicable industry best practices.</text></clause></subparagraph>
<subparagraph id="H7E7044BFB86B45A5A7154FABC1C50326"><enum>(C)</enum><text>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.</text></subparagraph> <subparagraph id="H4A7FA58EE437434F9FDDFBA4679F0172"><enum>(D)</enum><text>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— </text>
<clause commented="no" display-inline="no-display-inline" id="H7EBE263F1EE0487FA9CA1EE3B660E816"><enum>(i)</enum><text display-inline="yes-display-inline">necessary background checks; and</text></clause> <clause commented="no" display-inline="no-display-inline" id="H4DC4E2419B1441789E7B242C5737106C"><enum>(ii)</enum><text display-inline="yes-display-inline">measures to protect Department customer and employee safety.</text></clause></subparagraph></paragraph></subsection>
<subsection id="HF969B1D3137A45F094D86B3EE9FE46B1"><enum>(d)</enum><header>Annual updates</header><text>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—</text> <paragraph id="HF6891E2585E343AEA2F61886CE5689F8"><enum>(1)</enum><text>the progress of the Department in implementing the strategic human capital plan;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H575B771C199C495BBA4AB4C01AF1C91D"><enum>(2)</enum><text>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;</text></paragraph> <paragraph id="HC6BA36BA5FF74BEC83989C8B4802D97D"><enum>(3)</enum><text>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;</text></paragraph>
<paragraph id="H41780C07AAAA4568BDAAAEDC4C5FA4C0"><enum>(4)</enum><text>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;</text></paragraph> <paragraph id="H71C33F543E3F497D9F7C4E2FF66AA3CA"><enum>(5)</enum><text>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</text></paragraph>
<paragraph id="HB376974FBF394073837BAC866F388E57"><enum>(6)</enum><text>any differentiation from the Quadrennial Veterans Health Administration review required by section 7330C of this title.</text></paragraph></subsection> <subsection id="H6AB5CD5906DD47079A82F0C018E31BE4"><enum>(e)</enum><header>Comptroller General of the United States biennial reviews</header><text>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— </text>
<paragraph commented="no" display-inline="no-display-inline" id="H79B8C5E6586F49C4A86E8BB1ABA67A4F"><enum>(1)</enum><text display-inline="yes-display-inline">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</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H2A536128C5194499ADD171133429E0B7"><enum>(2)</enum><text display-inline="yes-display-inline">submit to Congress the findings of the Comptroller General with respect to the review conducted pursuant to paragraph (1). </text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H8EB706B9D4D245C6815F1101DEFEC6D2"><enum>(f)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text> <paragraph commented="no" display-inline="no-display-inline" id="H88C6D1B5949447EF844373E4C2A6C958"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>appropriate committees of Congress</term> means—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H4F70A04EA5AF4EF1BBB28AE3573033E1"><enum>(A)</enum><text display-inline="yes-display-inline">the Committee on Veterans' Affairs and the Committee on Appropriations of the Senate; and</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H27CFA360098E416E9258709824AE7E62"><enum>(B)</enum><text display-inline="yes-display-inline">the Committee on Veterans' Affairs and the Committee on Appropriations of the House of Representatives.</text></subparagraph></paragraph>
<paragraph id="H62863F3E649B427FA6069CF356224E35"><enum>(2)</enum><text>The term <term>veterans service organization</term> means any organization recognized by the Secretary under section 5902 of this title.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection commented="no" display-inline="no-display-inline" id="H5448B915E5004C9FBA44BE39CE256110"><enum>(b)</enum><header>Clerical amendment</header><text>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:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H716B9E53186F4EFDBA73344C38CFA5D1">
<toc>
<toc-entry level="section" bold="off">729. Strategic human capital plan.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="HE4F6F82E81C447F3BC5E153DB3B175A5"><enum>642.</enum><header>Department of Veterans Affairs reduction in force notice requirement</header>
<subsection commented="no" display-inline="no-display-inline" id="HECB2461B7EAD4D1EA766E425AF819F45"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/7">chapter 7</external-xref> of title 38, United States Code, as amended by section 2(a), is further amended by inserting after section 729 the following new section:</text> <quoted-block style="USC" display-inline="no-display-inline" id="HD9DE0644F4584ECAB309463528BBBC99"> <section id="HDCD3C541F7AC43DD90EB31E031948A23"><enum>729A.</enum><header>Reductions in force</header> <subsection id="H964DF689056B4B549D545EC2BBD1C2C4"><enum>(a)</enum><header>Notice required</header><text>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.</text></subsection>
<subsection commented="no" display-inline="no-display-inline" id="HA9D9BC08E84543E585C44DED4316FFFC"><enum>(b)</enum><header>Limitation</header><text>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.</text></subsection> <subsection id="HAB3E2B681E8B4E4EA010B884E8D2A8C9"><enum>(c)</enum><header>Contents</header><text>Notice regarding plans to carry out a reduction in force submitted pursuant to subsection (a) shall include the following:</text>
<paragraph id="H3A33EE3A674A4344BC5C0C40BD3DE18B"><enum>(1)</enum><text>The total number of employees of the Department who will be affected by the reduction.</text></paragraph> <paragraph id="H310EC6CF18474F95BFC7B76C49755873"><enum>(2)</enum><text>The offices of the Department that will be affected by the reduction, including, for each such office, the following:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H73D28DC094F949C18B041B93E0832F64"><enum>(A)</enum><text>The location of the office.</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H2FDD517695C44B1393E62BCA65502475"><enum>(B)</enum><text>The program of the Department carried out by the office.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H9AE90CA3E4A44453BEFFD24AFFE8684C"><enum>(C)</enum><text>The total number of employees of the office before and after the reduction in force.</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H55E30007420D4B2BABC9243FB5C99A12"><enum>(D)</enum><text>The services provided by the office.</text></subparagraph></paragraph>
<paragraph id="H12136E405B5E40EBA25B94612C4C8AA4"><enum>(3)</enum><text>A justification for the reduction in force, including how—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H4F759C83B5B3463D9F2BED1FCE288C2D"><enum>(A)</enum><text display-inline="yes-display-inline">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</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H2F7473073AC9407ABE48AB36046594A5"><enum>(B)</enum><text>the reduction in force aligns with the strategic human capital plan required by section 729 of this title.</text></subparagraph></paragraph> <paragraph id="HAEF35BBC347E403DB93038110A180D25"><enum>(4)</enum><text>Budgetary effects of the reduction in force.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="HEC376F01408E4519BC8C01DB4AFF7B77"><enum>(5)</enum><text display-inline="yes-display-inline">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.</text></paragraph></subsection> <subsection commented="no" display-inline="no-display-inline" id="HEC867B23BD074B9BA96C8A5DC62748BB"><enum>(d)</enum><header>Equal content</header><text>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.</text></subsection>
<subsection id="H8103674CEF1C498494CF45A21319EF1D"><enum>(e)</enum><header>Administrative remedy</header><text display-inline="yes-display-inline">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).</text></subsection> <subsection commented="no" display-inline="no-display-inline" id="H79E45F8ECDCF461A87EB58CBA0F34861"><enum>(f)</enum><header>Definitions</header><text display-inline="yes-display-inline">In this section:</text>
<paragraph commented="no" display-inline="no-display-inline" id="H9EE4FC0EF11244B8B8F5A1408602003E"><enum>(1)</enum><text display-inline="yes-display-inline">The term <term>appropriate committees of Congress</term> means—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H15367F5A1F3B43058BD4EB317659C0DF"><enum>(A)</enum><text display-inline="yes-display-inline">the Committee on Veterans' Affairs and the Committee on Appropriations of the Senate; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H61365129EA31403895FAC910A84D010B"><enum>(B)</enum><text display-inline="yes-display-inline">the Committee on Veterans' Affairs and the Committee on Appropriations of the House of Representatives.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HF478A37F2D6A4C2B92DC0B2002006698"><enum>(2)</enum><text display-inline="yes-display-inline">The term <term>reduction in force</term> 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.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H13D7C8C2F5404FCFA22A03F10FD101C1"><enum>(b)</enum><header>Clerical amendment</header><text>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:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HF9125A7DB7EF4D2CB8242CDC04EE7EA5"> <toc> <toc-entry level="section" bold="off">729A. Reductions in force.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> <section commented="no" display-inline="no-display-inline" id="HBE086788A1E24892A4160B8222136FFC"><enum>643.</enum><header>Detailed plans and justifications for reorganization of offices</header><text display-inline="no-display-inline">Section 510 of title 38, United States Code, is amended—</text>
<paragraph commented="no" display-inline="no-display-inline" id="H50406E99111945ABA8A0E478E4C4B9EF"><enum>(1)</enum><text>in subsection (f)(2)—</text> <subparagraph commented="no" display-inline="no-display-inline" id="HDC733315E48A44099C284C41902CD1F3"><enum>(A)</enum><text display-inline="yes-display-inline">in subparagraph (D), by inserting <quote>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</quote> before the period at the end; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HD8AB0D7E15C14D94944D899F108A989C"><enum>(B)</enum><text>by adding at the end the following new subparagraphs:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HE13BB825BBDA41B2A8D67D7171B1BF38"> <subparagraph id="HA09BDD2A958D4A1AB3584BFD3F88C7CB"><enum>(G)</enum><text>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.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H6E33A537946B41BFACAD1D471C6E8EF0"><enum>(H)</enum><text display-inline="yes-display-inline">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.</text></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H4DA24E37A0424BE38F357FCADD7AC711"><enum>(2)</enum><text>by redesignating subsections (e) and (f) as subsections (f) and (g), respectively; and</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H311CF2D138404AB0A97C931E4174B0FF"><enum>(3)</enum><text>by inserting after subsection (d) the following new subsection (e):</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H593195E75805406F8853AFA724E3DB55"> <subsection commented="no" display-inline="no-display-inline" id="H8D58BDBD02944F1CB45A31FF720E86B1"><enum>(e)</enum><text>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).</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>
<section id="HAFB7020FBAE04495A3C086926270EB65" commented="no" display-inline="no-display-inline"><enum>644.</enum><header display-inline="yes-display-inline">Rule of construction</header><text display-inline="no-display-inline">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.</text></section></subtitle> <subtitle style="OLC" id="HA452B82C0836470DB34D0A5583E60B08"><enum>E</enum><header>Veterans Infrastructure and Transformation</header> <section id="HBB965F951CC640268483CC57EFBFC05F"><enum>651.</enum><header>Short title</header><text display-inline="no-display-inline">This subtitle may be cited as the <quote><short-title>Veterans Infrastructure and Transformation Act of 2026</short-title></quote> or the <quote><short-title>VITAL Act of 2026</short-title></quote>.</text></section>
<section id="H3B718780E5174ABC8F2511FE5A744261"><enum>652.</enum><header>Modification of authority for sharing of health-care resources of Department of Veterans Affairs to include flexible space utilization and streamlined service agreements</header><text display-inline="no-display-inline"> Section 8153 of title 38, United States Code, is amended—</text> <paragraph id="HDF5AAAD99F6F4527830C0315CC61AE9C"><enum>(1)</enum><text>in subsection (a)(3)—</text>
<subparagraph id="HC868F9C5BDC743FCAF41A2FCD7A78196"><enum>(A)</enum><text>in subparagraph (A), by inserting <quote>physical</quote> before <quote>space</quote>;</text></subparagraph> <subparagraph id="H1EC069E8A1FE414D815C984E7567111F"><enum>(B)</enum><text>in subparagraph (B)(i), by inserting <quote>physical</quote> before <quote>space</quote>;</text></subparagraph>
<subparagraph id="H868223A731324E599ACB0FC0D62F3BBF"><enum>(C)</enum><text>by striking subparagraph (E);</text></subparagraph> <subparagraph id="HFE7AD8D318BE482D8770493E811E25F1"><enum>(D)</enum><text>by redesignating subparagraphs (C) and (D) as subparagraphs (D) and (E), respectively;</text></subparagraph>
<subparagraph id="HE89E5A48794C4E459A786C7425A7877F"><enum>(E)</enum><text>by inserting after subparagraph (B) the following new subparagraph (C):</text> <quoted-block style="OLC" display-inline="no-display-inline" id="H6158AD21FAA649ED98D0B2DADA5DF8CB"> <subparagraph id="H0EBAA9D7C74B4E48A86ED6D13D65EBBF" indent="up1"><enum>(C)</enum><text display-inline="yes-display-inline">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—</text>
<clause id="H83EDC4476B504D1A8B8E706A366EB8CA"><enum>(i)</enum><text>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</text></clause> <clause id="HE9C5AF7091654C47A96CB152E63F8CAC"><enum>(ii)</enum><text>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—</text>
<subclause id="HD347D71F3B44413CB29C47D21CF07FBA"><enum>(I)</enum><text>requires that payments for each fiscal year be made only from appropriated funds and available that year; and</text></subclause> <subclause id="HE657D1474A894CFCA8F31E2434E30B7F"><enum>(II)</enum><text>includes a provision that the Government’s obligations for future years is contingent upon availability of appropriations.</text></subclause></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></subparagraph>
<subparagraph id="H4F9A0892788D497D8D21B1C4A401EB04"><enum>(F)</enum><text>in subparagraph (D), as redesignated by subparagraph (D) of this paragraph, by striking <quote>subparagraph (A) or (B)</quote> and inserting <quote>subparagraph (A), (B), or (C)</quote>;</text></subparagraph></paragraph> <paragraph id="H3B5744E89CAD44FE83A53058C093281D"><enum>(2)</enum><text>by adding at the end the following:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H652E598FA83B4F42A06C43402AF9DF83">
<subsection id="H81F4FE15DF50481AB88A7BF15A168259"><enum>(h)</enum><text>In this section:</text> <paragraph id="HAA544D4287234E978814972822EA5DEF"><enum>(1)</enum><text>The term <term>commercial service</term> 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.</text></paragraph>
<paragraph id="H1A1611E6699D4B51BB98B292D5597A8B"><enum>(2)</enum><text>The term <term>common service</term> 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.</text></paragraph> <paragraph id="H28F78ED1B6A64A0288C47EEC28703B83"><enum>(3)</enum><text>The term <term>physical space</term> means a portion of a building or parking facilities.</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section>
<section id="HA2B6E2A2F27744B4821372BE362DB342"><enum>653.</enum><header>Use of commercial construction and facilities code and standards</header>
<subsection id="H4D86F92BF6C44263A2A50C50F3CAB51C"><enum>(a)</enum><header>In general</header><text>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.</text></subsection> <subsection id="H6C3026E6E44E441783B5B95C501B1C70"><enum>(b)</enum><header>Pilot projects</header><text>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.</text></subsection>
<subsection id="H4E39D19C7F9F48F19169E54183A2856A"><enum>(c)</enum><header>Reports</header><text>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.</text></subsection> <subsection id="HB99A053B2BDB4BF59762E90059DA2086"><enum>(d)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="HFD80793394ED4EB98A8B2E160632BAB0"><enum>(1)</enum><header>Commercial codes and standards</header><text>The term <term>commercial codes and standards</term> means building codes or standards of the following:</text> <subparagraph id="H5667FF15FE7F42BF91D09939DCF72EA5"><enum>(A)</enum><text>The National Fire Protection Association.</text></subparagraph>
<subparagraph id="H15479F6F6BFC439EB7E4A36D61B5CBC6"><enum>(B)</enum><text>The International Code Council.</text></subparagraph> <subparagraph id="H0BB08B34209E4046A78AE8AF4A96C431"><enum>(C)</enum><text>The American Society for Testing and Materials.</text></subparagraph>
<subparagraph id="H49770DFDE98747D7858A98CE1FD58F4F"><enum>(D)</enum><text>The American Society of Civil Engineers.</text></subparagraph> <subparagraph id="HD7445A2D6D8F416482F5F431BA161557"><enum>(E)</enum><text>Any other building code or standard, other than those described in (2), determined by the Secretary.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H37FBACDD642842509284C1611EEA4BCF"><enum>(2)</enum><header>Federal codes and standards</header><text display-inline="yes-display-inline">The term <term>Federal codes and standards</term> means the following:</text> <subparagraph id="HBAB3001A6F3B4DFF84A6787B2A6166D0"><enum>(A)</enum><text>Building codes or standards specific to one or more Federal agencies.</text></subparagraph>
<subparagraph id="HDACF10A004404F9DBF1D06013528A035"><enum>(B)</enum><text>Building codes or standards specific to the Department, including the Technical Information Library.</text></subparagraph> <subparagraph id="HD03E22520B98406CB25371C37AC2B430"><enum>(C)</enum><text>Standards of the Federal Guidelines Institute.</text></subparagraph></paragraph></subsection></section>
<section id="H72A968D01A79490D949465A6DF42D9F3"><enum>654.</enum><header>Feasibility study for full-service hospital of Department of Veterans Affairs in certain States</header>
<subsection id="H787B63DF4BCA4C7AA0AA6FEE7C4DA001"><enum>(a)</enum><header>In general</header><text>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.</text></subsection> <subsection id="H483CE232D0794AF38A0D9532A45260CD"><enum>(b)</enum><header>Publication</header><text>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).</text></subsection></section>
<section id="H08DAD2230DCB498789E04411D2A88743"><enum>655.</enum><header>Report on strategic plan for infrastructure and capital assets of Department of Veterans Affairs</header>
<subsection id="HE9538B7088B547098F0A5EBDC4F62F10"><enum>(a)</enum><header>Report</header><text>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.</text></subsection> <subsection id="HAECD2626A5A143D692330D6CCBA990E3"><enum>(b)</enum><header>Elements</header><text>The report required by subsection (a) shall cover known and projected requirements over a period of not less than 10 years for the following:</text>
<paragraph commented="no" display-inline="no-display-inline" id="HF913A3AE537D481484E996D91C6FE8BD"><enum>(1)</enum><text display-inline="yes-display-inline">Land acquisition.</text></paragraph> <paragraph id="H9841A0BED61B4D0782108D80D55F1ECB"><enum>(2)</enum><text>Operations and maintenance of facilities of the existing capital asset portfolio of the Department.</text></paragraph>
<paragraph id="HD999390C10C1405BB7905FA52FEE7E08"><enum>(3)</enum><text>Operations and maintenance of the planned future capital asset portfolio of the Department.</text></paragraph> <paragraph id="H7180028307D4490ABDDE5612DADCF838"><enum>(4)</enum><text>New construction, disaggregated by type of new construction, including the following types of construction:</text>
<subparagraph id="H61076AE3CCB74332996AC3E43C761ECA"><enum>(A)</enum><text>Major construction.</text></subparagraph> <subparagraph id="H2F8055A8F3E146869833A3CD1A4510ED"><enum>(B)</enum><text>Minor construction.</text></subparagraph>
<subparagraph id="H8086917ED02546BCBEA81DEF4AA79C16"><enum>(C)</enum><text>Nonrecurring maintenance.</text></subparagraph></paragraph> <paragraph id="H613AD3CB17304149962469B6AA5526D1"><enum>(5)</enum><text>Leasing.</text></paragraph>
<paragraph id="HFD72F1E4A12348D6A6DEF23599DB48C0"><enum>(6)</enum><text>Alternative acquisition methods, such as partnerships and donations.</text></paragraph> <paragraph id="HFA0262D08F2044A283EC399D6D5084CC"><enum>(7)</enum><text>Activation of space.</text></paragraph>
<paragraph id="H0764A82635B44E76A88100B76CF94B46"><enum>(8)</enum><text>Disposal, reuse, and remediation.</text></paragraph> <paragraph id="HAE791486FBAD4AE69AE0629276257914"><enum>(9)</enum><text>Facility lifecycle strategy process supporting the planning, programming delivery, management, and maintenance of the current and future capital asset portfolio of the Department.</text></paragraph>
<paragraph id="H1C4DCAEE9DA146E98D83D5C10294513C"><enum>(10)</enum><text>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.</text></paragraph> <paragraph id="H09C04FCE9E734C8EAC58B7D192281865"><enum>(11)</enum><text>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.</text></paragraph>
<paragraph id="H39498DD3EC3144ECBE2D5C5F9195CCAE"><enum>(12)</enum><text>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.</text></paragraph></subsection> <subsection id="H9E0DAF5A96854AA6989F7E8E9E256134"><enum>(c)</enum><header>Rule of construction</header><text>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.</text></subsection></section>
<section id="HFD9AA382C4FA4183A4C908D3A3405C85"><enum>656.</enum><header>Permanent extension of pilot program on acceptance by the Department of Veterans affairs of donated facilities and related improvements</header>
<subsection commented="no" display-inline="no-display-inline" id="H42D9B4A8D2724856A141525D227172D6"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Section 2 of the Communities Helping Invest through Property and Improvements Needed for Veterans Act of 2016 (<external-xref legal-doc="public-law" parsable-cite="pl/114/294">Public Law 114–294</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/8103">38 U.S.C. 8103</external-xref> note) is amended—</text> <paragraph commented="no" display-inline="no-display-inline" id="HE96A73C66F6A4018AFC50B755B6C961F"><enum>(1)</enum><text>in the section heading, by striking <quote><header-in-text style="OLC" level="section">Pilot</header-in-text></quote>;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H5418073B02E445E1A122FDC65036BE57"><enum>(2)</enum><text display-inline="yes-display-inline">in subsection (a), in the subsection heading, by striking <quote><header-in-text style="OLC" level="subsection">Pilot</header-in-text></quote>;</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H55710CAA95E1455F9A7A056462F985A0"><enum>(3)</enum><text>by striking <quote>pilot</quote> each place it appears;</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H868226A209E44CCBB4265BA8438FFF60"><enum>(4)</enum><text>by striking subsection (i); and</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="HEA4C6E4FB8C7417299F7307DEC1C0B6C"><enum>(5)</enum><text>by redesignating subsection (j) as subsection (i).</text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H4E567F12D93C4A3E841EB37A15072B0B"><enum>(b)</enum><header>Modification of acceptance of property</header><text>Paragraph (1) of subsection (b) of such section is amended to read as follows:</text> <quoted-block style="OLC" display-inline="no-display-inline" id="HB56EFFE20EA142ECB5EB91DA111E67A5"> <paragraph commented="no" display-inline="no-display-inline" id="HEF009B7A424C47449D40287AC7E02175"><enum>(1)</enum><text display-inline="yes-display-inline">the donation aligns with—</text>
<subparagraph id="HC8EC7EB79DD1462EAC35EA6377213B7A"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="H2047775C127542CBAD730DBCDDD0E54F"><enum>(B)</enum><text>any component or phase of a need described in paragraph (1); and</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="HA3A9D0EC1D7A47B3BB1C29BFDDED6A30"><enum>657.</enum><header>Authority to accept donations of construction services, minor construction or nonrecurring maintenance projects, and targeted contributions</header>
<subsection id="HD44E7B6F625F4DFDB7CD1AA722667B3A"><enum>(a)</enum><header>Authority</header><text>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—</text> <paragraph id="H2DEE3842744C409D976257A12C1886B5"><enum>(1)</enum><text>minor construction projects;</text></paragraph>
<paragraph id="H0F853002B6D0411F80F08177E2C4443A"><enum>(2)</enum><text>nonrecurring maintenance projects; or</text></paragraph> <paragraph id="HFF0AC9231BE74C20897996F01E1A1FDD"><enum>(3)</enum><text>construction services relating—</text>
<subparagraph id="H939746A3ABC542A780D8D288784A9963"><enum>(A)</enum><text>to minor construction projects;</text></subparagraph> <subparagraph id="HD80CD379635A4722BE53BA9CA86C4986"><enum>(B)</enum><text>to nonrecurring maintenance projects;</text></subparagraph>
<subparagraph id="H443AA750FF01475CA6233B71AD53890C"><enum>(C)</enum><text>to an existing facility of the Department; or</text></subparagraph> <subparagraph id="HE30555BF4BBC4D63945050A1DD604B1D"><enum>(D)</enum><text>to a new facility or portion thereof of the Department.</text></subparagraph></paragraph></subsection>
<subsection id="HD66DDB8924C547D78529E66E5593B45F"><enum>(b)</enum><header>Alignment to needs</header><text>The Secretary may accept a donation under this section only if—</text> <paragraph id="HB170EAB08A2748368EC6D1A9DCEBB780"><enum>(1)</enum><text>the donation aligns with—</text>
<subparagraph id="H5BAA0FF189854570BEA08B5AE161B8A7"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="H93AD27B30A694B0398160997F187B569"><enum>(B)</enum><text>any component or phase of a need described in subparagraph (A);</text></subparagraph></paragraph>
<paragraph id="H29FA9C8B07CB49D9B935C88052E7E44C"><enum>(2)</enum><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/114/294">Public Law 114–294</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/8103">38 U.S.C. 8103</external-xref> note);</text></paragraph> <paragraph id="HA5FAD49790834B9586FC8A444E6EBFA1"><enum>(3)</enum><text>the Secretary determines such donation would—</text>
<subparagraph id="H9576B006690F4378A049483E80FFC23C"><enum>(A)</enum><text>accelerate project completion;</text></subparagraph> <subparagraph id="H9959A259D10F4D9B86FBFAB19D15F4D5"><enum>(B)</enum><text>reduce the expense to the Department;</text></subparagraph>
<subparagraph id="HD806B4AB6CD14F3AB2F84EE3A07DA876"><enum>(C)</enum><text>improve facility condition; or</text></subparagraph> <subparagraph id="H780ED4B479174214A2CAD6D6C4D55DB0"><enum>(D)</enum><text>otherwise benefit veterans;</text></subparagraph></paragraph>
<paragraph id="H86AFA3AF458744BC8188BE722C2EB134"><enum>(4)</enum><text>the donor enters into a formal agreement with the Secretary that includes—</text> <subparagraph id="H39DDFF84542149D9B78D53EDA5B94F81"><enum>(A)</enum><text>provisions for the Department’s oversight during performance;</text></subparagraph>
<subparagraph id="H16E2ECA7EF9B4E57AAA9F0A19CAA320B"><enum>(B)</enum><text>compliance with applicable construction codes and standards, and applicable laws and regulations;</text></subparagraph> <subparagraph id="H0589805B40894DA480506CF5823260E3"><enum>(C)</enum><text>donor-provided insurance, warranties, and liability protections;</text></subparagraph>
<subparagraph id="H9C04D5D47E854022A9A843FD8F5BCBA9"><enum>(D)</enum><text>the amount of the donation and the amount of the Department’s funding contribution, if any;</text></subparagraph> <subparagraph id="H962AE623D02D4A1FA68EC352A6AA495B"><enum>(E)</enum><text>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</text></subparagraph>
<subparagraph id="HAEF06803BBDD4327B7D0D18093F7BB5B"><enum>(F)</enum><text>such other terms as the Secretary determines necessary.</text></subparagraph></paragraph></subsection> <subsection id="H41484A339A424411A303F68E6FA376A8"><enum>(c)</enum><header>Streamlined requirements</header><text>For donations under this section that do not involve transfer of real property title—</text>
<paragraph id="HB88711FAFCD14082AB11A319BEB77E72"><enum>(1)</enum><text>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;</text></paragraph> <paragraph id="H79D9C107613C49AC9A940AD509D845F6"><enum>(2)</enum><text>the donor shall obtain all federally required construction and facility related permits; and</text></paragraph>
<paragraph id="H2C0AFEA8E96A46409E8AF441F4F3F90A"><enum>(3)</enum><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/114/294">Public Law 114–294</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/8103">38 U.S.C. 8103</external-xref> note) to reflect the nature of services or targeted contributions.</text></paragraph></subsection> <subsection id="HB3A0DD0B950E4595AB602616392899A5"><enum>(d)</enum><header>Reporting</header><text>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 (<external-xref legal-doc="public-law" parsable-cite="pl/114/294">Public Law 114–294</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/8103">38 U.S.C. 8103</external-xref> note), with separate tracking for donations under this section.</text></subsection></section>
<section id="H982A86F1ADF148A9B06F29005865A49C"><enum>658.</enum><header>Report on use of additional authorities relating to recruitment and retention of personnel</header>
<subsection id="HFE51E74D5D444050BA388A3CDC4D20CB"><enum>(a)</enum><header>Report required</header><text>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.</text></subsection> <subsection id="HDDBE2E37124E4E58BC2BA2DC674C217E"><enum>(b)</enum><header>Definitions</header><text>In this section:</text>
<paragraph id="H69AD51A013174ADC96577ECDD481B91C"><enum>(1)</enum><header>Acquisition workforce of the Department</header><text>The term <term>acquisition workforce of the Department of Veterans Affairs</term> 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.</text></paragraph> <paragraph id="HE68B5396A1C140FBA0664C8F1E7E369B"><enum>(2)</enum><header>Appropriate committees of Congress</header><text>The term <term>appropriate committees of Congress</term> means the Committee on Veterans’ Affairs of the Senate and the Committee on Veterans’ Affairs of the House of Representatives.</text></paragraph></subsection></section>
<section id="H6BA246D42EFF4F79B1EF265A977DCFE2"><enum>659.</enum><header>Reports on key capital asset investments, activities, and performance of Department of Veterans Affairs</header>
<subsection id="H0A89457A5B3D4359A09C41A6B4301CEA"><enum>(a)</enum><header>In general</header><text>Section 8120 of title 38, United States Code, is amended to read as follows:</text> <quoted-block style="USC" display-inline="no-display-inline" id="HBDC1753AECF94E448FB406E79B5A58B1"> <section id="H4D038BA48B954944845ADF224AB8E25B"><enum>8120.</enum><header>Reports on key capital asset investments, activities, and performance</header> <subsection id="H41196984FB6C4A13B531763EED352BA8"><enum>(a)</enum><header>Capital asset investment, activities, and performance</header> <paragraph id="H0F9385C5CC7D4ED8BA57E281468AE455"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="HA3390B7A60734DFE8F3A4B723FD4B05F"><enum>(2)</enum><header>Elements</header>
<subparagraph id="H2810ECF4D9804C34BCBDE6E15E5220A2"><enum>(A)</enum><header>First report in each fiscal year</header><text>The first report under paragraph (1) in each fiscal year shall include the following:</text> <clause id="H5E4DE6C00404428AACAD7F07EF266D5A"><enum>(i)</enum><text>A brief summary of work that was completed on each capital asset project that was completed in the previous fiscal year.</text></clause>
<clause id="HD8830587F9554277A68C09674288D1FB"><enum>(ii)</enum><text>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.</text></clause> <clause id="H6FCEE17FCC3449F3A114BCDFB8E12CF6"><enum>(iii)</enum><text>With respect to each capital asset project completed in such year, the following:</text>
<subclause id="HB361B92FFB27466B9E056D359ACB9DBB"><enum>(I)</enum><text>The type of project (major construction, minor construction, nonrecurring maintenance, leases, or other category, including disposals).</text></subclause> <subclause id="HAECAB9E159354FE5A03048980920D430"><enum>(II)</enum><text>The estimated total cost and the actual total cost of the project.</text></subclause>
<subclause id="H66722C69340F4822B3BC5FB7468914D5"><enum>(III)</enum><text>A description of the project.</text></subclause> <subclause id="HA2D55EA5283A4EF3BBF48CD8E609C987"><enum>(IV)</enum><text>The location and facility with respect to which the project was carried out.</text></subclause>
<subclause id="HBA0673AF31FE4E56B9208F2B436626BE"><enum>(V)</enum><text>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.</text></subclause></clause> <clause id="HAAEEA9387F0843F5AD7898027EBB88B1"><enum>(iv)</enum><text>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)—</text>
<subclause id="H519E747331CF456D8E657DB3DBD9E0B5"><enum>(I)</enum><text>the reason for any such overage or delay; and</text></subclause> <subclause id="HACCE4FF4A90244728B31F07A1826F753"><enum>(II)</enum><text>actions being taken to prevent any such overage or delay in future projects.</text></subclause></clause>
<clause id="HCAD1785A18A24139B32332C5FC579D93"><enum>(v)</enum><text>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.</text></clause> <clause id="H9A318D8FED574357AA6663E8196A988E"><enum>(vi)</enum><text>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.</text></clause>
<clause id="H1862458553224352B0148931346A1F60"><enum>(vii)</enum><text>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:</text> <subclause id="HED81BF47C8B94E51929D816C66B7E40E"><enum>(I)</enum><text>The type of project (major construction, minor construction, nonrecurring maintenance, leases, or other category, including disposals).</text></subclause>
<subclause id="H032120F2287445D6981CFC8695A6CCDA"><enum>(II)</enum><text>The estimated total cost of the project.</text></subclause> <subclause id="H564B4EF21D80470880B14E0EAF8AF9FF"><enum>(III)</enum><text>A description of the project.</text></subclause>
<subclause id="HF2F05E71A80C43BFB8A6AD8943B7749F"><enum>(IV)</enum><text>The location and facility with respect to which the project was carried out or is expected to be carried out.</text></subclause> <subclause id="H24E128BB83C44DCAB8BF2F5EEB66942D"><enum>(V)</enum><text>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.</text></subclause></clause>
<clause id="H10D73A079806400D95FD74592E680110"><enum>(viii)</enum><text>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.</text></clause> <clause id="HBC4024BF7DC04BC2BCCDDAFDB4D0FDE4"><enum>(ix)</enum><text>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.</text></clause>
<clause id="H006DACEE46DE420CBCE374283E0D0C9C"><enum>(x)</enum><text>Meaningful metrics that show the progress of the Department toward meeting relevant goals of the Department relating to capital asset management.</text></clause> <clause id="H63A4CBD420624FFCAC7D2C4E4F6EF8B8"><enum>(xi)</enum><text>Such other matters as the Secretary considers appropriate.</text></clause></subparagraph>
<subparagraph id="H894221511C9F4B62A5E826CA8CC625B3"><enum>(B)</enum><header>Subsequent reports</header><text>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).</text></subparagraph></paragraph> <paragraph id="HAB2FD6D6C847438CA7FCC837DE49E9C4"><enum>(3)</enum><header>Matters relating to reporting costs</header><text>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.</text></paragraph></subsection>
<subsection id="H36DEC95CD84D4FEBBDD9BB1798774079"><enum>(b)</enum><header>Super construction projects</header>
<paragraph id="H018341601F664CD1A1A0121B04B19304"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="H43C3DB8D362844669EE59B6E181B52C2"><enum>(2)</enum><header>Elements</header><text>Each report required under paragraph (1) shall include, for each project described in such paragraph—</text>
<subparagraph id="H3116F7AE1D9345DAB5FFD24C061EDBD2"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="H5DE4FE24740441BD829728DED02BCD76"><enum>(B)</enum><text>the actual cost and schedule variances of the project, as of such day, compared to the planned cost and schedules for the project.</text></subparagraph></paragraph></subsection>
<subsection id="H76C3C4CD91454338B0EC42B1EA953EDB"><enum>(c)</enum><header>Definitions</header><text>In this section:</text> <paragraph id="H2BE4595754E54E5F95C49BD3F8AC6CE5"><enum>(1)</enum><header>Appropriate committees of Congress</header><text>The term <term>appropriate committees of Congress</term> means—</text>
<subparagraph id="H8227382DE2F24A269E8E6D44282B52A5"><enum>(A)</enum><text>the Committee on Appropriations and the Committee on Veterans’ Affairs of the Senate; and</text></subparagraph> <subparagraph id="HC3F40569ED814BED85333AC8964D98F5"><enum>(B)</enum><text>the Committee on Appropriations and the Committee on Veterans’ Affairs of the House of Representatives.</text></subparagraph></paragraph>
<paragraph id="HD162537A8F544CCCB1E0AB503A0820D8"><enum>(2)</enum><header>Capital asset project</header><text>The term <term>capital asset project</term> means a capital asset investment or activity of the Department.</text></paragraph> <paragraph id="H8427C5BCB2FA495EA509740F159795CF"><enum>(3)</enum><header>Super construction project</header><text>The term <term>super construction project</term> has the meaning given such term in section 8103(e)(3) of this title.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H1D5CF51070564A52AE565E206FEA720A"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> of title 38, United States Code, is amended by striking the item relating to section 8120 and inserting the following new item:</text> <quoted-block style="USC" id="HAF01908A5C6D4FFE9B3610357C0554D9"> <toc> <toc-entry level="section" idref="H4D038BA48B954944845ADF224AB8E25B">8120. Reports on key capital asset investments, activities, and performance.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> <section id="H2DE912755BC24A7FBC4E4928E4E56091"><enum>660.</enum><header>Development of streamlined procurement model; report</header><text display-inline="no-display-inline">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 <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> 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.</text></section>
<section id="H7A6FC86006C341B09FF97DDB80910C08"><enum>661.</enum><header>Submission and notification of cost estimates for medical facility leases</header>
<subsection id="H682A2E2102EC4F19A56DD053425BD041"><enum>(a)</enum><header>Submission of cost estimates for major medical facility leases with presidential budget request</header><text>Subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/81">chapter 81</external-xref> of title 38, United States Code, is amended by inserting after <external-xref legal-doc="usc" parsable-cite="usc/38/8104">section 8104</external-xref> the following new section:</text> <quoted-block id="HA18A337ACEE54A11A5863423592A24D9" style="USC"> <section id="H70786CB63A104F96B010996B5CB04B93"><enum>8104A.</enum><header>Submission of cost estimates for major medical facility leases with president’s budget request</header> <subsection id="HB83B603B938A48FD9C2105984BB21C00"><enum>(a)</enum><header>In general</header><text>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.</text></subsection>
<subsection id="H8E84B6D12F1247C4988E78A21C3D24F0"><enum>(b)</enum><header>Market-based cost estimate</header><text>Each market-based cost estimate required under subsection (a) shall include an evaluation of—</text> <paragraph id="H04618C04E7F24B55AA549CECD2DA5699"><enum>(1)</enum><text>local land values;</text></paragraph>
<paragraph id="H2E3B57812DAD4ABE8F5AEA65560922A4"><enum>(2)</enum><text>applicable construction costs; and</text></paragraph> <paragraph id="HB0DFC28CFE53448EA96DED2CC92A3BFC"><enum>(3)</enum><text>other cost factors the Secretary determines relevant to build-to-suit facilities.</text></paragraph></subsection>
<subsection id="H391FB611D3FE4E20BB318EBBB713BDE7"><enum>(c)</enum><header>Standardized methodology</header>
<paragraph id="H49BF12A591C44C148F524CCDB9E7C18F"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="H92FBC527768B43EDAC54D6D6A92D16F0"><enum>(2)</enum><header>Required elements</header><text>The methodology required under paragraph (1) shall include, at a minimum—</text>
<subparagraph id="H2C292AA2BFD94EEE9D2BF0AB8C7FD3B4"><enum>(A)</enum><text>base rent projections over the full lease term;</text></subparagraph> <subparagraph id="HED0702455D0744809D6021E6E501FBB1"><enum>(B)</enum><text>tenant improvement and buildout costs based on current medical facility standards;</text></subparagraph>
<subparagraph id="H53B92022DA2548C183F53676C821C9EE"><enum>(C)</enum><text>estimated operating expenses, including utilities, maintenance, and security;</text></subparagraph> <subparagraph id="H3798D16BE25844799D8BBF60F188CA50"><enum>(D)</enum><text>annual escalation factors tied to construction cost indices, labor rates, and market trends;</text></subparagraph>
<subparagraph id="HDCCA8D04A49746598319C612EDAAADF9"><enum>(E)</enum><text>cost assumptions for option periods or potential renewal terms; and</text></subparagraph> <subparagraph id="HF1C9362D628448F9B8EA2C05ABF6A259"><enum>(F)</enum><text>geographic adjustments using current regional market data to reflect location-specific construction and leasing conditions.</text></subparagraph></paragraph></subsection>
<subsection id="H0E2FA465691144F685C0EC4F2AD3679C"><enum>(d)</enum><header>Annual adjustment</header>
<paragraph id="HCC2F5007630F4004A202DCCFFC903D71"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="HA3175EAA085D44D3BACD85CD9D7CA6F4"><enum>(2)</enum><header>Indices</header><text>In adjusting a cost estimate under paragraph (1), the Secretary shall use such medical construction or real estate indices as the Secretary determines appropriate.</text></paragraph></subsection>
<subsection id="H9D7D4E74AA184CEE94EE3C1C63518E11"><enum>(e)</enum><header>Rules of construction</header>
<paragraph id="HA61245FA0DE04489B51EE9E603EAB887"><enum>(1)</enum><header>Budgetary treatment</header><text>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.</text></paragraph> <paragraph id="HC7C391E3C2DE4B02AC43B35D25539BC5"><enum>(2)</enum><header>Preservation of existing budget authority requirements</header><text>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.</text></paragraph></subsection>
<subsection id="HA8E389BEBAE649AFBC042487123F6DC3"><enum>(f)</enum><header>Definitions</header><text>In this section, the term <quote>major medical facility lease</quote> has the meaning given that term in section 8104(a)(3)(B) of this title.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection id="H214C561275ED4E579BAB46CECD201921"><enum>(b)</enum><header>Congressional notification and plan required for cost estimates exceeding approved prospectus amounts</header><text>Subchapter I of such chapter is further amended by inserting after section 8104A the following new section:</text>
<quoted-block id="H64C3FCDFF72241E4AEA81967FC37A1F9" style="USC">
<section id="HB173F6B0EF7A4DF9813A60A6A334BC35"><enum>8104B.</enum><header>Congressional notification and plan required for cost estimates exceeding approved prospectus amounts</header>
<subsection id="H968B619EF4B2457EB36EB3285D1149EF"><enum>(a)</enum><header>Price estimates required during solicitation phase</header><text>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.</text></subsection> <subsection id="H0442316BA8AF4655B1FC43E42AEB96C9"><enum>(b)</enum><header>Notification required</header><text display-inline="yes-display-inline">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.</text></subsection>
<subsection id="H819CFFEFDB454FDCBCF0C15F8064CCB4"><enum>(c)</enum><header>Plan required</header>
<paragraph id="HD5E342689629407AAB47A684EC273B57"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph> <paragraph id="H80190C1D4FD94D2F9F75C54ED9842062"><enum>(2)</enum><header>Limitation on award</header><text>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.</text></paragraph></subsection>
<subsection id="HF9B4D3CFB37645168FD57B6BB4214644"><enum>(d)</enum><header>Limitation on further action</header><text>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).</text></subsection> <subsection id="H07B1AF2E4C7A4CA7B8B1B738D9FF46FE"><enum>(e)</enum><header>Rule of construction</header><text>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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H153D7EF9063E48398F2AD5F7DE219DE0"><enum>(c)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 8104 the following new items:</text> <quoted-block id="HF1B20C92FE1B48C89ABD6F929185F9AE" style="USC"> <toc regeneration="no-regeneration"> <toc-entry level="section">8104A. Submission of cost estimates for major medical facility leases with President’s budget request</toc-entry> <toc-entry level="section">8104B. Congressional notification and plan required for cost estimates exceeding approved prospectus amounts</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section> <section id="H1069201D90B84241A0F7B4FA19508078"><enum>662.</enum><header>Report on capital asset and information technology needs of the research and development program of Department of Veterans Affairs</header> <subsection id="HADFAC9AAC0654A029CE25BBB5ED11913"><enum>(a)</enum><header>Report required</header><text>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.</text></subsection>
<subsection id="HF8C5FE53F4CA4EA8B03263FF7AC61C3E"><enum>(b)</enum><header>Contents</header>
<paragraph id="HF4A2873294274F8BB8E66244365E8503"><enum>(1)</enum><header>In general</header><text>The report required by subsection (a) shall include the following:</text> <subparagraph id="H04AEE3EF84734C018AEFF39F29D11FD5"><enum>(A)</enum><text>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.</text></subparagraph>
<subparagraph id="HA76557790A454DEB9E32091BFDBBCA26"><enum>(B)</enum><text>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.</text></subparagraph> <subparagraph id="H9F067005930942E098025CC485FFFE66"><enum>(C)</enum><text>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.</text></subparagraph></paragraph>
<paragraph id="H097307D447E3451E830AE8B5CB175CC7"><enum>(2)</enum><header>Requirements</header>
<subparagraph id="H1063F99832A143559173A8F72396BB6A"><enum>(A)</enum><header>Facilities</header>
<clause id="HBFB53E9A2425464AAE0174163CF38206"><enum>(i)</enum><header>Summaries by project</header><text>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.</text></clause> <clause id="HE3236AC6B4E3430DBC38E9EDC3D864E6"><enum>(ii)</enum><header>Identification of projects</header><text>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.</text></clause></subparagraph>
<subparagraph id="HB750E7701043492CB980EF079B2AC3F3"><enum>(B)</enum><header>Information technology</header><text>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.</text></subparagraph> <subparagraph id="HE050037E8DC547ADA1CE8E616B6852D2"><enum>(C)</enum><header>Scope</header><text>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.</text></subparagraph></paragraph></subsection>
<subsection id="H49009354907F4C4A9F821C1E8BF4579F"><enum>(c)</enum><header>Considerations</header><text>In preparing the report required by subsection (a), the Secretary may consider the following:</text> <paragraph id="HC2C72C2AF2CE4B0A8D037FF49B8A10B3"><enum>(1)</enum><text>The findings of the 2012 final report of the Research Infrastructure Program of the Department.</text></paragraph>
<paragraph id="HB6814D0252874BBDA47484E26D2C68CD"><enum>(2)</enum><text>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.</text></paragraph> <paragraph id="HB87D914CBCA948B3BC07A9D99E464DDA"><enum>(3)</enum><text>Such other matters as the Secretary considers appropriate.</text></paragraph></subsection></section>
<section id="H56E7865F5A454A88AD6F14DF5FB2981F"><enum>663.</enum><header>Improving prevention, detection, and reporting of waste, fraud, and abuse in Department of Veterans Affairs capital asset projects and activities</header>
<subsection id="HC47AC21ADA0B4E34AE999B69557B1105"><enum>(a)</enum><header>Report required</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the appropriate committees of Congress a report on 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.</text></subsection> <subsection id="H214EC39E39DC4D58BC025586BA2A9573"><enum>(b)</enum><header>Elements</header><text>The report required by subsection (a) shall include the following:</text>
<paragraph id="HBF0A08EA5F3D4A31B9EF0E47F910BDAD"><enum>(1)</enum><text>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.</text></paragraph> <paragraph id="H319050A0498041B788E3AF8060331290"><enum>(2)</enum><text>Recommendations for such legislative and administrative action as the Secretary determines appropriate to improve the prevention, detection, and reporting of waste, fraud, and abuse.</text></paragraph>
<paragraph id="H8833FB330E4643748F3A91954C65FCC8"><enum>(3)</enum><text>Such other matters as the Secretary considers appropriate.</text></paragraph></subsection> <subsection id="HF983824225414037A899DFF0A9547CCD"><enum>(c)</enum><header>Consultation</header><text>In carrying out subsection (a), the Secretary—</text>
<paragraph id="H979B3354E3A04DC69A59E5104F474AC8"><enum>(1)</enum><text>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</text></paragraph> <paragraph id="HC54AEA4BC2F345ABA8F42D33D3B5D6ED"><enum>(2)</enum><text>may consult with such other persons and entities on such matters as the Secretary considers appropriate.</text></paragraph></subsection></section>
<section id="H0367B6DBCC1846D2A19F3EC2B91D1081"><enum>664.</enum><header>Report on long-term care physical infrastructure needs of Department of Veterans Affairs</header>
<subsection id="HD384EED48ABD478B8D00475CE91EC9DD"><enum>(a)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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—</text> <paragraph id="H855CB7AF6A0A4D878F94CFE45DAA325C"><enum>(1)</enum><text>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;</text></paragraph>
<paragraph id="H4FF476F59A08407A88F40ED7896874B0"><enum>(2)</enum><text>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</text></paragraph> <paragraph id="H6032BB379C7E42C59F51F39519A81180"><enum>(3)</enum><text>with respect to any projects needed to provide the infrastructure specified under paragraph (1)—</text>
<subparagraph id="HB8597FF3F0E84D37B6C843F376C737A8"><enum>(A)</enum><text>the estimated individual project cost and total cost to accomplish those projects; and</text></subparagraph> <subparagraph id="H88762B746E574E2982D798881090E25D"><enum>(B)</enum><text>the estimated individual project timeline to accomplish each such project upon receipt of appropriate funding.</text></subparagraph></paragraph></subsection>
<subsection id="H32555C7494C94869908E6BA86674F9E8"><enum>(b)</enum><header>Inclusion of information regarding prioritization of certain projects</header><text>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.</text></subsection> <subsection id="H6BC5DA9932494D949D37ADD6B267BD1D"><enum>(c)</enum><header>Development of report</header><text>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.</text></subsection>
<subsection id="H1FABC8C8A2D24A5AAF2790CD15313D10"><enum>(d)</enum><header>Indication of types of projects</header><text>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.</text></subsection></section></subtitle> <subtitle id="H51EF0AC8EDA44AE79E64F9A3D908992B"><enum>F</enum><header>Other Health Care Matters</header> <section id="H84E97656388148ABA73EE41726349915"><enum>671.</enum><header>Prescription, delivery, distribution, and dispensation of controlled substance medications by covered health care professionals of Department of Veterans Affairs via telemedicine</header> <subsection commented="no" display-inline="no-display-inline" id="H16235E2B2FE4472FBDF02BEA78109985"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text display-inline="yes-display-inline">Subchapter III of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text>
<quoted-block style="USC" display-inline="no-display-inline" id="HBF687502A0F74DD881DF5275667992B2">
<section id="HBA3213202E184AE6B18D836159F70B38"><enum>1730D.</enum><header>Prescription, delivery, distribution, and dispensation of controlled substance medications via telemedicine</header>
<subsection id="H31AB1EE3E07E4964AD62DBE0204F9C1F"><enum>(a)</enum><header>In general</header><text>Notwithstanding sections 102(54) and 309(e) of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/802">21 U.S.C. 802(54)</external-xref> 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 (<external-xref legal-doc="usc" parsable-cite="usc/21/301">21 U.S.C. 301 et seq.</external-xref>), regardless of whether such covered health care professional has conducted an in-person medical examination of such patient, if—</text> <paragraph id="H9E57699446FB4F7BB32B358EC87CECE0"><enum>(1)</enum><text display-inline="yes-display-inline">such covered health care professional—</text>
<subparagraph id="H84A17F5706014C6C8FFDD44AA955E664"><enum>(A)</enum><text>is acting in the usual course of professional practice;</text></subparagraph> <subparagraph id="H252CC164AFD7437C9597823F3C51CDB0"><enum>(B)</enum><text>is registered pursuant to section 303(g) of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/823">21 U.S.C. 823(g)</external-xref>) in any State or is utilizing the registration of a facility of the Department registered pursuant to section 303(f) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/823">21 U.S.C. 823(f)</external-xref>);</text></subparagraph>
<subparagraph id="HA590F2030DA7479B864519F8937F7D02"><enum>(C)</enum><text>has access to medical documentation from an in-person medical evaluation of such patient in the past two years by—</text> <clause id="HBC19E2CF083B4F0DAB8E364DE4DA4FEB"><enum>(i)</enum><text>a covered health care professional;</text></clause>
<clause id="H92081DFA16EA44D99FAA721A72FF2DB3"><enum>(ii)</enum><text>a health care professional who furnished care and services under the Veterans Community Care Program under section 1703 of this title; or</text></clause> <clause id="H084AA1CB48E54EDC8637107A8E32E3B7"><enum>(iii)</enum><text>a health care professional of the Department of Defense; and</text></clause></subparagraph>
<subparagraph id="H64CD977EF6544C0888C9929D4A10CC75"><enum>(D)</enum><text>at the time of the telemedicine visit of the patient—</text> <clause id="H11430EA1AF274E2A98A35F72E7332A7C"><enum>(i)</enum><text>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</text></clause>
<clause id="H837421795CB64A01901584F2A3184018"><enum>(ii)</enum><text>provides documentation of—</text> <subclause commented="no" display-inline="no-display-inline" id="H4AFE0B8D02D04DAF8B9BD6947D45D29D"><enum>(I)</enum><text display-inline="yes-display-inline">such review;</text></subclause>
<subclause commented="no" display-inline="no-display-inline" id="HBC4425E62E99484C94282079E8EA16F4"><enum>(II)</enum><text display-inline="yes-display-inline">all successful attempts to access such databases and program; and</text></subclause> <subclause commented="no" display-inline="no-display-inline" id="H75FB7AF4246940EE9F835D67C13C5436"><enum>(III)</enum><text display-inline="yes-display-inline">all unsuccessful attempts to access such databases and program that resulted in the prescription of a limited supply under subsection (b); and</text></subclause></clause></subparagraph></paragraph>
<paragraph id="HA42FCAE623294F929FA5BA26297C3018"><enum>(2)</enum><text>such substance is delivered, distributed, or dispensed for a legitimate medical purpose.</text></paragraph></subsection> <subsection id="H1D42B2F100E5429991FF5FD0535922FD" commented="no"><enum>(b)</enum><header>Authority for limited supply</header> <paragraph id="H9A0745090B144830B993C7AD98560D93"><enum>(1)</enum><header>In general</header><text>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.</text></paragraph>
<paragraph id="H26DADE934C314A3D8071C5CBD29AD0AB"><enum>(2)</enum><header>Databases unavailable or inaccessible</header><text>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.</text></paragraph></subsection> <subsection commented="no" display-inline="no-display-inline" id="HE9B050331C8745BD9EDB6280CE4FF2AB"><enum>(c)</enum><header>Maximum supply</header><text>The authority under this section may be used to supply a controlled substance for not more than a six-month period.</text></subsection>
<subsection id="H2B49D348E77F4B23B0EFD5E5F8AB0401"><enum>(d)</enum><header>Use of authority</header><text>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.</text></subsection> <subsection id="H0073775B48C74A04815FF6AF3281795C"><enum>(e)</enum><header>Regulations</header> <paragraph id="H173A7B9E88494E0F8511FD3EC54E65B5"><enum>(1)</enum><header>In general</header><text>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).</text></paragraph>
<paragraph id="H1A5CC98332464AD9BA154E8EBDAB6D04"><enum>(2)</enum><header>Elements</header><text>The Secretary shall ensure the guidelines and process described in paragraph (1)—</text> <subparagraph id="HF157F9AA9198418FA6F387A991DECF48"><enum>(A)</enum><text>do not restrict access of a patient to in-person care; and</text></subparagraph>
<subparagraph id="HB30AA4CCA5B5497A9870158075A3F6B7"><enum>(B)</enum><text>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.</text></subparagraph></paragraph> <paragraph id="H5C85312C23414A1C93E65425056E7D20"><enum>(3)</enum><header>Initiating treatment</header> <subparagraph commented="no" display-inline="no-display-inline" id="H1D447F47A4D44ABD984E7E9594759E5C"><enum>(A)</enum><header>In general</header><text display-inline="yes-display-inline">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 (<external-xref legal-doc="usc" parsable-cite="usc/21/812">21 U.S.C. 812</external-xref>) unless the covered health care professional is providing treatment—</text>
<clause id="HEF65E6B5AD5E420ABB72BBA162E5F0F2"><enum>(i)</enum><text>for opioid use disorder;</text></clause> <clause commented="no" display-inline="no-display-inline" id="H9E098D5E0F0C4BF78AB61D0E54461181"><enum>(ii)</enum><text>for a patient receiving palliative care or enrolled in hospice care; or</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H7F93FECD953A4625839F046CE5F90A08"><enum>(iii)</enum><text>for a patient who is physically located in a medical facility where the patient is receiving in-person care.</text></clause></subparagraph> <subparagraph id="H40A9EB0B0B754E138507792B0F46E4B8"><enum>(B)</enum><header>Exception</header><text>The prohibition under subparagraph (A) shall not apply to renewal or maintenance of a previously prescribed medication described in such subparagraph.</text></subparagraph></paragraph></subsection>
<subsection id="H94825DB5A334480FB880F07F0DBF68AF"><enum>(f)</enum><header>Reporting</header>
<paragraph id="HA88A12C8262D45FD8A55D9CD56C59316"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of the enactment of the <short-title>Take Care of America’s Veterans Act</short-title>, 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.</text></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H435939BBB3ED4F998CED0E5ED1CB039F"><enum>(2)</enum><header>Elements</header><text display-inline="yes-display-inline">Each report under paragraph (1) shall indicate, at a minimum—</text>
<subparagraph id="H1AC3889EC14A42889BD49DB62B97C7F1"><enum>(A)</enum><text>how many patients received prescriptions for controlled substance medications through telemedicine under this section;</text></subparagraph> <subparagraph id="H9C3777177A884B64936909EA648B0DCE"><enum>(B)</enum><text>which controlled substances are being prescribed under this section and how many prescriptions were written for each such substance;</text></subparagraph>
<subparagraph id="HC5B85C65F3E8427EB66E486CFC8C1F6B"><enum>(C)</enum><text>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</text></subparagraph> <subparagraph id="H519659373F1A48C5ACD8E44991AFEAD7"><enum>(D)</enum><text>the barriers that exist to reviewing prescription drug monitoring programs of States and how often those barriers occur.</text></subparagraph></paragraph></subsection>
<subsection id="HFDBD052F6A9D413FA48AA5BBBD0A35BA"><enum>(g)</enum><header>Duration</header><text>The authority under this section shall terminate on September 30, 2031.</text></subsection> <subsection id="HBC673D5481564172813A5A5F0CAF691E"><enum>(h)</enum><header>Definitions</header><text display-inline="yes-display-inline"> In this section:</text>
<paragraph id="HE1B5C26A87A34AF1A0CA5F9D6518AF29"><enum>(1)</enum><text>The terms <term>controlled substance</term>, <term>deliver</term>, <term>dispense</term>, and <term>distribute</term> have the meanings given those terms in section 102 of the Controlled Substances Act (<external-xref legal-doc="usc" parsable-cite="usc/21/802">21 U.S.C. 802</external-xref>).</text></paragraph> <paragraph id="H3D05A06182F645E1BC32C39AD2D515C3"><enum>(2)</enum><text>The term <term>covered health care professional</term> means—</text>
<subparagraph id="H2885E6C58191488EA713B7DB2036C908"><enum>(A)</enum><text>a health care professional who—</text> <clause id="H43775920F6A744D79B4A27102DB20165"><enum>(i)</enum><text display-inline="yes-display-inline">is—</text>
<subclause commented="no" display-inline="no-display-inline" id="HFC99F76DC1AD46A1A894AD2793EF09D0"><enum>(I)</enum><text display-inline="yes-display-inline">an employee of the Department appointed under section 7306, 7401, 7405, 7406, or 7408 of this title or under title 5; or</text></subclause> <subclause commented="no" display-inline="no-display-inline" id="H1D4ED42DE4EE42FBBBBED01FC812887D"><enum>(II)</enum><text display-inline="yes-display-inline">operating from a facility of the Department, including a clinic of the Department;</text></subclause></clause>
<clause commented="no" id="HEC35CA4DC1874B668A80FFF0AF5D8392"><enum>(ii)</enum><text>is authorized by the Secretary to provide health care under this chapter;</text></clause> <clause id="HC003F6D0B75A421AB29B68595EC0CD7E"><enum>(iii)</enum><text>is required to adhere to all standards for quality relating to the provision of health care in accordance with applicable policies of the Department; </text></clause>
<clause id="H0FB5A018A8A544D7AD278CB92CBB708C"><enum>(iv)</enum><text>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</text></clause> <clause id="H5B67C76BEBF8472992F230B523579E4D"><enum>(v)</enum><text>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</text></clause></subparagraph>
<subparagraph id="H2254DAC1EF9643FDB79F9FE29DE6E457"><enum>(B)</enum><text>a health professions trainee who—</text> <clause id="H5A04BFBEBB254123A4AB647F6BA07374"><enum>(i)</enum><text>is appointed under section 7405 of this title; and</text></clause>
<clause id="HE785AD9514DB47978114C83EFC5006CE"><enum>(ii)</enum><text>is under the clinical supervision of a health care professional described in subparagraph (A).</text></clause></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection> <subsection commented="no" display-inline="no-display-inline" id="HF58B375D45ED4C6BAF6789512AB879BC"><enum>(b)</enum><header>Clerical amendment</header><text>The table of sections at the beginning of such chapter is amended by inserting after the item relating to section 1730C the following new item:</text>
<quoted-block style="USC" id="HF6CBCBA00AC14102B77FF8C58A4C52F7">
<toc>
<toc-entry level="section" idref="HBA3213202E184AE6B18D836159F70B38">1730D. Prescription, delivery, distribution, and dispensation of controlled substance medications via telemedicine.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subsection></section>
<section id="HA3E145DC9DF24EA3A6A05DA43D1B2CB2"><enum>672.</enum><header>Copayments for limited supplies of medications</header><text display-inline="no-display-inline">Paragraph (4) of section 1722A(a) of title 38, United States Code, is amended to read as follows:</text> <quoted-block id="HD52E8AA51BE7447985BFE387BC0C34E4" display-inline="no-display-inline" style="OLC"> <paragraph id="H875DE2BBE7A74442B1B0179B7CB84F12" indent="up1"><enum>(4)</enum><text>Paragraph (1) does not apply—</text>
<subparagraph id="H2838E996FC604B00B65A789BC1F0F3AC"><enum>(A)</enum><text>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</text></subparagraph> <subparagraph id="HCF867201BE874D1191276CF38BD6539D" commented="no" display-inline="no-display-inline"><enum>(B)</enum><text>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.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></section>
<section id="HE29B769AB2C6407C9DE5344E427AEFA1"><enum>673.</enum><header>Plan on establishment of interactive, online self-service module for care</header>
<subsection id="H74FCD22A31E94361BDAD08C17519D517"><enum>(a)</enum><header>In general</header><text>The Secretary of Veterans Affairs shall develop and implement a plan to establish, to the greatest extent practicable, an interactive, online self-service module—</text> <paragraph commented="no" display-inline="no-display-inline" id="HDC2030C614A54C149A8BD69C467F2912"><enum>(1)</enum><text display-inline="yes-display-inline">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—</text>
<subparagraph id="HC2E3F18D0EF94F96B9CC0DA1193B4599"><enum>(A)</enum><text>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;</text></subparagraph> <subparagraph id="HC40A199FED174A06B9C75ECB7897443E"><enum>(B)</enum><text>to appeal and track decisions relating to—</text>
<clause id="H2A6F03D1BDCC4C30879B42855C4B9C09"><enum>(i)</enum><text>denials of requests for authorization for care or services under section 1703 of title 38, United States Code; or</text></clause> <clause id="H60B4B80C20584A219206E6DF48A6D668"><enum>(ii)</enum><text>denials of requests for care or services at facilities of the Department, including under section 1710 of such title;</text></clause></subparagraph>
<subparagraph id="HD64E09443CDE40A89A082FD122079578"><enum>(C)</enum><text>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;</text></subparagraph> <subparagraph id="H9C86601AE79740ADBB8B7AE7996B5F4F"><enum>(D)</enum><text>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</text></subparagraph>
<subparagraph id="HA6E72174C5BE409EA3200B6629329B1C"><enum>(E)</enum><text>to view a provider directory, information regarding pending medical claims, and explanations of benefits; and</text></subparagraph></paragraph> <paragraph id="H374818029CB84233BD2865F74C5DDF0A"><enum>(2)</enum><text>to implement such other matters as determined appropriate by the Secretary.</text></paragraph></subsection>
<subsection id="H66BDDA44ECA449D899EEC8FD04C385EC"><enum>(b)</enum><header>Submittal of plan</header>
<paragraph id="H013619364B7647E38E733FAC61AD4671"><enum>(1)</enum><header>Initial plan</header><text>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).</text></paragraph> <paragraph id="H595103D503CA4834AA0FF5FD7C25274F"><enum>(2)</enum><header>Biannual update</header><text>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.</text></paragraph></subsection></section>
<section id="H439EDA35B19C497EAF0FA9465EA0A827"><enum>674.</enum><header>Modification of requirements for Center for Innovation for Care and Payment of the Department of Veterans Affairs and transfer of authority</header>
<subsection commented="no" display-inline="no-display-inline" id="H4F1B59496DA84FBBAAF1E1E02403FBFB"><enum>(a)</enum><header display-inline="yes-display-inline">In general</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/3">Chapter 3</external-xref> of title 38, United States Code, is amended by adding at the end the following new section:</text> <quoted-block style="USC" display-inline="no-display-inline" id="HBE199FABDA114824A8B666C231B8B583"> <section id="H27408420F49D4D26917640EE36932C49"><enum>326.</enum><header>Center for Innovation</header> <subsection commented="no" display-inline="no-display-inline" id="H45983336BC5D4DD2B91D7606AC23375D"><enum>(a)</enum><header>Establishment</header><text>There is established within the Department a Center for Innovation (in this section referred to as the <quote>Center</quote>).</text></subsection>
<subsection id="H1E405D27BFCC428783143F4FADACDDB4"><enum>(b)</enum><header>Purpose</header><text display-inline="yes-display-inline">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.</text></subsection> <subsection id="H4F220A5DFE5E42EF9564BC614078B1E3"><enum>(c)</enum><header>Identification and testing of models</header> <paragraph commented="no" display-inline="no-display-inline" id="H3938B1C518254D64BA7F55FFF91D1799"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Center shall—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H78CE1C7CCF3F406787A081E0F859D7BE"><enum>(A)</enum><text>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—</text> <clause commented="no" display-inline="no-display-inline" id="H5AF9BEA6E07D421C90FBC594BF9593C7"><enum>(i)</enum><text>reduce program expenditures; and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H86BD275E8AC543769267061334AB0809"><enum>(ii)</enum><text>preserve or enhance the quality of care furnished to veterans;</text></clause></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HD12CDE5C435F4905984FE29D504CB148"><enum>(B)</enum><text>give preference to models that improve the coordination, quality, and efficiency of health care services furnished under this title; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H962D6E06FF9E4F918787421A280D9E09"><enum>(C)</enum><text>evaluate the effect of applying such models on program expenditures and quality outcomes under this title.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H05664F36AC7040BE85F1A9A4E428D8EB"><enum>(2)</enum><header>Included models</header><text>The models identified and tested under paragraph (1) may include the following:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H4EB29F8C2D514B8D9018C81AF1DFF85D"><enum>(A)</enum><text>Bundled payment arrangements.</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H23E141227E134FD2B90EEDE38E1D5C6A"><enum>(B)</enum><text>Preventive care initiatives.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HD4F3CDD7DE824F9E9552D4BD20B40978"><enum>(C)</enum><text>Chronic care coordination models.</text></subparagraph></paragraph></subsection> <subsection id="HBDC0A5EA743341269E8CB088D25A336A"><enum>(d)</enum><header>Selection of models</header> <paragraph commented="no" display-inline="no-display-inline" id="HEB68AD801C34419386C82B72F7E34A9B"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary, acting through the Center, shall select models to be tested under subsection (b) from among those that—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HD7E76510CAF04A939655809B72ED20F3"><enum>(A)</enum><text>address a defined population for which there are demonstrated deficits in care leading to poor clinical outcomes or potentially avoidable expenditures; and</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H789121378E7147C8B495552AB71E5D7A"><enum>(B)</enum><text>are expected to reduce program costs while preserving or enhancing the quality of care furnished to veterans.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H008BD4631922411AB8A0656719EC0BF1"><enum>(2)</enum><header>Criteria</header><text>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.</text></paragraph></subsection> <subsection id="H0BFC1CDDBB8A4161A4E3A8BE32642E33"><enum>(e)</enum><header>Testing and evaluation</header> <paragraph commented="no" display-inline="no-display-inline" id="H63F290832BA9465E8AA9D19CCD759A5C"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall design and test each model under this section in a manner that allows for the evaluation of—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H873D60B9C934450F8F3C7BD30235FD52"><enum>(A)</enum><text>changes in program expenditures;</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H78E2383C85274EC8AC49D3041AF5381C"><enum>(B)</enum><text>changes in quality and outcomes of care for veterans; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H65F77E10D1154C10A12F14DFDCF3D39C"><enum>(C)</enum><text>other factors the Secretary determines relevant to care coordination, access, and equity.</text></subparagraph></paragraph> <paragraph commented="no" display-inline="no-display-inline" id="H32D10F5159EB4E789D92A736BC247F3A"><enum>(2)</enum><header>Evaluation</header><text>The Secretary shall evaluate each model under this section using scientifically valid methodologies, including control or comparison groups if practicable.</text></paragraph></subsection>
<subsection commented="no" display-inline="no-display-inline" id="H8309EB8C19E74F538DC9506D2AAE51CA"><enum>(f)</enum><header>Reporting</header>
<paragraph commented="no" display-inline="no-display-inline" id="H39CC5E4C8A7A42BDA91543772FE81E9B"><enum>(1)</enum><header>Annual report</header><text>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—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H5476F7916F104A148BC58349A591E026"><enum>(A)</enum><text>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;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H3A2B0BA477C84C70A660D01C6E8DA5BE"><enum>(B)</enum><text>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;</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H31551F0A7FFE406380991D5D6F8FF88D"><enum>(C)</enum><text>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;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H11A0FBDDA84F4759A54705D3A6641128"><enum>(D)</enum><text>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;</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H2DC0485C9C804351B6827EB736C144BA"><enum>(E)</enum><text>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;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HD6757B64CF78433EA318F9D9F188C7D1"><enum>(F)</enum><text>a description of provider, stakeholder, and veteran experiences; and</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H553D7C3EB8844432BCD1E9952270D539"><enum>(G)</enum><text>such other matters as the Secretary may consider relevant.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H52E2B19EE2A943E38011EE8F1CFB6D7B"><enum>(2)</enum><header>Final report on models</header><text>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—</text> <subparagraph commented="no" display-inline="no-display-inline" id="H5ABADC0CB84E49E4BDEA7157C2344624"><enum>(A)</enum><text display-inline="yes-display-inline">findings from the evaluation of such model;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HD8E4675A07664531B79AF8699923B536"><enum>(B)</enum><text display-inline="yes-display-inline">updated findings under paragraph (1) with respect to such model;</text></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="HF362B30061E34C208C7882EE6CE1C01F"><enum>(C)</enum><text display-inline="yes-display-inline">an assessment of the fiscal impact of such model; and</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H6832EE119D264CBE82A613CAC0C98E5C"><enum>(D)</enum><text display-inline="yes-display-inline">recommendations for expansion or termination of the use of such model.</text></subparagraph></paragraph></subsection> <subsection id="H177B6379C8734F20940D495B2FEE42BD"><enum>(g)</enum><header>Expansion of successful models</header> <paragraph commented="no" display-inline="no-display-inline" id="H449D11B8ACAE40AE857768E5AC8241E6"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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—</text>
<subparagraph commented="no" display-inline="no-display-inline" id="HE24F09F2B8BF4B35841C1C90B8A37B02"><enum>(A)</enum><text>the Secretary determines such expansion is expected to—</text> <clause commented="no" display-inline="no-display-inline" id="HE92278E7E148433C891A5A5B8753F93A"><enum>(i)</enum><text>reduce program expenditures without reducing quality of care; or</text></clause>
<clause commented="no" display-inline="no-display-inline" id="H4DEEBEA493644F1598F076776AA98CB6"><enum>(ii)</enum><text>improve quality of care without increasing program expenditures; and</text></clause></subparagraph> <subparagraph commented="no" display-inline="no-display-inline" id="H9FDE985E86214624B3DC27BDB40AE3CE"><enum>(B)</enum><text>the Chief Financial Officer of the Department certifies that such expansion will maintain budget neutrality.</text></subparagraph></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H25F449811B644D82BA1E61CE341CA73A"><enum>(2)</enum><header>Limitation</header><text>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.</text></paragraph></subsection> <subsection id="H4E0ABF18015A49058BB4CABA53DFD4DE"><enum>(h)</enum><header>Cost neutrality and funding</header> <paragraph commented="no" display-inline="no-display-inline" id="H583555F3D2094425B757A078704511CE"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">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.</text></paragraph>
<paragraph commented="no" display-inline="no-display-inline" id="H4D54E99E5258492B9155C7728E798146"><enum>(2)</enum><header>Use of available amounts</header><text>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.</text></paragraph></subsection> <subsection id="HD129F39FDFFC47F0B7DFACB0402F4FAA"><enum>(i)</enum><header>Rule of construction</header><text>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.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection>
<subsection id="H0289097DD0464E51BEB93126FCA13AF7"><enum>(b)</enum><header>Conforming and clerical amendments</header>
<paragraph commented="no" display-inline="no-display-inline" id="H6C3E21E094BC45279B66D0772EB478EA"><enum>(1)</enum><header display-inline="yes-display-inline">Conforming repeal</header><text>Section 1703E of title 38, United States Code, is repealed.</text></paragraph> <paragraph id="H00E5EF741C5E47C29A0E5B9EB25E7D6D"><enum>(2)</enum><header>Conforming amendments</header> <subparagraph id="H0FFD264D68BD4A209447B6C9BA6E2247"><enum>(A)</enum><header>Pilot program to improve administration of care under Veterans Community Care Program</header><text>Section 105(a) of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (<external-xref legal-doc="public-law" parsable-cite="pl/118/210">Public Law 118–210</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1703">38 U.S.C. 1703</external-xref> note) is amended, in the matter preceding paragraph (1), by striking <quote>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</quote> and inserting <quote>Pursuant to section 326 of title 38, United States Code, the Secretary of Veterans Affairs, acting through the Center for Innovation</quote>.</text></subparagraph>
<subparagraph id="H0DEF13509F8E4696BBD7125C785160F4"><enum>(B)</enum><header>Pilot program on consolidating approval process of Department of Veterans Affairs for covered dental care</header><text>Section 106(a) of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (<external-xref legal-doc="public-law" parsable-cite="pl/118/210">Public Law 118–210</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1703">38 U.S.C. 1703</external-xref> note) is amended, in the matter preceding paragraph (1), by striking <quote>the Center for Innovation for Care and Payment established under section 1703E of title 38, United States Code</quote> and inserting <quote>the Center for Innovation established under section 326 of title 38, United States Code</quote>.</text></subparagraph> <subparagraph id="H834B990ED90344E49D06146861FA5780"><enum>(C)</enum><header>Strategic plan on value-based health care system for Veterans Health Administration; pilot program</header><text>Section 107 of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act (<external-xref legal-doc="public-law" parsable-cite="pl/118/210">Public Law 118–210</external-xref>; <external-xref legal-doc="usc" parsable-cite="usc/38/1701">38 U.S.C. 1701</external-xref> note) is amended—</text>
<clause id="HED3BA9FFBEA046DB99B8D6DBD19A0754"><enum>(i)</enum><text>in subsection (a)(2)(A)(viii), by striking <quote>the Center for Innovation for Care and Payment of the Department under section 1703E of title 38, United States Code</quote> and inserting <quote>the Center for Innovation under section 326 of title 38, United States Code</quote>; and</text></clause> <clause id="H349E5934619E4F999DE7537C30C81573" commented="no" display-inline="no-display-inline"><enum>(ii)</enum><text>in subsection (c)(1), by striking <quote>the Center for Innovation for Care and Payment established under section 1703E of title 38, United States Code</quote> and inserting <quote>“the Center for Innovation under section 326 of title 38, United States Code</quote>.</text></clause></subparagraph></paragraph>
<paragraph id="H98FEC0A4157C42BF9770F300B3BBB7AB"><enum>(3)</enum><header>Clerical amendments</header>
<subparagraph commented="no" display-inline="no-display-inline" id="HDF964C81CDC945FE952F3B7271E6163D"><enum>(A)</enum><header display-inline="yes-display-inline">Chapter 17</header><text>The table of sections at the beginning of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/38/17">chapter 17</external-xref> of title 38, United States Code, is amended by striking the item relating to section 1703E.</text></subparagraph> <subparagraph id="HE10DC97520DF49E9AB81EEDE44A5444B"><enum>(B)</enum><header>Chapter 3</header><text>The table of sections at the beginning of chapter 3 of such title is amended by adding at the end the following new item:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H04B723CA9D6044F595E806272398FA45">
<toc>
<toc-entry level="section" bold="off">326. Center for Innovation.</toc-entry></toc><after-quoted-block>.</after-quoted-block></quoted-block></subparagraph></paragraph></subsection>
<subsection id="HB501F14385F14EE0B8FDD277CAF1C779"><enum>(c)</enum><header>Comptroller General report</header><text>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—</text> <paragraph id="HDCF917B258894430BF35EB5CD1B1AF71"><enum>(1)</enum><text>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</text></paragraph>
<paragraph id="HE0BD022577084A48BB8ABCEBEA2FB638"><enum>(2)</enum><text>containing such recommendations as the Comptroller General considers appropriate.</text></paragraph></subsection> <subsection id="H28419486D840483C98EFB00E0491C147"><enum>(d)</enum><header>Review of Veterans Community Care Program</header> <paragraph commented="no" display-inline="no-display-inline" id="H4C54BC7F0C00456D89330D83D93D3E4C"><enum>(1)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs, 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.</text></paragraph>
<paragraph id="H74223D0FE4324CD0941F3C3CFA1EE641"><enum>(2)</enum><header>Elements</header><text>The review required by paragraph (1) shall—</text> <subparagraph id="H6E9929C2AF404845B2AE4C22EDF293AD"><enum>(A)</enum><text>identify proven management and payment best practices of the Federal Government used under the Medicare program under title XVIII of the Social Security Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>), the Medicaid program under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), and the TRICARE program (as defined in section 1072 of title 10, United States Code);</text></subparagraph>
<subparagraph id="H7A353AEDB8F747C4AF97FD05B4156C67"><enum>(B)</enum><text>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;</text></subparagraph> <subparagraph id="H0A5A66DFEC6445A5BB82F99549D77677"><enum>(C)</enum><text>determine how the Secretary can improve access to care through the Veterans Community Care Program for veterans eligible for such care;</text></subparagraph>
<subparagraph id="H1F52B4FFB72A4790A2AAEE4D9CF3C888"><enum>(D)</enum><text>identify solutions to ease administrative, legislative, and regulatory burdens and improve efficiency in the Veterans Community Care Program;</text></subparagraph> <subparagraph id="H007F06941C1E4E5DB339ED50F33E72BB"><enum>(E)</enum><text>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;</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="H0D80BD25CAD2449F8122B7376CA7472C"><enum>(F)</enum><text display-inline="yes-display-inline">review how the Secretary—</text> <clause id="H5BB51FAD335146FEB0501EF518F2D119"><enum>(i)</enum><text>identifies eligibility for and reviews, processes, and approves referrals for care under the Veterans Community Care Program;</text></clause>
<clause id="H2777702A54B84E858564E4A4556F6148"><enum>(ii)</enum><text>authorizes the furnishing of services under the Veterans Community Care Program; and</text></clause> <clause id="H2FBF2A195AC44BFA89E22FD30C3FCDA2" commented="no" display-inline="no-display-inline"><enum>(iii)</enum><text>receives, reviews, processes, and approves requests for payment from participating entities and providers furnishing services under the Veterans Community Care Program.</text></clause></subparagraph>
<subparagraph id="H9639AEE5463B4564A613DE6FBFF1F4F9"><enum>(G)</enum><text>assess such other factors as determined appropriate by the Secretary in consultation with Congress.</text></subparagraph></paragraph> <paragraph id="H3040B5BB166E4148B89A41F0A3B77638" commented="no"><enum>(3)</enum><header>Briefing and report</header> <subparagraph commented="no" display-inline="no-display-inline" id="H1043D7BFCE354950B565A42EB4B223A8"><enum>(A)</enum><header>Briefing</header><text display-inline="yes-display-inline">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.</text></subparagraph>
<subparagraph commented="no" display-inline="no-display-inline" id="HF54BA91FFD804CFE80D7517F84653625"><enum>(B)</enum><header>Report</header><text display-inline="yes-display-inline">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—</text> <clause commented="no" display-inline="no-display-inline" id="H8C5B5BCA66284A67B6595B089B837F02"><enum>(i)</enum><text display-inline="yes-display-inline">a complete and unredacted list of all findings and recommendations from the review; and</text></clause>
<clause commented="no" display-inline="no-display-inline" id="HD256C4E19FE848D9A8C275DDD8E9AB43"><enum>(ii)</enum><text display-inline="yes-display-inline">any legislative, administrative, regulatory, policy, or other changes sought by the Secretary as a result of such findings.</text></clause></subparagraph></paragraph> <paragraph id="H76C3BA4B3EF242AFB779F64AEFFEF12F"><enum>(4)</enum><header>Veterans Community Care Program defined</header><text>In this subsection, the term <term>Veterans Community Care Program</term> means the Veterans Community Care Program under section 1703 of title 38, United States Code.</text></paragraph></subsection>
<subsection id="H66989DCAF73A42DE9F577AFDBAB3D4C3" commented="no"><enum>(e)</enum><header>Pilot programs</header>
<paragraph commented="no" display-inline="no-display-inline" id="H3BB29FAAE8094F2283CCD6C03D5E407B"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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.</text></paragraph> <paragraph id="HD5E63FB70EA543E6B00B3A9AC9287180"><enum>(2)</enum><header>Pilot programs described</header><text>The Secretary shall carry out the following pilot programs:</text>
<subparagraph commented="no" display-inline="no-display-inline" id="H0F703DD7DDB64A6CB11BA10A7E3CBAC6"><enum>(A)</enum><text display-inline="yes-display-inline">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.</text></subparagraph> <subparagraph id="H879AF7E1A3164A48B7E5693699345E1D"><enum>(B)</enum><text>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.</text></subparagraph></paragraph></subsection>
<subsection id="H2374EAD9652D49718B1740ADECB6F3C5" commented="no"><enum>(f)</enum><header>Modification of independent assessments of health care delivery systems and management processes</header><text>Subsection 1704A of title 38, United States Code, is amended—</text> <paragraph id="HD67C03D9E44748709ECBEEEF27929F70"><enum>(1)</enum><text>in subsection (a)(2)(I), by adding at the end the following new clause:</text>
<quoted-block style="OLC" display-inline="no-display-inline" id="H9FA9E418896E4698A0B53502D8968C97">
<clause id="H633AEEC8111B4117A9E9375680A38184" indent="up1"><enum>(vi)</enum><text>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 (<external-xref legal-doc="usc" parsable-cite="usc/42/1395">42 U.S.C. 1395 et seq.</external-xref>), the Medicaid program under title XIX of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/1396">42 U.S.C. 1396 et seq.</external-xref>), and the TRICARE program (as defined in section 1072 of title 10).</text></clause><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph> <paragraph id="H9CF9AC6EFB34411BBC1799B451006EEA"><enum>(2)</enum><text>in subsection (d), by inserting <quote>or federally funded research and development center</quote> after <quote>private entity</quote>.</text></paragraph></subsection></section>
<section id="H040D0298CD1C43D6B517E57AD8F80BA2"><enum>675.</enum><header>Report on improvements to clinical appeals process</header>
<subsection id="H788D55D4D2D14009B642FE5912EDAA21"><enum>(a)</enum><header>In general</header><text>Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs, 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.</text></subsection> <subsection id="H042AF718D37D43B8A2F6FA01C122BAE1"><enum>(b)</enum><header>Inapplicability of requirements relating to Federal advisory committees</header><text><external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/10">Chapter 10</external-xref> of title 5, United States Code, shall not apply to the consultation required by subsection (a).</text></subsection>
<subsection id="H27D870275B864D45A0573E0382155289"><enum>(c)</enum><header>Veterans service organization defined</header><text>In this section, the term <term>veterans service organization</term> means any organization recognized by the Secretary under section 5902 of title 38, United States Code.</text></subsection></section> <section id="H27A507B7D796445EA277FAFA05E3448A"><enum>676.</enum><header>Plan on increasing accessibility of care for veterans with spinal cord injury or disorder</header> <subsection id="HBB00FF070A7C48EAAC6EE3E3F903F5CE"><enum>(a)</enum><header>In general</header><text>Not later than one year after the date of the enactment of this Act, the Secretary of Veterans Affairs shall 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.</text></subsection>
<subsection id="HD18C6542C70E4EC4A5EDB5085D75B4C1"><enum>(b)</enum><header>Consultation</header><text>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.</text></subsection> <subsection id="H133EC9950D004D90AC03B93E40D18030"><enum>(c)</enum><header>Elements</header><text>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.</text></subsection>
<subsection id="HB5F56C0924D64A24AD118087C8ACFD79"><enum>(d)</enum><header>Veterans service organization defined</header><text>In this section, the term <term>veterans service organization</term> means any organization recognized by the Secretary under section 5902 of title 38, United States Code.</text></subsection></section></subtitle>